Objective: The present study aimed to identify pesticide poisoning symptoms and related protective habits to effectively prevent pesticide poisoning among farmworkers in Kratie, Cambodia, where pesticide poisoning is an urgent public health problem. Materials and Methods: This cross-sectional study based on a questionnaire survey analyzing social demographics, number of symptoms, and protective behavior regarding pesticide application was conducted in Kratie Province from January 25 to 31, 2021. In total, 210 farmworkers completed the survey. The effects of social demographics and pesticide-protective behavioral scores on the number of symptoms were investigated using multivariable regression analysis. Results: The observed number of symptoms was 1.16 times higher among women (P=0.004), increased with the duration of work, and decreased with age. In addition, we identified five significant pesticide-protective behaviors: 1) preparing using gloves, 2) using protective equipment, 3) avoiding wiping sweat, 4) avoiding leaking, and 5) resting when feeling ill. Pesticide-protective behaviors tended to decrease with the duration of working years in the low-education group (B=-0.04, SE=0.01), whereas no association was observed in the high-education group (B=0.01, SE=0.01). Conclusion: Pesticide-protective behaviors significantly correlated with fewer symptoms. The female and aging groups required continuous special education or instructions for implementing pesticide-protective actions, especially the aforementioned five protective actions.
Pesticide-protective behaviors significantly correlated with fewer symptoms.
cross-sectional self-report and a low-reliability behavior measure leave direction and behavior-specific effects uncertain
The observed number of symptoms was 1.16 times higher among women (P=0.004), increased with the duration of work, and decreased with age.
adjusted Table 6 estimates support the associations, though cross-sectional sampling limits broader inference
Pesticide-protective behaviors tended to decrease with the duration of working years in the low-education group, whereas no association was observed in the high-education group.
a stratified cross-sectional model supports the pattern, but the underlying behavior measure has unconfirmed reliability
we identified five significant pesticide-protective behaviors: 1) preparing using gloves, 2) using protective equipment, 3) avoiding wiping sweat, 4) avoiding leaking, and 5) resting when feeling ill.
Table 6 significance is offset by low scale reliability, unmeasured confounding, and uncertain temporal direction
Derived from the full evaluation — not a separate score.
Strengths
The study documents symptom patterns and associated factors in 210 farmworkers from five rural districts of Kratie, adding evidence from an under-studied setting.
↳ Materials and Methods, Study Design and Participants; Results, Tables 1–2
The Discussion explicitly identifies convenience sampling, limited generalizability, missing pesticide-type and socioeconomic data, and the behavioral measure’s Cronbach’s alpha of 0.4519.
↳ Discussion, limitations paragraph
Table 6 presents adjusted incidence-rate ratios, standard errors, and P values for demographic variables and all nine behavioral scores, making the central analysis readily inspectable.
↳ Materials and Methods, Data Analysis; Results, Table 6
Limitations
The reported Cronbach’s alpha of 0.4519 means the reliability of the pesticide-protective behavior measure was not confirmed, materially weakening confidence in the five specific behaviors highlighted.
↳ Discussion, limitations paragraph
Behaviors and symptoms were measured concurrently, yet the Discussion describes behaviors as effective in reducing pesticide effects and as significantly suppressing symptoms. Temporal direction and reverse causation remain unresolved.
↳ Materials and Methods, Procedure and Outcomes; Discussion, paragraph 3
The adjusted model lacks pesticide type, exposure intensity, economic conditions, and baseline health information, limiting interpretation of the behavior–symptom associations.
↳ Materials and Methods, Data Analysis; Discussion, limitations paragraph
The paper makes a useful geographic extension by documenting symptoms and behavioral correlates among farmworkers in Kratie. Its descriptive reporting and adjusted estimates are clear, and the Discussion candidly lists several important limitations. The central behavior–symptom inference is nevertheless substantially constrained by concurrent self-report, unmeasured exposure and health factors, convenience sampling, and the behavior measure’s Cronbach’s alpha of 0.4519. Describing the behaviors as effective and symptom-suppressing therefore goes beyond what the cross-sectional design establishes.
Nabu’s assessment, alongside the field’s view.
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Limited2.6
Confidence mediumThe study adds localized evidence on pesticide-related symptoms and behavioral correlates among 210 farmworkers in an under-studied Cambodian province. The advance is incremental because the demographic and behavioral patterns largely extend prior regional findings rather than resolve a major uncertainty.
“These findings are consistent with those of a previous study in Southeast Asia”
The cross-sectional questionnaire and adjusted Poisson model support descriptive associations, but concurrent self-report, major unmeasured exposure and health factors, convenience sampling, and low scale reliability substantially constrain behavior–symptom inference. Causal wording in the Discussion further exceeds the design’s temporal and confounding control.
“five of the nine behaviors... significantly suppressed the number of pesticide poisoning symptoms”
The paper follows a clear progression from objectives and measures to regression results and limitations. Precision is reduced when the Discussion describes cross-sectional associations as behaviors that were effective in reducing effects and suppressing symptoms.
“preventive behaviors that were effective in reducing the health effects of pesticides”
The paper compares its findings with prior Southeast Asian and Chinese work and provides six specific limitations. The low Cronbach’s alpha is disclosed but not carried through to the certainty of the five behavior-specific conclusions and education recommendations.
“the reliability of pesticide-protective behavior was not confirmed”
Caveats4 of 4 checks
The paper contains a survey-date inconsistency and reports low internal consistency for the protective-behavior measure. These issues require caution but do not indicate fabrication or invalidate the descriptive symptom findings.
Ethics approval, informed consent, funding, and the funder’s stated non-involvement are declared. No text-grounded research-conduct concern was identified.
Flags: 2 declared / 5 total
1 of 1 checkable references verified
16 references in manuscript 2 are books, websites or datasets — counted, but not index-checkable 13 could not be checked — not the same as no match found
References not verified automatically are resolved manually within 24 hours.
No retraction or expression of concern found in Crossref (includes Retraction Watch).
Sources: Crossref (incl. Retraction Watch) ✓
Where this paper’s evidence sits on the path from initial observation to real-world use.
The work remains an observational field survey and does not evaluate an education program, protective intervention, or operational implementation process. Substantial further testing is required before the recommendations become actionable.
“further research is required to investigate objective health effects and self-reported symptoms”
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