Knowledge-practice gap in pesticide safety among male farmers in Greece

In this cross-sectional study, 252 male farmers from Northern and Central Greece were recruited through convenience sampling between February 2022 and March 2023. Pesticide-safety knowledge and self-reported practices were assessed through structured interviews, and associated factors were examined using correlation and multivariable regression analyses. Knowledge was very high (mean = 9.77/10; 88.5% answered all items correctly), yet unsafe practices remained common (mean score = 2.02/5; Cronbach's α = 0.85). Greater knowledge was associated with safer practices (Spearman's ρ =  -0.23, p < 0.001). In multivariable analysis, higher education, greater knowledge, and current organic farming were associated with safer practices, whereas high cumulative pesticide exposure, larger farm area, and household pesticide use were associated with less safe practices. In sensitivity analyses, each additional protective measure was associated with a lower non-personal protective equipment (non-PPE) unsafe-practice score (adjusted β =  -0.20, p < 0.001), while higher non-PPE unsafe-practice scores were associated with greater odds of reporting a previous high pesticide exposure event (adjusted odds ratio (OR) = 2.30, 95% CI = 1.43-3.72). These findings highlight a substantial gap between pesticide-safety knowledge and self-reported safety practices.