From awareness to action: determinants of zoonotic risk perception and protective practices among farm and livestock workers.

Introduction: Zoonotic disease prevention among farm and livestock workers depends not only on awareness, but also on how workers perceive occupational risk and the feasibility of protective action. This systematic literature review examined how farm and livestock workers perceive zoonotic disease risks and how these perceptions relate to everyday practices and working environments. Methods: The review followed PRISMA guidance and used a PICO-based question formulation. Searches were conducted in Web of Science and Scopus. A total of 28 studies were included, covering dairy, pig, poultry, and mixed livestock systems across Africa, Asia, Europe, and the Americas. Evidence was synthesized thematically, with attention to risk perception, knowledge gaps, protective practices, and socio-environmental determinants. Results: Workers generally recognized that animals can transmit disease to humans, but their understanding of specific pathogens, transmission routes, high-risk tasks, and preventive measures was uneven. Knowledge gaps were most evident for endemic, environmentally mediated, and parasitic infections. A persistent perception-behavior gap was observed, particularly where personal protective equipment, sanitation, clean water, supervision, and institutional support were limited. Discussion: Protective practices were shaped by socio-cultural norms, gendered labor roles, livelihood pressures, environmental conditions, workplace safety climate, and employer or institutional support. The findings highlight the need for multi-level One Health strategies that combine worker-centered education with improvements in infrastructure, regulation, organizational safety culture, and cross-sector collaboration. The review also identifies the need for future research in under-studied agricultural settings, including plantation contexts.