Risk reduction of paraquat exposure through risk communication model in maize farmers at Namtok sub-district, Nanoi district, Nan province, Thailand

Abstract

Objectives: 1) To provide background and assess an association among the knowledge, attitudes, and practices of pesticide use and exposure in the maize farmersat Namtok sub-district, Nanoi district, Nan province; 2) To modify risk communication model for reducing risk of paraquat exposure in the maize farmers at Nantok sub-distric, Nanoi district, Nan province t; 3) To evaluate the effectiveness of risk communication model in the maize farmers at Namtok sub-district, Nanoi district, Nan province. Methods: Cross-sectional was conducted by face to face interviewed with questionnaires, in-depth interviewed and participatory observed in the first phase. Quasi-experimental was conducted in the second phase. Risk communication model was developed base on risk communication principle and was implemented into experimental group. Risk communication model comprised 4 components including public meeting workshop, production and distribution media, home visit and Personal Protective Equipment (PPE.) supporting. Public meeting workshop comprised 6 sessions within 2 days including focus group discussions, toxicity and health effect of paraquat, environmental effect of paraquat, susceptibility to paraquat exposure, peer norms for safe paraquat handling, skill training to increase self-efficacy beliefs. Risk communication model was performed in the target area within 6 months. Finally, the last phase was evaluated effectiveness of risk communication model Results: Phase 1: The majority of maize farmers have high knowledge, positive attitude, good practices, but maize farmers still have poisoning toxic symptoms due to pesticide exposure because some farmers did not use PPE and some farmers used improperly PPE. Phase 2: Primary outcome, paraquat residues in human serum were less than 0.21 mg/l (Limit of Detection, LOD) in both groups. After intervention, paraquat residues more than 0.2 1 mgll were detected in 4 cases (7.8%) of experimental group and 11 cases (19.0%) of control group. Proportion test by non parametric statistic was almost significant w0.05). Secondary outcome, knowledge attitude, and practice within group in experimental group were significantly increase (p<0.05) whereas the control group were not. Knowledge, attitude, and practice between group after intervention were significantly difference (p<0.05). Moreover, the difference of mean of knowledge, attitude, and practice of paraquat and exposure between groups was strongly difference. The proportion of personal protective equipments (PPEs) use between group after intervention was significantly difference in use of hat, scarf, goggle, glove, and mask (p<0.05). Full compliance of PPE use was significant difference between group both before and after intervention (p<0.05). Finally, the proportion of paraquat poisoning toxic symptoms between group after intervention were significantly difference in burn nose, eye irritation, tear drop, and mucus symptoms (p<0.05) Conclusion and discussion: Risk communication model may not affected to significantly decrease paraquat residue and paraqaut poisoning toxic symptoms after intervention in the experimental group when compared with the control group. On the other hand, risk communication model was affected to significantly increase the knowledge, attitude, and practice of paraquat use and exposure and significantly increase full compliance of PPE use after intervention in the experimental group when compared with the control group. In conclusion, the occupational exposure of paraquat that the maize farmers may not pose a health risk, if they follow the recommendations for use and adherence to safe working practices. The future research should be repeated done risk communication model in this area and other similar areas.