Table 1 Summaries of reports on exposure and health impacts

[19]

Pesticide use and exposure among framers was studied through qualitative and quantitative data. Individual in-depth interviews, focus group discussions, and a household survey were used. This was supplemented by interviews with retailers and agricultural staff at district and sub-county levels, combined with field observations

Eastern Uganda: 200 smallholder farmers including 144 male and 64 female-headed households in Paya sub-county, Tororo district

Exposure to permethrin, profenofos, cypermethrin, endosulfan and dimethoate were associated to an increased risk of skin irritation, cough/throat irritation, headache, dizziness, breathing difficulties and nausea

[39]

A mixed methods research consisting of a survey, key informant interviews and document review were used to asses knowledge, pesticide practices and associated toxicity symptoms among farmers

Southern Ethiopia: 100 smallholder farmers in two rural kebeles of Finchawa and Tullo in Hawella Tula sub city in Hawassa city administration, Sidama

About 91.8% of the respondents were males and 8.2% females. Exposure to endosulfan, diazinon and flazasulfuron was associated to headache, skin rash, slow heartbeats, chest pain, mood change, dizziness, skin or eye burning, eye pain and coughing

[7]

Structured interviews and walk-through surveys were used to explore pesticide use on male and female flower farmers. In addition, blood samples were collected from the target population to assess concentration levels of serum cholinesterase

Southern Ethiopia: 588 (311 female and 277 male) flower farm workers from 15 different flower farms

Out of 277 males, 148 were pesticide applicators and 129 non-applicators. Females had been working in planting, weeding, cultivating and harvesting flowers inside the greenhouses. Linked to exposure to organophosphates and pyrethroids, the blood measurements indicated a higher levels of abnormal cholinesterase among female greenhouse workers, female and male packinghouse workers, male sprayers and non-sprayers. Out of the 154 pesticides used in the farms, 55% were unregistered, one pesticide was classified as class Ib, while 27.4% were class II

[17]

A survey was used to assess pesticide exposure and self-reported symptoms among male and female farm workers

Mt Elgon region of Uganda: 71 men and 55 women coffee farm workers covering two districts: Sironko and Namisindwa

About 52% of men and 36% women apply pesticides. Cough was reported among 48% of male and 38% of female farmers, while headache and skin itching were reported among 9% and 5% of women and men, respectively, linked to exposure to cypermethrin. Others pesticides were mentioned in local names

[28]

Several research tools such a survey, urine and fractional exhaled nitric oxide were used to investigate the relationship between exposure to organophosphates and pyrethroids with asthma-related outcomes among women

The Western Cape province of South Africa: 211 female (89 farm workers and 24 farm residents) and 98 residents surrounding farms

Urinary pesticide metabolites measurements indicated higher levels of exposure of farm workers to a number of organophosphates and some pyrethroids. Women with depressed cholinesterase levels had an increased odds of having allergic airway inflammation, based on the fractional exhaled nitric oxide determination. Asthma and allergic outcomes were higher among town residents than the other groups

[52]

Self-administered questionnaires were used to assess pesticide exposure among women. Besides, measurement of urinary organophosphate and pyrethroid metabolite concentrations were assessed to investigate the relationship between residue levels and neurotoxic symptoms among female farm workers and residents in neighboring towns

Western Cape of South Africa: 211 female farm workers and residents in neighboring towns in table, wine grape and fruit producing areas

Among all the farm workers, only 2% of women were pesticide applicators. The urinary pesticide metabolites measurements shows high levels of exposure of participants to chlorpyrifos, methamidophos, azinphos methyl, monocrotophos, terbufos, parathion, and fenamiphos, deltamethrin, permethrin, cypermethrin and cyfluthin, several of which belong to the WHO pesticide class II and Ib. Out of 186 urine samples collected, 18 had a creatinine concentration outside the WHO recommended range

[21]

A questionnaire and walk-through survey were conducted to explore the respiratory and dermal symptoms experienced by workers and the control groups

Oromia region of Ethiopia: 213 workers from 3 rose flower farms and 60 control groups from supermarkets

20.6% were male sprayers and non-sprayers and 79.3% females working in cutting and weeding in the greenhouse and bundling, quality control, and packing of the flowers, storage, and transport outside the greenhouse. Flower farm workers inside the greenhouse, female cutters and weeders and male sprayers had a higher prevalence of respiratory and dermal symptoms than workers outside the greenhouse, linked to exposure to organophosphates, carbamates and pyrethroids, most of them are classified as class Ib and II by WHO

[42]

A household survey was conducted to assess knowledge, pesticide use and poisoning symptoms among farmers

Uganda: 204 farmers in the three major potato-growing agroecological zones

58% and 42% of the respondents were males and females, respectively. Exposure to a number of fungicides and insecticides are associated to skin itching and, burning, coughing, a runny nose, teary eyes, and dizziness among male and female smallholder farmers

[8]

A survey and clinical examinations were used to assess the poisoning symptoms experienced by horticultural farm workers and residents and their possible association to pesticide exposure

Lake Naivasha of Kenya: 801 (352 male and 449 female) horticultural farm workers and residents in five communities (i.e., Kamere, Kwa Muia, Kioto and Karagita)

About 88.5% of males were pesticide applicators while 61.6% of females working in planting, weeding, harvesting and pruning. Those who weeded, planted, and harvested flowers reported the highest proportion of symptoms such as respiratory; skin, joints and bones; and nervous systems than sprayers

[24]

The association between pesticide exposure and cholinesterase levels among women currently living on a farm and residents living in towns neighboring the farms was assessed through self-administered questionnaires and blood metabolite concentration of organophosphates and carbamates. In addition, fractional exhaled nitric oxide measurement was also used to assess allergic airway inflammation among the target groups

Western Cape of South Africa: 211 women (113 women currently living on a farm and 98 residents in towns in surrounding farms)

Blood metabolites measurements indicated high levels of exposure of participants to cholinesterase-depressing pesticides such as the organophosphates (chlorpyrifos, diazinon, dichlorvos, and malathion) and carbamates (i.e., carbaryl). As the fractional exhaled nitric oxide measurement shows those with lower cholinesterase levels had almost fivefold increased odds of having highly probable allergic airway inflammation. Asthma and allergic outcomes were higher among town residents surrounding farms than the other groups

[4]

A mixed methods approach comprising survey, in-depth interviews and field observations were used to assess the occupational induced health problems among floriculture workers

Oromia region of Ethiopia: 612 flower farm workers in the nine floriculture farms in Sebeta town and the surrounding

Women workers constitute almost 80% of the employees of the flower sector. About 52.4%, were temporary employed, 22.3% permanent and 25.3% daily laborers. About 51.6% were working in greenhouses (which included supervisors, coordinators and cleaners), 27.0% pack house, 15.9% spraying and 5.5% were irrigation. Skin problems, respiratory problems, fatigue, headache and sleepiness in both sexes were reported

[32]

Blood was measured to establish levels of poisoning by organophosphates and/or carbamates. A survey was used for data on knowledge, attitudes and practices of pesticides among farm workers

Kwekwe district, Zimbabwe: 246 (149 male and 97 female) farm workers in the eleven commercial farms of Kwekwe district

About 60.6% of the respondents were males and 39.4% females. The blood metabolites measurements indicated high levels of exposure of participants to organophosphates, pyrethroids and carbamates. Out of 98% respondents whose blood was tested, 24.1% had an abnormal cholinesterase level. Among these, the most affected were sprayers (50%), followed by those who worked in previously sprayed areas 49%, loaders (31%), mixers (29%), repairers (22%), waste disposers (9%) and store managers (7%). Compared with males, who were all pesticide applicators, female farm workers were more likely to have an abnormal cholinesterase levels than males

[53]

A survey was conducted to compare reproductive outcomes among female farmers working in the irrigation scheme and drylands

Kwa-Zulu-Natal, South Africa: 911 women farmers in the irrigation scheme and drylands

45.5% of women were sprayers. About 887 of women reported 4796 pregnancies, 322 spontaneous miscarriages, 137 infant deaths. They were exposed to a wide variety of pesticides, several of which belong to the WHO pesticide classes I and I

[41]

In addition to survey, blood cholinesterase measurement was performed among farmers and the control groups

Ashanti region, Ghana: 63 male and female farmers and 58 farmers who did not apply pesticides for the last 2 months

The majority of men were pesticide applicators. Blood results shows a higher levels of exposure of participants to organochlorine, organophosphate, pyrethroid, carbamate insecticides. Levels of cholinesterase were significantly lower in exposed farmers than in controls. Low cholinesterase level has been associated with an elevated risk of body weakness and headache

[23]

An association between women’s exposure to pesticides and birth defects was investigated through a survey. Further, information on birth defects was obtained from a hospital. The cases were children who were diagnosed with selected birth defects and the controls were children born in the same areas as the cases

Eastern cape of South Africa: 89 case mothers and 178 control mothers

Most of the case mothers were working in vegetable gardening and subsistence farming. About 80% of the cases and 74% of the controls were involved in food gardening and farming. Babies with birth defects were 7 times more likely to be born to occupationally exposed women and were twice as likely to be born to women who were involved in dipping livestock used to prevent ticks and 6.5 times more likely to be born to women who were using empty pesticide containers for carrying domestic water