This study provides important information about the hazards of pesticide use among farmers in Iran. Our study showed that the storage and disposal of containers is a matter of concern. In our study, 15.5% farmers buried the empty containers on the farm, 35.1% discarded them in the trash bin, 22.7% sold, and 17.5% incinerate them. Jallow et al. showed that 50% of farmers in Kuwait disposed empty containers in trash bins or did other unsafe practices such as discarding on the farm (27%), incinerating on the farm (43%), reusing (6%), and burying on the farm (25%); and only 39% reported disposing in hazardous waste collection sites19. These dangerous disposing methods can lead to significant environmental and human health problems23,24. The safest method for disposal of empty pesticide containers is disposing in hazardous waste collection sites, but these sites do not exist in most Iranian cities.

The findings of the present study regarding farmers’ sources of information on pesticide use are somewhat consistent with previous studies but also show notable differences. In the present study, 81.2% of farmers obtained information from multiple sources, with government agencies (35.1%) and pesticide suppliers (29.2%) being the primary sources. This suggests a relatively diversified approach to information-seeking among Iranian farmers. In contrast, Tsakiris et al. found that 50.5% of farmers had low or potentially low use of information sources, while the remaining 49.5% had potentially or very high use. Additionally, agricultural supply stores were the main information providers for 88.1% of farmers in their study25. Both studies highlight that farmers rely on external sources (government agencies, suppliers, or agricultural stores) rather than self-education or scientific literature. However, the present study shows a higher reliance on multiple sources (81.2%), whereas Tsakiris et al. found a more polarized distribution (nearly half of farmers had low information-seeking behavior). The dominant role of pesticide suppliers and agricultural stores aligns with the findings of Tsakiris et al., though the exact proportions differ.

Storing pesticides in living areas can greatly increase the potential for high toxic exposure, especially if it is stored in places where farmers prepare food, eat, and sleep. In Iran storerooms are often left unlocked, making them accessible to children. In our study, around 83% of farmers stored pesticides in the storeroom, while 11.3% stored them in other places, such as inside their homes. Results of Jallow et al. in Kuwait showed that 59% of the farmers used locked chemical storage units, 34% used open sheds, and 30% stored pesticides openly. However, 15% stored pesticides in inappropriate places, 8% in regular fridges, and 20% within living areas19. In a study conducted by Sankoh et al., on rice farmers of Sierra Leonean, only 27% of farmers stored pesticides in the storeroom3.

In the present study, 12.2% of the farmers were illiterate. The majority of farmers were capable of reading labels, and prepared pesticides according to proper information sources such as the pesticide seller; and stored unused residuals in a storeroom. However, reading the labels does not always guarantee a complete understanding of the information. Sankoh et al. found that only 20.6% of the farmers who were able to read, fully comprehended the instructions written on the labels3. Other studies showed, farmers who read pesticide labels demonstrated better safety practices in handling pesticides compared to those who couldn’t read the labels26, and safety had a negative correlation with illiteracy. Several other studies27,28,29,30, also confirmed a link between literacy levels and pesticide safety practices. Collectively, these studies provide substantial evidence that education and literacy significantly impact the use of PPE and safe handling of pesticides31.

A number of different types of personal protective gear (PPE)—including gloves, boots, hats, long-sleeve shirts, and chemical-resistant coveralls—is utilized in pesticide handling in an endeavor to minimize exposure through the skin. The choice of PPE depends on a number of different factors, including exposure conditions, pesticide toxicity, and preference. Gloves and boots are often considered the minimum PPE for most pesticide applications. In cases involving highly toxic pesticides, the use of more than one form of PPE is advised in an effort to minimize exposure further32. From our research, we found that a large percentage of participants reported the usage of gloves, boots, and masks, with usage ranging from 75.5% to 80%, and that older farmers showed a greater tendency to utilize PPE. Sapbamrer et al. study found that a large percentage of Thai rice farmers, ranging from 74 to 96%, utilized some form of PPE5. However, in a study by Okoffo et al. of Ghanaian cocoa farmers, a mere 35% of them utilized complete PPE when spraying pesticides, while about 20% applied pesticides with no protective clothing, and most (45%) applied only partial PPE when spraying33. These findings imply that usage of PPE varies among different populations and is perhaps subject to demographic, structural attributes of the farms, behavior and psychosocial factors, as well as physical settings31.

It is essential to follow safety instructions immediately after spraying pesticides, as well. According to our results, the majority of the farmers took a shower, and changed and washed their clothes after spraying; and only a few percent of them consumed meals, vegetables, or water around or inside the farm immediately after spraying. Interestingly, these behaviors were not found to be related to the participants’ level of education. Following safety instructions post spraying plays a crucial role in protection against pesticide exposure. In Okoffo et al. study, 55.8% and 45% of participants drank water or alcohol, or ate food during and after pesticide application33. Also, data from a study by Mubushar et al. in Pakistan reported that only 45.6% of the farmers always showered, and 54.4% did so sometimes, after pesticide application20. Raimi et al. reported that only about 70% of the farmers in their study in Nigeria wash hands with water or both water and soap after using pesticides34.

Our findings showed that symptoms found in neurological, respiratory, ocular, dermal, and gastrointestinal systems were more common among farmers compared to other symptom groups. More specifically, neurological and respiratory symptoms were notably more common, perhaps due to the extensive exposure of those organ systems during pesticide application procedures. Our findings support those of several previous studies. Lekei et al., for example, reported headaches and skin irritation as common symptoms in their study18. Likewise, Jallow et al. reported cases of itchy eyes and headaches among the farmers following exposure to pesticides19. These findings support the susceptibility of particular organ systems to the deleterious effects of pesticide exposure18,19.

Regarding PPE, the use of protective boots showed a consistently significant association with all symptoms, except for dental symptoms, after adjusting for other factors. The use of hats was also associated with less musculoskeletal symptoms, and gloves showed significant associations with digestive and eye symptoms. Coveralls and masks were found to have significant associations with eye and neurological symptoms, respectively. Also, it was found that only about 56% of the participants used PPE and 20% of the total participants reported experiencing symptoms after pesticide spraying. In the study of Memon et al. over 55% of the respondents did not use any protective equipment while picking cotton. Moreover, having up to 16 years of experience in picking was associated with using more personal protective equipment; and when their experience exceeded 16 years, there was less usage of PPE. Also, less use of PPE was associated with more skin and eye injuries, headaches, stomachaches, and fevers. But, no significant relation was found between the use of gloves and symptoms35.

This was one of the few studies that has assessed the safety behaviors of farmers in Iran, and the studies about rice farmers are even less. A study in Mazandaran Province, in northern Iran was conducted by Sharifzadeh et al. to investigate the determinants of farmers’ safety behavior when working with pesticides. In this study, only a small percentage practiced safe behaviors; 8.9% used PPE, 8.6% followed the safety rules when using pesticides, 2.7% adhered to hygienic practices after pesticide application, and 2.4% avoided health hazards. Additionally, the results of this study indicated that the farmers’ understanding of the importance of various safety measures when using pesticides was not fully reflected in their practices. But our study conducted in the neighboring province showed that rice farmers had a higher level of compliance with safety behaviors when using pesticides30. In another study conducted by Bagheri et al. on farmers in northwestern Iran, nearly 30% of farmers discarded the leftover pesticide solution used in sprayers. Regarding the washing of sprayers, 55.3% washed them in their yard, 21% in rivers or canal flows, and 14.7% in farm water sources. About 64.3% reported leaving the wash materials on the farm, while around 34.0% disposed them into rivers or canal flows. Most farmers wore pants and shirts when working with pesticides, and fewer used masks, gloves, or hats36. Whereas in our study, most respondents used gloves, boots, and masks (75.5–80%).

This study has some limitations that need to be noted. Firstly, the information gathered in this study depended on self-reporting. The researchers explained their aim to the participants and guaranteed them anonymity, yet the possibility of some respondents reporting misinformation, especially about the use of PPE to conform to socially desirable responses, exists. In addition, the reported symptoms may not be caused by pesticide exposure exclusively, since some other factors may have affected symptoms in some of the farmers. Another limitation is the fact that the farmers did not check for their clarification in relation to labels, encompassing color codes and toxicity signs. In this regard, even those participants who read the labels and supporting information might not grasp the meanings and intricacies involved in the contained information. Last, the application of findings from this study is constrained by the limited sample size. The study examined a small sample of participants, and hence, they may not be representative of the whole number of Iranian rice cultivators. Therefore, therefore, a need for prudence should be exercised in using the findings to make inferences about other agricultural populations. Our aim, however, was to examine and draw attention to important occupational health issues and pesticide safety concerns in, and among, farmers. Regardless of its limitation, this study sheds light on pesticide safety procedures among Iranian farmers and underscores the need for intervention through specifically designed educational approaches and regulations to protect the health of farmers.