first_pagesettingsOrder Article Reprints Open AccessArticle Exploring Pesticide Knowledge, Practices, and Health Perceptions Among Farmers in Akkar, Lebanon by Nisreen Hassan Akkouch 1,*,Jalal Halwani 1ORCID andIssam Shaarani 2ORCID 1 Water and Environment Science Laboratory, Faculty of Public Health, Doctoral School of Science & Technology, Lebanese University, Tripoli 1300, Lebanon 2 Faculty of Medicine, Beirut Arab University, Beirut 1107 2809, Lebanon * Author to whom correspondence should be addressed. Int. J. Environ. Res. Public Health 2025, 22(2), 260; https://doi.org/10.3390/ijerph22020260 Submission received: 14 December 2024 / Revised: 3 February 2025 / Accepted: 5 February 2025 / Published: 12 February 2025 Downloadkeyboard_arrow_down Browse Figures Versions Notes Abstract Background: The unregulated and widespread use of agricultural pesticides in Lebanon has led to critical health and environmental challenges. Small-scale farmers in Akkar, a key agricultural region, are particularly vulnerable due to limited knowledge, unsafe practices, and insufficient access to safety resources. Objectives: This study evaluates the knowledge, practices, and perceived health impacts of pesticide use among small-scale farmers in Akkar. It aims to identify gaps and provide targeted recommendations for interventions that enhance safety, sustainability, and environmental conservation. Methods: A cross-sectional survey involving 151 farmers was conducted from November 2022 to January 2023 using a validated questionnaire. Descriptive statistics, regression analysis, and Tukey’s HSD post hoc tests were used to assess knowledge and practice scores and identify predictors. Results: Farmers demonstrated moderate knowledge (mean score: 0.545) and practices (mean score: 0.607). However, environmental awareness was low, with only 9.3% recognizing water contamination risks. Alarmingly, 37.7% of farmers reported using no protective gear, while 67.5% experienced acute symptoms such as respiratory irritation and skin issues. Education was a significant predictor of knowledge (p < 0.01). Conclusions: This study underscores the pressing need for tailored educational programs, accessible protective equipment, stricter regulatory frameworks, and environmental conservation strategies to reduce health risks and promote sustainable pesticide use.