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1
Knowledge, Attitude, and Practice (KAP) of using
Personal Protective Equipment (PPE) for chilli-
growing farmers in Hua Rua sub-district, Muang district, Ubonratchathani Province, Thailand
By: Saowanee Norkaew
Thesis Advisor: Dr. Wattasit SiriwongThesis Co-Advisor: Prof.Dr. Mark G. Robson
Date: 12 March 2010
2
Background
Pesticides are widely used throughout the world,
especially in agriculture for crop protection (WHO).
Studies on knowledge, attitude and practice (KAP)
show that unsafe use of pesticides is common in
developing countries; further study is needed to develop
and improve interventions on the safe use of pesticide
(Sematong et al., 2008, Janhong et al., 2005, Recera et al., 2006).
3
Thailand is a country that produces food to supply
the world’s population; however, an important problem
related to agriculture is pesticide poisoning reported.
Pesticide poisoning is highest among occupational
diseases (80% of total occupational diseases reported)
(Division of Epidemiology, 2008).
About 40% of Thailand workforce are employed in agriculture (National Statistical Office, 2009).
Background
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Objectives:
To evaluated the knowledge, attitudes, and practices
(KAP) associated with pesticide use and exposure in the chilli-
growing farmers in Hua Rua sub-district, Muang district,
Ubonratchathani Province, Thailand.
To assess the knowledge, attitude and practice on using
personal protective equipment of chili-growing farmers.
To provide recommendation to farmers to reduce their exposure to pesticide.
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Research Design:
● Cross sectional study
Methodology
Study population:
Chilli-growing farmers who apply pesticides to their field directly.
The age of farmers >18 years old; includes men and women excludes children and pregnant women.
Selecting only one person from each household.
322 persons are selected from 1,200 chilli-growing farmers households (N) as a target population (n).
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Measurement Tools:
The questionnaire was designed to assess the knowledge,
attitude and practice on personal protective equipment.
Questionnaire was adopted from instruments used in previously reported studies.
Research Methodology
Data collection was through a questionnaire to interview chilli-growing farmers administered in person.
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Measurement Tools: The questionnaire consists of five parts.
Part 1: Socio demographics (16 questions)
The questions include background and general
information: age, gender, education, marital status, weight,
family status, income, amount of land owner.
Part 2: Information regarding pesticide use (8 questions)Information on pest problems: insects, weeds, disease.
Research Methodology
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Part 3: Knowledge regarding using pesticide (15 questions)
Knowledge of using pesticide, personal protective equipment,
health effect of pesticides.
A correct answer will give 1 score and 0 score for wrong answer.
The scores vary from 0-15 points and will classify into 3 levels as
follow: Bloom’s cut off point, 60%-80%
Scores Descriptions
0-09 (Less than 59%) Low levels
10-12 (60-80%) Moderate levels13-15 (80-100%) High levels
Research Methodology
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Part 4: Attitudes regarding using pesticide (15 questions)
Farmers respond to 10 statements are a Likert’s scale which include both positive and
negative. The rating scale is measure as follow:
The scores varied from 0 to 60 and all individual answers were summed up for total
scores and calculate for means. The scores were classified into 3 levels (Positive Attitude, Neutral
Attitude and Negative Attitude).
Positive Attitude 48-60 scores (80%-100%)
Neutral Attitude 36-47 scores (60%-80%)Negative Attitude 00-35 scores (Less than 59%)
Positive Statement Negative Statement
Choice Scores Choice Scores
Strongly agree 4 Strongly agree 0
Agree 3 Agree 1
Neural 2 Neural 2
Disagree 1 Disagree 3
Strongly disagree 0 Strongly disagree 4
Research Methodology
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Part 5: Practice of pesticide usage (23 questions)
This part asks about how often they use each personal protective
equipment. There were 8 statements witch include both positive and negative.
The rating scale is measure as follow:
The scores ranged from 0 to 92 and were classified into 3 levels (Good
Practice, Fair Practice and Poor Practice).
Good Practice 87-92 scores (80%-100%)
Fair Practice 65-86 scores (60%-80%)Poor Practice 00-64 scores (Less than 59%)
Positive Statement Negative Statement
Choice Scores Choice Scores
Usually 4 Usually 1
Sometime 3 Sometime 2
Rarely 2 Rarely 3
Never 1 Never 4
Research Methodology
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Data analysis
Statistical technique
SPSS v 17 software for windows is used for quantitative data analysis.
Descriptive statistics such as frequency, percentage, mean and
standard deviation.
Inferential statistics - use Spearman’s Rank Correlation
Coefficient was used to describe the strength and direction of the
relationship between knowledge and attitude, knowledge and practice, and attitude and practice.
Research Methodology
21
The total response was 330 cases
Table1 Social and demographic characteristics of the chilli-growing farmers who participated in the study
Characteristics (n=330) No. (%)
Age (years) mean=42, SD= 10.7
< 30
-31-40
-41-50
-51-60
> 60
35
130
105
40
20
10.5
39.6
31.9
12.0
6.0
Gender
-male
-female
175
155
53
47
Marital status
-single
-couple
-withdraw
35
290
5
10.6
87.9
1.5
Status in family
-head of family
-spouse
-child
-parent
-occupant
170
110
25
5
20
51.5
33.3
7.6
1.5
6.1
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Characteristics (n=330) No. (%)
Education
-Never
-Primary school
-Secondary school
-High School
-Bachelor’s degree
10
235
50
30
5
3.0
71.2
15.2
9.1
1.5
Income (Bath/year)
<50,000
-50,001-150,000
-151,000-300,000
>300,001
190
95
40
5
57.6
28.8
12.1
1.5
Land owner
-< 3 rais
-3-5 rais
-5-7 rais
215
100
15
65.2
30.3
4.5
Table1 Social and demographic characteristics of the chilli-growing farmers who participated in the study
24
Table 2 Information of problem of weed, insect, pesticide use of the chilli growers who participated in the study
Characteristics Number (%)
Insect problem
-yes
-no
280
50
84.8
15.2
Weed problem
-yes
-no
200
130
60.6
39.4
Plant disease problem
-yes
-no
245
85
74.2
25.8
Commonly used chemical
-Abamectin
-Selecron (profenofos)
-Podium 600 (chlorpyrifos)
155
77
49
47.0
23.3
14.9
Pesticide Application*
-apply by self
-apply by hired applicator
270
60
81.8
18.2
25
Characteristics Number (%)
Source of pesticide information*
-radio
-TV
-document/article
-broadcast tower
-neighbor
-agricultural office
-public health office
-pesticide salesman
-community leader
-health volunteer
41
52
42
28
33
59
7
48
7
13
12.42
15.75
12.72
8.48
10.00
17.89
2.12
14.56
2.12
3.94
Have you had a cholinesterase test in the last 12 months?
-never
-yes but not know result
-yes and normal
-yes and not normal
-yes with health effects
115
20
160
30
5
34.8
6.1
48.5
9.1
1.5
Table 2 Information of problem of weed, insect, pesticide use of the chilli growers who participated in the study
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Part 3: Knowledge regarding using pesticide
0
10
20
30
40
50
60
70
80
90
Low level Moderate level
Low level
Moderate level
77.2%
22.8%
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Part 4: Attitude regarding using pesticide
40
42
44
46
48
50
52
54
56
Negative Attitude Neutral Attitude
Negative Attitude
Neutral Attitude
54.5%
45.5%
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Part 5: Practice of pesticide usage
0
10
20
30
40
50
60
70
80
90
Poor practice Fair practice Good practice
Poor practice
Fair practice
Good practice
9%
85%
6%
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The association between knowledge and attitude, knowledge and practice, and attitude & practice
Variables Statistic test Spearman’s rho p-value
Knowledge & Attitude Spearman’s rank correlation 0.216 0.01
Knowledge & Practice Spearman’s rank correlation 0.285 0.01
Attitude & Practice Spearman’s rank correlation 0.305 0.01
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Discussion and Conclusion
The total response was 330 cases
– The average age was 42 years old
– 53% were male, married, and head of family
– 71% was graduated primary school.
– All of them owned the property ,more than 60% owned
less than 3 rais
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Growers reported only a few symptom of pesticide exposure
- headache
Growers expressed either neutral or negative attitude.
The majority (85%) described their practices use as “fair”
Limitations
- recall bias
- limited information in current questionnaire
Discussion and Conclusion
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Farmers had limited formal education.
There was a little positive association between
knowledge, attitude and practice.
This study found that the majority chilli-growing farmers
have low knowledge, negative attitude and fair practices.
Discussion and Conclusion
Therefore, the educational programs, legislation
promoting the use of safer pesticide, and implementation
of personal protective measures are necessary to continues for decreasing the pesticide exposure.
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Recommendations:
Improving the devices or redesigning the device to ensure the chilli-
growing farmers to use them effectively and using safety practices.
Should be develop evidence-based methods, which can assess the
occupational health risk.
For policy on the basis of the findings in this study, the following
issues should be considered for improving knowledge of chilli-growing
farmers of harmful effects of pesticide and importance of using PPE at
work
Public education is necessary to address the knowledge gap.
Therefore educational programs should be organized for improving
knowledge about harmful effects of pesticide and it should focus mainly to
reduce the awareness of the people of the importance of using PPE.
Free publishing materials concerning to education, training and specific information on occupational health be effected.
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Further study
Thailand have many agriculture that could be study in other area or other agriculture.
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Acknowledgement
College of Public Health Science, Chulalongkorn University
International Training and Research in Environmental and
Occupational Health grants (ITREOH NIH Fogarty)