title: Do Bolivian small holder farmers improve and retain knowledge to reduce occupational pesticide poisonings after training on Integrated Pest Management?
abstract: BACKGROUND
  Pesticide consumption is increasing in Bolivia as well as pest resistance, pesticide poisonings and pollution of the environment. This survey evaluates the training of small holder farmers on pesticide handling and ecological alternatives to reduce the negative pesticide effects.
  
  
  METHODS
  A baseline survey was performed in 2002 and follow-up surveys in 2004 and 2009. Farmers were selected and trained on Integrated Pest Management (IPM) from 2002 to 2004 in Farmer Field Schools (FFS). After exclusions and drop outs, 23 FFS trained farmers could be compared to 47 neighbor farmers for changes in 'knowledge, attitude and practice' (KAP) on IPM and symptoms of poisoning when handling pesticides. Statistical analysis was performed with SPSS version 21.0 using χ2-test, Cochran's Q test and Student's T-test.
  
  
  RESULTS
  Improvements were seen in both groups but most significant among the FFS farmers. At baseline no difference were seen between the two groups apart from a more frequent use of personal protection among the FFS farmers. After the training was finished significant differences were seen between FFS farmers and neighbor farmers on all KAP variables, a difference reduced to six of the KAP variables in 2009. No difference was seen in self-reported poisonings after pesticide handling. FFS farmers improved their KAP scores markedly during training and there after retained their knowledge, while neighbor farmers improved during the entire period. Ecological farming without the use of pesticides increased most among the FFS farmers.
  
  
  CONCLUSIONS
  The study showed a sustained improvement among Farmers Field School trained farmers on personal protection and hygiene when handling pesticides, knowledge and use of IPM and ecological alternatives and a reduction in self-reported symptoms after pesticide handling. Similar though less pronounced improvements was seen among neighbor farmers having had less training and information on pesticide handling and alternatives than the FFS trained farmers. Training of farmers on IPM and good agricultural practices has positive effects, but is scarce in Bolivia as in most low-income countries and must be encouraged to support an improved and sustainable food production and to protect the health of farmers and consumers as well as the environment.
authors.affiliation: Department of Occupational and Environmental Medicine, Odense University Hospital, and University of Southern Denmark, Odense, Denmark. erik.joers@rsyd.dk.
authors.forename: Erik
authors.initials: E
authors.lastname: Jørs
authors.forename: Flemming
authors.initials: F
authors.lastname: Lander
authors.forename: Omar
authors.initials: O
authors.lastname: Huici
authors.forename: Rafael
authors.initials: R
authors.lastname: Cervantes Morant
authors.forename: Gabriel
authors.initials: G
authors.lastname: Gulis
authors.forename: Flemming
authors.initials: F
authors.lastname: Konradsen
mesh_terms: D000328:Adult; D000368:Aged; D000383:Agriculture; D015331:Cohort Studies; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010571:Pest Control / Q000379:methods*; D010575:Pesticides / Q000506:poisoning*; D055815:Young Adult
chemical_list: D010575:Pesticides