Introduction Global estimates of pesticide poisonings in agriculture are hard to find, although important for prevention. The reason is a poor registration of poisonings in especially middle- and low-income countries. WHO estimated 20–25.000.000 occupational pesticide poisonings around 1990 and a newer estimate from 2009 mentions 3–5.000.000 serious occupational poisonings per year. The number of poisonings varies between surveys, including our own from Bolivia, Nepal and Uganda depending on toxicity of pesticides used, spraying frequency and personal protection performed when spraying.

Methods Surveys were identified through Pubmed and WebofScience and selected on the basis of titles, abstracts and full articles.

Results Different surveys reports a varying number of self-reported pesticide poisonings from a few percent and up to more than 90% among farmers each year. The magnitude depends on the criterias used to define a poisoning such as ‘one or more symptoms after spraying’, ‘the seriousness of symptoms’, ‘the need for medical treatment in connexion with a poisoning’.

The fewest numbers are reported from high income countries and the highest from low income countries. Personal protective devices seems to be important for the experience of symptoms such as the use of boots, gloves, hat. Likewise hygienic factors such as changing clothes and bathing after spraying, eating and smoking during spraying operations, reading labels of use and maintenance of spraying equipment are of importance. Intergrated pest management as a preventive method can apart from increasing yields, also lower risk factors for poisonings and decrease the number of poisoning symptoms.

Conclusion Pesticide poisonings must be counted in millions each year. Prevention is possible by banning the most toxic pesticides, secure availability of protective equipment and information on hygienic measures to perform when using pesticides. Integrated pest management gives solutions but must be politically promoted to stop the increasing pesticide use in traditional agriculture.