with an ever increasing global population , demands for food and energy become difficult to ignore and the major portion of available food and energy is produced by agriculture and livestock activities .
furthermore , more healthy food is needed . to attain a sustainable development in the agricultural sector , farmers welfare and health should be considered .
measures taken to protect their health against occupational hazards include identifying hazards and threatening diseases ( 1 ) .
pesticides can not selectively activate , that is , in addition to affecting targets and pests , they also have side effects on non - target species ( including humans ) ( 2 ) .
previous research has indicated that , in the united states alone , more than 2 billion pounds of pesticides have been used in a variety of different sectors , including agriculture and forestry ( 3 ) . due to the high consumption rate people
have more exposure to pesticides , and , as a result , adverse effects on people s health are becoming more apparent .
american public health association ( apha ) indicates that many american farmers are exposed to different types of pesticides ( 4 ) .
a significant portion of the pesticides produced globally were used in developing countries ( 5 ) .
increases in poisoning by agricultural pesticides have been observed due to increased use and high accessibility in these countries , compared to that in developed countries .
poisoning by agricultural pesticide especially organophosphorus pesticides is estimated to cause many deaths among farmers in china ( 6 ) . as a society ,
we have resorted to using pesticides as one of the more practical ways for controlling and fighting plant pests to prevent loss of agricultural products .
pesticides consist of chemical components that are often highly toxic to human health and are the active ingredients for controlling the population of plant pests , insects , and vermin ( 7 , 8) .
the us environmental protection agency ( usepa ) had defined pesticides as  any substance or mixture of substances intended for preventing , destroying , repelling , or mitigating any pest  ( 9 ) .
more than 800 different types of chemicals are used to control insects , weeds , plant pests , and disease - carrying insects .
increases in the amount of agricultural products and decreases in the number of parasitic diseases are the positive outcomes of using such chemicals .
about 500,000 cases of pesticide poisoning are reported annually and , in addition , about 5000 cases of death are recorded .
most of the acute poisoning cases occur in lower income countries , which is attributed to the storing pesticides at home near food items ( 10 ) .
the world health organization ( who ) supervises the safety and toxic effects of pesticides .
although all pesticide containers must carry warning labels , due to the lack of proper education and illiteracy of villagers , they have gone unnoticed . with the lack of monitoring of the manufacturing , production , and selling of non - standard pesticides and their high availability in the market , these pesticides are often used improperly , which leads to additional effects on environment and public health in the long run and immediate adverse effects on farmers health ( 7 ) .
some researchers have drawn attention to the association between pesticides exposure and some types of cancers , including blood , lymphatic system , lip , stomach , lung , brain , and prostate cancers ( 11 )
. a prospective cohort study of 57,311 licensed pesticide applicators in iowa and north carolina failed to show any relationships between exposure to glyphosate and some types of cancer ( 12 ) .
children s exposure to pesticides is another important issue ( 13 ) . previous research in california failed to show any correlation between pesticide use and cancer incidence , but there were some exceptions , including a correlation between leukemia and atrazine ( r=0.40 ) and brain cancer and atrazine ( r=0.54 ) ( 14 ) .
risk of death in agricultural workers is twice as high as that in other fields . providing occupational health services , keeping medical records ,
monitoring agricultural workplaces , and improving quality and production of healthy agricultural products are important components in decreasing threats to farmers health ( 10 ) . who has classified agricultural pesticides in three classes :
in fact , who advocates the policy of restricting or banning use of class i pesticides and using fewer pesticides with minimum adverse health effects on individuals ( 7 , 8 , 15 , and 16 ) . therefore , given the high levels of pesticide usage , human exposure to these pesticides is almost inevitable , and can occur quite accidentally as a result disposal of pesticides and their containers into the environment ( 1720 ) .
the incidence of poisoning in developing countries is 13 times greater than that in industrial countries . according to iran s census bureau data
, a total of 15,800 tonnes of pesticides were sold in 1996 ; 27,200 tonnes in 2001 ; and 20,890 tonnes in 2006 .
hence , it can be assumed that in the past half - century , approximately 1 million tonne pesticide has been imported into iran ( 21 ) .
agricultural activities are the main activity for people living in fasa , iran and are an important source of income for people in this region .
the objectives of this research were to gather information about the demographic features of farmers , previous poisonings , and the extent of farmers knowledge on the use of pesticides and their hazards in the different counties and villages of fasa , fars province , iran .
this cross - sectional study was carried out from march to july 2012 in the nobandegan and sheshdeh counties , and villages including miandeh , fedshkuyeh , senan , rahimabad , and others in the fasa suburban countryside .
in fact , a total of 200 farmers were selected according to family records , a list of households with at least one member employed in agriculture ( either as a main or secondary occupation ) . in this list ,
the household s numbers were recorded and proportionated to the village population ; necessary samples were selected ( sheshdeh with 6204 people ; nobandegan with 2720 people ; villages , including miandeh , with 5603 people ; rahimabad with 646 people ; senan with 1832 people ; and fedshkuyeh with 4638 people ) . to collect data , an appropriate questionnaire designed by the authors was implemented .
the information gathered included : 
 demographic features ( age , working experience , and education levels of farmers)agricultural products ( barley , maize , wheat , canola , cotton , and sugar beet ) and acreage under cultivationtype of used pesticides ( organophosphate and organochlorine ) and the purpose of pesticide use ( controlling pests , insects and vermin)severity of reactions ( acute and chronic toxicity of pesticides such as digestive response , eye response , motor response on the basis of hospital records and farmers interview)any history of poisoning with pesticides ( on the basis of hospital admitting and farmers interview)pesticide spraying methods ( man - carried motorized sprayer , tractor - carried sprayer , and hand - held sprayer)use of personal protection equipmentknowledge of adverse effects of pesticides ( knowing about adverse effects of pesticides on human health , environment ( air , water , and soil ) , and other species such as animals and plants ) demographic features ( age , working experience , and education levels of farmers ) agricultural products ( barley , maize , wheat , canola , cotton , and sugar beet ) and acreage under cultivation type of used pesticides ( organophosphate and organochlorine ) and the purpose of pesticide use ( controlling pests , insects and vermin ) severity of reactions ( acute and chronic toxicity of pesticides such as digestive response , eye response , motor response on the basis of hospital records and farmers interview ) any history of poisoning with pesticides ( on the basis of hospital admitting and farmers interview ) pesticide spraying methods ( man - carried motorized sprayer , tractor - carried sprayer , and hand - held sprayer ) use of personal protection equipment knowledge of adverse effects of pesticides ( knowing about adverse effects of pesticides on human health , environment ( air , water , and soil ) , and other species such as animals and plants ) the data was analyzed using descriptive statistical testing for determining the mean and standard deviation values with the spss 16 statistical software package ( spss inc . , chicago , illinois , united states of america ) .
this cross - sectional study was carried out from march to july 2012 in the nobandegan and sheshdeh counties , and villages including miandeh , fedshkuyeh , senan , rahimabad , and others in the fasa suburban countryside .
the cluster - sampling method was used to select farmers . in fact , a total of 200 farmers were selected according to family records , a list of households with at least one member employed in agriculture ( either as a main or secondary occupation ) . in this list ,
the household s numbers were recorded and proportionated to the village population ; necessary samples were selected ( sheshdeh with 6204 people ; nobandegan with 2720 people ; villages , including miandeh , with 5603 people ; rahimabad with 646 people ; senan with 1832 people ; and fedshkuyeh with 4638 people ) .
the information gathered included : 
 demographic features ( age , working experience , and education levels of farmers)agricultural products ( barley , maize , wheat , canola , cotton , and sugar beet ) and acreage under cultivationtype of used pesticides ( organophosphate and organochlorine ) and the purpose of pesticide use ( controlling pests , insects and vermin)severity of reactions ( acute and chronic toxicity of pesticides such as digestive response , eye response , motor response on the basis of hospital records and farmers interview)any history of poisoning with pesticides ( on the basis of hospital admitting and farmers interview)pesticide spraying methods ( man - carried motorized sprayer , tractor - carried sprayer , and hand - held sprayer)use of personal protection equipmentknowledge of adverse effects of pesticides ( knowing about adverse effects of pesticides on human health , environment ( air , water , and soil ) , and other species such as animals and plants ) demographic features ( age , working experience , and education levels of farmers ) agricultural products ( barley , maize , wheat , canola , cotton , and sugar beet ) and acreage under cultivation type of used pesticides ( organophosphate and organochlorine ) and the purpose of pesticide use ( controlling pests , insects and vermin ) severity of reactions ( acute and chronic toxicity of pesticides such as digestive response , eye response , motor response on the basis of hospital records and farmers interview ) any history of poisoning with pesticides ( on the basis of hospital admitting and farmers interview ) pesticide spraying methods ( man - carried motorized sprayer , tractor - carried sprayer , and hand - held sprayer ) use of personal protection equipment knowledge of adverse effects of pesticides ( knowing about adverse effects of pesticides on human health , environment ( air , water , and soil ) , and other species such as animals and plants )
the data was analyzed using descriptive statistical testing for determining the mean and standard deviation values with the spss 16 statistical software package ( spss inc . , chicago , illinois , united states of america ) .
endosulfan was a dominant organochlorine pesticide and is being phased out due to its acute toxicity and carcinogenic nature . in addition , the use of endosulfan has been banned ( 22 ) .
the dominant mode of spraying was tractor - carried sprayer machine ( 69% ) and the second most common method was man - carried motorized sprayer ( 26% ) .
thirty percent of participants used no personal protection equipment when spraying pesticides and only 32% used personal respiratory protection devices , such as masks , during the activity . it should be noted that farmers used only disposable masks , and others deemed covering their face with a veil to be sufficient .
our findings also indicated that about 22.5% of participants had been poisoned on at least one occasion , with 16.25% going to the doctor at least once due to the adverse effects of pesticides , and with 2% being hospitalized at least once . regarding the extent of farmers knowledge of proper use of the pesticides
, our findings indicated that only 22% of participants understood the instructions attached to the pesticide containers .
overall , we found out that farmers knowledge about pesticides usage and associated adverse effects was extremely limited .
forty - two percent of farmers disposed of the empty container in the farmlands and only 31% of them disposed of these containers in a healthy and environmentally friendly fashion .
as shown in table 1 , some farmers reported experiencing pesticide poisoning symptoms , including giddiness ( 50% ) and nausea ( 23% ) .
a major hurdle in the understanding of the adverse health effects of pesticides in agricultural occupational health is illiteracy and the lack of information available to farmers ( 7 ) .
the high rate of illiteracy among farmers leads to their lack of knowledge about the side effects of pesticides and methods to alleviate these side effects ( 8) .
it is highly recommended that training courses for farmers should be held to educate farmers on the side effects of pesticides , improve their knowledge , and to encourage them to acquiring literacy ( 7 ) .
the average age of participants ( 46.65 ) and high rate of illiteracy ( 55% ) naturally accounts for their lack of knowledge and partially for their poor performance ; although , knowledge is necessary for proper performance , it is not sufficient and other factors such as cheap and affordable personal protection equipment need to be considered .
furthermore , introduction of modern methods of controlling pests is necessary ( 8) . the prevalence of symptoms was approximately 22.5% , according to participants self - reporting , which is quite high and consistent with related figures in developing countries ( 2324 ) . reading and acting according to the instructions on the pesticide containers , using protective devices , keeping pesticides in the original containers , and buying only the amount you need may help to reduce exposure risks ( 25 ) .
eighty - six percent of the participants used organophosphorus based pesticides , a common and effective pesticide .
it is recommended that in every region and depending on the importance and prevalence of using pesticides , instruction booklets should be prepared to make farmers familiar with pesticides , how to use them , and ways to minimize short- and long - term adverse effects under the supervision of a well - defined unit of experts ( 7 ) .
the booklets should be in persian , which will hopefully result in a better understanding of booklets .
it should be noted that only a few people resorted to health and treatment centers after poisoning and only 38% of them are diagnosed as occupational poisoning . in many cases , applicators of the pesticides
deem the symptoms related to poisoning as coming from fatigue , work pressures , and an integral part of the work , and hence , give little attention to poisoning ( 7 , 8 , and 26 ) . as poisoning via mouth , respiration , and skin absorption is prevalent , and the symptoms often appear as acute poisoning , it seems that the severity of poisoning is higher than the predicted level , which necessitates more research .
it is evident that the chronic and long - term effects of poisoning and symptoms , including nervousness , memory loss , dizziness and tremors , lend additional dimensions to the issue ( 27 ) .
attempts to regulate sale and use of pesticides , decreases in pesticide use and use of other anti - pest methods , changes public attitudes about  pesticide - free products  , providing cheap and affordable protective facilities , preparing proper educational material through mass media , training health workers , especially in villages , and education on poisoning symptoms and relevant first aid are recommended ( 2830 ) .
organic farming emphasizes on keeping the ecological balance and improving biological processes , which add to the sustainability of agricultural ecosystems ( 31 ) . as mentioned before
an extended study in 2004 in the us carried out on 18,782 farmers who using pesticides concluded that there was a link between neurological symptoms in farmers and the number of days when the farmer used pesticides .
this research indicates that new strategies are needed to improve farmers work environment to prevent occupational hazards to the farmers .
monitoring workers health and preparing and implementing proper regulations are essential parts of a program ( 7 ) .
our findings also showed that about 30% of participants did not use any personal protective devices .
as using effective protection devices is an important approach to prevent poisoning , it is recommended that briefing sessions for farmers should be held to provide information about the ways to use personal protection devices and effects on their health .
another issue is the lack of facilities for spraying farmers and employers neglect in providing these facilities .
the farmers knowledge of pesticide use is lacking , given that 78% of them did not read and understand the container labels .
this can be attributed to their highly specialized language or farmers illiteracy of foreign languages .
illiteracy played an important role here . with preparing booklets and labels and holding briefing sessions in persian in a way that meets
the farmers needs to understand the material , the issue could be solved to a great extent .
given the environmental hazards of disposing of containers of pesticides , the issues of regulations , and the farmers lack of knowledge may give rise to further issues . by providing training for farmers about ways to burn or to dispose of these containers , important outcomes could be achieved .
occupational and safety requirements and trainings could help to promote occupational safety and health in workplaces ( 32 ) .
in summary , given the toxicity and hazards of pesticides and their adverse effects on farmers health , effective measures should be adopted to decrease in the amount of pesticides used . conducting training programs for
considering the carcinogenic effects of pesticides , it is suggested that the association of these factors is investigated in future studies .
 background : with the growing global population , it is becoming increasingly difficult to ignore the demands for food and energy . 
 a major portion of the food and energy is produced via agriculture and livestock activities . 
 the objectives of this research are to gather information regarding the demographic features of farmers , previous poisoning , and the extent of farmers knowledge in the use of pesticides and associated hazards in different counties and villages in fasa , a city located in the fars province of iran.methods:this cross - sectional study was carried out from march to july 2012 in the nobandegan and sheshdeh counties , and villages including miandeh , fedshkuyeh , senan , rahimabad , and other places in the fasa suburban countryside . to collect data , 
 an appropriate questionnaire was designed and implemented.results:a total of 200 farmers participated in the study . 
 we found that 55% of farmers were illiterate . 
 approximately 86% of used pesticides were organophosphorus compounds . around 30% of the farmers used no protective equipment while working with pesticides , and only 22% of farmers had read and understood the instructions on the pesticide containers.conclusion:given the toxicity and hazards of pesticides and their adverse effects on farmers health , effective measures should be adopted to decrease the amount of pesticides used . conducting training programs for 
 farmers may help to reduce pesticide exposure risks . 
Introduction
Material and Methods
Study design and setting
Sampling
Measurement tool
Statistical analyzes
Results
Discussion
Conclusions