Extensive pesticides use combined with socioeconomic vulnerabilities may increase adverse environmental and human health implications. This study aimed to investigate the association between pesticide exposure, socioeconomic vulnerabilities, dietary diversity and diabetes prevalence among an agricultural population. A mixed-method cross-sectional study was conducted among 400 adults in the Thiruvananthapuram district, Kerala, India. Quantitative data were collected through stratified random sampling using structured questionnaires based on Agricultural Health Study (AHS) and WHO-STROBE guidelines. Anthropometric (body mass index (BMI)), random blood glucose (RBG) and blood pressure (BP) were measured. Qualitative data were collected through focus group discussions (FGDs) with stakeholders (farmers, health workers, agricultural officers, and community leaders). Results showed 18% of overall diabetes prevalence among 400 participants with double burden (24%) observed among agricultural farmers/workers compared to non-farmers (12%). Farmers mostly (89.5%) economically vulnerable with only primary education (65%) and 41.8% of farmers not using any kind of protective practices. Multivariate analysis revealed significant association between diabetes and pesticide exposure (adjusted odds ratio (AOR) = 2.31; 95% CI: 1.063–5.008), hypertension (AOR = 3.45; 95% CI: 1.295–9.239), and dietary diversity (AOR = 3.98, 95% CI: 1.853–8.570) among farmers. Majority of farmers (60.1%) reported no symptoms, and 39.9% experienced at least one symptom following pesticide exposure indicating underreported pesticide related symptoms. Qualitative data confirmed financial insecurities, and poor pesticide safety practices among farmers. Creating awareness and training on safety practices, promoting alternative eco-friendly pesticides use and providing nutritional and economic support to affected population will reduce pesticide burden on human and environmental health.
R et al. (Fri,) studied this question.