PANNA: It's Time for Global Monitoring of Acute Pesticide Poisoning
See PANUPS updates service, for complete information.
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 39 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 date from as far back as 1973. Meanwhile, worldwide pesticide production doubled between 1970 and 1985. Patterns of pesticide consumption have been shifting as well: in the last three decades the percentage of pesticides used in developing countries increased from 20% to 40%.
As pesticide use increases, the number of pesticide poisonings increases as well. While both acute and chronic pesticide poisonings seriously impact victims' health and livelihood, acute cases are easier to identify, document, and quantify as arguments to curb the use of hazardous pesticides. Recent and increasingly detailed studies indicate that the WHO's outdated estimates of 3 million cases and 220,000 deaths from acute pesticide poisonings worldwide account for only a tiny fraction of the real number of cases. This is because 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 pesticides is the norm, given that farmers and farmworkers 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.
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 20 of every 100 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 39 million people may suffer from poisonings each year.
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. A study that tracked 50 Vietnamese farmers' pesticide usage for one year found that they suffered 54 potentially moderate poisonings per month, but only two cases per month were treated at the local health center. In South Africa, a study revealed that only 4.2% of acute pesticide poisoning cases were officially reported during a five-year period.
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 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.
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." The United States does not have a national pesticide illness reporting requirement, and only 13 states of 50 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.
Still, despite serious problems implementing existing reporting requirements, California is considered a model for the rest of the country and elsewhere. The state has established reporting systems for both pesticide use and related illnesses, and provides public access to the data. Public release of this information helps build public pressure to improve pesticide regulations and worker protection.
On a global scale, the ongoing lack of data documenting the extent of acute pesticide poisoning on a global scale 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. 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 of tracking acute pesticide poisonings around the globe will require international collaboration and resources. Without these efforts, the health and lives of millions around the world will continue to be destroyed as part of "agriculture as usual."
For information on identifying cases of pesticide poisoning, and on reporting incidences in the United States see www.pesticideinfo.org.
For those of who you are Pesticide Action Network members, you can look forward in mid-March to reading this article and many other useful, provocative stories in our new publication. For those of you who are not members, please become one today with a minimum contribution of $35.
Habib, Nasire. "Invisible Farmers: Rural Roles in Pakistan" from Silent Invaders: Pesticides, Livelihoods and Women's Health.
Kishi, Misa, Norbert Hirschhorn, Marlinda Qjajadisastra, Latifa N. Satterlee, Shelley Strowman, and Russell Dilt. 1995. "Relationship of Pesticide Spraying to Signs and Symptoms in Indonesian Farmers" Scandinavian Journal of Work and Environmental Health, 21: 124-33.
London and Bailie. 1998. "Enhanced Surveillance for Pesticide Poisoning in the Western Cape--An Elusive Target" South Africa Medical Journal September 88(9):1105-9
Murphy, Helen H., Nguyen Phung Hoan, Patricia Matteson, and Alma Linda C. 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.
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.
Pesticide Action Network Asia-Pacific. Poisoned and Silenced.
Pesticide Action Network UK. 2000. "Pesticide poisoning--we still do not know" Pesticides News No. 50. http://www.pan-uk.org/pestnews/pn50/pn50p3.htmValentina, Forastieri. "SafeWork: The ILO Programme on Occupational Safety and Health in Agriculture" International Labor Organization, Geneva, October 1999. Available at ILO website: http://www.ilo.org/public/english/protection/safework/agriculture/agrivf01.htm