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Systematic review on education of agricultural workers improving safety and health literacy

Authors: Coman MA, Marcu A, Chereches RM, Leppälä J, Van Den Broucke S.

Educational Interventions to Improve Safety and Health Literacy Among Agricultural Workers: A Systematic Review. Int. J. Environ. Res. Public Health 2020, 17, 1114. https://pubmed.ncbi.nlm.nih.gov/32050565/ (free full text)

Almost half of the world’s labor force works in agriculture, often in hazardous conditions causing numerous preventable diseases and accidents. Education has the potential to increase the level of health and safety literacy, improving the health of the farmers. A systematic literature search was conducted describing 36 studies that met preset criteria, aiming at the prevention of farm-induced diseases and injuries. Only articles written in English were included.

A clear and informative overview is given over the studies. The concept of safety and health literacy is used in a wide sense. The educational approaches represented an inspiring variety: lectures, videos, games, puppet shows, mural paintings, interactive exercises, community fairs, body awareness sessions, and many more.

The authors discuss the issue of the numerous contextual factors influencing the results in all studies that must be described carefully, but cannot be randomized. Examples of contextual factors are types of crops, different techniques, differences between farmers populations, different weather, and market prices. So, the results of the studies presented “are not generalizable and do not guarantee the success of the intervention if transferred from one context to another”.  The reader must be creative as public and occupational health is not the same as mathematics.

Interventions with the strongest results used evidence-based theories as a basis for the intervention, involved the community, included cultural aspects and individual factors such as for migrant populations and families, and scheduled more than one moment for the intervention. Only offering education as intervention has limited effect.

The authors recommend that studies should make use of a longitudinal design with a control group, and use biomarkers besides observations and self-reports in measuring behavior change. The review can inspire researchers and policy makers when designing new public and occupational health programs to improve the health and safety of farmers and their families.

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