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Neurobehavioural symptoms and acute pesticide poisoning: a cross-sectional study among male pesticide applicators selected from three commercial farming systems in Ethiopia
  1. Beyene Negatu1,2,
  2. Roel Vermeulen1,
  3. Yalemtshay Mekonnen3,
  4. Hans Kromhout1
  1. 1 Division of Environmental Epidemiology, Institute for Risk Assessment Science, Utrecht University, Utrecht, The Netherlands
  2. 2 Pesticide Registration Team, Federal Ministry of Agriculture and Natural Resource, Addis Ababa, Ethiopia
  3. 3 College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
  1. Correspondence to Beyene Negatu, Federal Ministry of Agriculture and Natural Resources, Addis Ababa, Ethiopia; beyene.negatu{at}


Objective To estimate prevalence of acute pesticide poisoning (APP) and its association with neurobehavioural symptoms in Ethiopian pesticide applicators.

Methods We performed a cross-sectional survey among 256 pesticide applicators from small-scale irrigated farms, a large-scale open farm and large-scale greenhouses. APP was ascertained using a modified WHO case definition, and neurobehavioural symptoms were collected with a standardised questionnaire (Q16). Exposure to pesticides was estimated using detailed exposure algorithms specifically developed for Ethiopian farms. Multiple logistic regression models were used to estimate risk of APP and its association with neurobehavioural symptoms.

Results Overall APP prevalence was 16%. Working as an applicator in greenhouses was strongly associated with APP (OR 3.00, 95% CI 1.38 to 6.54). Estimated annual pesticide exposure was also associated with APP (OR 1.14, 95% CI 1.00 to 1.20). Longer duration of employment appeared to be negatively associated with APP. Having had an APP was strongly associated with reporting more neurobehavioural symptoms (OR 2.15, 95% CI 1.01 to 4.58) independent of cumulative pesticide exposure. Cumulative exposure to pesticides appeared to be associated with neurobehavioural symptoms among applicators without and with APP.

Conclusions We showed a substantial prevalence of APP that differed between farming systems and was strongly associated with neurobehavioural symptoms. Intensity of exposure was also clearly associated with these symptoms. Reduction and control of occupational exposure to pesticides is urgently needed in Ethiopia.

  • acute pesticide poisoning
  • neurobehavioral symptoms
  • occupational exposure
  • ethiopia

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  • Contributors BN, HK, RV, YM: conception and planning; BN and YM: collection of the data; BN, HK, RV: analysis and interpretation of the data. All authors participated in drafting and finally approving of the manuscript.

  • Funding This study was supported by the Pesticide Risk Reduction Program-Ethiopia. PRRP was a comprehensive program for pesticide registration and management started in 2010 and lasted till 2015. The following donors funded the program: Ministry of Agriculture and Natural resources Rural Development of Ethiopia, the Government of the Netherlands, Food and Agriculture Organization of the United Nations and the Strategic Approach to International Chemicals Management. The sponsors have no involvement in the study design; in the collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication.

  • Competing interests None declared.

  • Ethics approval Addis Ababa University College of Natural Sciences, Addis Ababa Ethiopia reviewed and approved the research protocol.

  • Provenance and peer review Not commissioned; externally peer reviewed.