Health Impacts of Pesticide Exposure Among Farmers: A Systematic Review and Implications for Agronursing Practice

Authors

  • Enggal Hadi Kurniyawan Faculty of Nursing, Universitas Jember, Indonesia
  • Dicky Endrian Kurniawan Faculty of Nursing, Universitas Jember, Indonesia
  • Kholid Rosyidi Muhammad Nur Faculty of Nursing, Universitas Jember, Indonesia
  • Alfid Tri Afandi Faculty of Nursing, Universitas Jember, Indonesia
  • Yeni Fitria Faculty of Nursing, Universitas Jember, Indonesia
  • Emi Wuri Wuryaningsih Faculty of Nursing, Universitas Jember, Indonesia
  • Robby Prihadi Aulia Erlando Faculty of Nursing, Universitas Jember, Indonesia

DOI:

https://doi.org/10.53713/htechj.v4i1.593

Keywords:

Pesticide exposure, farmers, agronursing, occupational health, rural health

Abstract

Pesticide exposure among farmers poses significant health risks globally; however, comprehensive recent evidence on the role of nursing in mitigating these hazards remains underexplored. This systematic review aims to synthesize empirical findings from 2024 to 2025 on the health impacts of pesticide exposure in farming populations and discusses implications for agronursing practice. Following the PRISMA 2020 guidelines, a systematic search was conducted across Scopus, PubMed, and ProQuest using the keywords "pesticide," "farmer," and "nursing." From an initial pool of 2,757 records, 10 original research articles published between 2024 and 2025 met the inclusion criteria: full-text, English-language, open-access, peer-reviewed research articles with ethical clearance, an active DOI, and no study design restrictions beyond excluding non-original works. The 10 included studies were conducted in Thailand, Spain, Greece, Ethiopia, Indonesia, Türkiye, and India. These studies revealed consistent associations between pesticide exposure and adverse health outcomes, including sleep disorders, depression, suicide attempts, oxidative stress, DNA damage, elevated inflammatory markers, and increased stroke risk biomarkers. Behavioral assessments indicated widespread deficiencies in safe pesticide handling and low risk perception. Importantly, nurse-led interventions demonstrated effectiveness in improving occupational health service delivery and farmer knowledge. Pesticide exposure continues to pose a risk to farmers' health across diverse global settings. Agronursing emerges as a vital interdisciplinary approach to address this challenge through education, early detection, advocacy, and community-based prevention. Integrating agronursing competencies into primary healthcare and nursing curricula is crucial for protecting agricultural workers and promoting sustainable rural health.

References

Ahmad, M. F., Ahmad, F. A., Alsayegh, A. A., Zeyaullah, M., AlShahrani, A. M., Muzammil, K., Saati, A. A., Wahab, S., Elbendary, E. Y., Kambal, N., Abdelrahman, M. H., & Hussain, S. (2024). Pesticides' impacts on human health and the environment, with their mechanisms of action and possible countermeasures. Heliyon, 10(7), e29128. https://doi.org/10.1016/j.heliyon.2024.e29128

Aslam, S., Hussain, B., Riaz, S., Yousaf, M., Sohail, B., Ullah, F., & Hussain, S. (2024). Empowering farmers through science communication: A framework for pesticide risk awareness and adoption. Social Sciences & Humanities Open, 11, 101491. https://doi.org/10.1016/j.ssaho.2025.101491

Brito, D. C. D., Xavier, D. M., Redü, A. D. O., Lourenção, L. G., Soares, F. G., Gomes, G. C., & Perin, L. F. (2024). Strategies used by nurses regarding underreporting of rural work accidents due to pesticide use. Revista Brasileira de Enfermagem, 77(2), e20230384. https://doi.org/10.1590/0034-7167-2023-0384

Cancino, J., Soto, K., Tapia, J., Muñoz-Quezada, M. T., Lucero, B., Contreras, C., & Moreno, J. (2023). Occupational exposure to pesticides and symptoms of depression in agricultural workers. A systematic review. Environmental Research, 231, 116190. https://doi.org/10.1016/j.envres.2023.116190

Cestonaro, L. V., Macedo, S. M. D., Piton, Y. V., Garcia, S. C., & Arbo, M. D. (2022). Toxic effects of pesticides on cellular and humoral immunity: an overview. Immunopharmacology and Immunotoxicology, 44(6), 816–831. https://doi.org/10.1080/08923973.2022.2096466

Chekol, G. M. (2025). Understanding the factors behind non-adherence to pesticide safety guidelines among smallholder farmers in Fogera and MEcha districts, northwestern Ethiopia. BMC Research Notes, 18(1), 177. https://doi.org/10.1186/s13104-025-07217-z

Costopoulou, D., Kedikoglou, K., Vafeiadi, M., Roumeliotaki, T., Margetaki, K., Stephanou, E. G., Myridakis, A., & Leondiadis, L. (2024). Systematic investigation of organochlorine pesticides and polychlorinated biphenyls blood levels in Greek children from the Rhea birth cohort suggests historical exposure to DDT and through diet to DDE. Environment International, 187, 108686. https://doi.org/10.1016/j.envint.2024.108686

Dewi, NP., Adisyah Maulidina Safi’i, Dynta Eka Anggraeni, Kurniyawan, E. H., Dicky Endrian Kurniawan, Rosyidi Muhammad Nur, K., & Tri Afandi, A. (2025). Agronursing Approaches in Supporting the Mental Health of Agricultural Workers. Health and Technology Journal (HTechJ), 3(5), 557–570. https://doi.org/10.53713/htechj.v3i5.497

El-Gameel, D., Hamdy, N. A., El-Yazbi, A. F., Ghanem, M. A., El-Khordaugi, L. K., Abdallah, S. M., Mechref, Y., & El-Yazbi, A. F. (2023). Chronic Exposure to Organophosphate Pesticides and Elevated Markers of Systemic Inflammation: Possible Neuroinflammatory and Genotoxic Effects. The Journal of Pharmacology and Experimental Therapeutics, 385, 27. https://doi.org/10.1124/jpet.122.190690

Gosavi, G. A., & Kothare, S. (2024). A Study to assess the effect of Planned Teaching on Knowledge and Practices regarding Health Hazards of Pesticides among Farmers in selected rural community, Pune. International Journal of Nursing Education and Research, 12(1), 53-56. https://doi.org/10.52711/2454-2660.2024.00012

Gurbuz, I. B. (2024). Analysis in Terms of Environmental Awareness of Farmers’ Decisions and Attitudes: Reducing Pesticide Use and Risks. Sustainability, 16(11). https://doi.org/10.3390/su16114323

Halbleib, M. L., & Dinsdale, B. (2023). Farmer-centered pesticide risk reduction education in Senegal: A novel, participatory approach. Journal of International Agricultural and Extension Education, 30(1), 7-20. https://doi.org/10.4148/2831-5960.1127

Juntarawijit, C., Chaichanawirote, U., Yaowapanon, N., & Noppakun, K. (2025). Pesticide exposure and sleep disorder: A cross-sectional study among Thai farmers. Heliyon, 11(1), e41123. https://doi.org/10.1016/j.heliyon.2024.e41123

Kangavari, M., Sarvi, M., Afshari, M., & Maleki, S. (2024). Understanding determinants related to farmers’ protective measures towards pesticide exposure: A systematic review. PLOS ONE, 19(2), e0298450. https://doi.org/10.1371/journal.pone.0298450

Keleb, A., Ademas, A., Abebe, M., Berihun, G., Desye, B., & Bezie, A. E. (2024). Knowledge of health risks, safety practices, acute pesticide poisoning, and associated factors among farmers in rural irrigation areas of northeastern Ethiopia. Frontiers in Public Health, 12, 1474487. https://doi.org/10.3389/fpubh.2024.1474487

Kumboyono, K., Chomsy, I. N., Rachmawati, S. D., Hayati, Y. S., Setiawan, M., Hakim, A. K., & Wihastuti, T. A. (2024). Analysis of monocyte chemoattractant protein-1 and interleukin-1β levels with adrenocorticotropic hormone levels in farmers: early detection of vascular inflammation due to pesticide exposure. Environmental Pollutants and Bioavailability, 36(1). https://doi.org/10.1080/26395940.2024.2391352

Kurniawan, D. E., Sulistyorini, L., Khamid, M. N., & Sarosa, I. (2022). Agronursing-Based Care Model as an Approach to Reduce Loss to Follow-Up Cases among People With HIV AIDS in Indonesia: A Perspective. Nursing and Health Sciences Journal (NHSJ), 2(4), 299–302. https://doi.org/10.53713/nhs.v2i4.200

Kurniyawan, E. H., Cahyani, P. S. R., Khoiriyah, A. A., Purnomo, F. K. A., Afandi, A. T., Kurniawan, D. E., & Nur, K. R. M. (2023). Coping Mechanisms Used by Farmers to Encounter Psychosocial Problems: Literature Review. Health and Technology Journal (HTechJ), 1(4), 445–454. https://doi.org/10.53713/htechj.v1i4.84

Lari, S., Yamagani, P., Pandiyan, A., Vanka, J., Naidu, M., Senthil Kumar, B., Jee, B., & Jonnalagadda, P. R. (2023). The impact of the use of personal protective equipment on the minimization of effects of exposure to pesticides among farm workers in India. Frontiers in Public Health, 11, 1075448. https://doi.org/10.3389/fpubh.2023.1075448

Miladinov, G. (2023). Impacts of population growth and economic development on food security in low-income and middle-income countries. Frontiers in Human Dynamics, 5, 1121662. https://doi.org/10.3389/fhumd.2023.1121662

Pumsopa, N., Jirapongsuwan, A., Kalampakorn, S., & Siri, S. (2025). The effect of strengthening nurse practitioners' competency in occupational health services for agricultural workers exposed to pesticides in primary care units, Thailand: a before-and-after study. Journal of Educational Evaluation for Health Professions, 22, 14. https://doi.org/10.3352/jeehp.2025.22.14

Putri, E. R. M., Sadewa, A. H., & Supangat (2025). Influence of chronic pesticide exposure on malondialdehyde and 8-OHdG levels among Wuluhan farmers, Jember, Indonesia: a cross-sectional study. BMC pharmacology & toxicology, 26(1), 165. https://doi.org/10.1186/s40360-025-01013-y

Ramadhani, Kanaya Nugita, Dinda Wahyu Dinanti, Kurniyawan, E. H., Kholid Rosyidi Muhammad Nur, Alfid Tri Afandi, & Endrian Kurniawan, D. (2025). The Impact of Pesticide Exposure on Farmers’ Respiratory Health: An Agronursing Perspective. Health and Technology Journal (HTechJ), 3(5), 665–675. https://doi.org/10.53713/htechj.v3i5.514

Sarma, P. (2022). Farmer behavior towards pesticide use for reduction production risk: A Theory of Planned Behavior. Cleaner and Circular Bioeconomy, 1, 100002. https://doi.org/10.1016/j.clcb.2021.100002

Setyopranoto, I., Panggabean, A. S., Dwianingsih, E. K., Setyaningrum, C. T. S., Sutarni, S., Malueka, R. G., & Rochmah, M. A. (2024). Associations between pesticide exposure with biomarkers of stroke risk factors in farmers. Journal of neurosciences in rural practice, 15(1), 130–133. https://doi.org/10.25259/JNRP_157_2023

Temesgen, A., Yenew, C., Bayeh, G. M., Ejigu, A. G., Gebeyehu, A. A., Tsega, T. D., Ahmed, A. F., Yemata, G. A., Yirdaw, G., Tsega, S. S., Anteneh, R. M., Enawgaw, A. S., Mekonen, H., Kebede, A. M., Mekonnen, B. A., Alemayehu, M. A., Azmeraw, Y., Yigzaw, Z. A., & Yeshiwas, A. G. (2025). Assessing pesticide handling practices and predictors among farm workers in Awi zonal administration using health belief model. Scientific Reports, 15(1), 33635. https://doi.org/10.1038/s41598-025-09135-3

Zheng, R., Romero-del Rey, R., Ruiz-Moreno, F., Garcia-Gonzalez, J., Requena-Mullor, M., Navarro-Mena, A. Á., López-Villén, A., & Alarcon-Rodriguez, R. (2024). Depressive symptoms and suicide attempts among farmers exposed to pesticides. Environmental Toxicology and Pharmacology, 108, 104461. https://doi.org/10.1016/j.etap.2024.104461

Zhou, W., Li, M., & Achal, V. (2025). A comprehensive review on environmental and human health impacts of chemical pesticide usage. Emerging Contaminants, 11(1), 100410. https://doi.org/10.1016/j.emcon.2024.100410

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Published

2026-02-14

How to Cite

Kurniyawan, E. H., Kurniawan, D. E., Nur, K. R. M., Afandi, A. T., Fitria, Y., Wuryaningsih, E. W., & Erlando, R. P. A. (2026). Health Impacts of Pesticide Exposure Among Farmers: A Systematic Review and Implications for Agronursing Practice. Health and Technology Journal (HTechJ), 4(1), 109–119. https://doi.org/10.53713/htechj.v4i1.593