Ph d dissertation abstract agriculture evaluate the impact of pesticide use to farmer’s health in tea cultivating in thai nguyen and the intervention’s effects

Knowledge, practice about using pesticides is still restrictive, which causes bad effect on human health.. Describe the knowledge, attitude and practice KAP of farmer exposure to pestici

MINISTRY OF EDUCATION AND TRAINING

THAI NGUYEN UNIVERSITY -*** -

NGUYEN TUAN KHANH

Evaluate the impact of pesticide use to farmer’s health in tea cultivating in ThaI Nguyen and the intervention’s effects

Speccialty: Social hygiene and Health Organization

Code: 62 72 73 15

SUMMARY OF PhD THESIS

THAI NGUYEN – 2010

The research was conducted at:

THAI NGUYEN UNIVERSITY OF MEDICINE AND PHARMACY

Advisors:

1 Prof PhD Do Van Ham

2 Prof PhD Nguyen Van Dip

Opponent 1: ………

Opponent 2: ………

Opponent 3: ………

The dissertation will protected in front of State Dissertation

Appraisal Council at: Thai Nguyen University of Medical and Pharmacy

At… hours on… date……… month…… year…

The information from this dissertation is available at:

- National Library

- Learning Resource Center, Thai Nguyen University

- Library of Thai Nguyen University of Medical and Pharmacy

INTRODUCTION

Using pesticides is a objective reality and a indispensable action

in agricultural production World due to the effects of pesticides (P) is estimated about 39 million people yearly acute poisoning and 3 million people among them with heavy acute poisoning and 220 thousand people yearly dead people all over the world

Current situation of poisoning pesticides in Vietnam are still becomes serious According to Ha Minh Trung, Vietnam is estimated that if there are about 11.5 million agricultural households with rate of 18.26 % poisoned chronic by pesticides, the number of chronic poisoning in the country up to 2.1 million The main reason is due to abusing and use and indiscriminate pesticides, particularly 98.0 % due

to abuse or mix 2 to 3 times condenser than guide on the package, with 84.17 % to 93.23 % not adequate using personal protective equipment (PPE)when spraying

The most pesticides using is in cultivating tea about both quantity and frequency of injection Thai Nguyen has an area of nearly 16,000 hectares of tea, tea cultivation in many areas of remote and disadvantaged areas, socio-economic conditions of underdeveloped, low education level Knowledge, practice about using pesticides is still restrictive, which causes bad effect on human health To contribute for taking care of farmer health cultivating tea and build suitable interfere model with actual condition at these areas,

we carry out researching this thesis with a view to:

1 Describe the knowledge, attitude and practice (KAP) of farmer exposure to pesticides

2 Determine disease model and describe some factors related to farmer health in cultivating tea

3 Construction and appreciate of effect of interfere model on human health protection suitably for current conditions in Thai Nguyen

Charter 1 DOCUMENT OVERVIEW

Pesticides is used spreadingly at every nation in the world with income over USD 30 billion from 2005

1.1 The situation of using pesticides and knowledge, attitude and

practice of farmers usually contact with pesticides

1.1.1.The situation of using pesticides

Pesticides had existed from ancient period and until19th century,

it was used widely but chemical methods at this time have not had big role in agricultural production From the beginning of 20th century to

1960, oganic pesticides was invented and chemicals is used at maximum level and its bad consequences had started causing human and environment The period from 1960 to 1980 had left many bad consequences on environment and community health From 1980s to now, environment protection is paid more attention In Vietnam, pesticides is used from 1957, means the periods of centered – plan economy from 1957 to 1990: importing and distributing pesticides depends on the state Amount of pesticides was not used much, only about 15,000 tons per year Most of them were medicals with so long reserved time or high poison Period from 1990 to now, market economy with available goods and many types is used in timely Amount of pesticides is used for heavy industry increasingly

1.1.2 Knowledge, attitude, practice of person contacting with

Effect of pesticides on human health includes pernicious and chronic poison

1.3 Some studied intervention models to protect human health when

exposure to pesticides has been deployed out in Vietnam

The thesis related to this problem is still rare, especially in mountainous areas, highland such as Thai Nguyen Some interfere researches have been carried out at some area in Vietnam: The thesis 11-08 of Ministry of Agriculture and Rural Development in combination with Ministry of Health and Ministry of Defence has implemented from 1996 to 2000 In 2002, Bui Thanh Tam and her parner researched community model for using pesticides safety at a district of low land and a district of Northern highland The subject Job Department of Occupational Health - University Thai Nguyen of Medical and Pharmacy has carried out many thesises related to human health in agriculture labor but it is only at experimental level Until now, no thesis helps to protect farmer health cultivating tea when contacting with pesticides Therefore, carrying out a research to take care of farmers here is very nescessary

Charter 2 SUBJECTS AND METHOD 2.1 Subjects

2.1.1 Subjects described

- KAP study subjects, examinations assess the actual structure of common diseases and interventions are in direct spray pesticides in the tea growing households, have time for 5 years and tea area about over 1800 m2

- Person investigated and interviewing detail is bosses of pesticides selling shops at Tan Linh commune, People Commitee leader, Chairman of commune farmer Union, Chairman of the Commune Women's Union and some farmers

- Audience research is the only toxic products

2.2 Place of the research

Be carried out at Phuc Xuan commune - Thai Nguyen city and two communes including Phuc Linh & Tan Linh, Dai Tu district, Thai Nguyen province This research is intervention at Tan Linh and controls Phuc Linh commune

2.3 Time of the research: From January 2007 to June 2010

2.4 Research method: Epidemiology research design describes

cross-sectional design in combination qualitative and quantitative Participation of community

2.5 Sample size and sampling method

2.2.1 Sample size for descriptive study

Describing sample interviews farmer’s knowledge, attitude, practice (KAP)

Applying formula calculating sample size basing rate:

n = z2(1- α/2) p(1-p)/d2 With given number, n = 385 people Person appreciated is 877 farmers usually contacting with pesticides in 385 households

2.5.2 Sampling intervention studies

- The sample size for intervention studies as follows:

n = (Z 1- α/2 + Z 1 -β)2 p1 q1 + p2 q2

(p1 - p2 )2 With given number, n = 90.16 (about 91 people) Take extra 20 % like this, sample size for each commune is 119 people

2.6 Research design technique

Intervention activities

Communications: Combine direct communication with indirect

communication with an aim to change behavior Direct communication: Through training time, conference, practice guide

Especially, through club activity "Farmers - Small business- Medical

staff" Indirect communication: On Media include many kinds and

means

Examination of patients, drug treatment for some common diseases Advise about health for pesticides user

Chapter 3 RESULTS

Research 385 persons, we have the following results:

3.1 The current status of KAP about pesticides of tea cultivating farmer in Thai Nguyen (n = 385)

Table 3.2 Pesticides using time basing on sex

Table 3.4 Knowledge of weather and wind direction chosen when

Table 3.4 shows: Know spray downwind low rate of 44.4 %, the rate

is very low that a full 29.6 %

Table 3.8 Know about health conditions to ensure the spray

No Health conditions to ensure

the spray

1 Don’t spray when there are

sick, pregnant, lactating

2 Older, children who do not

go spraying

3 Periodic health examination 139 36.1 246 63.9

4 Not spraying over 2 hours/

day, two weeks/phase

Table 3.8 shows that rate of farmers with full knowledge is very low (21.0

%) Rate of the elderly and children still use to pesticides (19.0 %)

Table 3.12 Pesticides mixed practice

No Pesticides mixed

Table 3.12 shows that mixture rate of many kinds of pesticides when

spraying is very high (82.3 %), rate of farmers exact practice mixed pesticides the guide is very low (17.4 %)

Table 3.13 Practice using personal protective equipment

protective equipment

Table 3.16 Information supply resource

No Information Supply

was guided; 83,4%

3.2 Health situation and some factors related to the health of people regularly exposed topesticides

- The most muscle symptoms of farmers contacting with pesticides during the last time is nervous system, digest Some popular symptoms such as tiredness (77.9 %), headache (73.1 %), dazzle, vertigo (78.4 % Some disease groups with high rate such as diseases about nose and sore (86.9 %), eyes (84.8 %), bone muscle (63.7 %), skin (40.1 %), etc

- The risk is due to: unsafe pesticides mixture, solider pesticides mixture than guide, mix many kinds of pesticides in the spray related

to disease nose and throat, increased 2.66 times compared with the correct mixture

- The risk to spraying the windward with nose and sore diseases

is 2.55 times more than right the wind direction pesticides

- The risk of going on with disease due to unsafe medicine mixture is 2.31 times more than right mixture The risk of having eye disease due to spraying wind ward increases 3.27 times more than using glasses

3.3 Results of intervention studies

3.3.1 Intervention activities

- Build Project implement leading committee, propose commune People Committee to set up "Farmers - Small business - Medical staff" club basing on links between “Farmer – The sale of pesticide – commune Medical staff”, keep the club once three months

- Organize three training classes for main officers to take charge

of the program, organize 14 training days at village (a day for each

village) with 856 participants

- Celebrate 02 conference days at commune People Committee

with 397 participants 04 training days at the edge

- Deliver 1000 books: “Chemicals are used for agriculture and

community health” Deliver handout to all 1469 households

Propagandizing on media of commune (259 days)

- All 6 commune Medical staff are trained again about against pesticides poison Project Steering Committee combining with Commune People's Committeemanaging pesticide suppliers, vendors

- Every month, Management committee meets "Farmers - Small business - Medical staff" to appreciate results and withdraw

experiments for activities in month and build next solution

Table 3.21 Synthetic training, communication activity

3 Train for commune

Medical staff

4 Workshop (session) Commune People

committee and study subjects

6 Practice in the field Study subjects 4 472

Activity to protect health when exposure with pesticides

- Organize periodical medical examination, advisory and care for

human health on using pesticides, discover health problems at farmers exposed to pesticides Keep clinic to discover health problems at Tan Linh commune health station Test quantitative blood samples enzyme cholinesterase

- Supply medicine to treat free for patient; advisory and introduction to go to treat heavy diseases

- Celebrate summary conference to appreciate effectively model

"Farmers - Small business - Medical staff"

3.3.2 Effect of interfere solutions at Tan Linh

Table 3.22 Knowledge of Medical staff and pesticide sellers

Pre-intervention

Post- intervention

Table 3.22 shows that:

- Before the intervention, no Medical staff and pesticides seller is trained

- After the intervention, 100 % pesticides seller and Medical staff know how to use, storage as well as prevention of pesticide poisoning

- The number of stores selling pesticides already registering business increases by from 50 % to 100 %

Table 3.32 The result oftesting is comparition about active

Enzym Cholinesterase (Normally 5,300-12,900U/L)

Index

Pre-intervention n=60 (1)

Post- intervention n=51(2)

Test 1stn=60(1)

Test 2ndn=51(2)

X ±± SD 6744+ 1175 8800+2206 7324+1966 8354+2995

Result of Table 3.32 shows that:

- At Tan Linh after 2 years intervention activity enzyme

cholinesterase average has increased The ratio of person who has actived enzym below normal standard decreased from 8.33 % to 1.96

Pre-Post- intervention n=15

First test n=15

Second test n=15

Result of Table 3.32 shows that: Total all kind of chemical noxious is

average to discovery on 01 sample at Tan Linh has decreased from 6,46 kinds /sample to 5,80 kinds /sample

Meanwhile at PhucLinh increase from 0,6 kind/ 01 sample to 6,68

kinds/sample The difference is statistically significant p <0.05

Table 3:37 Really effective for KAP's growing up tea exposure to

pesticides after 2 years of intervention at Tan Linh

Group The specific targets Index

Effective Interven -tion %

Index

Effective Control

%

Interve -ntion effect

%

Know

-ledge

Knowing the treatment of poisoning 88.7 22.1 66.6

Know the health conditions when

spraying

Understanding the colour on the pack 67.1 13.5 53.6 Understanding how to mix pesticide 56.0 3.7 52.3 Know how maintenance and storage 64.5 16.7 47.8

Understand the purpose of (P) use 52.3 17.0 35.3 Know the way into the body 43.6 15.4 28.2 Know the harmful effects of (P) 36.9 14.5 22.4 Know the symptom of poisoning 44.1 22.6 21.5

Attitu

-de

Interesting to wind direction 10.9 3.5 7.4

Worried poisoning when exposed (P) 2.6 2.5 0.1

Practi

-ce

Spraying pesticides correctly 46.7 2.6 44.1

Don’t allow to use pesticide forbid 23.1 10.1 13.0

Result of table 3.37 shows that: After 2 years intervention,

model of education to prevent from noxious of pesticides to give clear result, knowledge and practicing has raised, knowledge of intervention effect to achieve 66,6 % and practicing has raised to 61,5

% achieve too

Table 3.38 Really effective for health of person who growing up tea contacts with pesticides after 2 years intervene at Tan Linh

Group The specific targets Index Effective

Intervention %

Index Effective Control %

Intervention effect %