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Pesticide use and safety practices

among Greek tobacco farmers: A
survey
a a a
Christos A. Damalas , Eleni B. Georgiou & Maria G. Theodorou
a
Department of Agricultural Development of Pieria, Katerini,
Greece
Version of record first published: 22 Jan 2007.

To cite this article: Christos A. Damalas, Eleni B. Georgiou & Maria G. Theodorou (2006): Pesticide
use and safety practices among Greek tobacco farmers: A survey, International Journal of
Environmental Health Research, 16:5, 339-348

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 International Journal of Environmental Health Research
October 2006; 16(5): 339 – 348

Pesticide use and safety practices among Greek tobacco

farmers: A survey

CHRISTOS A. DAMALAS, ELENI B. GEORGIOU, &

MARIA G. THEODOROU

Department of Agricultural Development of Pieria, Katerini, Greece

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Abstract
An attempt was made to explore knowledge, attitudes, and practices towards safety issues of pesticide
handling among tobacco farmers of the rural area of Pieria in northern Greece. From the 310 survey
questionnaires that were mailed out, 223 were received fully and correctly completed resulting in a quite
satisfactory response rate of 72%. A large majority of the farmers (96%) viewed pesticides as a guarantee for
high tobacco yields and high product quality. Almost all farmers (99%) thought that pesticides can have
serious adverse effects on users’ health. Skin contact was recognized as the most common route of exposure
during pesticide use (58%). Despite awareness of potential health risks by pesticide handling, a significant
proportion of the farmers (46%) reported not using any special protective equipment when spraying
pesticides. From those who reported that they use protective equipment, most stated that they normally use
a hat (47%) and boots (63%). Only few farmers reported using a face mask (3%), gloves (8%), and
coveralls (7%) on a regular basis. The reasons for not using protective equipment during pesticide handling
were that protective equipment is uncomfortable (68%), too expensive to buy (17%), time-consuming to
use (8%), not available when needed (6%), and not necessary for each case (2%). A large majority of the
farmers (84%) said that they replace work clothing when it wears out and a considerable part (48%) stated
that they wash work clothing after several uses. Although farmers’ knowledge of potential hazards by
pesticide use was high, the reported safety measures were poor. Continuous emphasis on the basic safety
precautions required when using pesticides and on the importance of protective equipment is essential for
changing wrong habits of farmers which can be hazardous for their health.

Keywords: Awareness, attitudes, pesticide misuse, protective equipment, risk

Introduction
Pesticides are considered a vital component of modern farming, playing a major role in
maintaining high agricultural productivity. However, concerns about human health and
environmental effects of pesticides have increased over the past several years (Van der Werf
1996; Wilson & Tisdell 2001; Pimentel 2005). With increasing legislation and environmental
pressure, it is essential that everything possible is done to ensure that pesticides are used
correctly to obtain the maximum benefit with the minimum of risk for the human and the
environment. Careless handling of pesticides usually as part of the operator error due to wilful
negligence, lack of information or lack of training can pose a serious health risk for farmers

Correspondence: C. A. Damalas, Department of Agricultural Development of Pieria, 28th Octovriou 40, 60100 Katerini, Greece.
Tel: þ30 23510 69219. Fax: þ30 23510 69111. E-mail: damalas@mail.gr

ISSN 0960-3123 print/ISSN 1369-1619 online ª 2006 Taylor & Francis

DOI: 10.1080/09603120600869190
 340 C. A. Damalas et al.

who are the major pesticide users and are regularly exposed to pesticides in many ways
(Woodruff et al. 1994; Koh & Jeyaratnam 1996; Reeves & Schafer 2003).
In general, the way in which pesticides are applied has a strong bearing on the degree of
hazard for farmers. For example, leakages from joints in the application equipment may often
cause farmers to come into direct skin contact with large amounts of a pesticide. Similarly,
blocked or unsuitable nozzles of the spraying equipment affect the quality of application and
increase the degree of exposure. Changes in the wind speed and direction during spraying can
result in pesticide absorption by the respiratory tract. Application on extremely hot and dry days
promotes pesticide drift and increases exposure. Spraying in poorly ventilated spaces, such as
greenhouses, expose farmers to inhalation and absorption by skin of high concentrations of
pesticides. Spraying from the air can create a risk for farmers who are not involved in the
operation, the population at large, food products left in the open and the environment as a
whole. All the above situations, which are common during pesticide application, may result in
direct and prolonged exposure of farmers to pesticides and may affect their health.
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Farmers’ knowledge of the potential hazards of pesticide handling is important for the
prevention of exposure to pesticides. Levels of knowledge regarding routes of exposure to
pesticides and specific health effects of pesticides may vary considerably among farmers. Most
Latin farm workers in North Carolina knew that pesticides could be harmful, though they
varied in their levels of knowledge regarding pathways of exposure, specific health effects of
pesticides, and ways to avoid and reduce exposure (Elmore & Arcury 2001). Farm workers in
the Gaza Strip reported high levels of knowledge on the health impact of pesticides (Yassin
et al. 2002). Similarly, high levels of knowledge about the adverse effects of pesticides on
health have been found among pesticide applicators in Texas, but inhalation was erroneously
considered the main route of exposure to pesticides by the majority of farmers (Martinez et al.
2004). Farmers in Ecuador had good knowledge about the acute health effects of pesticides
and their exposure routes (Hurtig et al. 2003). Rice farmers in Japan had good knowledge on
technical aspects of pesticides but this was not reflected at the cognitive level (Parveen et al.
2003). Moderate or low levels of knowledge about pathways of absorption of pesticides and of
potential symptoms following exposure were found among farm workers in Egypt (Stewart
1996), Ghana (Clarke et al. 1997), Ethiopia (Mekonnen & Agonafir 2002), and Lebanon
(Salameh et al. 2004). Similarly, while the majority of farmers in Wyoming did not feel
pesticides were adversely affecting the environment, possible detrimental health effects from
applying pesticides were a concern (Van Tassell et al. 1999). Moreover, farmers’ knowledge
about the health dangers of pesticides was not sufficient to change their behaviours in
Indonesia, where it was found that the overriding concern was crop damage that leads to
economic loss and not health issues (Kishi 2002).
Poor knowledge and understanding of safe practices in pesticide use, erroneous beliefs
about the necessity of personal protective equipment, use of pesticides in excessive
concentrations than those needed, and poor maintenance facilities for application equipment
can seriously impair farmers’ abilities to protect themselves against potential risks (Koh &
Jeyaratnam 1996). In particular, lack of personal protection equipment or failure to use it
properly is a major problem during pesticide application. It is also essential that the available
protective equipment is suitable for the purpose used and fits the user properly and
comfortably. If it is unsuitable for the purpose used or does not fit the user well, it will not be
worn and apparently it will not protect. While farmers may be aware of the necessity of using
protective equipment when using pesticides, they usually prefer not to use such equipment
which they consider as uncomfortable, cumbersome, or non-essential (London 1994;
Sivayoganathan et al. 1995; Stewart 1996; Clarke et al. 1997; Gomes et al. 1999; Mekonnen
& Agonafir 2002; Perry et al. 2002; Yassin et al. 2002).
 Pesticide use and safety practices among Greek tobacco farmers 341

The aim of this study was to assess knowledge, attitudes, and practices towards safety issues
of pesticide handling among tobacco farmers of the rural area of Pieria in northern Greece.

Methods
A survey of tobacco farmers was conducted in September 2004 in the rural area of Pieria.
Tobacco growers were selected from other farmers of the area because tobacco is a major crop
for the area and it receives annually many pesticide treatments of different categories. Among
the active ingredients used for pest control in tobacco the most common for the area are:
fosetyl-Al, metalaxyl-M, penconazole, propamocarb, propineb, and thiophanate-methyl
(fungicides), carbaryl, cypermethrin, dimethoate, imidacloprid, methamidophos, and meth-
omyl (insecticides), carbofuran, ethoprophos, fenamiphos, oxamyl, and terbufos (insecticides
used mainly as nematicides), ethofumesate, fluazifop-p-butyl, napropamide, pebulate,
pendimethalin, and quizalofop-p-ethyl (herbicides), and metham sodium (soil disinfectant).
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Participants were identified by the Directorate of Agricultural Development of Pieria

(Department of Tobacco) as tobacco growers and were expected to be able and willing to
complete the questionnaire. Selection of individual farmers was completely random. Data were
collected using a structured questionnaire with simple questions regarding views and attitudes
of tobacco farmers about pesticide handling and safety issues related to pesticide handling. In
particular, farmers were asked to what extent they agree or disagree with a series of statements
describing attitudes related to pesticide handling and safety issues selecting one of the following
options: strongly agree, somewhat agree, somewhat disagree, and strongly disagree (Likert-type
scale). In addition, respondents were presented with a number of multiple choice tests and were
asked to choose the answer which they thought it best described their opinion or attitude for
each particular case. Besides closed questions, free space for additional comments or
alternative answers was included as well. The questionnaire was first tested in a small group of
colleagues and was appropriately modified according to reactions, comments, and suggestions.
Questionnaires were mailed out in September 2004 to 310 people. Each person on the
mailing list was also contacted by telephone to determine whether that person was indeed a
tobacco grower and if he had completed and mailed the survey questionnaire. Several growers
chose to complete the survey over the telephone rather than in writing. In some cases, a
personal contact with growers was arranged. From the 310 survey questionnaires that were
mailed out, 223 were received fully and correctly completed after several and persistent
follow-up attempts, resulting in a quite satisfactory response rate of 72%.
Data were coded and entered into specially designed databases (Microsoft Access). As soon
as the data had been initially entered they were carefully checked for possible entry errors.
Relative frequencies of answers were calculated for each question. Subsequently, data were
transferred to appropriate spreadsheets (Microsoft Excel) and SPSS (version 10) for statistical
analysis. Relative frequencies were compared using the Chi-square (w2) test to determine
significant differences in proportions of given answers. Relative frequencies were further
compared (where necessary) using the z-test. Mean differences were declared significant at
the 95% confidence level.

Results
Respondents’ data
A total of 223 tobacco farmers completed the questionnaire fully and correctly. The 223
tobacco growers who eventually completed the questionnaire represented a total area of
 342 C. A. Damalas et al.

557.5 ha growing tobacco in 2004 covering the 7.3% of the total area cultivated with tobacco
in Pieria that year. Farm size ranged from 0.5 – 4 ha. All respondents of the survey were male.
The reason for this is that men are normally involved in pesticide handling and application,
whereas women do participate in various other activities except pesticide handling. Mean age
of the farmers was 45.9 years (age range from 21 – 70 years) with a standard deviation 11.95
years. Age distribution of the farmers is shown in Table I.
A considerable number of the farmers (31.4%) were in the age group of 41 – 50, whereas
20.6 and 22.4% were in the age group 31 – 40 and 51 – 60, respectively. Education level of
the respondents is shown in Table II. A considerable number of the farmers (48%) had
completed primary education, whereas a significant number of the farmers (37%) had
completed lower secondary education. All participants were full-time farmers earning all of
their income from agricultural activities. The participants may be characterized as small-scale
landowners with small landholdings (family farms with a high level of productivity) who
operate their farms with varying technical and financial means and produce for the domestic
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and export market. All farmers performed most of the farming activities by themselves along
with their family members using the appropriate machinery. Immigrant farm workers were
employed when needed. In addition, all farmers applied pesticide products on their own using
their own spraying equipment.

Respondents’ attitudes
A large majority of the farmers (96%) thought that pesticides are indispensable for high yields
and high product quality in tobacco culture (Figure 1). Almost all farmers were aware that
pesticides can have various adverse effects on users’ health (99%) (Figure 2).
Skin contact was stated as the most common route of exposure during pesticide handling
(58%), whereas a considerable number of the farmers thought that inhalation is the primary
pathway of exposure to pesticides (35%) (w2 ¼ 84.2, p 5 0.001) (Table III).
A significant number of the farmers (46%) reported not using any protective equipment
when spraying pesticides (w2 ¼ 0.7, p 5 0.5) (Table IV). Use of long sleeved shirts, long pants,
and shoes plus socks were assumed for all farmers and were not counted as separate gear
items. From those who reported that they use protective equipment, most stated that they
mainly use a hat (47%) and boots (63%) (Table V). Only few farmers reported using a face
mask (3%), gloves (8%), and coveralls (7%) on a regular basis. Some farmers stated that these
items are used occasionally. No farmer reported using a respirator.
Among the reasons for not using protective equipment during pesticide application farmers
reported that protective equipment is uncomfortable (68%), too expensive to buy (17%),
time-consuming to use (8%), not available when needed (6%), and not necessary for each
case (2%) (w2 ¼ 151.0, p 5 0.001) (Table VI). A large majority of the farmers (84%) indicated
that they replace work clothing when it wears out (w2 ¼ 260.6, p 5 0.001) (Table VII) and a

Table I. Age of respondents.

Age No. %

21 – 30 27 12.1
31 – 40 46 20.6
41 – 50 70 31.4
51 – 60 50 22.4
61 – 70 30 13.5
 Pesticide use and safety practices among Greek tobacco farmers 343
Table II. Education of respondents.

Education level No. %

None (or primary uncompleted) 8 3.6

Primary 107 48.0
Lower secondary 82 36.8
Upper secondary 24 10.7
Tertiary 2 0.9
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Figure 1. Farmers’ attitudes on the necessity of pesticide use in tobacco culture.

Figure 2. Farmers’ attitudes about potential health risks of pesticide use.

 344 C. A. Damalas et al.
Table III. Most common route of exposure during pesticide handling*.

Route of exposure No. %

Skin contact 129 57.8

Inhalation 78 34.9
Digestion 14 6.3
Eye contact 2 0.9

*Farmers were asked to choose only one statement, which best described their situation.

Table IV. Compliance of farmers with protective equipment use.

I use protective equipment No. %

Almost always 121 54.3

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Almost never 102 45.7

Table V. Type of protective equipment worn when handling pesticides and frequency of use.

Protective equipment Frequency of use No. %

Hat Almost always 57 47.1

Occasionally 51 42.1
(w2 ¼ 23.4, p 5 0.001) Almost never 13 10.7
Boots Almost always 76 62.8
Occasionally 42 34.7
(w2 ¼ 54.7, p 5 0.001) Almost never 3 2.5
Gloves Almost always 10 8.3
Occasionally 23 19.0
(w2 ¼ 71.5, p 5 0.001) Almost never 88 72.7
Goggles Almost always 0 0.0
Occasionally 8 6.6
(w2 ¼ 163.2, p 5 0.001) Almost never 113 93.4
Face mask Almost always 4 3.3
Occasionally 12 9.9
(w2 ¼ 129.4, p 5 0.001) Almost never 105 86.8
Coveralls Almost always 9 7.4
Occasionally 14 11.6
(w2 ¼ 102.6, p 5 0.001) Almost never 98 81.0
Respirator Almost always 0 0.0
Occasionally 0 0.0
(w2 ¼ 200.2, p 5 0.001) Almost never 121 100.0

Table VI. Reasons for not using protective equipment*.

I do (would) not use protective equipment because No. %

It is uncomfortable 152 68.2

It is too expensive to buy 37 16.6
It is time-consuming to use 17 7.6
It is not available when needed 13 5.8
It is not necessary for each case 4 1.8

*Farmers were asked to choose only one statement, which best described their situation.
 Pesticide use and safety practices among Greek tobacco farmers 345

sizeable part (48%) stated they wash work clothing after several uses (w2 ¼ 11.7, p 5 0.01)
(Table VIII). Only 2% of the farmers said that they normally replace work clothing seasonally
and only 32% stated that they wash work clothing immediately after use.

Discussion
A large majority of the farmers viewed pesticides as a guarantee for high tobacco yields and
high product quality. This belief is not unusual considering that tobacco is a sensitive plant
prone to many pests which often affect plant growth and reduce yield and quality. Many of
these pests are difficult to control and often tobacco culture needs high chemical inputs to
overcome heavy pest infestations. A similar view about the necessity of pesticide use was
found among Egyptian farmers (Stewart 1996).
Almost all farmers were aware that pesticides can have serious adverse effects on users’
health and most farmers knew that the main route of exposure during pesticide use is skin
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contact. As mentioned earlier, all participants were full-time farmers, applied pesticides on
their own, and apparently had great experience with pesticide handling. This can explain the
high levels of awareness to questions regarding risks from pesticide use. Farmers with more
time spent working in the fields or those who had been exposed to pesticides are expected to
have higher levels of knowledge about these topics because experience may have motivated
them to learn more about pesticide safety when the occasion for doing so arose. Pesticide
applicators who reported that they applied pesticides (were exposed to pesticides) in their
work for five or more years gave high percentages of correct responses to knowledge questions
concerning pesticide safety (Martinez et al. 2004). However, it is possible that familiarity with
pesticides may lead to complacency and greater risk taking as some farmers may feel that after
many years in farming new efforts to protect their health are unnecessary.
A considerable number of the farmers reported not using protective equipment on a regular
basis. Hat and boots were used more often than gloves, mask, and coveralls which in turn
were used only occasionally and by a small minority of farmers. Similar attitudes towards
personal protection use have been reported in a number of studies from different areas.

Table VII. Frequency of replacement of work clothing*.

I replace my work clothing No. %

Annually 4 1.8
When afforded 1 0.4
When necessary 1 0.4
When it wears out 187 83.8
If contaminated by pesticide spill 30 13.5

*Farmers were asked to choose only one statement, which best described their situation.

Table VIII. Frequency of washing work clothing*.

I wash my work clothing No. %

After several uses 107 48.0

Immediately after use 71 31.8
When heavily contaminated 45 20.2

*Farmers were asked to choose only one statement, which best described their situation.
 346 C. A. Damalas et al.

Poor use of protective equipment has been reported among farmers in the Western Cape
(London 1994), Sri Lanka (Sivayoganathan et al. 1995), Egypt (Stewart 1996), Ghana
(Clarke et al. 1997), United Arab Emirates (Gomes et al. 1999), Gaza Strip (Yassin et al.
2002), Ethiopia (Mekonnen & Agonafir 2002), and United States (Carpenter et al. 2002;
Perry et al. 2002). In most cases, use of protective equipment was low despite the availability
of protective devices and the adequate knowledge of farmers about potential impact of
pesticides on their health. However, Schenker et al. (2002) found that over 93% of California
farmers reported using personal protection when using pesticides, which was a considerably
higher frequency than for farmers in other parts of the country.
Most farmers reported that the main reason for not using protective equipment during
pesticide handling is discomfort. A similar attitude has been reported for farmers in Sri Lanka
(Sivayoganathan et al. 1995). In general, performing work in a hot environment is more
stressful for the worker than performing similar work in a neutral environment. Individuals
wearing chemical protective clothing in the heat require progressively shorter work periods
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and more frequent and longer rest periods (White et al. 1991). Heat stress is particularly
important for farmers who normally perform hard working activities in warm or hot
environments. Unfit equipment or clothing which hinders free movement of the body further
deteriorates the situation and increases discomfort. Thus, although protective equipment is
often available, farmers do not use it in every day practice since they find it uncomfortable and
stressful. Discomfort, however, is usually determined by a combination of physiological,
psychological, and physical factors. Research has shown that complaints of discomfort
decreased markedly within a short day period indicating that the principle of adaptation seems
to be an important facet which has to be developed for effective personal protective device
programs (Abeysekera & Shahnavaz 1990).
Suitable work clothing protects the body against splashes that may occur while pouring
concentrates from a container, as well as spray mists that may drift on the applicator
under certain conditions (Whitford et al. 2003). Most farmers reported that they replace
work clothing when it wears out, whereas a considerable part stated they replace work
clothing only if contaminated by a pesticide spill. It is evident that replacement of work
clothing is not done as often as it should be. Protective clothing must be inspected and
replaced on a regular basis. If work clothing is allowed to become badly worn or torn then
this allows pesticides to penetrate more easily and may counter any benefit of wearing the
clothes. As clothing becomes worn, thin, or torn it should be replaced by new garments.
Most farmers reported that they wash work clothing after several uses, whereas a smaller
number stated they wash work clothing immediately after use. Washing of work clothing
took place at home by housewives separately from other clothing after pre-rinsing with hot
water. It is evident that although women may not commonly engage in the application of
pesticides, they can be exposed to pesticides by doing the laundry unless they handle
clothing properly and take protective measures during this process. Washing work clothing
immediately after each use is important for preventing exposure to pesticide residues.
Clothing that has been used during pesticide handling must be considered contaminated
whether or not this is obvious and should not be used again until cleaned (Whitford et al.
2003). The longer the clothing is stored before washing, the harder it is to remove
pesticide residues. Thorough cleaning of work clothing is equally important to good
maintenance to prevent secondary exposure and contamination of farmers and possibly
other family members by pesticides.
This survey reports attitudes of tobacco farmers towards safety practices and pesticide use
relying solely on information given by the respondents. The objective of the survey was
primarily descriptive with a view to an assessment of farmers’ attitudes on the topics
 Pesticide use and safety practices among Greek tobacco farmers 347

examined. The reported attitudes were not monitored or verified in practice and therefore
there may be some inaccurate data submitted depending on honesty and memory of the
respondents. Self-reports suffer limitations of this kind as people frequently want to report
socially desirable behaviours. However, the sample surveyed was completely random and
sufficient to be considered representative for the average tobacco farmer in Pieria.

Conclusion
Results of this study reported that awareness of health risks by pesticide use among tobacco
farmers participated in this survey was high. However, the reported safety practices during
pesticide application were inadequate. In particular, compliance of farmers with protective
equipment use was inconsistent. Consequently, increased exposure to pesticides may be often
expected for farmers and the potential risks from pesticide handling may be high. Proper
training in pesticide handling and education on the hazards of pesticide exposure would
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diminish substantially the health hazards currently facing by farmers. Continuous emphasis
on the importance of protective equipment is essential for changing wrong habits of farmers
which can be hazardous for their health.

Acknowledgements
The authors gratefully acknowledge Mr Vasilis Navrozidis, agronomist of the tobacco
growers’ cooperative of Moschopotamos Pieria, for his assistance during the survey and
Mr Costas Tsintsifas, Head of the Directorate of Agricultural Development of Pieria, for
encouraging and warmly supporting the idea of this survey.

References
Abeysekera JDA, Shahnavaz H. 1990. Adaptation to discomfort in personal protective devices: an example with safety
helmets. Ergonomics 33:137 – 145.
Carpenter WS, Lee BC, Gunderson PD, Stueland DT. 2002. Assessment of personal protective equipment use
among Midwestern farmers. Am J Ind Med 42:236 – 247.
Clarke EEK, Levy LS, Spurgeon A, Calvert IA. 1997. The problems associated with pesticide use by irrigation
workers in Ghana. Occup Med 47:301 – 308.
Elmore RC, Arcury TA. 2001. Pesticide exposure beliefs among Latino farmworkers in North Carolina’s Christmas
tree industry. Am J Ind Med 40:153 – 160.
Gomes J, Lloyd OL, Revitt DM. 1999. The influence of personal protection, environmental hygiene and exposure to
pesticides on the health of immigrant farm workers in a desert country. Int Arch Occ Env Hea 72:40 – 45.
Hurtig AK, Sebastian MS, Soto A, Shingre A, Zambrano D, Guerrero W. 2003. Pesticide use among farmers in the
Amazon Basin of Ecuador. Arch Environ Health 58:223 – 228.
Kishi M. 2002. Farmers’ perceptions of pesticides and resultant health problems from exposures. Int J Occup Env
Heal 8:175 – 181.
Koh D, Jeyaratnam J. 1996. Pesticides hazards in developing countries. Sci Total Environ 188:S78 – S85 (Suppl.).
London L. 1994. Agrichemical safety practices on farms in the Western Cape. S Afr Med J 84:273 – 278.
Martinez R, Gratton TB, Coggin C, Rene A, Waller W. 2004. A study of pesticide safety and health perceptions
among pesticide applicators in Tarrant County, Texas. J Environ Health 66:34 – 37.
Mekonnen Y, Agonafir T. 2002. Pesticide sprayers’ knowledge, attitude and practice of pesticide use on agricultural
farms of Ethiopia. Occup Med 52:311 – 315.
Parveen S, Nakagoshi N, Kimura A. 2003. Perceptions and pesticides use practices of rice farmers in Hiroshima
prefecture, Japan. J Sustain Agr 22:5 – 30.
Perry MJ, Marbella A, Layde PM. 2002. Compliance with required pesticide-specific protective equipment use. Am J
Ind Med 41:70 – 73.
Pimentel D. 2005. Environmental and economic costs of the application of pesticides primarily in the United States.
Environment, Development and Sustainability 7:229 – 252.
 348 C. A. Damalas et al.
Reeves M, Schafer KS. 2003. Greater risks, fewer rights: US farmworkers and pesticides. Int J Occup Env Heal
9:30 – 39.
Salameh PR, Baldi I, Brochard P, Abi Saleh B. 2004. Pesticides in Lebanon: a knowledge, attitude, and practice
study. Environ Res 94:1 – 6.
Schenker MB, Orenstein MR, Samuels SJ. 2002. Use of protective equipment among California farmers. Am J Ind
Med 42:455 – 464.
Sivayoganathan C, Gnanachandran S, Lewis J, Fernando M. 1995. Protective measure use and symptoms among
agropesticide applicators in Sri Lanka. Soc Sci Med 40:431 – 436.
Stewart DJ. 1996. Pesticide use, habits and health awareness among Egyptian farmers. Ambio 25:425 – 426.
Van der Werf HMG. 1996. Assessing the impact of pesticides on the environment. Agr Ecosyst Environ 60:81 – 96.
Van Tassell LW, Ferrell MA, Yang B, Legg DE, Lloyd JE. 1999. Pesticide practices and perceptions of Wyoming
farmers and ranchers. J Soil Water Conserv 54:410 – 414.
White MK, Hodous TK, Vercruyssen M. 1991. Effects of thermal environment and chemical protective clothing on
work tolerance, physiological-responses, and subjective ratings. Ergonomics 34:445 – 457.
Whitford F, Stone J, MacMillan T. 2003. Pesticides and personal protective equipment: selection, care, and use.
Purdue University Cooperative Extension Service, Publication PPP-38. p 36.
Downloaded by [University of Arizona] at 02:28 11 November 2012

Wilson C, Tisdell C. 2001. Why farmers continue to use pesticides despite environmental, health and sustainability
costs. Ecol Econ 39:449 – 462.
Woodruff TJ, Kyle AD, Bois FY. 1994. Evaluating health risks from occupational exposure to pesticides and the
regulatory response. Environ Health Persp 102:1088 – 1096.
Yassin MM, Abu Mourad TA, Safi JM. 2002. Knowledge, attitude, practice, and toxicity symptoms associated with
pesticide use among farm workers in the Gaza Strip. Occup Environ Med 59:387 – 393.