Knowledge and practices regarding safe pesticide use among farmers in the Bardiya District,Nepal: A cross-sectional study

Abstract

Introduction:

Improper pesticide handling poses immediate and long-term health risks. This is particularly true in developing countries, where these chemicals are often used with minimal protection. This study aimed to assess farmers’ knowledge and practices regarding safe pesticide use in Nepal.

Methods:

A cross-sectional study was conducted among 287 farmers in Rajapur Municipality, Nepal, in 2024. The respondents were selected using systematic random sampling. Data were collected through face-to-face interviews using a validated questionnaire. Descriptive statistics were used to summarize categorical variables, Pearson’s correlation was used to analyze the relationship between knowledge and practice, and multivariate logistic regression was used to identify significant factors associated with adequate knowledge and practice (p < 0.05).

Results:

Respondents had a mean age of 42.1 years (SD ± 10.8). Most farmers (86.8%) demonstrated adequate overall practices. However, only 2.1% used a complete set of personal protective equipment, 97.9% prepared pesticides in the field, and only 5.2% received training, indicating critical gaps in safe practice. Similarly, only 34.5% of respondents had adequate knowledge, particularly farmers’ knowledge of reading instructions (20.2%), and symptom recognition (21.3%) was poor. A moderate positive correlation (r = 0.458, p < 0.001) was observed between knowledge and practice. Factors significantly associated with knowledge included years of pesticide use, social media exposure, and training. Ethnicity and family type were associated with adequate practices.

Conclusion:

Despite adequate overall practices, significant knowledge gaps and poor safety practices were identified. Targeted educational interventions and training programs are crucial to enhance knowledge and promote safe behaviors.

Keywords

farmers pesticides knowledge practice Nepal

Introduction

Pesticides are chemical substances or mixtures that are used to control pests, bacteria, fungi, and rodents that damage crops. They also help protect humans from diseases spread by insects, such as malaria and dengue. Farmers use pesticides to reduce crop losses in both fields and storage.¹

Agriculture plays a major role in water pollution worldwide by discharging large quantities of both organic and inorganic contaminants into water sources. As agricultural productivity increases, pesticide use also increases, leading to higher levels of pesticide residues in food and the environment, posing health risks to humans and other living beings.² In 2020, global pesticide use totaled 2.7 million tons, valued at USD 41.1 billion, with 220,000 annual deaths from acute pesticide exposure, 99% of which occurred in developing countries.³ The World Health Organization (WHO) reports that pesticide poisoning affects approximately 3 million people annually in rural areas of developing countries, leading to 200,000 deaths each year. Among these, 25 million farmers experience mild poisoning, whereas serious cases result in significant fatalities, with approximately 180,000 farmworker deaths reported annually.⁴

In developing countries, farmers use agricultural chemicals with very little protection and have limited opportunities to enhance their safety. Precautionary measures, such as wearing personal protective equipment (PPE), practicing good hygiene, and using pesticides at appropriate doses, can help reduce health problems among farmers.⁵

Agriculture plays a crucial role in Nepal’s economy, accounting for 23.95% of its Gross Domestic Product (GDP). Commercialization has become a key strategy to boost production. However, both subsistence and commercial farmers often resort to the indiscriminate use of chemical fertilizers, pesticides, and intensive cropping practices, posing significant risks to long-term agricultural sustainability, particularly for farmers in developing countries like Nepal.^6,7 Nepal imports approximately 211 tons of active pesticide ingredients each year, which include 29.19% insecticides, 61.38% fungicides, 7.43% herbicides, and 2% other types.⁸

Nepal’s average pesticide consumption has increased from 142 to 396 g/ha, with commercial vegetable farming in districts such as Sarlahi, Kavre, and Dhading reaching 1600 g/ha. Pesticide use in Nepal is lower than in other Asian countries; however, it is unevenly distributed.⁹ To improve pesticide management, Nepal introduced the Pesticide Act in 1991 and the Pesticide Regulation in 1993, both of which have been in effect since July 16, 1994.⁸ However, pesticide application in Nepal often exceeds government recommendations, resulting in higher exposure risks compared to China.³ Despite this act, poor regulation and monitoring have failed to prevent improper application and illegal imports, including banned toxic pesticides, further endangering farmers’ health and the environment.^3,8

Pesticide exposure can lead to both immediate and long-term health consequences, particularly in developing countries like Nepal.¹⁰ The Environmental Protection Agency (EPA) states that pesticide health risks vary by type. Chronic effects include cognitive, motor, sensory, and neurological deficiencies, whereas acute symptoms include nausea, headaches, and respiratory problems due to pesticide exposure.⁴ A recent study conducted in Tokha Municipality in Nepal reported that headache (69.5%), skin irritation (42.8%), and burning eyes (31.3%) were the most common health problems.¹¹ A similar study conducted in Bhaktapur, Nepal, reported eye irritation in 87 (76.3%) participants, difficulty in breathing in 70 (61.4%), and fatigue in 55 (48.2%).¹² Government and development sector initiatives to minimize pesticide use are inadequate. It is essential for research- and practice-based organizations in Nepal to critically evaluate program approaches and measure their effectiveness in fostering long-term behavioral changes. Furthermore, a significant gap exists between the knowledge and practices related to safe pesticide use.¹³

Few studies in Nepal have investigated farmers’ knowledge and practices related to pesticides.¹⁴ Most farmers are unaware of the various types of pesticides, safety measures, and harmful effects on human health and the environment.¹⁵ Thus, farmers’ understanding, practices, and attitudes about potential pesticide hazards are crucial for preventing and managing exposure to pesticide.⁴ This study aimed to assess knowledge and practices regarding safe pesticide use among farmers in the Bardiya District, Nepal.

Methods

This cross-sectional study was conducted at Ward No. 9 of Rajapur Municipality, Bardiya District, Lumbini Province, Nepal. Rajapur Municipality was established on May 18, 2014. The study area was selected based on the convenience of the researchers. The study population included farmers whose primary occupation was farming and who had been using any type of pesticide for at least 1 year, regardless of the type of farming they practiced.

The sample size for this study was calculated using Taro Yamane’s formula ¹⁶:

n = \frac{N}{1 + N \cdot e^{2}},

where N (total number of farming households) was 748 and e (margin of error) was set at 5%. The initial sample size was estimated to be 260.63 (rounded to 261). To account for potential logistical challenges during face-to-face data collection (e.g. household inaccessibility and the need for repeat visits), the target sample size was increased by 10% to 287. All 287 selected households were successfully interviewed, and no responses were excluded, resulting in a final sample size of 287.

A household list of farmers was obtained from Barghar (a village chief elected annually by the community), and systematic random sampling was employed. The sampling interval was calculated as 748/287 = 2.60, which was rounded to 3. The first household was selected by simple random sampling, and subsequent households were selected in every third interval. Only one respondent was selected from each household, prioritizing the primary decision-maker in farming. In the absence of a primary decision maker, another eligible household member was interviewed. If no eligible respondents were present during the first visit, a second attempt was made. If no one was available during the second visit, the household was excluded, and the nearest eligible household was included. Respondents who were mentally ill, refused to provide consent, or were younger than 18 years of age were excluded.

A structured questionnaire was used to collect data. The questionnaire was self-constructed based on relevant literature^17
–19 and consisted of sections on sociodemographic information, pesticide use, sources of information and training, and knowledge and practices related to pesticide safety. Sociodemographic information included age (years), sex, ethnicity, religion, family type, and education. Respondents were considered literate if they could read all or part of a sentence and had received at least a basic-level education. All sociodemographic variables were categorized according to the Nepal Demographic and Health Survey 2022 classification.²⁰ The pesticide use, sources of information, and training section included variables such as annual expenditure on pesticides (in Nepalese Rupees (NPR)), years of pesticide use, forms and types of pesticides used, preferred climate for pesticide use, and sources of information and training on integrated pest management (IPM). The annual pesticide expenditure and years of pesticide use were categorized as <10,000 versus ≥10,000 NPR and <10 versus ≥10 years, respectively, based on median values. Social media as a source of information and participation in IPM training were recorded as binary variables (yes or no).

Twelve structured questions (e.g. importance of reading instructions, primary use of pesticides, recognition of health effects, and role of PPE) assessed knowledge, while 10 questions (e.g. pesticide storage, preparation location, PPE use, disposal, personal hygiene, and avoidance of consumption) measured practices. Respondents were provided with multiple predefined response options, including correct and incorrect choices. Some questions had “yes” or “no” response options. The correctness of the responses was determined based on established literature and expert consensus used during questionnaire development. Each correct response was assigned a score of 1; incorrect responses were scored as 0. Respondents who correctly answered six or more knowledge questions were categorized as having adequate knowledge, and those who correctly answered five or more practice questions were categorized as having adequate practice. All the responses were self-reported.

Data were collected through face-to-face interviews between April 18 and 28, 2024. The researchers were directly involved in data collection, and local residents assisted in identifying eligible households. Initially, two public health experts reviewed the questionnaire to ensure content validity, focusing on the relevance and clarity of the items. Item validity was further assessed through item-total correlation using Pearson’s correlation coefficient. Based on expert feedback and correlation analysis, a few questions were revised or removed. The revised questionnaire was then pilot-tested with 10% (n = 29) of the sample in a similar setting (Ward No. 6) to evaluate feasibility, clarity, and reliability. Based on the pilot findings, further refinements were made before the final data collection. Internal consistency was measured using Cronbach’s alpha, with values of 0.7 for knowledge and 0.8 for practice, indicating good internal consistency.

Statistical analysis

Completed questionnaires were checked daily for consistency and missing data. Respondents were revisited to address any missing information. Data were coded and entered into the Statistical Package for the Social Sciences (SPSS) version 26 for analysis. Descriptive statistics were calculated for categorical variables. Bivariate analysis was performed to identify the factors associated with knowledge and practices. Variables with a p-value < 0.05 in the bivariate analysis were included in the multivariate logistic regression model. Multicollinearity among predictor variables was assessed using the variance inflation factor (VIF), and model fit and assumptions were evaluated. Pearson’s correlation coefficient was used to assess the relationship between knowledge and practice scores. Statistical significance was set at p < 0.05.

Results

The respondents had a mean age of 42.1 years (SD ± 10.8), with 31.0% aged 30–39 years and 31.4% aged 50–59 years. Most respondents were male (64.5%) and belonged to the Janajati ethnic group (95.8%). Hinduism was the most common religion (93.7%). More than half of the respondents (54.7%) were unable to read and write. Among those who were literate, 45.4% had completed basic education, 49.2% had completed secondary education, and only 5.4% had studied at university level. Regarding family type, 53.7% of the respondents lived in nuclear families, whereas 46.3% lived in joint families (Table 1).

Table 1.

Sociodemographic characteristics of the respondents (n = 287).

Variables	Frequency	Percentage
Age group
Mean, SD	42.12 ± 10.79
20–29	31	10.8
30–39	89	31.0
40–49	68	23.7
50–59	90	31.4
60+	9	3.1
Sex
Male	185	64.5
Female	102	35.5
Ethnicity
Janajati	275	95.8
Dalit	6	2.1
Brahmin/Chhetri	5	1.7
Madhesi	1	0.3
Religion
Hinduism	269	93.7
Christianity	17	5.9
Buddhism	1	0.3
Education
Illiterate	157	54.7
Literate	130	45.3
If literate	n = 130
Basic level (grades 1–8)	59	45.4
Secondary level (grades 9–12)	64	49.2
University	7	5.4
Types of family
Nuclear	154	53.7
Joint	133	46.3

Most farmers in the study area relied heavily on chemical pesticides. Specifically, 57.1% spent more than NPR 10,000 annually on pesticides. Two-thirds (65.9%) had used pesticides for over a decade, with a median duration of 12 years (range: 7–20 years). All farmers preferred applying liquid pesticides on sunny days. While most (80.8%) received pesticide-related information from fellow farmers, only a small proportion (5.2%) received formal training on integrated pest management (IPM; Supplemental Table S1).

Majority of the respondents (84.3%) demonstrated good storage practices by keeping pesticides in locked storage rooms. However, 14.6% stored them in risky locations, such as “anywhere” (no fixed place) or in kitchens (1.1%). Most respondents (97.9%) prepared pesticides in the field, which may increase exposure risks, whereas only 14.3% used designated areas outside their homes.

Although 79.8% reported using some form of personal protective equipment (PPE) when handling pesticides, adherence to essential PPE components was low. Among the 229 PPE users, all (100%) wore long-sleeved shirts made of tightly woven fabric, and 99.1% used masks (often cloth masks). However, critical PPE items such as gloves (27.1%), boots (24.5%), and goggles (7.0%) were rarely used.

Improper disposal of residual pesticides was common among respondents: 34.1% applied leftovers to other plants, 25.4% discarded them on bare land, and 16.7% and 14.3% used environmentally harmful methods such as dumping in streams/rivers and burning, respectively. Only 9.4% disposed of leftovers properly by using them solely on crops specified on the pesticide label (Table 2).

Table 2.

Distribution of safety practices during pesticide use (n = 287).

Variables	Frequency	Percentage
Where do you store pesticides?
In a locked storeroom	242	84.3
Anywhere (no fixed place)	42	14.6
In the kitchen	3	1.1
Where do you usually prepare pesticides?
In the field	281	97.9
Outside the house in a designated area	41	14.3
Anywhere (no specific location)	1	0.3
Do you use personal protective equipment while handling a pesticide?
Yes	229	79.8
No	58	20.2
What safety precautions do you take while handling pesticides?^a	n = 229
Long-sleeve shirts	229	100
Masks	227	99.1
Long trousers	182	79.5
Hat	130	56.8
Gloves	62	27.1
Boots	56	24.5
Goggles	16	7.0
What do you do with leftover pesticides?
Use on other plants	98	34.1
Discard on bare land	73	25.4
Discard in the stream/river	48	16.7
Burn	41	14.3
Use only on target crops as specified on the label	27	9.4

Multiple response.

The assessment revealed significant gaps in farmers’ knowledge about pesticide use and safety. Only 20.2% of respondents stated that the instructions should be read before handling pesticides. Although 84.7% of respondents had heard of PPE, their understanding of its specific components was inadequate. Most farmers (83.3%) considered masks to be part of PPE; however, a concerningly low proportion recognized goggles (8.0%) and boots (17.8%) as essential PPE.

Furthermore, knowledge about the side effects and symptoms of pesticide exposure was poor. Specifically, 42.2% of respondents accurately identified headaches and dizziness as common symptoms, and even fewer recognized more severe symptoms, such as difficulty breathing (5.2%) and nausea and vomiting (13.2%; Table 3). The mean knowledge score of farmers was 4.5 (SD ± 2.3), indicating that only 34.5% of farmers had adequate knowledge of pesticides based on the total score (Supplemental Table S2).

Table 3.

Item analysis and proportion of correct responses on knowledge of pesticide use among respondents (n = 287).

Knowledge statement	Correct	Incorrect
Knowledge statement	n (%)	n (%)
Before using pesticides, you should carefully read the instructions	58 (20.2)	229 (79.8)
Pesticides are primarily used to control pests and weeds	182 (63.4)	105 (36.6)
Exposure to pesticides can have negative health consequences	159 (55.4)	128 (44.6)
Headaches and dizziness are common symptoms of pesticide exposure	121 (42.2)	166 (57.8)
Skin rashes can be a side effect of exposure to pesticides	71 (24.7)	216 (75.3)
Nausea and vomiting are possible symptoms of pesticide poisoning	38 (13.2)	249 (86.8)
Difficulty breathing is a serious health concern after pesticide exposure	15 (5.2)	272 (94.8)
I have heard about personal protective equipment	243 (84.7)	44 (15.3)
A mask is considered part of the personal protective equipment for protection from pesticide exposure	239 (83.3)	48 (16.7)
Gloves are a type of personal protective equipment for the protection of the hands from pesticide contact	76 (26.5)	211 (73.5)
Goggles are a form of personal protective equipment to protect the eyes from pesticide splashes	23 (8.0)	264 (92.0)
Boots are also considered as personal protective equipment	51 (17.8)	236 (82.2)

To provide a more detailed understanding of pesticide safety practices, an item-wise analysis of the 10 key safe practices was conducted (Table 4). Based on this assessment and the total practice score, the majority (86.8%) demonstrated adequate overall practices, with a mean score of 5.8 (SD ± 1.1; Supplemental Table S2). However, significant safety concerns persist despite this overall adequacy. Only 2.1% of participants consistently used a complete set of recommended PPE during handling. Several specific essential PPE items, such as gloves, boots, and goggles, were neglected. Moreover, 85.7% of respondents demonstrated incorrect practices regarding the preparation area, such as mixing pesticides directly in the field (Table 2). Similarly, 90.6% of respondents disposed of leftover pesticides incorrectly, using methods such as discarding them on bare land or in rivers, burning, or applying them to other plants (Tables 2 and 4).

Table 4.

Item analysis and proportion of correct practices related to pesticide use (n = 287).

Practice statements	Correct	Incorrect
Practice statements	n (%)	n (%)
Storage of pesticides	242 (84.3)	45 (15.7)
Preparation area for pesticides	41 (14.3)	246 (85.7)
Use of at least one form of PPE	229 (79.8)	58 (20.2)
Use of complete PPE during handling	6 (2.1)	281 (97.9)
Correct disposal of leftover pesticides	27 (9.4)	260 (90.6)
Handwashing after handling pesticides	87 (30.3)	200 (69.7)
Shower immediately after pesticide application	283 (98.6)	4 (1.4)
Change of clothes after handling pesticides	284 (99.0)	3 (1.0)
Separate washing of contaminated clothes	233 (81.2)	54 (18.8)
Avoidance of chewing/eating during spraying	219 (76.3)	68 (23.7)

Despite these critical safety gaps, positive practices have been observed. For instance, the majority (84.3%) of farmers demonstrated correct pesticide storage practices. Additionally, 79.8% used at least one form of PPE and adhered to basic hygiene measures, such as bathing after spraying (98.6%), changing clothes (99.0%), and washing contaminated clothing separately (81.2%). Similarly, 76.3% avoided eating or chewing during spraying (Table 4).

There was a moderate but statistically significant positive correlation (r = 0.458, p < 0.001) between knowledge and practice (Supplemental Table S3).

Bivariate and multivariate analyses were conducted to identify significant predictors. Only variables showing significant associations in the bivariate analysis were included in the multivariate logistic regression model. The first model, which measured the association between selected independent variables and knowledge level, showed a good fit (Hosmer-Lemeshow test: p = 0.420; Nagelkerke R² = 0.2). Results showed that respondents who had been using pesticides for a decade or more had 1.8 times higher odds of having adequate knowledge (AOR = 1.8, 95% CI = 1.03–3.32, p = 0.040) than their counterparts. Similarly, respondents who cited social media as their source of information on pesticide use (AOR = 1.8, 95% CI = 1.00–3.24, p = 0.049) and those who received IPM training (AOR = 5.6, 95% CI = 1.50–20.99, p = 0.010) had significantly higher odds of having adequate knowledge (Table 5).

Table 5.

Factors associated with farmers’ knowledge of pesticide use: Multivariate logistic regression analysis (n = 287).

Variables	B	SE coef.	Knowledge
Variables			OR (95% CI)	p-value*	AOR (95% CI)	p-value*
Education
Illiterate	-	-	1.00 (Ref.)	-	1.00 (Ref.)	-
Literate	0.318	0.285	1.8 (1.08–2.89)	0.023	1.4 (0.79–2.40)	0.264
Yearly expenditure on pesticides in NPR
<10,000	-	-	1.00 (Ref.)	-	1.00 (Ref.)	-
≥10,000	0.320	0.281	2.0 (1.18–3.27)	0.009	1.3 (0.79–2.39)	0.255
Years of pesticide use
<10	-	-	1.00 (Ref.)	-	1.00 (Ref.)	-
≥10	0.613	0.299	2.0 (1.18–3.50)	0.011	1.8 (1.03–3.32)	0.040
Social media as a source of information
No	-	-	1.00 (Ref.)	-	1.00 (Ref.)	-
Yes	0.588	0.299	2.4 (1.41–3.98)	0.001	1.8 (1.00–3.24)	0.049
IPM training
No	-	-	1.00 (Ref.)	-	1.00 (Ref.)	-
Yes	1.726	0.673	8.5 (2.34–30.92)	0.001	5.6 (1.50–20.99)	0.010

OR: odds ratio; AOR: adjusted odds ratio; B: coefficient; CI: confidence interval; SE: standard error.

Factors with a p-value < 0.05 were considered statistically significant.

The second multivariate logistic regression model, conducted to assess the association between selected independent variables and pesticide use practices, also demonstrated a good fit (Hosmer-Lemeshow test: p = 0.660, Nagelkerke R² = 0.2). This model revealed two significant predictors of adequate pesticide use. Farmers of Janajati ethnicity exhibited significantly higher odds of following safe practices than those of other ethnicities (AOR = 4.2, 95% CI = 1.15–15.07, p = 0.030). Similarly, farmers residing in nuclear families demonstrated significantly higher odds of adopting safe practices than those living in joint families (AOR = 2.3, 95% CI = 1.14–4.81, p = 0.020; Table 6).

Table 6.

Factors associated with pesticide use practices among farmers: multivariate logistic regression analysis (n = 287).

Variables	B	SE coef.	Practice
Variables			OR (95% CI)	p-value*	AOR (95% CI)	p-value*
Ethnicity
Others	-	-	1.00 (Ref.)	-	1.00 (Ref.)	-
Janajati	1.425	0.657	3.5 (1.01–12.04)	0.048	4.2 (1.15–15.07)	0.030
Types of family
Joint	-	-	1.00 (Ref.)	-	1.00 (Ref.)	-
Nuclear	0.853	0.367	2.2 (1.09–4.46)	0.028	2.3 (1.14–4.81)	0.020

OR: odds ratio; AOR: adjusted odds ratio; B: coefficient; CI: confidence interval; SE: standard error.

Factors with a p-value < 0.05 were considered statistically significant.

Discussion

The primary objective of this study was to assess the knowledge and practices regarding the safe use of pesticides among farmers in Rajapur Municipality, Bardiya District, Nepal. Our findings indicate that fellow farmers play a crucial role as a source of information, consistent with studies conducted in Pakistan²¹ and Indonesia,²² which identified peer-to-peer interactions as significant channels for knowledge dissemination. This reveals common problems in the rural areas of South Asia. Farmers have limited access to government support. Therefore, they rely on peer networks as their most accessible and trusted source. Sharing information is helpful; however, it can lead to unsafe practices without proper training.

A substantial number of farmers in our study lacked formal training in pesticide handling, which is consistent with previous studies conducted in other regions of Nepal.^11,13 Similar challenges to training access have also been reported in Iran⁵ and Northwest Ethiopia.¹⁷ This pattern indicates common barriers in low-resource farming areas in various countries. These barriers included limited training program outreach, low investment in farmer education, economic challenges, and weak policy enforcement. A study in Bangladesh⁵ found that trained farmers used pesticide safety measures more effectively. These findings demonstrate the need for strong IPM training programs. Many farmers reported that they did not read the instructions on pesticide labels before use, a result that aligns with that of previous studies.^17,21 Such a lack of knowledge increases the risk of improper pesticide handling and its associated health hazards. A previous study in Nepal showed that low literacy levels and limited access to educational resources prevented farmers from participating in training.³ This also makes it difficult for them to understand the written instructions.²³ Our study also included a significant proportion of illiterate respondents. This could be the reason why farmers do not receive formal training and do not read instructions before using pesticides. Furthermore, 63.4% of the respondents in our study reported that pesticides were primarily used to control pests and weeds, which is consistent with the findings of previous studies.²⁴ This indicates that respondents had a basic understanding of pesticide functions.

In our study, only 55.5% of the farmers were aware of the adverse health effects of pesticides. In contrast, a study conducted in the Rupendehi district in Nepal²⁵ reported a higher degree of awareness (90%). A similar study in Pakistan²⁶ also found that 86.36% of farmers recognized the health risks of pesticides. This result is higher than that of a previous study. This disparity may be attributed to the higher literacy rates in comparative studies, sample size differences, and other sociodemographic characteristics. Despite these differences, our findings highlight a significant gap in farmers’ awareness of pesticide-related health risks. Specifically, farmers showed poor recognition of common symptoms of pesticide poisoning, such as headaches, dizziness, skin rash, nausea, vomiting, and difficulty breathing. This finding is in contrast with findings from Rupendehi District, Nepal, where respondents reported greater awareness of symptoms.²⁷ This might be because they had more farming experience or better access to health information. Unrecognizing poisoning symptoms can delay treatment. This can worsen health and extend the exposure. If symptoms are not linked to pesticide use, clinicians may overlook the occupational history, leading to misdiagnosis, and missed prevention opportunities.²⁸

Most farmers in our study reported storing pesticides in locked rooms, a practice that aligns with the findings of a previous study in Nepal,¹¹ in which 40.2% of farmers adopted similar storage practices. However, another study in Nepal²⁹ found that 45.9% of farmers stored pesticides in general storage rooms. This indicates that storage practices can vary by region. These differences can be influenced by factors such as household structure, awareness of pesticide safety, access to storage facilities, and the presence of children. However, our finding of locked storage is encouraging. However, it is important to ensure that these storage areas are secure and well-ventilated. This helps reduce the risk of accidental poisoning.

Approximately four-fifths of the farmers in our study reported using at least one form of personal protective equipment during pesticide handling. These findings are consistent with those of previous studies.^14,17 However, this finding is significantly different from that of a study conducted in Ethiopia,³⁰ which reported that 90% of farmers did not use PPE during pesticide handling. Such variations may be due to differences in access to protective gear, awareness of pesticide-related health risks, enforcement of safety regulations, and common farming practices in each region. Face masks were the most common PPE, similar to other studies.^11,23 However, a critical concern is that these masks are often improvised and are usually made of cloth and low quality. Farmers reported choosing cloth masks because of their affordability, local availability, comfort (less heat and suffocation), and avoidance of pesticide odors. Although cloth masks may offer minimal protection compared with no mask, they do not protect against vaporized pesticides.³¹ Their poor filtration efficiency and loose fit significantly increase the risk of inhalation exposure to hazardous chemicals. In contrast, certified respirators, such as N95 masks, are designed to block airborne pesticides and should be used during spraying operations.³² Although most farmers recognize face masks as essential PPE, the cost, availability, and lack of awareness about the limitations of cloth masks remain major barriers to the use of certified masks.

Furthermore, recognition and use of other essential certified PPE, such as gloves, boots, and goggles, remained at a concerningly low level, consistent with previous findings.¹⁵ These PPE items are critical for preventing dermal and ocular exposure, which are the primary routes of pesticide absorption. Goggles protect against chemical splashes and vapors that reach the eyes, boots shield the feet and legs during spraying, and gloves are essential when handling or mixing chemicals.³² Notably, in this study, a low proportion of complete PPE use (2.1%) was observed, similar to the results reported in the Bhaktapur District of Nepal³³ and Brazil.³⁴ Despite good general practices, this reflects persistent gaps in safe pesticide use, particularly PPE use. Previous studies in Nepal have also noted PPE unavailability, lack of awareness, and discomfort as the key barriers.⁹ Educational interventions and formal training have proven effective in this regard, as reported by Koju et al.³⁵ They found that following an educational intervention and respondents’ participation in training, they exhibited a marked increase in adopting improved pesticide handling practices, including the effective use of PPE.

Our findings revealed limited attention to the proper disposal of pesticides, with common practices including throwing them on bare land, into rivers, and burning them, similar to previous studies.^9,36 A study conducted in Ethiopia³⁰ highlighted even more hazardous disposal practices, revealing that 92% of farmers dispose of empty pesticide containers in the fields, ignoring safety concerns, and 86.7% apply leftover pesticides directly to other crops. These unsafe practices in the study area and similar settings may arise from low awareness of environmental risks, limited training on safe disposal and inadequate waste disposal systems in rural areas. Such improper disposal practices contaminate the environment, destroy microbial populations, and pose significant health risks to humans and animals.^9,36 We should discourage practices that can contaminate water sources, harm wildlife, and lead to food safety concerns.

Our study revealed good hygiene practices, as farmers reported taking showers and washing clothes after spraying the pesticides. These practices are similar to the findings of previous studies conducted in Nepal.²⁵ In addition, most farmers reported changing clothes after spraying and not chewing anything while handling pesticides. These practices were consistent with those observed in other studies.^26,37 Such hygiene practices play a crucial role in minimizing the risk of pesticide exposure to farmers. Increased awareness through peer sharing and local health messaging may influence positive behaviors. While these positive hygiene practices are encouraging, it is important to reinforce their importance and ensure that farmers have access to clean water and sanitation facilities.

In terms of overall knowledge and practice, our study found that approximately one-third of respondents had adequate knowledge of pesticide safety, whereas a large majority exhibited adequate practices. Other studies have observed this gap between knowledge and practice, such as that conducted in Northwest Ethiopia,³⁸ where 33.3% of farmers had good knowledge, and 61.3% had good practices. However, other studies have reported varying levels of knowledge and practices among farmers in different countries. For example, studies conducted in Lalitpur, Nepal,²⁹ Malaysia,³⁹ Ethiopia,³⁰ Nakhon Nayok Province, Thailand,⁴⁰ and Bangladesh⁴¹ reported that a significant proportion of farmers had poor pesticide safety knowledge and practices. These differences may reflect variations in education levels, exposure to training programs, and the effectiveness of local awareness efforts. Although our findings suggest that farmers in Rajapur Municipality may engage in positive practices (storage, hygiene, and not eating or chewing while spraying), their limited knowledge can undermine these practices in the long term.

Our analysis found a moderate but statistically significant positive correlation between knowledge and practice, a result consistent with previous studies.^24,37,42 This indicates that as farmers’ knowledge of safe pesticide handling increases, so does their safety practices. We also found that years of pesticide use and participation in training sessions were significantly associated with better knowledge, a result supported by prior research,⁴³ which may have indirectly contributed to better adherence to safe practices. Additionally, social media emerged as a significant influencer of farmers’ knowledge levels, a finding that aligns with Ramavhale et al.⁴⁴ Social media are a powerful tool in agriculture, facilitating the dissemination of timely, relevant, and reliable information that can drive agricultural development and innovation. However, it is crucial to acknowledge the potential limitations of social media, such as the spread of misinformation and the digital divide, which can limit farmers’ access to information. Similarly, in our study, ethnicity and family type were significantly associated with pesticide use. These findings reveal that ethnicity and family structure may play crucial roles in influencing farmers’ adoption of safe pesticide use practices. Understanding these factors is essential for developing targeted interventions to improve pesticide safety practices among different groups within the farming community.

Several factors may explain the relatively good pesticide practices observed among the farmers in this study, despite their limited formal education and training. While formal education may play a significant role, practical experience appears to be a significant driver. Extensive hands-on experience contributes to a deeper understanding of pesticide handling, even in the absence of formal instructions. Furthermore, reliance on fellow farmers as the primary source of pesticide-related information indicates that knowledge and best practices are being disseminated within the community through observations, shared experiences, and local networks. However, it is also important to acknowledge that this reliance on informal learning perpetuates misinformation and outdated practices. Therefore, integrating formal training and educational resources into existing networks can further enhance safe pesticide handling practices.

Limitations

This study was conducted in a single ward in Rajapur Municipality, Bardiya District, which limits the generalizability of our findings. Agricultural practices, including crop types, pest populations, pesticide use patterns, and the availability of banned chemicals, can differ significantly across wards, neighboring municipalities, and various ecological regions of Nepal. Additionally, farmers’ education levels and access to government or non-governmental organization (NGO) services can affect their knowledge and use of pesticides. As such, the findings may not be representative of farmers from other parts of the Bardiya District or the country as a whole.

Furthermore, the study focused solely on assessing farmers’ knowledge and practices regarding safe pesticide use, without including an evaluation of their attitudes. Understanding farmers’ attitudes can provide deeper insights into the behavioral drivers that influence pesticide use and safety practices. Thus, future research should include larger and more diverse samples across many regions, adopt mixed-methods approaches, and include assessments of attitudes to confirm and contextualize these findings.

Conclusion

This study revealed a gap between knowledge and practice regarding pesticide safety among farmers in Rajapur Municipality. While the majority demonstrated adequate practices, particularly in hygiene, only a small fraction possessed sufficient knowledge. Farmers exhibited significant knowledge gaps regarding the importance of reading instructions, recognizing pesticide exposure symptoms, and identifying all forms of PPE. Critically, despite relatively good hygiene practices, significant issues persist regarding the effective use of PPE, pesticide preparation, and disposal, all of which pose environmental and health risks. Moreover, very few farmers consistently use a complete set of PPE when handling pesticides, highlighting a critical area for improvement. Although goggles, gloves, and boots are essential forms of PPE, farmers do not fully recognize their importance, as evidenced by their knowledge gaps and practices.

Although knowledge and practice were positively correlated, the gap between them highlighted the need for comprehensive interventions. We recommend that mandatory, government-sponsored training programs on safe pesticide handling be implemented through community-based, farmer group-led sessions, supported by Nepal’s agricultural extension workers (government-trained field staff such as Junior Technicians and Junior Technical Assistants) and community health workers. To address low literacy levels among farmers in the study area, these programs should use visual learning materials, such as posters, illustrated flipcharts, and video demonstrations in local languages (Tharu and Nepali), along with pictorial step-by-step guides for key safety practices. Audio messages delivered through mobile phones or village loudspeakers can further support learning among farmers with limited reading ability. Leveraging existing social networks within farming communities to promote safe pesticide practices and using social media for timely information dissemination are crucial steps. Additionally, establishing effective pesticide collection and disposal programs, along with improving access to affordable and appropriate PPE, such as through subsidized distribution by municipality, group purchasing through cooperatives, and partnerships with local agro-vet shops, is essential. Particular emphasis should be placed on providing certified respirators (e.g. N95 masks) and other essential protective gear such as boots and goggles. These multi-faceted interventions are essential for bridging the knowledge-practice gap. They promote safe and sustainable pesticide use in Rajapur Municipality and across the broader agricultural sector.

Supplemental Material

sj-docx-1-phj-10.1177_22799036251350211 – Supplemental material for Knowledge and practices regarding safe pesticide use among farmers in the Bardiya District, Nepal: A cross-sectional study

Supplemental material, sj-docx-1-phj-10.1177_22799036251350211 for Knowledge and practices regarding safe pesticide use among farmers in the Bardiya District, Nepal: A cross-sectional study by Rajesh Karki, Naresh Tharu and Maheshor Kaphle in Journal of Public Health Research

Footnotes

Acknowledgements

The authors would like to express their sincere gratitude to the local residents who generously assisted in identifying and locating the households. We also extend our heartfelt thanks to all the members of the community who participated in the study.

ORCID iD

Rajesh Karki

Ethical considerations

Ethical approval for this study was obtained from the Institutional Review Committee of the Yeti Health Science Academy on 8th April, 2024 (Ref. No.2080/081-415).

Consent to participate

Written informed consent was obtained from each respondent before participation in the study. The purpose of the study, potential risks and benefits, and respondents’ right to withdraw at any time were explained to each respondent clearly and understandably. All methods were conducted following the principles of the Declaration of Helsinki. Data collection and analysis were performed by the STROBE Statement guidelines.

Author contributions

RK designed the study, developed the methodology, conducted the data analysis, and drafted the initial manuscript. NT conducted a comprehensive literature review, developed the research proposal, and collected data. MK critically reviewed and edited the manuscript and assisted with data collection. All authors have reviewed and approved the final manuscript for publication.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data availability statement

All data generated or analyzed during this study are included in this article and its supplementary information files.

Supplemental material

Supplemental material for this article is available online.

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