Original Article

Health Symptoms and Health Literacy of Pesticides Used among Thai Cornfield Farmers


Background: We aimed to explain health symptoms and health literacy on the use of pesticides, investigate predicting factors and to formulate the health literacy model for the appropriate use of pesticides by cornfield farmers in the northern of Thailand.

Methods: The reliability and validity from 246 samples were selected by proportional stratified random sampling. Data were collected through a questionnaire in 2016 in Phayao province and were analysed by descriptive statistics and logistic regression.

Results:  All of samples exposed from paraquat, the mean years of farm experience were 14.1 yr and five groups of health symptoms from pesticides were muscle and skeleton, epithelial/ mucosal, neurobehavioral, gastrointestinal and endocrine group. The predicting factors had influenced the health literacy of cornfield farmers regarding the use of pesticides were as following: 1) attitude on pesticides exposure (OR= 1.43, CI=1.26-1.64), 2) prevention of the practice of pesticides exposure(OR= 1.03, CI=1.01-1.05) 3) outcome of the expectation on the prevention of pesticides exposure (OR= 0.584, CI=0.41-0.82), 4) the number of secondary occupation(OR= 0.58, CI=0.38-0.89). These affecting factors were considered for the construction of a health literacy model on the use of pesticides. It could predict the model at 42.5%. The health literacy model could be equal to constant (6.85) + attitude on pesticides exposure (0.36) + behavior on the prevention of pesticides exposure (0.03) – outcome expectation on the prevention of pesticides exposure (0.54)- frequency of secondary occupation (0.53).

Conclusion: We recommend intervention of attitude, practice, outcome expectation and occupation to set up policy for health services among cornfield farmers.

1. World Health Organization (2018). Pesticide residues in food. http://www.who.int/en/news-room/fact-sheets/detail/pesticide-residues-in-food
2. Bureau of occupational and environmental disease (2017). Report of occupation and environment of disease and hazard 2014. http://envocc.ddc.moph.go.th
3. Bureau of occupational and environmental disease (2017). Report of occupation and environment of disease and hazard 2016. http://envocc.ddc.moph.go.th
4. Office of Agricultural Economics of Thai-land (2017). Predicted production of field corn 2015. http://www2.oae.go.th/forecast/04_DEC2558/Thai/situation/sit_t_03.pdf
5. Semathong S, Zapuang K, Kitana N (2008). Pesticides use, famer knowledge and awareness in Thong Pha Phum region, Kanchanaburi Province. J Health Res, 22(1): 15-20.
6. Sapbamrer R, Damrongsat A, Kongtan K (2011). Health impact assessment of pes-ticides use in the northern Thai farmers. J Environ Res, 33(1):1-11.
7. Department of Agriculture, Ministry of Ag-riculture and Cooperatives. Summative of agricultural hazardous on 2018. http://www.doa.go.th/ard/?page_id=386
8. Nutbeam D (2000). Health literacy as a pub-lic health goal: a challenge for contempo-rary health education and communication strategies into the 21st century. Health Promot Int, 15(3): 257-67.
9. Nutbeam, D (1998). Health promotion glos-sary. World Health Organization. Geneva.
10. Kickbusch I (2001). Health literacy: address-ing the health and education divide. Health Promot Int, 16(3): 289–97.
11. World Health Organization. (2018). Health Literacy. https://www.who.int/healthpromotion/conferences/9gchp/health-literacy/en/
12. Baker DW, Paker RM, Williams MV, Clark WS (1998). Health literacy and risk of admission. J Gen Intern Med, 13: 791-98.
13. Griffey RT, Kennedy SK, LMcGownan L, et al (2014). Is low health literacy associat-ed with increased emergency department utilization and recidivism? Acad Emerg Med, 21(10): 1109-15.
14. Baker DW, Wolf MS, Feinglass J, et al (2007). Health literacy and mortality among elderly persons. Arch Intern Med, 167(14): 1503-9.
15. Intarakamhang U, Kwanchuen Y (2016). The development and application of the ABCDE-health literacy scale for Thais. Asian Biomed, 10(6): 587-94.
16. Rakchat A, Bumrerraj S (2016). Patients’ health literacy at Wanyai hospital 2015. Community Health Development Quaterly Khon Khan University, 4(4): 459-73.
17. Visanuyothin S, Chatanuluk C, Saengsuwan S, et al (2015). Health literacy of village health volunteers in municipalitiy, Na-khon Ratchasima, Thailand. J Public Health Dev, 13(1): 37-54.
18. Sitthikhankaew R, Chaleekrua T (2016). Health literacy of hypertensive patients among Hmong hill tribe in Wiangkaen District, Chiangrai Province. In: The 2nd Phayao Graduate Research Conference (PGRC 2). University of Phayao, Phayao Province, pp. 41-59.
19. Thummaphol P, Piaseu N, JarupatMaruo S (2016). Health literacy and clinical out-comes in people with hypertension, dyslipidemia and type 2 Diabetes Mellitus. Journal of Nursing and Health Care, 34(3): 176-82.
20. Riangkam C, Wattanakitkrileart D (2016). Health literacy, self-efficacy, age and visual acuity predicting on self-care behaviors in patients with type 2 Diabetes. J Nurs Sci, 34(4): 35-46.
21. Phuengphasook S, Wanitkun N, Towsa-kulkao T and Utriyaprasit K (2017). Health literacy, health education outcomes and social influence, and their relation-ships with thpe-2 Diabetes and/or Hy-pertension patients’ clinical utcomes. Thai Journal of Nursing Counci, 32(2): 111-25.
22. Hongkrajok H, Pathumarak N, Masingboon K (2016). Influences of health literacy, perceived self-efficacy, and patient-health care provider communication on self-care behaviors among patients with primary hypertension. Royal Thai Navy Medical Journal, 43(2): 39-54.
23. Yormprakhon S, Wattanakitkrileart D, Pongthavornkamol K, Chuchottaworn C (2014). The influence of health literacy, perceived social support, and uncertainty in illness on functional status in patients with chronic obstructive pulmonary dis-ease. J Nurs Sci, 32 (3): 64-3.
24. Chang LC (2011). Health Literacy, self-reported status and health promoting behaviors for adolescents in Taiwan. J Clin Nurs, 20(1-2): 190-6.
25. Bodur AS, Filiz E , Kalkan, I (2017). Factors Affecting health literacy in Adults: A community based study in Konya, Tur-key. International Journal of caring Sciences, 10(1): 100-9.
26. Sentell T, Zhang W, Davis J, et al (2014). The influenc of community and individu-al health literacy on self-reported health status. J Gen Intern Med, 29(2): 238-304.
27. Sak G, Rothenfluh F, Schulz PJ (2017). Asessing the predictive power of psycho-logical empowerment and health literacy for older patients’ participation in health care: a crossectional population. BMC Geriatr, 17(1): 59.
28. Chen JZ, Hsu HC, Tung HJ and Pan LY (2013). Effects health literacy to self-efficacy and preventive care utilization among older adults. Geriatr Gerontol Int, 13 (1): 70-6.
29. Kim SH, Yu X (2010). The mediating effect of self-efficacy on the relationship be-tween health literacy and health status in Korean older adults: A short report. Ag-ing Ment Health, 14(7): 870-3.
30. Protheroe J, Whittle R, Bartlam B, et al (2017). Health literacy, associated lifestyle and demographic factors in adult popula-tion of an English city: a cross-sectional survey. Health Expect, 20(1): 112-9.
31. Kruger JS and Rei Suzuki (2016). Health lit-eracy, self-rated health, and health screen-ing behavior of older Adults. The Health Education Monograph Series, 33 (1): 6-10.
32. Guntzviller LM, King AJ, Jensen JD, Davis LS (2017). Self-efficacy, health literacy, and nutrition and exercise behavior in a low-income, hispanic population. J Immigr Minor Health, 19(2): 489-93.
33. Lee YJ, Shin SJ, Wang RH, et al (2016). Pathway of empowerment perceptions, health literacy, self-care behaviors to gly-cemic control in patients with type 2 dia-betes mellitus. Patient Educ Couns, 99(2): 287-94.
34. Reisi M, Mostafavi F, Javaszade H, et al (2016). Impact of Health Literacy, self-efficacy, and outcome expectations on adherence to self-care behaviors in Irani-ans with Type 2 Diabetes. Oman Med J, 31(1): 52-9.
35. Hsiang-Ru L, Der-Min W, Pi-Hsia L, Yu-Siang J (2018). Health literacy teaching be-liefs, attitudes, efficacy, and intentions of middle school health and physical educa-tion teachers. J Sch Health, 88(5): 350-8.
36. Ubbes VA, Dillhoff R. and Maldonado W (2018). Reading and writing attitude of children: conceptual implications for health education and health literacy. Jour-nal of Health Education Teaching, 9(1): 49-67.
37. Sapamrer R and Nata S (2014). Health Symptoms related to pesticides expose and agricultural tasks among rice farmers from northern of Thailand. Environ Health Prev Med, 19(1): 12-20.
38. Mwabulambo SG, Mrema EJ, Ngowi AV, et al (2018). Health symptoms associated with pesticides exposure among flower and onion pesticide applicator in Arusha Region. Ann Glob Health, 84(3): 369-79.
39. Oztas D, Kurt B, Koc A, et al (2018). Knowledge level, attitude, and behavior of farmers in Cukurova region regarding the use of pesticides. Biomed Res Int, 2018:6146509.
40. Onmoy PJ, Aungudornpukee P (2018). Health impact assessment and self-prevention behavior from pesticide use among shallot farmers in Chaichumpon Sub-district, Laplae District, Uttaradit province. Journal of Community Development and Life Quality, 4(3): 417-27.
41. Supanvanich, S and Podhipak A (1993). A. Principle of epidemiology. Faculty of Public Health, Mahidol University. Bangkok.
42. Kaewdumkeng K, TreePhetoorai N (2011). Health literacy. Department of Health Ed-ucation. Ministry of Public Health. Non-thaburee.
IssueVol 49 No 11 (2020) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v49i11.4725
Health symptoms Health literacy Pesticides Cornfield farmers

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
SRISOOKKUM T, SAPBAMRER R. Health Symptoms and Health Literacy of Pesticides Used among Thai Cornfield Farmers. Iran J Public Health. 49(11):2095-2102.