Knowledge, attitudes and practices (KAP) among agricultural extension workers concerning the reduction of the adverse impact of pesticides in agricultural areas in Tanzania.

BACKGROUND: Extension workers are educated locally to enable them to train farmers in using improved local farming methods and imported technology, such as pesticides, to increase crop production. However, the extension workers are not adequately trained in health aspects of pesticides and hence are unable to provide adequate services to farmers with regard to safe use of pesticides. OBJECTIVE: The present study assessed the knowledge, attitudes and practices of agricultural extension workers with respect to health effects of pesticides in order to develop strategies for the control of pesticide exposure and prevention of pesticide poisoning in Tanzania. METHODS: A survey of Tanzanian agricultural extensionists was undertaken in 1991-1994 using a standardized questionnaire in face-to-face interviews. Extensionists who were district agricultural officers, assistant agricultural officers, agricultural assistants, and field assistants, working in the coffee and cotton growing areas (N = 61) within a radius of 15 km of farm, estate or village under farm worker study (reported elsewhere) were included in the survey. RESULTS: The majority of extensionists knew that pesticides could enter the human body but only a quarter perceived pesticides as a major problem in the community they served. The majority showed awareness of potential health hazards of the different pesticides used in their service areas, but they did not recognize what pesticides were responsible for poisoning. A high proportion was familiar with first aid procedures in case of pesticide poisoning; however, many procedures described were not appropriate for pesticide poisoning. CONCLUSIONS: The survey indicated that training of agricultural workers in health aspects of pesticide exposure is an important task for adequate provision of service to farmers with regard to safe use of pesticides in Tanzania. Nevertheless, the appropriate role of extensionists in reducing the health impact of pesticides would be to advocate pesticides of low toxicity or non-chemical pest control.

Acute health effects of organophosphorus pesticides on Tanzanian small-scale coffee growers.

Acute health effects of organophosphorus (OP) pesticides on coffee farmworkers in 1991-1992 in Tanzania are reported to provide a basis for concern over farmworkers being overexposed during application. Workers exposed to OP pesticides (N=133) were drawn from a population of about 240,000 coffee farmers. They were interviewed on symptoms and personal protection, and their erythrocyte acetylcholinesterase (AChE) activity was determined during both spraying and nonspraying period. AChE activities during spraying and nonspraying period were comparable (mean 32.0, SD 7.8 vs. 33.0, SD 8.7 U/g HgB, P=0.26). The prevalence of cough, headache, abdominal pain, excessive sweating, nausea, excessive salivation, diarrhea, and vomiting did not differ significantly between spraying and nonspraying periods. There was no suggestion of decreased AChE in exposed subjects who complained of OP-related symptoms compared to symptomless exposed subjects. Use of gloves, long boots, head cover, face cover, and coverall was not significantly associated with AChE activity. No marked AChE depression was found during spraying season, which may explain the lack of association between symptoms and AChE. The fact that only moderately toxic OP pesticides were used may indicate that toxicity was not sufficiently high to cause depression. Experience, however, suggests that occupational poisoning remains a potential serious danger in coffee cultivation in Tanzania.

Pesticide-handling practices in agriculture in Tanzania: observational data from 27 coffee and cotton farms.

The practices of pesticide handling in agriculture were surveyed in 1991-1993 in Tanzania, to identify hazardous practices and farms where they occurred. The study involved 23 coffee farms with 246 persons exposed to hazardous practices, and four cotton farms with 45 exposed. An observation form addressed locations of important places with respect to pesticide spraying, storage, disposal, and equipment; personal protection; and hygiene. More pesticide formulations were used for coffee compared with cotton and by individual rather than cooperative farms. Coffee farms more often had unlabeled pesticide containers and missing mixing instructions, while cotton pesticides were stored in bedrooms, near food, and near open fires, and pesticide leftovers were often present. Hazardous practices were more pronounced at individual than cooperative farms, with significant differences in pesticide storage areas, as well as unlabeled and non-original containers. The study demonstrated the need to train farmers in pesticide safety, strengthen advisory and regulatory services, and extend protection to farm workers' families.

Assessment of the ability of health care providers to treat and prevent adverse health effects of pesticides in agricultural areas of Tanzania.

A survey of Tanzanian health care providers in agricultural areas was undertaken in 1991-1994 to assess their knowledge of toxic effects of pesticides, experiences and practices, as well as of their needs for appropriate information in order to develop effective strategies for reducing pesticide poisoning. Face-to-face interviews were conducted with 104 physicians, clinical officers and nurses at health care facilities in the coffee and cotton growing areas. Eighty percent of respondents reported to have seen one and nine of them two to four cases of pesticide poisoning in the preceding three months. A significantly higher annual number of poisonings were observed in coffee than in cotton area (GM 0.5 vs 0.1). Also the number of cases registered in hospitals was considerably higher than that in the out-patient health care (GM 1.7 vs 0.2). Pesticide poisoning was regarded as a major problem in the community by 63% of health care providers, including 77% of hospital staff. One third of health care providers thought that a certain percent of pesticide poisoning cases remain unrecognized, and that this percentage is higher in cotton than in coffee growing areas. The respiratory tract was the major route for pesticide to enter the human body; this was followed by gastrointestinal tract, skin, and eyes. Only one percent of the respondents could identify the groups of pesticides (organophosphate vs organochlorine) mostly used in the study areas. The survey indicated that training of hospital staff in toxicity of pesticide exposure is an important task and a prerequisite for efficient recognition, diagnosis and treatment of pesticide poisoning cases in Tanzania.

The status of pesticide usage in East Africa

A descriptive epidemiologic study using pretested questionnaires was conducted in East Africa in 1989/90 and looked at various types of pesticides in current usage in the region especially with regard to their procurement; distribution and utilization. Hospital records were examined for reported cases of pesticide poisoning as well as assessing the knowledge and the awareness of health care providers on the recognition and potential of pesticide poisoning. The main pesticide importers in the region were the Ministries of Agriculture whereas distribution was dominated by co-operative unions. Although pesticide regulatory mechanisms existed; their weak structures enabled the importation and usage of pesticides no longer in use in the countries of origin. Incidents of abuse were noted; as in the use of organochlorine pesticides on food crops and reported poisoning cases in the district hospitals where Kenya and Tanzania reported 455 and 736 cases respectively. Though tentative; more than 40 per cent of the health care professionals interviewed could not recognise pesticide poisoning cases. Therefore to avert pesticide related morbidity and mortality in the region; pesticide regulatory bodies need strenghning while pesticide users; the general public and health care workers should be educated on pesticides