Pesticides play an important role in agricultural development. However, pesticide application can result in both acute and chronic human toxicities, and the adverse effects of pesticides on the environment and human health remain a serious problem. There is therefore a need to discuss the application methods for pesticides, the routes of pesticide exposure, and the health risks posed by pesticide application. The health problems related to pesticide application and exposure in developing countries are of particular concern. The purpose of this paper is to provide scientific information for policymakers in order to allow the development of proper pesticide application technics and methods to minimize pesticide exposure and the adverse health effects on both applicators and communities. Studies indicate that there are four main pesticide application methods, including hydraulic spraying, backpack spraying, basal trunk spraying, and aerial spraying. Pesticide application methods are mainly selected by considering the habits of target pests, the characteristics of target sites, and the properties of pesticides. Humans are directly exposed to pesticides in occupational, agricultural, and household activities and are indirectly exposed to pesticides via environmental media, including air, water, soil, and food. Human exposure to pesticides occurs mainly through dermal, oral, and respiratory routes. People who are directly and/or indirectly exposed to pesticides may contract acute toxicity effects and chronic diseases. Although no segment of the general population is completely protected against exposure to pesticides and their potentially serious health effects, a disproportionate burden is shouldered by people in developing countries. Both deterministic and probabilistic human health risk assessments have their advantages and disadvantages and both types of methods should be comprehensively implemented in research on exposure and human health risk assessment. Equipment for appropriate pesticide application is important for application efficiency to minimize the loss of spray solution as well as reduce pesticide residuals in the environment and adverse human health effects due to over-spraying and residues. Policymakers should implement various useful measures, such as integrated pest management (IPM) laws that prohibit the use of pesticides with high risks and the development of a national implementation plan (NIP) to reduce the adverse effects of pesticides on the environment and on human health.

Studies evaluating dermal exposure to pesticides among applicators in tropical countries have largely been conducted using the patch dosimetry and hand wiping/washing techniques. This study used the more accurate whole-body dosimetry technique to evaluate dermal exposure to chlorpyrifos among applicators on rice farms in Ghana. The exposure levels were plotted as Cumulative Probability Distribution (CPD). Total Dermal Exposure (TDE) of chlorpyrifos among the median exposed and the 5% highly exposed groups during a spray event were 24 mg and 48 mg, respectively. When these were converted as a percentage of the quantity of active ingredient applied (Unit Exposure, UE), UE values of 0.03% and 0.06% were found among the median exposed and the 5% highly exposed groups, respectively. Overall, the hands were the most contaminated anatomical regions of the applicators, both in terms of proportion of TDE (39%) and skin loading (13 μg/cm). Also, the lower anatomical region was more contaminated (82% of TDE) compared to the upper anatomical region (18% of TDE). The levels of chlorpyrifos TDE among the applicators were found to be influenced by the quantity of insecticide applied and the height of the crops sprayed (p < 0.05). The pesticide UE data of the present study can be used to estimate the levels of dermal exposure under similar pesticide use scenarios among applicators. The findings of the present study suggest that protecting the hands and the lower anatomical regions with appropriate PPE may significantly reduce exposure among applicators.

Generally, there is limited information on pesticide absorbed dose levels and health risk attributable to the dermal route of exposure among applicators. The objective of this study was to evaluate the absorbed dose levels and consequent health risk from dermal exposure to chlorpyrifos among applicators on rice farms in Ghana. The whole-body dosimetry technique was used to capture chlorpyrifos residues penetrating the applicators' clothing and reaching their skin, as well as residues reaching uncovered body areas of the applicators. Acute (ADD) and chronic (LADD) absorbed dose levels of chlorpyrifos were estimated from the residues and plotted as cumulative probability distributions. Health risk from chlorpyrifos exposure was characterized using the Hazard Quotient (HQ) technique. Three of the four acute exposure guideline values used in the study indicated that applicators, represented by the median-exposed (ADD, 15 μg/kg/day) and the 5% - highly exposed (ADD, 27 μg/kg/day) groups were at high risk of acute adverse health effects due to chlorpyrifos exposure, with HQ values ranging from 1.5 to 5 and 2.7 to 9, respectively. Regarding chronic adverse health effects, none of the guideline values suggested risk among the median-exposed group (LADD, 0.3 μg/kg/day), with HQ values ranging from 0.03 to 1. However, two of the chronic exposure guideline values suggested that the 5%- highly exposed group (LADD, 0.6 μg/kg/day) may be adversely affected, with HQ values ranging from 1.2 to 2. These findings highlight the importance of the dermal route as a major pesticide exposure pathway and suggest possible exposure minimization strategies.

Chlorpyrifos is a neurotoxic insecticide that is widely used in the agricultural sector of Ghana. The main objective of this study was to evaluate the levels of chlorpyrifos exposure and health risk among applicators (n = 21) on irrigated rice farms in Ghana, based on a typical application event. Pre- and post-application urine samples (24-h) were collected from the applicators and analysed for 3,5,6-trichloro-2-pyridinol (TCP), using LC-MS/MS. The levels of chlorpyrifos-absorbed dose with the applicators were estimated from the urinary TCP levels. Prior to application, the median absorbed dose of chlorpyrifos (background exposure) with the applicators was 0.2 μg/kg/day (range 0.05 to 2 μg/kg/day). Following application, the median absorbed dose of chlorpyrifos (application exposure) increased 30-fold to 6 μg/kg/day (range 0.7 to 74 μg/kg/day). The mean elimination half-life (t) of chlorpyrifos was calculated to be 50 h. Hazard quotient (HQ) values (HQ > 1) obtained with the chronic (10 μg/kg/day) and acute (100 μg/kg/day) guideline values of the WHO suggested no risk of chronic or acute health effects, respectively, among both the median and 5% highly exposed groups. However, HQ values (HQ > 1) obtained with the chronic (0.3 μg/kg/day) and acute (5 μg/kg/day) guideline values of the USEPA suggested risk of chronic and acute health effects, respectively, among both the median and 5% highly exposed groups. The quantity of chlorpyrifos formulation applied, spraying duration, and the number of spray tanks applied significantly correlated with the absorbed dose levels of chlorpyrifos from application exposure. Therefore, these factors suggest means to reduce exposure and consequent health risk among the applicators.

Background: Maternal mortality is unacceptably high in Ghana. This situation is attributed partly to non-availability of healthcare services and poor utilization of these services when they are available. More deliveries are still performed at home, and in many cases, without the supervision of trained attendants, despite the Ghana Government's fee exemption policy on maternal deliveries. The purpose of this study was to identify factors that predict home delivery among mothers. Materials and Methods: An unmatched case control study was conducted among mothers in the Bosomtwe-Atwima-Kwanwoma district of Ghana. A total of 114 mothers consisting of 54 cases and 60 controls participated in the study. A multi-stage sampling technique was used to select participants of the study. Data were collected using pre-tested questionnaires and analyzed using EPIINFO (3.3) and STATA (8.2) statistical software. Results: Mothers aged 31 years and above (AOR 3.00, 95% CI: 1.16-7.74) and those with primary or no formal education (AOR 3.88, 95% CI: 1.60-9.46) were more likely to deliver at home. Also, the risk of home delivery for mothers with more antenatal care (ANC) clinic visits was less by 0.3 (30%) (AOR 0.70, 95% CI: 0.53-0.88). Conclusion:The factors infl uencing home delivery among mothers were maternal ages of 31 years and above, primary or no formal education, and less than four ANC visits. Interventions aimed at improving female education, increasing the number of ANC visits, and providing counselling, follow-up, and support to older pregnant mothers are recommended to increase the number of women who deliver in healthcare facilities.