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Little is known about pesticide exposure risks for children in rural areas in China, many of whom have been left behind by migrant workers. To survey caregivers of children in rural China and assess their pesticide use and disposal methods, the measures were used to protect the children and their perceptions of the adverse effects of pesticides on children’s health. Three or four villages in each of Xinhua, Gongan and Sansui Counties in China were selected by random cluster sampling. The main caregivers of children aged 1–6 years were surveyed in face-to-face interviews. The questionnaire used was adapted from the World Health Organization “Exposure to Pesticides: Standard Protocol” survey and similar studies. The study included 464 caregivers (mean age, 46.4 years), who were most commonly the children’s grandparents (65.3%). Among the caregivers, 41.9% were educated to middle school level or higher, 45.4% had a household income < 297 USD, and 29.7% had received education/training about pesticide use/adverse health effects in children. The score for caregivers’ knowledge of the adverse effects of pesticides on children’s health was higher in those who had received education/training (5.1 ± 2.6 vs. 3.4 ± 2.5,  P  < 0.001). Factors associated with unsafe behaviors during pesticide use included grandparent as the caregiver (odds ratio [OR] 0.551; 95% confidence interval [95% CI] 0.368–0.824;  P  = 0.004), annual income < 297 USD (OR 0.580; 95% CI 0.395–0.853;  P  = 0.006), and insufficient health-related education/training (OR 0.436; 95% CI 0.286–0.665;  P  < 0.001). Improved education and training are needed to promote the safe use of pesticides by caregivers of children in rural China.   Electronic supplementary material  The online version of this article (10.1007/s11356-019-05560-w) contains supplementary material, which is available to authorized users.

Knowledge and behavior regarding pesticide use: a survey among caregivers of children aged 1–6 years from rural China