Factor Related to Health and Occupational Safety Status of Farmers in Kelantan, Malaysia

Abstract

The agricultural sector in Malaysia contributes significantly to the national economy. However, farmers are exposed to potential hazard while handling pesticides which are routinely used to increase yields and quality of agricultural products. This study was conducted to determine the status of health and occupational safety of farmers in Tumpat, Pasir Puteh and Bachok, Kelantan. This cross-sectional study involved 270 farmers aged between 18 and 75 years old. Quantitative and qualitative methods were used in this study. Purposive sampling method was employed in choosing the locations. Simple random sampling was employed in choosing the respondents from farmers‘ name list. Health assessment consists of blood pressure, anthropometry, blood tests, liver function and the presence of pterygium. Nerve conduction threshold, lung function, and identification of trace elements were carried out by using Neurometer CPT / Eagle, Cosmed Quark PFT 2007 spirometry and Inductively Coupled Plasma Mass Spectrometry respectively. Occupational safety status was measured based on personal protective equipment (PPE) practice. Knowledge, Attitude and Practice (KAP) were evaluated using a questionnaire. Qualitative method consists of focus group discussion, in depth interview and parcipatory approach. A total of 46.2% (n=36) farmers scored low for health, while 60.0% (n=162) farmers showed sign and symptom of pesticide poisoning. Farmers who applied six to seven types of PPE was 67.0% (n=181). A total of 42.6% (n=115) farmers obtained low score for knowledge, 68.8% (n=183) scored high for attitude and 96.7% (n=258) scored high for practice. Knowledge showed a low correlation with the practice of farmers (r=0.215, p<0.001). Knowledge (χ2=20.103, p<0.001) and practice (χ2=8.279, p<0.01) showed a significant association with usage of PPE. Practice showed significant association with farmers health (χ2=6.259, p<0.05). A total of 83.0% (n=139) farmers who claimed to use of face mask showed normal blood glucose (χ2=7.928, p<0.001), 69.0% (n=119) showed normal blood uric acid (χ2=6.878, p<0.001) and 67.0% (n=125) do not shows any sign and symptom of pesticide poisoning (χ2=12.486, p<0.05). A total of 84.0% (n=203) farmers who applied head protection had high blood pressure (χ2=4.769, p<0.05). Findings from qualitative method revealed improper usage of PPE among farmers such as used of hat and gloves made from cotton fabric which would absorb pesticide. Health and occupational safety status of farmers were affected by multiple factors which include environmental aspect, pesticides exposure, usage of PPE, hygiene practices, nutritional intake and hiring worker. Based on factor analysis, farmers health tests was categorized into 5 groups as followed: i) body mass index and blood pressure, ii) lung function, iii) blood tests, iv) trace element and v) nerve function and acetylcholinesterase level. In conclusion, the status of health and occupational safety of the farmers are worrying and the farmers should continuously be given health education.