Self-reported respiratory health outcomes and pesticide exposure among male date farmers in Riyadh and Al-Qassim, Saudi Arabia: a cross-sectional mixed methods study

Respiratory diseases are a significant occupational health issue for agricultural workers, especially those exposed to high levels of pesticides in date palm farming; a culturally and socially important crop in Saudi Arabia. This study aims to estimate the prevalence of physician-attended respiratory conditions, examine the relationship between farmers’ demographics, pesticides use, and safety measures practiced among date farmers in Riyadh and Al-Qassim regions. Additionally, elicit farmers’ needs to minimize the effect of using pesticides on their health. Sixty-five male date farmers from Riyadh and Al-Qassim participated in a cross-sectional survey with a mixed methods design. Data were collected via one-line self-administered validated questionnaire covering demographics, pesticide use, safety practices, and respiratory health hazards. Statistical analyses identified significant associations between pesticide exposure and respiratory outcomes, while descriptive content analysis of the open-ended responses provided further insight into the quantitative findings. Breathing difficulties while handling pesticides were reported by 33.85% of participants, and 30.77% reported respiratory symptoms or dizziness during or after spraying; 13.85% reported doctor visits for serious respiratory issues. Physician-attended respiratory conditions were significantly associated with pesticide type ( p = 0.040) and experiencing respiratory symptoms when using pesticides ( p < 0.001). Quantitative data complimented the qualitative information, as the descriptive content analysis revealed existing knowledge gaps, inadequate training, and insufficient precautions. This study provides an assessment of occupational health experience from a group of farmers. The results indicate a strong link between pesticide exposure and physician-attended respiratory conditions among farmers, revealing significant gaps in occupational safety training and health protections. This underscores the urgent need for policy interventions to protect the occupational health of agricultural workers in Saudi Arabia.