Abstract There are close to 29,000 farm operations in Québec, and they employ some 125,000 farm workers (2007). Pesticides are used on these farms to control crop pests, but they can have short-term as well as long-term health effects on farm workers exposed to them, mainly through the skin. Pesticide use is thus controlled and risk prevention measures are recommended. Personal protective equipment (PPE) plays a key role in reducing the risks of exposure. Because of the lack of data on occupational illnesses and injuries caused by pesticides in Québec, however, the current prevention message is not getting across. This multidisciplinary study presents a status report on the use of personal protective equipment (PPE) to shield workers from agricultural pesticides, describes the contexts and practices of pesticide use in Québec’s apple industry and offers a preliminary priority list of the top pesticides necessitating protective measures. Possible courses of action are also suggested and discussed. In Canada, the Pest Management Regulatory Agency (PMRA) is responsible for pesticide regulation. The PMRA carries out risk assessments and determines the mitigation measures necessary to ensure safe working conditions. The assessments are based on studies of exposure scenarios in which PPE use is considered by applying a protection factor (%) for each type of equipment. PPE use recommendations, which appear on virtually all pesticide labels, have the force of law and compliance is supposed to guarantee an acceptable risk. Recommended respiratory protective equipment must be certified, but skin protective equipment is described generically. Standards that can help to clearly identify protective clothing needed and give minimum performance requirements exist throughout the world. CSA standard Z16602 on chemical protective clothing suggests a classification system based on the nature of the potential risk, but chemical resistance to pesticides is not considered. ISO standard 27065 specifically addresses protective clothing for application of pesticides, defining performance requirements for three levels of protective clothing, which can then be selected according to the potential risk in a given situation. Measurements of the protective efficacy of clothing under real working conditions can supplement the information provided in standards. About 20 scientific studies of protective clothing used in the agricultural sector were identified. The protection factors measured are comparable to those applied by the PMRA in its risk assessments, but the reliability of the comparisons is undermined by the small amount of data available, the substantial methodological and experimental variability of the studies and various difficulties or shortcomings that make it impossible to be certain that the anticipated protective efficacy of the PPE is attained. This study of Québec apple growers provided a better understanding of the realities of the industry and made it possible to contextualize the findings of the status report. More than 500 apple-growing operations, most of them small, were identified in Québec. The growers report strong economic pressure, stemming in particular from the cost of land, equipment, trees and pesticides. Environmental issues, new parasites, frost, hail, and the concentration and proximity of the orchards are additional challenges. To deal with these and ensure an adequate return, growers experiment with different types of plantations, apple varieties, tree training practices and pesticides. Apple producers have witnessed changes in the industry over the past 15 years. Most expressed agreement with the objectives and practices of integrated fruit production (IFP): new insecticides are replacing older ones, with preference given to lower-risk pesticides, and an application strategy based on regular monitoring has been widely adopted. These changes have been supported by independent agronomists as well as agronomists from Québec’s ministry of agriculture, fisheries and food (MAPAQ) and from technical clubs—key stakeholders whose opinions are valued by growers. Economic constraints and pressure from pests, however, sometimes lead growers to choose the pesticides that are most effective—and less compatible with IFP goals. Most growers prefer selling to wholesalers, because that is how they get the best prices for their fruit. This, coupled with consumer demand for “perfect” fruit, can affect the number of applications and contribute to apple-grower exposure to pesticides. An exploratory analysis of farm operations and exposure situations has also demonstrated that site layout, pesticide formulation and packaging, and equipment design determine exposure when mixing and applying pest control products. In these situations and others, PPE can play a significant role in protecting against exposure, but it is not always used, or used correctly—as repeatedly reported in other studies. Growers say there is not enough clear information about the risks of pesticides or the best methods of protection against them. Perception of the risk and lack of information about it, coupled with time and financial constraints, are additional factors in the failure to systematically use PPE. A variety of measures can be suggested for better prevention against pesticide-related risks in agriculture, specifically among apple growers. Initiatives to raise awareness among apple producers, through training, for example, could help to convince them of the need for a systematic and rigorous approach to the protection of their current and future health. Concerted efforts by concerned institutions and the agricultural and scientific communities could support growers’ efforts to reduce pesticide use. A preliminary list of pesticides, based on risk indices developed in this study for the products most commonly used by apple growers, may help guide prevention and research efforts. Standardization and better design of equipment used by growers could help to reduce exposure. In addition, clear identification of recommended PPE on pesticide labels and better characterization of PPE performance would be worthwhile. Also, the necessary PPE training and information should be jointly developed by stakeholders and disseminated through a network of key partners trusted by growers.