Is agricultural intensification a growing health concern?

In response to the global demand for food, agricultural practices have been intensifying rapidly worldwide, and concurrently, the production of substantial amounts of livestock waste. Waste and waste by-products, such as excreta and wastewater, are commonly used in crop agriculture in many parts of Southeast Asia. While reusing waste prevents the application of chemical fertilizers, reduces environmental impact, and improves agricultural productivity, inappropriate waste handling practices can pose health risks to farmers, to the general public who live close to farms, and to consumers.

The livestock sector is growing in Vietnam, contributing to 16% of total agricultural output and 85 million tons of waste per year. While a number of studies have described farmers’ waste management practices and characterized actual health risks associated with such practices, few have considered farmers’ perceptions of health risks and its implications on health-related behaviours. Furthermore, despite the influence that policymakers have in shaping the waste management practices of farmers, even fewer studies have considered policymakers’ perspectives. In our new paper published in Sustainability, we explored the health risk perceptions of farmers, community leaders, researchers, and policymakers in Vietnam.

We conducted interviews in Hanoi where many national research institutes and ministries are located. Interviewees included representatives from the National Institute for Hygiene and Epidemiology, National Institute for Occupational and Environmental Health, Soil and Fertilizer Research Institute, Vietnam National University for Agriculture, Hanoi University of Public Health, Ministry of Health, and Ministry of Agriculture and Rural Development. Around 60 km south of Hanoi, in Hoang Tay commune, Ha Nam Province, we also interviewed community leaders and farmers (Figure 1). Similar to other areas in central and northern Vietnam, wastewater and excreta are commonly used for agricultural purposes in Hoang Tay. We asked farmers to reflect on their own waste management practices, while decision-makers focused on broader waste management issues and current policies. We achieved theoretical saturation, a point where no new themes were observed, after 19 interviews (12 women, 7 men).

Figure 1. Hoang Tay commune in Ha Nam Province, Vietnam.

We found some contrasting perspectives among stakeholders. Researchers and government representatives perceived the lack of farmers’ knowledge of safe waste management practices was responsible for farmers’ use of ‘outdated’ and often ‘unsafe’ waste management practices. However, many farmers were aware of the health risks and safe hygienic practices but felt that safety measures were impractical and viewed susceptibility to diseases as low risk. Farmers also identified unfavorable working conditions and limited financial capacity as barriers to adopting safe management practices (Figure 2). At the broader level, inadequate communication between ministries often led to the creation of inconsistent waste management regulations; thus, creating barriers to safe and sustainable waste management.

Figure 2. Farmer perceptions

To address these barriers, we recommend promoting collaboration between sectors, encouraging farmer-to-farmer knowledge sharing, and designing and implementing risk communication strategies that account for risk perceptions of stakeholders. Through this, farmers can better use excreta and wastewater in agriculture in a manner that protects the health of the environment, farm workers, and public at large.


Veidt J, Lam S, Nguyen-Viet H, Tuyet-Hanh TT, Nguyen-Mai H, Harper SL. (2018). Is agricultural intensification a growing health concern? Perceptions from waste management stakeholders in Vietnam. Sustainability. 10(12): 4395.

Leave a Reply