Integrated Agronursing Strategies to Mitigate Occupational Hazards among Global Agricultural Workers
DOI:
https://doi.org/10.53713/htechj.v4i3.724Keywords:
Agronursing, Occupational Health and Safety, Agricultural Workers, Pesticide Exposure, Heat StressAbstract
Agricultural occupational hazards pose escalating threats to farming populations globally, yet fragmented evidence limits cohesive clinical and policy responses. This systematic review synthesizes contemporary research to inform an integrated agronursing framework addressing occupational health and safety among farmers. Following PRISMA 2020 guidelines, we searched Scopus, PubMed, and ProQuest for English-language, open-access studies published between 2022 and 2026. Ten studies spanning eight countries underwent a Joanna Briggs Institute critical appraisal and narrative synthesis due to methodological heterogeneity. Results indicate strong positive correlations between hazard knowledge and safety behaviors, though high-risk practices persist, including pesticide overconcentration (74.6%) and inconsistent use of personal protective equipment. Panel regression analysis revealed a monotonic escalation in severe agricultural trauma above 20°C, increasing 123% beyond 30°C. Multicomponent educational interventions demonstrated significant short-term improvements in sun safety knowledge and protective behaviors. At the same time, qualitative evidence highlighted structural determinants, piece-rate compensation, infrastructure deficits, and cultural norms that independently mediate risk exposure. Media analyses further revealed tendencies to individualize injury responsibility, obscuring upstream regulatory drivers. These findings confirm that knowledge acquisition alone cannot sustain behavioral change without concurrent environmental and policy-level interventions. Consequently, agronursing practice must evolve from episodic clinical care toward proactive, ecologically grounded models integrating standardized psychosocial screening, climate-responsive surveillance, and advocacy for equitable safety protocols. This framework equips rural health systems with evidence-based strategies to implement contextually tailored interventions, ultimately safeguarding farmer wellbeing and strengthening global agricultural resilience.
References
Aslam, S., Hussain, B., Riaz, S., Yousaf, M., Sohail, B., Ullah, F., & Hussain, S. (2025). 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
Castrillon, C. M., Peachey, K. L., Harrison, L., Franklin, R., Lyle, D., & Lower, T. (2026). Leading indicators for farmers’ work health and safety in Western agricultural systems: A systematic review. Journal of Agromedicine, 31(1), 129–138. https://doi.org/10.1080/1059924X.2025.2580501
Cho, S. (2026). Heat and harm: The effect of temperature on severe agricultural trauma in South Korea. Safety and Health at Work, 17(1), 91–98. https://doi.org/10.1016/j.shaw.2025.12.007
Comi, M., Becot, F., & Bendixsen, C. (2022). Automation, climate change, and the future of farm work: Cross-disciplinary lessons for studying dynamic changes in agricultural health and safety. International Journal of Environmental Research and Public Health, 20(6), 4778. https://doi.org/10.3390/ijerph20064778
Derringer, J. C., & Biddle, M. J. (2022). Potential directions for farm stress research: A systematic review of educational interventions to reduce psychosocial stress among farm and rural populations. The Journal of Rural Health, 38(3), 554–573. https://doi.org/10.1111/jrh.12633
Drerup, E. A., Kilanowski, J. F., Jepsen, S. D., Brinkman, P., & Duffy, S. (2022). Health behavior resources available to farmers in rural Ohio. Journal of Agromedicine, 27(1), 7–14. https://doi.org/10.1080/1059924X.2021.1893882
Eggert, E., Gunga, H., Sié, A., Ouermi, L., Ouédraogo, W. A., Kwaro, D., Sauerborn, R., Bunker, A., Barteit, S., Bärnighausen, T., & Maggioni, M. A. (2025). Physical effort during labour and behavioural adaptations in response to heat stress among subsistence farmers in Burkina Faso: A gender-specific longitudinal observational study. The Lancet Planetary Health, 9(12), 101344. https://doi.org/10.1016/j.lanplh.2025.101344
Ekmekci, M., & Yaman, S. (2024). Occupational health and safety among farmers: A comprehensive study in Central Anatolia, Turkey. BMC Public Health, 24(1), 2732. https://doi.org/10.1186/s12889-024-20249-7
El Khayat, M., Halwani, D. A., Hneiny, L., Alameddine, I., Haidar, M. A., & Habib, R. R. (2022). Impacts of climate change and heat stress on farmworkers' health: A scoping review. Frontiers in Public Health, 10, 782811. https://doi.org/10.3389/fpubh.2022.782811
El-Shafei, D. A., & Said, R. M. (2023). Sun safety: Knowledge and behavior among Egyptian farmers—A multicomponent intervention study. Journal of Cancer Education, 38(3), 1042–1049. https://doi.org/10.1007/s13187-022-02230-3
Elliott, K. C., Lincoln, J. M., Flynn, M. A., Levin, J. L., Smidt, M., Dzugan, J., & Ramos, A. K. (2022). Working hours, sleep, and fatigue in the agriculture, forestry, and fishing sector: A scoping review. American Journal of Industrial Medicine, 65(11), 898–912. https://doi.org/10.1002/ajim.23418
Fazel, S. S., Fenton, S., Braun, N., Forsman-Phillips, L., Linn Holness, D., Kalia, S., Arrandale, V. H., Tenkate, T., & Peters, C. E. (2023). Tailored sun safety messages for outdoor workers. Safety and Health at Work, 14(1), 43–49. https://doi.org/10.1016/j.shaw.2023.01.001
Florez-Acevedo, S., Blancas, M. T., & Spector, J. T. (2025). Occupational heat exposure and mental health outcomes: A review and framework incorporating social determinants of health to guide future research. Current Environmental Health Reports, 12(1), 15. https://doi.org/10.1007/s40572-025-00479-6
Fortabong, A. A., Kloot, K., Reedy, N., Peck, B., & Terry, D. (2025). Rural nursing workforce sustainability in Australia: A scoping review of global retention strategies. Australian Journal of Rural Health, 33(4), e70079. https://doi.org/10.1111/ajr.70079
Garner, I., McFeeters, D., Guy, A., Hopley, R., & Galbraith, N. (2025). Understanding farmer mental health and wellbeing in a volatile, isolating, and misunderstood industry. Journal of Rural Studies, 118, 103648. https://doi.org/10.1016/j.jrurstud.2025.103648
Gunn, K. M., Skaczkowski, G., Dollman, J., Vincent, A. D., Short, C. E., Brumby, S., ... Turnbull, D. (2022). Combining farmers’ preferences with evidence-based strategies to prevent and lower farmers’ distress: Co-design and acceptability testing of iFarmWell. JMIR Human Factors, 9(1), e27631. https://doi.org/10.2196/27631
Hayden, M. A., Barim, M. S., Weaver, D. L., Elliott, K. C., Flynn, M. A., & Lincoln, J. M. (2022). Occupational safety and health with technological developments in livestock farms: A literature review. International Journal of Environmental Research and Public Health, 19(24), 16440. https://doi.org/10.3390/ijerph192416440
Kurniyawan, E. H., Afandi, A. T., Nur, K. R. M., Kurniawan, D. E., Aung, S., & Mukhtar, M. (2026). Health impacts of climate change on farmers in agricultural communities. Health and Technology Journal, 4(2), 231–244. https://doi.org/10.53713/htechj.v4i2.665
Li, S., Spector, J. T., Choi, S. D., Zhao, M., Scott, E., Germain, C. M., & Zhang, K. (2025). Health, safety, and aging in elderly farmers in the United States and beyond: A systematic scoping review. Journal of Agromedicine, 30(4), 812–832. https://doi.org/10.1080/1059924X.2025.2539127
Maniago, J., Ngaya-an, F., Olivar, J. J., Tungcul, L., & Turingan, O. (2026). Toward the integration of agro-nursing in Philippine public health systems: A policy analysis. Journal of Rural Community Nursing Practice, 4(1), 22–43. https://doi.org/10.58545/jrcnp.v4i1.670
Milkovich, P. J., Perez-Sanz, S., Garcia, K., Mejia, P., Johnson, A., & Sorensen, J. A. (2025). Media advocacy for farm safety and health: Current landscape and future directions. BMC Public Health, 25(1), 970. https://doi.org/10.1186/s12889-025-22162-z
Najafi, E., Khanjani, N., Parastar, S., Azizi Shalke, B., Fathzadeh, Y., Nazari, S., Asgari, E., & Najafi Saleh, H. (2025). Assessment of pesticide handling and use practices and associated health and safety concerns among rice farmers in Northern Iran. Scientific Reports, 15(1), 25303. https://doi.org/10.1038/s41598-025-09624-5
Norvivor, F. A., Peprah, E. K., Danso, D., & Konutse, O. W. (2025). Occupational pesticide exposure and safety assessment among farmers in Hohoe municipality: An ethnographic qualitative study. PLOS ONE, 20(12), e0337693. https://doi.org/10.1371/journal.pone.0337693
Parasram, B., & Choudhury, A. (2025). Occupational safety and health risks of farmers: A qualitative study in Guyana. WORK. https://doi.org/10.1177/10519815251358253
Pooladvand, S., & Hasanzadeh, S. (2023). Impacts of stress on workers’ risk-taking behaviors: Cognitive tunneling and impaired selective attention. Journal of Construction Engineering and Management, 149(8), 04023060. https://doi.org/10.1061/JCEMD4.COENG-13339
Rudolphi, J. M., Issa, S., Cuthbertson, C., & Barnett, K. (2025). Stress, health, and injury among Illinois farmers. American Journal of Industrial Medicine, 68(9), 761. https://doi.org/10.1002/ajim.70000
Sexsmith, K., Palacios, E. E., Gorgo-Gourovitch, M., & Huerta Arredondo, I. A. (2022). Latino/a farmworkers’ concerns about safety and health in the Pennsylvania mushroom industry. Journal of Agromedicine, 27(2), 169–182. https://doi.org/10.1080/1059924X.2021.1935374
Shaban, M., Amer, F. G. M., & Shaban, M. M. (2024). The impact of nursing sustainable prevention program on heat strain among agricultural elderly workers in the context of climate change. Geriatric Nursing, 58, 215–224. https://doi.org/10.1016/j.gerinurse.2024.05.021
Shah, J., & Alharthi, M. (2024). Risk sources in agriculture and farmers’ behavior in risky prospects: A systematic review. Management & Sustainability: An Arab Review, 3(2), 169–196.
Sookhtanlou, M., Allahyari, M. S., & Surujlal, J. (2022). Health risk of potato farmers exposed to overuse of chemical pesticides in Iran. Safety and Health at Work, 13(1), 23–31. https://doi.org/10.1016/j.shaw.2021.09.004
Stufano, A., Plantone, D., Ravallese, R., Sacino, G., Ravallese, R., Schino, V., Manco, C., Righi, D., Lucchese, G., De Stefano, N., & Lovreglio, P. (2025). Heat stress and neurological biomarkers in outdoor workers: A cross-sectional observational study. Environmental Research, 288, 123273. https://doi.org/10.1016/j.envres.2025.123273
Susanto, T., & Berdida, D. J. E. (2025). Roles of agro-nursing in bringing health services in rural and remote areas of Indonesia. Jurnal Keperawatan Padjadjaran, 13(1), 1–6. https://doi.org/10.24198/jkp.v13i1.2784
Tomar, P., & Rao, N. V. (2025). Climate health competencies for the health workforce in low-middle income countries: A scoping review. VeriXiv, 2, 342. https://doi.org/10.12688/verixiv.2055.1
Werner, L., Carrion, D., & Huguet, N. (2025). Risk for renal injury from heat-related stress among outdoor workers and the imperative for climate-responsive health policies. The Journal of Climate Change and Health, 26, 100600. https://doi.org/10.1016/j.joclim.2025.100600
Wongta, A., Sawarng, N., Tongchai, P., Yana, P., & Hongsibsong, S. (2024). Agricultural health and safety: Evaluating farmers’ knowledge, attitude, and safety behavior in Northern Thailand. Safety and Health at Work, 15(4), 435–440. https://doi.org/10.1016/j.shaw.2024.09.005
Zhang, M., & Kim, R. (2025). Occupational health in agriculture: A re-emerging frontier in worker protection. Global Health Journal, 9(2), 65–71. https://doi.org/10.1016/j.glohj.2025.06.001












