HOUSEHOLD BIOCIDE USE AND PERSONAL SAFETY PRACTICES AMONG RURAL POPULATION IN SOUTH INDIA: A COMMUNITY-BASED STUDY/ UZYWANIE BIOCYDOW W GOSPODARSTWIE DOMOWYM I SPOSOBY ZABEZPIECZANIA SIE PRZED NIMI WSROD LUDNOSCI WIEJSKIEJ W POLUDNIOWYCH INDIACH-STUDIUM SPOLECZNOSCI LOKALNEJ.
Vector-borne diseases account for 17% of the estimated global burden of infectious diseases . Vector control is an important strategy used in the control of vectorborne diseases, and chemical control is the most widely used approach in the community . In India, household biocides are used as insecticides, fungicides and rodenticides, out of which insecticides are the most frequently used . Acute exposure to the household biocides causes various health hazards for human beings ranging from allergic asthmatic reactions  to gastrointestinal and neurological symptoms  and accidental or incidental poisoning . Chronic exposure may lead to neurological symptoms, changes in memory and attention status . Chronic exposure may also lead to cancers like brain tumors , acute leukemia  and non-Hodgkin's lymphoma [10-12].
The studies on household biocide use in India are limited. A study done in rural Tamil Nadu among 144 households reported that the prevalence of household biocide is as high as 96.5% . Studying biocide-handling practices in the community will help in educating people regarding safe handling practices. In this study, we aimed at determining the prevalence of the biocide use in households and assessing personal protection measures, post handling practices and storage methods in a rural area of South India.
MATERIAL AND METHODS
A community-based cross-sectional study was carried out in 2 villages in Union Territory of Puducherry in June 2014. Puducherry, formerly known as Pondicherry, is located in the southern part of India with 4 small unconnected districts: Pondicherry, Karaikal and Yanam on the coasts of Bay of Bengal, and Mahe on the coast of Arabian Sea. For our study, 2 villages namely Thondamanatham and Thuthipet were selected randomly out of the 4 villages under the Rural Health Centre of a teaching hospital in Pondicherry district. The population of Thondamanatham is about 4000 and Thuthipet is approx. 1000. A substantial proportion of working population is represented by daily wagers in small factories. The literacy rate of Thondamanatham is 82% and that of Thuthipet is 84% .
Considering 50% of households are expected to be using biocides (p), with 5% absolute precision (d) and a error of 5%, the required sample size was 400. All houses in the selected 2 villages were visited, and personal interviews were conducted with adults above 18 years of age. Information on the socio-demographic profile, pests present in the houses, biocides used, frequency of biocide use, personal protection measures and practices after handling biocides, storage method of biocides was collected during personal interviews using pretested interview schedule. The study was conducted in the month of June 2014.
Operational definition of few products, which contain biocides, is as follows: Mat vaporizers are electric vaporizer systems in which the heating device is available as a plug-in version to be placed somewhere in the room. Liquid vaporizers consist of a heating and a refill in the form of a bottle containing biocide solution. Chalk includes biocides in the form of normal looking chalks. Education of the participants is categorized according to years of schooling as illiterate (no formal education), primary (1-5 years), secondary (6-8 years), high school (9-10 years), higher secondary (11-12 years), and graduate and above.
The procedures followed in this study were in accordance with the ethical standards of the Helsinki Declaration of 1975, as revised in 1983. Informed consent was obtained from the participants before interviewing. Anonymity is maintained regarding the identity of the participants.
Data was single-entered in EpiData Entry (version 3.1, EpiData Association, Denmark) and analyzed in Statistical Package for the Social Sciences (SPSS) (version 16, SPSS Inc., USA). Categorical variables like gender, education, a type of a house, biocide usage and related handling practices are summarized as proportions.
A total of 416 households were interviewed. Mean (M) age of respondents [+ or -] standard deviation (SD) was 38 [+ or -] 16 years old. The majority (72%) of respondents were females and were housewives. About 75% of the respondents had at least primary education. The majority of the household heads were males (91%) and 75.5% had at least primary education. In the majority of the houses (73.6%), the head of the household was a non-agricultural daily wager and driver (truck or bus drivers). On average, each household had 4 family members. Respondents reported presence of different kinds of pests in households like mosquitoes, cockroaches, ants, rats, lizards and spiders. Out of the total households, 96% of them had at least 1 pest, with an average of 3 pests in a household.
The majority of the households (85.8%) reported the presence of at least 1 biocide at the time of the interview, with an average of 2 biocides per a household. The usage and safety practices related to biocides are described in the Table 1. The mosquito liquidizer was the most commonly used biocide (45%) followed by the mosquito coil (31%), ant powder (30%) and ant chalk (20%). The majority of the biocides were kept 4 feet (122 cm) above the ground. Except naphthalene and mosquito mat, the other biocides were not kept in the cupboard in the majority of the houses.
Information on persons handling the biocides, storage practices and post handling practices are described in the Table 2. Biocides like the cockroach spray, cock roach chalk, rat cake and rat powder were handled only by adults. Whereas in some of the households, children were handling biocides like the mosquito coil (4%), liquidizer (4.4%), mat (14.3%), ant chalk (2.4%) and ant powder (0.8%), apart from adults. Personal protective measures like an apron, masks or gloves were practised mainly while handling the cockroach spray (40%). They were not used when handling biocides like the mosquito coil, mosquito mat, and ant chalk and rat powder.
Post-handling practice like hand washing was practiced in all households after using the rat cake and rat powder. However, hand washing is not always practised while handling the mosquito coil (77%), liquidizer (68%) and mat (87.5%). Mosquito repellants (the mat, coil, liquidizer) and naphthalene balls were predominantly stored in the living room. Whereas the ant powder, ant chalk, rat powder, rat chalk, cockroach chalk and spray were stored in the living room as well as in the kitchen and storeroom.
In the majority of the households, no personal protective measures like gloves/apron or masks were used while using biocides. In all households (100%), personal protection measures were not used while handling the mosquito coil, mat, ant chalk and rat powder. Clothes were used as face masks by 7 out of 20 participants handling the cockroach spray. Gloves were used by around 5% of participants handling the liquidizer, naphthalene balls, ant powder, rat cake and cockroach chalk.
The frequency of biocide use in households is shown in the Table 3. Naphthalene balls for the cockroach were mostly used on weekly basis whereas mosquito coils and liquidators were mostly used on a daily basis.
The prevalence of household biocides use is high in the study setting and this finding is similar to another study from India . Mosquito repellents are the most com monly used household biocides, out of which the liquid vaporizer is most commonly used and is followed by the mosquito coil. But studies done in urban  and rural  areas of Chennai show that coils are the most commonly used mosquito control measure. The possible reasons for the preference for the liquidizer rather than the coil in this study setting may be due to the perceived adverse effects in using the mosquito coil and the advancement in safety practices with time. The ant powder is the third most commonly used household biocide. Though the prevalence of naphthalene balls is less compared to other studies, their use is dangerous as it is a probable carcinogenic agent . Moreover, naphthalene balls were mostly stored in living rooms, which is an unsafe practice.
Personal protective measures like wearing a cloth mask were used only when handling the cockroach spray. They were not used when handling other biocides. This finding is similar to a study by Rushton et al. in the United Kingdom .
Our study shows that children are handling biocides like the mosquito coil and liquidizer, that contain harmful chemicals like pyrethroids. Menegaux et al.  concludes that pyrethroid-based insecticidal shampoo use is associated with the increased risk of acute childhood leukaemia and Ma et al.  discusses the potential etiologic role of household biocidal exposures in childhood leukaemia in California. However, children are not handling biocides like the ant powder and rat powder. The majority of the households follow hand-washing practice after handling repellents for the cockroach, rat and ant. But, in 1/3 of the houses, hand-washing practice is not followed when handling the mosquito liquid vaporizer and coils.
Mosquito coils, mats and liquidizers are mostly stored in living rooms. The World Health Organization recommends the storage of biocides in rooms other than living rooms . In 1/3 of the households, the ant chalk, ant powder and rat repellents were mostly stored in the kitchen. In the majority of the houses, biocides were not placed in cupboards and cupboards were also not locked. In 25% of the houses, the biocides were kept at less than 4 feet (122 cm) height, which is accessible to children and may lead to accidental or incidental poi soning in the case children [6,18]. This study shows that people in this rural area are not following safe handling practices.
In India, the National Vector Borne Disease Control Programme (NVBDCP) under the Ministry of Health and Family Welfare has developed guidelines for the usage and storage of pesticides as the indoor residual spray and insecticide-treated mosquito nets . But guidelines regarding the household usage and storage of biocides like the mosquito coils, mat and liquidizer, and ant chalk are lacking and have to be framed. The study was conducted in a small geographical area; hence generalizability of the study findings may be limited. The biocide handling practices are collected through self-reporting, which may have introduced desirability bias while reporting safety practices.
The use of household biocides was high in this study area. Storage, handling and post handling practices were not optimal. Health education sessions to improve the awareness regarding safe handling of biocides are recommended in this rural area.
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Karthik Balajee Laksham
Perumal Murthy Sambath
Manoj Kumar Arunachalam
Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India Department of Preventive and Social Medicine
Corresponding author / Autor do korespondencji: Palanivel Chinnakali, Jawaharlal Institute of Postgraduate Medical Education and Research, Department of Preventive and Social Medicine, Dhanvantri Nagar, 605006 Puducherry, India, e-mail: email@example.com
Received: August 26, 2015, accepted: July 5, 2016
Table 1. Household biocide usage and safety storage practices among rural households (N = 416) in Puducherry, South India Tabela 1. Uzywanie biocydow i bezpieczenstwo ich przechowywania w wiejskich gospodarstwach domowych (N = 416) w Puducherry w Biocide storage Przechowywanie biocydu [n(%)] Biocide Biocide usage cupboard Biocyd Stosowanie szafka biocydu [n (%)] total under lock (under lock and zamykana na without lock) klucz ogolem (zamykana na klucz i niezamykana) Against mosquitos / Przeciw komarom coil /spirala 129 (31.0) 61 (47.2) 11 (18.0) liquidizer / 189 (45.4) 65 (34.3) 9 (13.8) elektrofumigator z plynem mat / 8 (1.9) 7 (87.5) 2 (28.5) elektrofumigator z wkladkami Against cockroaches /Przeciw karaluchom naphthalene / 31 (7.5) 25 (80.6) 6 (24.0) naftalen 20 (4.8) 15 (75.0) 4 (26.6) spray / spray 35 (8.4) 23 (65.7) 6 (26.0) chalk / kreda Against ants / Przeciw mrowkom powder / proszek 126 (30.3) 62 (49.2) 12 (19.3) chalk / kreda 85 (20.4) 58 (68.2) 7 (12.0) Against rats / Przeciw szczurom cake / kostka 35 (8.4) 18 (51.4) 5 (27.7) powder / proszek 3 (0.7) 1 (33.3) 0 (0.0) Biocide storage Przechowywanie biocydu [n(%)] Biocide at height Biocyd above 4 feet (122 cm) na wysokosci powyzej 122 cm Against mosquitos / Przeciw komarom coil /spirala 87 (67.4) liquidizer / 166 (87.8) elektrofumigator z plynem mat / 6 (75.0) elektrofumigator z wkladkami Against cockroaches /Przeciw karaluchom naphthalene / 26 (83.8) naftalen 18 (90.0) spray / spray 30 (85.7) chalk / kreda Against ants / Przeciw mrowkom powder / proszek 97 (77.0) chalk / kreda 74 (87.1) Against rats / Przeciw szczurom cake / kostka 30 (85.7) powder / proszek 3 (100.0) Table 2. Handling of biocides among rural households (N = 416) in Puducherry, South India Tabela 2. Uzywanie biocydow w wiejskich gospodarstwach domowych (N =416) w Puducherry w poludniowych Indiach Biocide handlers Personal protection Biocide Osoby stosujace usage Biocyd biocyd [n (%)] Stosowanie ochrony osobistej [n (%)] adults children yes no dorosli dzieci tak nie Against mosquitos / Przeciw komarom coil / spirala (N = 124 (96.0) 5 (4.0) 0 (0.0) 129 (100.0) 129) liquidizer / 181 (96.5) 8 (4.4) 2 (1.1) 187 (98.9) elektrofumigator z plynem (N = 189) mat / 7 (85.7) 1 (14.3) 0 (0.0) 8 (100.0) elektrofumigator z wkladkami (N = 8) Against cockroaches /Przeciw karaluchom naphthalene / 30 (96.7) 1 (3.3) 1 (3.2) 30 (96.8) naftalen (N = 31) spray / spray (N = 20 (100.0) 0 (0.0) 8 (40.0) 12 (60.0) 20) chalk / kreda (N = 35 (100.0) 0 (0.0) 1 (2.9) 34 (97.1) 35) Against ants / Przeciw mrowkom powder / proszek (N 125 (99.2) 1 (0.8) 10 (7.9) 116 (92.1) = 126) chalk / kreda (N = 83 (97.6) 2 (2.4) 0 (0.0) 85 (100.0) 85) Against rats / Przeciw szczurom cake / kostka (N = 35 (100.0) 0 (0.0) 2 (5.7) 33 (94.3) 35) powder / proszek (N 3 (100.0) 0 (0.0) 0 (0.0) 3 (100.0) = 3) Biocide post-handling Biocide storage Biocide practices Praktyki Przechowywanie Biocyd po uzyciu biocydu [n (%)] biocydu [n (%)] yes no living other tak nie room room pokoj inny dzienny pokoj Against mosquitos / Przeciw komarom coil / spirala (N = 100 (77.5) 29 (22.5) 117 (95.1) 6 (4.9) 129) liquidizer / 130 (68.8) 59 (31.2) 186 (99.5) 1 (0.5) elektrofumigator z plynem (N = 189) mat / 7 (87.5) 1 (12.5) 8 (100.0) 0 (0.0) elektrofumigator z wkladkami (N = 8) Against cockroaches /Przeciw karaluchom naphthalene / 25 (80.6) 6 (19.4) 28 (93.3) 2 (6.7) naftalen (N = 31) spray / spray (N = 18 (90.0) 2 (10.0) 13 (65.0) 7 (35.0) 20) chalk / kreda (N = 34 (97.1) 1 (2.9) 28 (80.0) 7 (20.0) 35) Against ants / Przeciw mrowkom powder / proszek (N 122 (96.8) 0 (3.2) 88 (70.4) 37 (29.6) = 126) chalk / kreda (N = 82 (96.5) 3 (3.5) 62 (73.8) 22 (26.2) 85) Against rats / Przeciw szczurom cake / kostka (N = 35 (100.0) 0 (0.0) 21 (65.6) 11 (34.4) 35) powder / proszek (N 3 (100.0) 0 (0.0) 2 (66.7) 1 (33.3) = 3) Table 3. Frequency of biocide usage among rural households (N = 416) in Puducherry, South India Tabela 3. Czestosc uzywania biocydow w wiejskich gospodarstwach domowych (N = 416) w Puducherry w poludniowych Indiach Biocide usage Stosowanie biocydu [n (%)] Biocide Biocyd daily once a week once a month codziennie raz w or less raz tygodniu w miesiacu lub rzadziej Against mosquitos / Przeciw komarom coil / spirala 91 (70.5) 28 (21.7) 10 (7.7) (N = 129) liquidizer / 144 (76.2) 32 (16.9) 13 (6.8) elektrofumigator z plynem (N = 189) mat / elektrofumigator z wkladkami (N = 8) 5 (62.5) 3 (37.5) 0 (0.0) Against cockroaches / Przeciw karaluchom naphthalene / naftalen 3 (9.7) 27 (87.1) 1 (3.2) (N= 31) spray / spray (N = 20) 4 (20.0) 10 (50.0) 6 (30.0) chalk / kreda (N = 35) 6 (17.1) 17 (48.6) 12 (34.3) Against ants /Przeciw mrowkom powder /proszek 34 (27.0) 55 (43.7) 37 (29.4) (N = 126) chalk / kreda (N = 85) 29 (34.1) 39 (45.9) 17 (20.0) Against rats /Przeciw szczurom cake / kostka (N = 35) 7 (20.0) 12 (34.3) 16 (45.7) powder / proszek 0 (0.0) 1 (33.3) 2 (66.7) (N = 3)
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|Author:||Laksham, Karthik Balajee; Kalidoss, Vinothkumar; Sivanantham, Parthibane; Sambath, Perumal Murthy; A|
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