ECONOMIC COST OF AGROCHEMICALS FOR THE HEALTH OF COTTON

FARM WORKERS: A CASE STUDY OF PUNJAB, PAKISTAN

Javaria Nasir1, Muhammad Ashfaq1,2, Syed Asif Ali Naqvi1, , Sarfraz Hassan1, Asad
Imran3, Arif H. Makhdum3, Sultan Ali Adil1 and Asghar Ali1
ABSTRACT
Pakistan’s economy profoundly depends upon cotton which contributes 6.7 percent in
agricultural value addition and 1.4 percent in the national GDP. It is a high valued crop,
farmers apply extensive amount of agrochemicals to averse the risk of pest damage.
Agrochemicals produce serious damages to farm workers who are exposed extensively to
pesticides. That is why the current study was aimed at identification of agrochemical use
practices and precautionary measures adopted by farmers and to monetize the health cost of
farm worker incurred due to exposure of agrochemicals. Primary data was collected from
Bahawalpur district of Punjab from 65 cotton pickers and 65 applicators. The results showed
that the major reason of intoxication is illiteracy, lack of training and information about
pesticide safety, poor pesticide application technology and lack of personal protective
equipment. Average health cost and average daily income of applicator were PKR 542 and
PKR 325 respectively. While for the case of cotton pickers the average health cost was PKR
625 per year and their average wage was PKR 201 per day. The regression results showed
that health cost increased by increase in age, duration of work, acute symptoms and health
centre distance. The health cost for female are larger than male and smokers health cost was
higher than non-smokers. The health cost decreased by education, adoption of precautionary
measure and availability of extension facility (training, workshop and discussion).
Key Words: Cotton, agrochemicals, health cost, picker, applicator, Punjab
INTRODUCTION
Agriculture is the most important sector of Pakistan economy having share of 21.4 percent in
GDP, 45 percent of employment. Cotton is the most important crop in Pakistan’s economy

1
Institute of Agricultural and Resource Economics, University of Agriculture Faisalabad, 38000,
Pakistan
2
Corresponding Author Email: ashfaq9@hotmail.com
3
World Wide Fund for Nature-Pakistan

[SYLWAN., 159(1)]. ISI Indexed 253

 because it provides raw material to textile industry. The soil, cheap labor and other climatic
conditions give a comparative advantage to the cotton crop on other cash crops (Bakhash et
al., 2006). It contributes 1.4 percent in GDP of Pakistan and 6.7 percent in value added in
Agriculture. The cotton production is decreased than the last years due to fall in the area
sown which is due to less rates of cotton nationally and internationally prevailed during last
two years that discouraged the cotton farmers to put more area under crop and shifting the
area to other crops like maize and rice due to their better returns (GOP, 2014).
Agrochemicals play a vital role in meeting demands of escalating population for food, cotton
fiber and tobacco. In cotton crop, pests especially the bollworms which are causing
noteworthy crop damage and are liable for substantial chemical pesticide applications in
almost the entire world’s cotton growing regions (Zehr, 2010). The survival of cotton
growing farmers is doubtful without pesticide usage; therefore proper periodic trainings are
required to avoid the pesticide related health hazards among cotton growing community (Haq
et al., 2008). These pesticides disperse in the atmosphere and affect the unprotected
agricultural workers. The major routes by which pesticides can be absorbed by human body
are skin, lungs and gut. Skin is a major place for accidental exposure. These chemicals have
structural similarity with toxicants so they are very injurious for living organisms especially
for human health. Unregulated and excessive use also hinders the war against insect and pest.
Rough estimates given by international business companies show that approximately 80 to 90
percent of pesticide was used for cotton crop and remaining 10 to 20 percent was frenzied on
other crops and vegetables (Hashmi et al., 2011). Farmers spray intensive amount of pesticide
to protect their crops from pest damage in order to optimize agriculture output on limited area
of land. Agrochemicals acute poisoning are 3.5 to 5 million a year. The agrochemicals not
only kill pest but they also kill beneficial organisms, contaminate environment and their
residue level is found in human tissues blood, milk and in fetus and produce neurological
diseases, cancer and birth defects. So pesticides should be monitored from “farm to fork”. A
study in Multan revealed that approximately 37% spray men were found to be involved in
oral intake of agrochemicals. Therefore, there are chances of absorption, inhalation and
ingestion of agrochemicals in cotton growers. So there is a dire need of training for the
persons which are directly involved in cotton growing activities to secure them from
hazardous environment (Haq et al., 2007).

[SYLWAN., 159(1)]. ISI Indexed 254

 The most important work related hazard among farmers of developing countries is pesticide
exposure (Wesseling et al. 2001; Coronado et al. 2004). The major reason of pesticide
harming in the developing countries is the use of highly toxic pesticide and there is no any
regulation and legislative framework about pesticide use (Konradsen et al., 2003). The major
reason of intoxication are illiteracy, lack of training and information about pesticide safety,
poor pesticide application technology and lack of personal protective equipment.(Hurting et
al., 2003; Atreya, 2008). Majority of women worked in diverse agricultural activities
including sowing, harvesting and picking, majority participate in picking and harvesting to
increase their family income (Nazir et al., 2013).
Pesticide affects health of farm workers in a drastic manner, about 21 % of pesticide use
produced at least three neurobehavioral, gastrointestinal and respiratory symptoms of
pesticide harming (Kishi et al., 1995). Cotton picking is mostly done by female of every age
group from 8 years manually, these are illiterate landless female workers belonging to poor
families of low income group. It is very common practice to use extensive amount of
agrochemicals on field crops specially cotton. Practically there is no systematic gauge to
access impacts of agrochemicals on the environment and human health (Iqbal et al., 1997).
The estimates of World Health Organization showed that the annual death rate due to
pesticide is 220 thousands and the poisoning cases due to pesticide are 3 million. There is a
tendency to rise in the situation which is alarming especially in developing countries because
most of cases are reported in developing nations. In developing countries pesticide handling
and usage is nonscientific and unsystematic (WHO, 1990). The main reasons of hazards of
agrochemicals are lack of knowledge, awareness and information. The human health and
environmental effects of agrochemicals can be avoided by awareness, education and
changing pesticide use behavior and attitude of farmer (Dasgupta and Meisner, 2005).
This study was aimed to explore the pesticide usage impacts on the farm workers health
damage value. It was further narrowed down by analyzing the pesticide usage awareness,
perceptions and precautionary measures adopted by farm workers. Impacts on the health
among farm workers due to pesticide exposure and the determinants that affect health of farm
worker were quantified. Health cost of farm workers due to exposure of agrochemicals was
also estimated. The rest of the paper is organized as follows: second part includes data
collection procedure and delineates the empirical model, third section presents empirical

[SYLWAN., 159(1)]. ISI Indexed 255

 results and discusses their implications, and fourth and the last section offer conclusion and
policy suggestions.
MATERIALS AND METHODS
In the current study impacts of pesticide usage on the farm workers health were quantified.
For this primary data was collected from district Bahawalpur with the help of a well-
structured pre-tested questionnaire. A random sample of 65 cotton pickers and 65 pesticide
applicators was collected. The data was analyzed with the help of EViews 3.1 and Microsoft
Excel. District Bahawalpur is the largest cotton producer it produce 1.1 million bales and
about .3 million Hectare area of district Bahawalpur is under cotton crop (GOP, 2011). For
the estimation of health cost of farm worker cost of illness approach was used. This approach
quantity the economic load of diseases and assess the maximum amount that could be saved
if a disease were to be eradicated (Rice, 2000). In the study both direct and indirect costs
were estimated. Here direct costs estimate opportunity cost of resources used for treating a
particular illness while the other indirect costs, measure the amount of resources lost due to a
specific illness (Hodgson and Meiners, 1982). The conceptual model underlying the next two
stages of econometric analysis. First stage includes quantification of cost of illness model
inorder to elucidate the principal aspects affecting health costs among small farmers. Acute
pesticide poisoning symptoms are the most serious medical conditions affecting health costs.
Then in the second stage, determinants of the acute illness episodes experienced by the
pesticide applicators were measured.
Cost of Illness Model
The resulting Health cost is an estimate and if we find the determinants of health coat then we
need to specify an econometric model and find the determinants of health cost (Birnbaum et
al. 2005; Swensen et al. 2003). To find the determinants of health cost of farm worker TOBIT
Model was used.
There was data on both discrete (at 0) and continuous parts. One natural extension of probit is
called the Tobit (Tobin’s Probit) and is giver by the following in Equation 1:
Yi* = Xi β+ є i
Yi = Yi* if Yi* > 0
0 if Yi*≤ 0 (1)

[SYLWAN., 159(1)]. ISI Indexed 256

 This model is called the a censored regresson model because it is possible that the health cost
is zero or sensored. That is, we could write the model as
Yi = max ( 0, Xi β + є i) (2)
Where,
Y =0, 1, 2, 3….. = Health Cost of Farm worker
And the dependent variables are
X1 = Age of Farm workers, X2 = Formal Education of Farm workers, X3 = Gender of Farm
workers, X4 = Work Duration of Farm workers, X5 = Acute symptoms, X6 = Personal Habits
of Farm Worker, X7 = Availability of Extension facility, X8 = Health care distance of Farm
worker
And X9 = Precautionary measures adoption
Acute symptoms model
Poisson Regression Model: It was applied to find the determinants of health impairment.
The probability distribution that is definitely suited for count data is the Poisson probability
distribution (Gujrati 2003).
f (Y) = µ Y e-µ / Y! (3)
In Equation 3 f (Y) denotes the probability that the number of ailment take non-negative
integer values, and Y! is the factorial of Y.
The poisson regression model may be written as,
Yi=E (Yi) + ui =µ i + ui
µ i=E (Yi) =β1+Β2X2+β3X3……βkXk
Where,
Y =0, 1, 2, 3….. = Number of ailments
And the dependent variables are
X1 =Age of Farm Workers (Cotton pickers and applicators), X2 = Education of farm worker,
X3=Duration of Work of applicator and cotton picker, X4=Personal Habits (Smoking, drink
or eating niswar), X5= Precautionary Measures Adoption
RESULTS AND DISCUSSION
Socioeconomic characteristics of the sampled respondents are offered in Table 1. According
to education, farm workers divided in four categories listed in table. Most of sample of farm
worker was illiterate and belong to poor families. About 82 percent of applicator and 78

[SYLWAN., 159(1)]. ISI Indexed 257

 percent of cotton pickers were illiterate and these findings were consistent with results of
Atreya (2005). There is strong relationship between the education and spraying experience
with their level of knowledge and skill of using personal protection accessories. The results
of revealed that the pesticide applicator has high income than cotton picker. Bahawalpur is
the study area and the rural population of study area lack opportunities, so there is excess
labor and the wage rate is also low as compared to other cotton growing areas of Pakistan.
The average income of cotton picker was 200 and 58 percent pickers was in range of 151-
250.
Table 1: Socioeconomics characteristics of the farm workers in the study area
Indicator/Unit Applicator Cotton picker
Frequency Percentage Frequency Percentage
Age (years)
below 20 5 7 6 9
21-30 16 25 25 39
31-40 21 33 23 35
41-50 12 19 9 14
Above 50 11 16 2 3
Education(years)
Illiterate 53 82 51 78.4
Primary 4 6 11 16.9
Middle 7 11 2 3
Metric 1 1 1 1.53
Family Members (Numbers)
Up to 5 17 26.15 14 21.6
6-10 42 64.61 27 41.5
Above 10 6 9.24 24 36.9
Income (PKR)
0-150 1 1 26 40
151-250 19 30 38 58.5
251-350 21 32 1 1.5
351-450 19 30 0 0
451-550 5 7 0 0

The estimated health cost contain different components mitigation cost, cost of medication,
travel cost, dietary expenses, productivity loss, loss in income of attended person and home
remedies expense. It does not take in to account the mortality effects and cost related to
discomfort. The health cost of applicator is on average PKR 542 while the average income of
applicator is PKR 325. Standard deviation is quite high which shows that there is high

[SYLWAN., 159(1)]. ISI Indexed 258

 dispersion from mean value of health cost because some applicator experience no cost at all
some experience serious hazards and high medication cost, so there is much dispersion in
health cost of applicators. The health cost of cotton picker is PKR 625.7. Mostly cotton
pickers does not include skin rashes, eye irritation and itching as disease they said that it is
common if they have to work then these ailments will happen and does not use precautionary
gadgets at all due to hot weather and cost concerns. The larger cost is due to productivity loss
if they had skin irritation and giddiness then it will affect their efficiency and if there is major
problem like giddiness, fever and shortness of breath then they will not pick cotton in those
days. The similar results were reported by Atreya (2005) in Nepal and Ngowi et al. (2007) in
Tanzania.
Table 2: Components of health cost of applicators and cotton pickers (PKR).
Cost Item Applicator S.E of mean Cotton Picker S.E of mean
Precautionary Measures 22 47 3.13 1.66
Treatment 168 47.3 205.56 41.61
Travel Expense 19.25 4.5 30.52 10.97
Dietary Expenses 1.46 0.84 16.67 5.931
Productivity Loss 250.92 46.78 353.91 66.6
Productivity loss of 73.85 16.7 17.78 6.17
Attendant
Home Remedies 6.77 1.6 1.98 .718
Health 542.28 102.66 625.7 105.2
Tobit Model was used to estimate the linear function of health cost to estimate different
factors affecting the health cost. Partial regression coefficients and their t-values are
presented in Table 2. The coefficient of the age has positive sign having the value of 19.57,
indicates that with the increase in one year of age, the health cost increased on average by
PKR 19.57 keeping other factors constant. Its value is significant at 1 percent level of
significance. Coefficient of education is 15.68 having negative sign, shows that if the farm
worker education increased by one year of schooling then the health cost declined on average
by PKR 15.68 while other factors constant. The gender of farm worker has coefficient of
288.39 with negative sign which shows that if the farm worker is male then the health cost
will decreased on average PKR 288.39 keeping other factors constant. Its value is not
significant.

[SYLWAN., 159(1)]. ISI Indexed 259

 If the work duration of farm worker increased by 1 hour per day then the health cost
increased on average PKR 133.81 rupees keeping other factors constant. Its sign is significant
and positive at 5 percent level of significance. Its coefficient value is 166.13 with positive
sign which exhibited that the health cost is positively related to acute symptoms and
increased on average 166.13 rupees if the prevalence of acute symptoms increases by one
time of ailment. Its value is significant at 1 percent level of significance. Personal habits
include that if the worker is smoker, alcoholic etc. Its sign is positive if the farm worker is
smoker then the health cost on average increased by 132.20 rupees. The coefficient of
precautionary measures adoption is 326.62 which have negative sign shows negative relation.
If the farm worker use the protective clothing than on average the health cost decreased by
PKR 326.62 keeping all other factors constant. Its value is significant at 5 percent level of
significance. The Coefficient of this variable is 208.7 with positive sign, which shows that if
the distance of health care centre is increased by 1 kilometer the health cost increased on
average PKR 208.7. Its value is significant at 1 percent level of significance. These findings
were in line with the finding of (Hossain et al., 2004). The coefficient of extension facility is
40.04 with negative sign which shows that if the worker have attended any workshop or
training then the health cost decreased by 40.04 rupees. The coefficient is not significant. The
adjusted R2 is 0.61 which shows that 61 percent of variation in dependent variable has been
explained by the model. Similar findings regarding health costs of pesticide usage have been
quantified by Maumbe and Swinton (2002).
Table 3: Determinants of health cost of farm worker Dependent Variable: Cost of
illness of farm worker (PKR).
Independent variables Coefficient z-value
Constant -1742.29*** -4.26
Farm worker Characteristics
Farm worker age 19.57*** 2.95
Formal education -15.68 -0.45
Gender -288.39 -1.56
Health related variables
Duration of work 133.18** 0.04
Acute symptoms 166.14*** 3.33
Personal Habits 132.20 0.84
Precautionary measures -326.62** -2.02
Institutional Variables
Health centre distance 208.70*** 0.001

[SYLWAN., 159(1)]. ISI Indexed 260

 Extension facility -40.04 -0.30
R2 0.64
Adj R2 0.61
Log likelihood -531.77
***=significant at 1% level, **=significant at 5% level, *=significant at 8% level
Given the critical contribution of pesticide-related acute symptoms to health costs second
stage analysis proposed by Maumbe and Swinton (2002). The results of Poisson models
showed that pesticide related acute symptoms rises with increase in age and duration of work.
Results are given in the Table 4. The number of ailment for female cotton picker are more as
they spend more time in poisonous field area and eat and drink at farm in some cases. The
age, gender, personal habits, duration of work and protective clothing are significant at 1
percent level of significance; the positive sign shows direct relationship between number of
ailments and age, smoking, and work duration. If the age increases then the probability of
number of ailments will also increase. The sign of education is negative which exhibit that
probability of ailments will decrease if the farm worker is literate. The variable of education
is significant is at 5 percent. The precautionary measure adoption has negative sign, which
shows that the probability of ailments will decrease by increase in adoption of precautionary
measures. The smokers have more probability of ailments than a non-smoker. The similar
results have been reported by Maumbe and Swinton (2002) and Kouse and Qaim (2012).
Table 4: Determinants of number of ailments of farm workers
Dependent Variable: Number of ailments
Independent variables Coefficient z-value
Farm worker Characteristics
Farm worker age 0.02*** 4.86
Formal education - 0.07** -2.01
Gender 0.69*** 3.39
Health related variables
Personal habits 0.42*** 3.23
Exposure variable
Duration of work 0.25*** 4.76
Protective clothing - 0.82*** -4.45
N 130
Log Likelihood chi-square 177.25
χ2 p-value 0.0000
***=significant at 1% level, **=significant at 5% level, *=significant at 8% level

[SYLWAN., 159(1)]. ISI Indexed 261

 CONCLUSIONS

Agrochemicals play a momentous role in meeting demands of escalating population of cotton

fiber and tobacco. These pesticides disperse in the atmosphere and affect the unprotected
agricultural workers. Benefits provided by pesticides are also entailed with a lot of risks and
problems. Results of the study showed that the major reasons of intoxication were illiteracy,
lack of training and information about pesticide safety, poor pesticide application technology
and lack of personal protective equipment. The result exhibited that the most of the farm
workers were illiterate, having large family size with very low income. Most of pesticide
applicators were illiterate they could not read the label only 12 percent read the labels. The
estimated health cost contain different components like; mitigation cost, cost of medication,
travel cost, dietary expenses, productivity loss, loss in income of attended person and home
remedies expense. Results of applicators and cotton pickers were positive for variables of age
and smoke, while it was negative for education and precautionary measures adoption. There
was no uniformity between pesticide consumption and yield increase for the case of cotton.
Due to threat of pest attack and over advertisement campaigns by corporation’s growers
apply pesticides regularly which cause health and environmental difficulties. The number of
ailment for female cotton picker are more as they spend more time in poisonous field area
and eat and drink at farm in some cases. It was also clear that the health cost increased by
duration of work, increase in age, acute symptoms and health centre distance. The health cost
for female were larger than male and smokers health cost was higher than non-smokers.
These findings were in line with the finding of (Hossain et al., 2004). The health cost could
be decreased by education, adoption of precautionary measure and availability of extension
facility like, workshop and discussions.

LITERATURE CITED

Ajayi, O., F. Akinnifesi, and G. Sileshi. 2011. Human health and occupational exposure to
pesticides among smallholder farmers in cotton zones of Côte d'Ivoire. Health. 3:631-
637.
Alavanja, M.C., N.L. Sprince, E. Oliver, P. Whitten, C.F. Lynch, P.P. Gillette, N.L. den-
Sacket, and C. Zwerling. 2001. Nested Case-Control Analysis of High Pesticide
Exposure Events from the Agricultural Health Study. Am. J. Ind. Med. 39: 557-563.

[SYLWAN., 159(1)]. ISI Indexed 262

 Aslam, M., S. Kanwal, T. Ali, A. Ajaz and M.I. Zafar. 2009. Personal protection accessories
as a primary health safety measures in pesticide use. Pak. J. Agri. Sci. 46(1): 498-503.
Atreya, K. 2005. Health costs of pesticide use in a vegetable growing area, central mid-hills,
Nepal. Him. J. Sci. 3(5): 81-84.
Atreya, K. 2008. Probabilistic Assessment of Acute Health Symptoms Related to Pesticide
Use Under Nepalese Agriculture. Int. J. Environ. Heal R.18(3): 187-208.
Birnbaum, H.G., R.C. Kessler, S.W .Lowe, K. Secnik, P.E. Greenberg, S.A. Leong, and A.R.
Swensen. 2005. Costs of Attention Deficit Hyperactivity Disorder: Excess Costs of
Persons with ADHD and Their Family Members in 2000. Curr. Med. Res. Opin. 21
(2): 195-205.
Coronado, G., D.B. Thompson, L. Strong, W.C. Griffith and I. Islas. 2004. Agricultural task
and exposure to organophosphate pesticides among farm workers. Environ. Health. 18
Persp. 112: 142-147.
Dasgupta, S. and Meisner, C. 2005, “Health Effects and Pesticide Perception as Determinants
of Pesticide Use: Evidence from Bangladesh”, World Bank Policy Research Working
Paper 3776.
Government of Pakistan (GOP). 2011. Agricultural Statistics of Pakistan 2010-2011.
Statistics Division, Pakistan Bureau of Statistics.
Government of Pakistan (GOP) 2014. Economic survey of Pakistan 2013-14. Finance
division, Economic Advisor’s wing, Islamanad. Pakistan.
Haq, Q., I.A. Fareedi, T. Ali, M. Ahmad and N. Iftkhar. 2008. Pest diagnosis and pesticide
use by cotton growers of multan area and their occupational health. Pak. J. Agri. Sci.
45(4): 535-539.
Haq, Q., T. Ali, M. Ahmad and I.A. Faridi. 2007. Conceptual analysis of cotton growing
community about pesticides: A case study of district Multan. Pak. J. Agri. Sci. 44(3):
498-503.
Hashmi, Imran and Khan A. Dilshad. 2011. Adverse Health Effects of Pesticides Exposure in
Agricultural and Industrial Workers of Developing Country, Pesticides - The Impacts
of Pesticides Exposure, Prof. Margarita Stoytcheva (Ed.). In Tech, Available at
:http://www.intechopen.com/books/
Hodgson, T.A. and M.R. Meiners. 1982. Cost of Illness Methodology: A Guide to Current

[SYLWAN., 159(1)]. ISI Indexed 263

 Practices and Procedures. Milbank. Mem. Fund. Q. 60(3): 429-462.
Hurtig, A.K., M.S. Sebastian., Soto, A. Shingre, D. Zambrano, W. Guerrero. 2003. Pesticide
use among farmers in the Amazon Basin of Ecuador. Arch. Environ. Health. 14(58).
223-228.
Hossain, F. C.E. Pray, Y. Lu, J. Huang, C. Fan, R. Hu. 2004. Genetically modified cotton and
farmers’ health in China. Int. J. Occup. Environ. Health. 10: 296-303.
Iqbal, Z., K. Zia, and A. Ahrnad, 1997. Pesticide abuse in pakistan and associated human
health and envirnmental risks. Pak. J. Agri. Sci. 34: 94-97.
Javed, M.S., S. Hassan, S. A. Adil, A. Ghafoor, K. Bakhsh and A. Siddique, 2006.
Comparative Advantage of Cotton Production and Its Policy Implications in Pakistan.
Pak. J. Agri. Sci. 43(4): 193-196.
Kishi, M., N. Hirchhorn, M. Djajadisastra, L.N. Satterlee, S. Strowman, and R. Dilts. 1995.
Relationship of pesticide spraying to signs and symptoms in Indonesian farmers.
Scand. J. Work Environ. Health. 21: 124-133.
Konradsen, F., W. Van der Hoek, D.C. Cole, G. Hutchinson, H, Daisley, S. Singh, M.
Eddleston. 2003. Reducing acute poisoning in developing countries-options for
restricting the availability of pesticides. Toxicology. 192: 249-261.
Kouser, S. and M. Qaim. 2012. Valuing financial, health and environmental benefits of Bt
cotton in Pakistan. Selected Paper prepared for presentation at the International
Association of Agricultural Economists (IAAE) Triennial Conference, Foz do Iguaçu,
Brazil, 18-24 August, 2012.
Maumbe, M.B. and S.M. Swinton. 2002. Hidden health costs of pesticide use in Zimbabwe’s
smallholder cotton growers. Soc. Sci. Med. 57: 1559-1571.
Nazir, S., I.A. Khan, B. Shahbaz, and F. Anjum. 2013. Rural women’s participation and
constraints in agricultural activities: A case study of District Nankana Sahib, Punjab.
Pak. J. Agri. Sci. 50(2): 317-322.
Ngowi, A.V.F., T.J. Mbise, A.S.M. Ijani and O.C. Ajayi. 2007. Pesticide use by smallholder
farmers in vegetable production in northern Tanzania. Crop Prot.26: 1617-1624.
Rice, D.P. 2000. Cost of Illness Studies: What is Good About Them? ,Injury Prevention. 6:
177-179.
Swensen, A., H.G. Birnbaum, K. Secnik, M. Marynchenko, P. Greenberg, and A. Claxton,

[SYLWAN., 159(1)]. ISI Indexed 264

 2003. Attention Deficit/Hyperactivity Disorder: Increased Costs for Patients and Their
Families. J. Am. Acad. Child Adolesc. Psychiatry. 42(12): 1415-1423.
Weaseling, C., A. Aragon, L. Castillo, M. Corriols, F. Chaverri, E. de la Cruz, E.M. Keifer,
P. Monge, T.J. Partanen, C. Ruepert, B.V.W de Joode. 2001. Hazardous pesticides in
Central America. Int. J. Occup. Environ. Health. 7: 287-294.
World Health Organization (WHO) 1990. Public health impacts of pesticides use in
agriculture. ISBN 924156139 4 (NLM Classification: WA 240), World Health
Organization, Geneva, Switzerland.
Zehr, U.B. 2010. Cotton: Biotechnological Advances. Springer, Heidelberg.

[SYLWAN., 159(1)]. ISI Indexed 265

 Health Cost of Farm Worker
(Cost of Illness Approach)

Cost of Illness Model

(Tobit Model)

Acute Symptoms Model

(Poisson Regression Model)

Figure 1: Econometric modeling pattern to identify factors of pesticide related health costs

[SYLWAN., 159(1)]. ISI Indexed 266