- An unpublished study being the first of its kind in Nepal known to the research group documents the seriousness of the problem in Chitwan. A comparative cross-sectional study was conducted among 90 vegetable farmers using hand pressured backpack sprayers and 90 blood donors. Fifty %, 15 % and 13 % of the pesticides used by the vegetable farmers could be categorized as moderately, highly and slightly hazardous, respectively, according to the World Health Organization Hazard Classification. Organophosphates were one of the most common pesticides used by the vegetable farmers; the moderately hazardous chlorpyrifos and imidacloprid as well as the highly hazardous dichlorvos. Poor working practices without adequate safety precautions were common among the vegetable farmers. The vegetable farmers reported a higher number of acute organophosphate poisoning symptoms and had lower levels of acetyl cholinesterase than blood donors. Chitwan has a total population of around 566,661 and was a largely uncultivated dense forest before the Nepali government started spraying with the insecticide dichlorodiphenyltrichloroethane for a Malaria Eradication Project in the 1950s. Immediately, Chitwan became a major farming region and services and infrastructure expanded across the area. Out of a total 46,894 hectare of arable land, 44,291 hectare is used for agricultural purpose (maize, rice, wheat, beans, lentils, mustard and vegetables). Agriculture is the primary source of income for 75 % of the population. Around 4000-5000 people of the working population is engaged in vegetable farming. Chitwan has 40 village district committees and the District Agricultural Office considers 10 of these as pocket areas in terms of vegetable farming based on their own observations, experiments, monitoring and personal communication with vegetable farmers. The ten pocket areas are Mangalpur, Jagatpur, Shukranagar, Chainpur, Bhandara, Gitanagar, Sibanagar, Jutpani, Kumroj and Padampur. To the extent that it is possible farmers fulfilling the inclusion and exclusion criteria of the present study in these pocket areas will be recruited: