Assessing farmers’ knowledge, attitudes, health risk perceptions, and practices toward pesticide use in Morocco

Agriculture plays a vital role in Africa’s economy, yet farmworkers remain disproportionately exposed to pesticide-related health risks. Guided by the Theory of Planned Behavior, this study examined farmworkers’ knowledge, attitudes, practices, and perceptions regarding health risks associated with pesticide use and protective measures in Morocco. A cross-sectional study was conducted among 314 agricultural workers across seven major farming areas. Participants had a mean age of 40 ± 15.08 years, ranging from 18 to 77 years, were predominantly male (64.3%), and largely had no formal education or only basic literacy (74.2%). Among respondents with complete data (n = 300), 86.3% (n = 259) were unable to name the pesticides they used. Only 33.3% (n = 100) demonstrated good knowledge of pesticide safety, while 44.7% (n = 134) expressed positive attitudes toward safe pesticide application. Structural analysis showed that safety attitudes were the strongest determinant of reported pesticide safety practices, with health risk perception also influencing them. These findings suggest that improving knowledge alone is insufficient and that behavioral interventions should prioritize attitudinal change to promote safer pesticide use. By elucidating the behavioral and perceptual drivers of pesticide practices in low-resource farming communities, this study provides evidence to inform targeted public health and occupational safety interventions in Africa. Notably, the high willingness of farmers (93%) to participate in human biomonitoring initiatives highlights the feasibility of integrating biomonitoring and surveillance into prevention-oriented agricultural health strategies.