Pesticide Exposure and Mucocutaneous Symptoms Among Thai Agricultural Workers: A Cross-Sectional Study

Abstract

Highlights: Public health relevance This study quantifies the prevalence and clinical patterns of pesticide-attributed mucocutaneous symptoms among agricultural workers in southern Thailand. It evaluates dermatology-specific quality of life using the Dermatology Life Quality Index (DLQI) to characterize the occupational burden of these symptoms. Public health significance Pesticide-attributed symptoms were reported by 14.6% for skin involvement, 5.3% for ocular involvement, and 0.4% for oral/nasal involvement; symptoms were predominantly mild and intermittent. DLQI scores were generally low overall but were significantly higher among participants reporting skin and ocular symptoms. Public health implications The findings support strengthening personal protective equipment (PPE) training, practical risk communication, and routine screening for mucocutaneous symptoms within occupational health services. These data can inform surveillance and prevention strategies aimed at reducing pesticide-related mucocutaneous morbidity in Thailand and comparable agricultural settings. Exposure to plant protection products (pesticides) is common among agricultural workers and may represent an underrecognized cause of mucocutaneous disease. We conducted a descriptive cross-sectional survey in agricultural communities in southern Thailand (August–November 2025) to estimate the prevalence, clinical characteristics, and dermatology-specific quality-of-life impact of pesticide-attributed symptoms. Agricultural workers with pesticide use or exposure within the preceding 12 months were recruited via convenience sampling; participants provided consent and completed standardized interviewer-administered questionnaires assessing demographics, pesticide exposure history and application practices, personal protective equipment (PPE) use, self-reported cutaneous and mucosal symptoms (ocular and oral/nasal), and the Dermatology Life Quality Index (DLQI). Of the 354 eligible individuals, 228 participated in the study, and 226 were included in the analyses. The median age was 54 years (interquartile range [IQR], 15), and 82.7% were male. Overall, 14.6% reported pesticide-attributed cutaneous symptoms, 5.3% reported ocular mucosal symptoms, and 0.4% reported oral/nasal mucosal symptoms. Cutaneous manifestations were predominantly symptoms occurring after exposure, with pruritic, erythematous eruptions affecting the arms and hands that typically resolved within 1–7 days after cessation of exposure. Among symptomatic participants, the median DLQI was 0.5 (IQR 3.0); however, DLQI scores were significantly higher among participants who reported pesticide-attributed cutaneous symptoms (p < 0.001) and ocular symptoms (p < 0.001). These findings suggest that pesticide-associated mucocutaneous effects are generally mild yet clinically meaningful, underscoring the need to strengthen PPE training, risk communication, and occupational health surveillance in agricultural settings.