Pesticide exposure and associated acute health effects among smallholder farmers in Mbale District, Eastern Uganda

Abstract

Introduction: Pesticide use for agriculture is on the rise in Uganda. Many farmers improperly use pesticides, which puts them at risk of exposure and adverse health effects. We assessed pesticide exposure levels and acute health effects among smallholder farmers in Mbale district, Uganda. Methods: A total of 576 smallholder farmers in Mbale District were surveyed in August 2020 to assess pesticide exposure using a semi-structured questionnaire. A cumulative exposure score was generated from six self-reported determinants (e.g., use of personal protective equipment, method of application, mixing, duration of spraying, bathing, and changing clothes after applying pesticides). Farmers with a monthly cumulative pesticide exposure score > 22.5 were categorised as having high exposure to pesticides. We used a multivariable modified Poisson regression model to determine factors associated with high pesticide exposure, reporting prevalence ratios (PR) and confidence intervals as measures of association. Results: Of the 576 smallholder farmers, 71% (409/576) reported using pesticides, and 70% (403/576) were male. Of the 409 pesticide users, 43.0% (176/409) experienced high exposure to pesticides. Among pesticide users, majority, 80.9% (331/409), reported at least one acute health effect, with skin irritation (60.5%), headache (31%), nausea (24.7%) and dizziness (27.4%) being the most common. High pesticide exposure levels were twice as high among male pesticide users (aPR 2.19; 95% CI: 1.49, 3.20) compared to females. Farmers who used pesticide mixtures (aPR: 1.47; 95%CI: 1.03, 2.10) were more likely to experience high levels of pesticide exposures. Wearing rubber boots while handling pesticides (aPR: 0.49; 95%CI: 0.34, 0.71) was protective of high pesticide exposure. Conclusion: Exposure to pesticides was high among smallholder farmers, particularly among males and those who used pesticide mixtures. These findings highlight the need for targeted occupational health and agricultural policies to strengthen safe pesticide handling practices and mitigate exposure-related health effects among smallholder farmers.