Download Issue The Invisible Epidemic: Global Acute Pesticide Poisoning
by Margaret Reeves, Kirsten Schwind, and Renata Silberblatt
Unlike many diseases, pesticide poisoning is completely preventable. People can make decisions either to release hazardous pesticides into the environment, or to replace them with least toxic alternatives. Meanwhile, millions of victims of pesticide poisoning suffer in anonymity, while pesticide manufacturers disingenuously insist that their products are “safe if used as directed.”
Human health consequences of pesticide poisoning range from acute short-term effects such as respiratory problems, irritation of skin, eyes, throat, and digestive problems to chronic and long-term effects such as cancer, birth defects, and neurological afflictions. While both acute and chronic pesticide poisonings seriously impact victims’ health and livelihoods, acute cases are easier to identify, document, and quantify as arguments to curb the use of hazardous pesticides. That’s why documenting the extent of acute global pesticide poisoning is a key step in creating the political will to ban the worst pesticides at the international level.
The World Health Organization (WHO) maintains statistics on the global incidence of common health problems ranging from diarrhea to AIDS. Yet while acute pesticide poisoning affects as many as thirty-nine million people around the world, there is no current global mechanism to track poisonings or diseases closely related to pesticide use. The WHO’s most recent estimates of acute global pesticide poisoning were calculated in 1973. [1] Meanwhile, worldwide pesticide production doubled between 1970 and 1985, and is still increasing today. Patterns of pesticide consumption have been shifting as well: in the last three decades, developing countries’ share of global pesticide use increased from 20% to 40%. [2]
No global documentation
As pesticide use increases, the number of pesticide poisonings increases as well. Recent detailed studies indicate that the WHO’s outdated estimates of three million cases and 220,000 deaths from acute pesticide poisonings annually worldwide account for only a tiny fraction of the real number of cases. These estimates are based on government records of pesticide-related hospitalizations, while the vast majority of acute pesticide-related illnesses do not result in hospitalization.
Underreporting of pesticide-related illnesses is the norm, given that farmers and farm workers frequently cannot afford medical treatment at all, much less hospitalization. “Unless we are unable to move, we do not think of going to a doctor or of taking medicine,” remarked a Pakistani woman asked in a study if she seeks treatment for pesticide poisoning. “Where can we get that much money to spend on treatment?” another participant responded.[3]
Shocking rates of poisoning
When researchers interview farmers and farmworkers directly, studies in many countries show that 90% or more of all poisoning cases may go unreported by the medical establishment. In Central America, the Pan American Health Organization (PAHO) found that only between one and twenty of every one hundred cases of acute pesticide poisoning are officially reported. Over 95% of the cases of acute pesticide poisoning went unreported in Nicaragua, Belize, and Guatemala. PAHO estimates about 3% of exposed agricultural workers suffer from an episode of acute pesticide poisoning annually—with a population of about 1.3 billion agricultural workers worldwide, that means that as many as thirty-nine million people may suffer from acute poisonings each year. [2], [4]
This pattern of shockingly high rates of pesticide poisoning reported by researchers but missing from official sources and statistics is repeated throughout the world. In Asia, a study of 228 Indonesian farmers and professional pesticide applicators found that 21% suffered from three or more symptoms per spray operation, a rate much higher than previously documented in Indonesia or elsewhere. [5] A study that tracked fifty Vietnamese farmers’ pesticide usage for one year found that they suffered fifty-four potentially moderate poisonings per month, but only two cases per month were treated at the local health center. [6] In South Africa, a study revealed that only 4.2% of acute pesticide poisoning cases were officially reported during a five-year period. [7]
Women especially face difficulties in seeking care for acute pesticide poisoning. According to Pesticide Action Network Asia-Pacific, very few women know that the highest absorption point is the genital area, and do not realize the risks they are taking by working as pesticide sprayers. When women workers experience severe vaginal burning sensations after spraying, these workers are often too shy or ashamed to describe this problem to male medical personnel. [8]
Report Revelas Impacts of Neurotoxins on Farm Workers
Children are exposed to pesticides while working in the fields, at home, and in school, and are more sensitive to their effects. A recent study found that newborns can be up to 164 times more sensitive to the organophosphate pesticide chlorpyrifos than their mothers. See www.panna.org/magazine/106 for more details. Credit: Jocelyn Sherman
One reason the health hazards of women workers have been underestimated historically is that exposure limits to hazardous substances are calculated based on male populationsCredit: Marcia Ishii-Eiteman
Efforts to monitor pesticide poisoning are as patchy in industrialized countries as in the global South. In the U.S., methods for documenting possible or likely pesticide poisoning vary widely across states. In the state of Washington, a coalition of groups including the Farm Worker Pesticide Project, Columbia Legal Services, Farmworker Justice Fund, and United Farm Workers helped influence the creation of a state medical monitoring program. When monitoring, officials analyze blood samples of farm workers who regularly handle organophosphate and carbamate neurotoxic pesticides. If tests reveal that exposure to these pesticides has resulted in depressed levels of cholinesterase (ChE), the enzyme essential to proper nerve function, then an investigation may be conducted to determine cause, such as violations of worker protection regulations. Recommended remedies include removal from the job and compensation.
More Messages from Monitoring: Year 2 of Washington State’s Farm Worker Medical Tracking Program revealed that nearly 10% of tested workers (compared to 21% the first year) had levels of ChE depression requiring workplace investigation. Ten of the 611 workers exhibited ChE depressions alarming enough that they were removed from their jobs. Particularly problematic was the application of Lorsban (chlorpyrifos) and Guthion (azinphos methyl) to fruit trees using air-blast sprayers. At least sixty-six violations of worker safety regulations were cited.
Unfortunately, the real impact of widespread use of organophosphate and carbamate pesticides may be far greater since: 1) prior exposure to pesticides among forty-eight of the tested workers may have lowered the ChE baseline against which subsequent levels are compared; 2) some qualified workers were not tested; and 3) workers with significant ChE depressions did not qualify to be included in the medical monitoring program.
Tribunal Investigates Children’s Poisoning in Peru
High in the Peruvian Andes in the windswept town of Taucamarca, twenty-four of the village’s forty-eight schoolchildren died in 1999 after drinking a school breakfast milk substitute accidentally mixed with methyl parathion. When the students began to foam at the mouth and writhe in pain, parents carried their children down the mountain to the nearest health post, an hour’s walk from the village. Over half of the children died in their parents’ arms before reaching help.
Methyl parathion is a highly toxic organophosphate pesticide sold in Peru by Bayer under the trade name Folidol. To support the Taucamarca community and investigate Bayer’s and the Peruvian government’s lack of action and failure to accept responsibility, Peru’s Pesticide Action Network organization (known by its Spanish acronym RAAA) organized the Citizens’ Tribunal on the Taucamarca Case in coordination with Peruvian human rights, environmental, and labor rights organizations. The Tribunal found Bayer responsible for violating international safety standards, and the Peruvian government responsible for failing to protect the human rights and physical safety of its poorest and most vulnerable citizens. The Tribunal reinvigorated an official congressional investigation into the tragedy.
For more information, see http://www.panna.org/magazine/105.
Not just developing countries
Wealthier countries have not done much better at tracking acute pesticide poisoning incidents. In 2000, the British Minister of State for the Environment, Transport, and the Regions admitted to Parliament that “Comprehensive information on the number of people who are poisoned by pesticides each year is not available.” [9] The United States does not have a national pesticide illness reporting requirement, and only thirteen states of fifty require doctors or employers to report pesticide-related illnesses. Even in California, the state with arguably the most rigorous pesticide use and pesticide-related illness reporting, underreporting remains a problem for reasons common to workers around the globe: lack of health insurance or accessible medical facilities, fear of retaliation and job loss, and a seriously inadequate understanding among both workers and physicians regarding the recognition of pesticide-related illnesses. [10]
Still, despite serious problems implementing existing reporting requirements, California is considered a model for the rest of the country and elsewhere. The state provides public access to data on both pesticide use and reported illnesses. Public release of this information helps build public pressure to improve pesticide regulations and worker protection.
We need to know
On a global scale, the ongoing lack of data documenting the extent of acute pesticide poisoning is a recipe for continued failure to address this serious problem. As long as the problem remains officially invisible, its existence will continue to be officially denied—the status quo supported by the $28 billion global pesticide industry. [11] Much better information must be made publicly available about the true extent of pesticide poisonings, and its many health and environmental consequences. The establishment of coordinated systems for tracking acute pesticide poisonings around the globe will require international collaboration and resources. Without these efforts, the use of hazardous pesticides will continue unabated at the expense of the lives and well-being of millions around the world.
For information on how to report poisoning incidences in the United States, see http://www.pesticideinfo.org.
Dr. Margaret Reeves is a Senior Scientist and Kirsten Schwind was Editor and Staff Writer at PAN. Renata Silberblatt was an intern at PAN and researched this article.
References
1. World Health Organization. 1973. Technical Report Series No. 513, WHO, Geneva, Switzerland.
2. Pan American Health Organization. 2002. “Epidemiological Situation of Acute Pesticide Poisoning in the Central American Isthmus, 1992–2000” Epidemiological Bulletin, Vol. 23 No. 3, September.
3. N. Habib. 2003. “Invisible Farmers: Rural roles in Pakistan” In M. Jacobs and B. Dinham (eds.), Silent Invaders: Pesticides, livelihoods and women’s health. Zed Books, New York, p. 90.
4. V. Forastieri. 1999. “SafeWork: The ILO Programme on Occupational Safety and Health in Agriculture” International Labor Organization, Geneva, October. Available at ILO website: http://www.ilo.org/public/english/protection/safework/agriculture/agrivf01.htm.
5. M. Kishi, N. Hirschhorn, M. Qjajadisastra, L.N. Satterlee, S. Strowman, and R. Dilts. 1995. “Relationship of pesticide spraying to signs and symptoms in Indonesian farmers” Scandinavian Journal of Work and Environmental Health, 21: 124–33.
6. H.H. Murphy, N.P. Hoan, P. Matteson, and ALC Morales-Abubakar. 2002. “Farmers’ Self-Surveillance of Pesticide Poisoning: a 12-month Pilot Study in North Vietnam” International Journal of Occupational and Environmental Health Vol. 8, No. 3, July/Sept.
7. L. London and R. Bailie. 1998. “Enhanced Surveillance for Pesticide Poisoning in the Western Cape—An Elusive Target” South Africa Medical Journal September 88(9):1105–9.
8. Pesticide Action Network Asia-Pacific (PAN AP). 2002. Poisoned and Silenced: A study of pesticide poisoning in the plantations. Tenaganita and PAN AP, Penang, Malaysia.
9. Pesticide Action Network UK. 2000. “Pesticide poisoning—we still do not know” Pesticides News No. 50. http://www.pan-uk.org/pestnews/pn50/pn50p3.htm
10. M. Reeves, A. Katten and M. Guzmán. 2002. Fields of Poison 2002: California farmworkers and pesticides. Pesticide Action Network, San Francisco, CA.
11. Agrow: World Crop Protection News. 2003. “Global agrochemical sales flat in 2002” February 28, No 419. http://www.agrow.co.uk/.