Background: This paper aims to examine the determinants of health and pesticide exposure among villagers in durian-growing communities in Nakhon Si Thammarat Province, southern Thailand, and Sisaket Province, northeastern Thailand, where pesticide-related health impacts have been identified by local stakeholders as a major public health concern. Methods: This study is presented as an invited commentary and was informed by input from local stakeholders, including district-level leaders and community representatives, who identified the health impacts of pesticide use as a critical public health concern in their communities. Field observations, interviews and focus group discussions with local leaders, villagers and farmers were conducted to better understand community practices and exposure patterns. Results: Key determinants shaping pesticide exposure in rural communities include: (1) occupational and behavioral factors, (2) environmental conditions, (3) technological changes, (4) chemical use, (5) social and economic factors, (6) health system capacity, and (7) policy and structural contexts. Conclusion: Pesticide exposure in rural communities is influenced by multiple interconnected determinants, including occupational practices, environmental conditions, technological changes, and system-level gaps. Addressing these risks requires integrated approaches combining effective policy implementation, risk communication, and community-based interventions to reduce exposure and protect public health. Keywords: Pesticide exposure; Environmental and occupational health; Determinants; Rural communities; Lessons learned.
Rattanawitoon et al. (2026) studied this question.