Evaluation of two-year recall of self-reported pesticide exposure among Ugandan smallholder farmers.

OBJECTIVES: To evaluate smallholder farmers' recall of pesticide use and exposure determinants over a two-year period in a low-income country context. METHODS: The Pesticide Use in Tropical Settings (PESTROP) study in Uganda consists of 302 smallholder farmers who were interviewed in 2017. In the same season in 2019, these farmers were re-questioned concerning pesticide use (e.g., use of active ingredients) and exposure information (e.g., crops, personal protective equipment [PPE], hygienic behaviours) they had previously provided. The extent of recall bias was assessed by comparing responses at follow-up in 2019 with practices and behaviours reported from the baseline interview in 2017. RESULTS: An 84% (n = 255) follow-up response rate was attained. We found instances of better recall (e.g., overall agreement >70% and Area Under the Curve (AUC) values > 0.7) for the use of some active ingredients, commonly used PPE items, and washing clothes after application, whereas only 13.3% could correctly recall their three major crops. We observed a trend where more individuals reported the use of active ingredients, while fewer reported the use of PPE items, two years later. In general, we found better agreement in the recall of years working with pesticides compared to hours per day or days per week in the field, with no apparent systematic over or under reporting by demographic characteristics. CONCLUSIONS: While some of these findings provide consistency with those from high-income countries, more research is needed on recall in poorly educated agriculture communities in low- and middle-income settings to confirm these results.

Recent pesticide exposure affects sleep: A cross-sectional study among smallholder farmers in Uganda.

BACKGROUND: Poorly educated smallholder farmers in low-income countries are highly exposed to pesticides. This can result in adverse mental health issues, of which sleep problems might be an underlying indicator. We aim to examine the association between sleep problems and pesticide exposure among smallholder farmers in Uganda. METHODS: A cross-sectional survey with 253 smallholder farmers was conducted between October and December 2019. Sleep problems were assessed during the week before the visit using the Medical Outcomes Study Sleep Scale (MOS-SS). Exposure to pesticides was assessed as application days of any pesticide and as use of 2,4-D, glyphosate, mancozeb, organophosphates & carbamates, pyrethroids and other pesticides during the week and year prior to the visit. Associations were assessed using adjusted multivariable logistic regression models. RESULTS: Increased odds ratio (OR) for the sleep problem index 6-items (OR [95% Confidence Interval] 1.99 [1.04; 3.84] and 3.21 [1.33; 7.82]), sleep inadequacy (1.94 [1.04; 3.66] and 2.49 [1.05-6.22]) and snoring (3.17 [1.12; 9.41] and 4.07 [1.04; 15.14]) were observed for farmers who respectively applied pesticides up to two days and three or more days in the past week compared to farmers who did not apply during the past week. Gender-stratified analyses showed a higher OR for female applicators (4.27 [1.76-11.16]) than for male applicators (1.82 [0.91-3.79]) for the association between the sleep problem index 6-items and pesticide use in the week before the visit. Increased ORs were also observed for the association between the sleep problem index 6-item and mancozeb exposure during the past year 2.28 [1.12-4.71] and past week 2.51 [0.86-7.55] and glyphosate exposure during the past week 3.75 [1.24-11.8] compared to non-applicators. DISCUSSION: Our findings suggest an increased risk of sleep problems among smallholder farmers in a pesticide-exposure-dependent way in a low-income context. Further gender-stratified, longitudinal investigations are warranted to confirm these findings.