Picture of Margaret Reeves

Margaret Reeves

Pesticide poisonings: A (solvable) global crisis

A recent systematic review of unintentional acute pesticide poisonings found that an estimated 385 million farmers and farmworkers are poisoned every year around the world.

Content warning: This blog post contains discussion of suicide.

A recent systematic review of unintentional acute pesticide poisonings found that an estimated 385 million farmers and farmworkers are poisoned every year around the world. That’s about 44% of the global population of 860 million people working in agriculture. Fatalities were also estimated, and found to be around 11,000 annually. This is the first global estimate of unintentional pesticide poisonings done since 1990. 

Historically undercounted

The World Health Organization estimate from 1990 relied mostly on hospital registries data on severe poisoning cases, reporting about one million annual cases. A follow-up paper using data from surveys of self-reported symptoms in two Asian countries resulted in an estimated 25 million farmers and farmworkers poisoned by pesticides (including mild symptoms of poisoning) every year. 

Why do estimates range so widely? One factor is that the 1990 estimates relied on different data sources — the WHO estimate was on severe cases and mostly from hospital data, while the other estimate relied on self-reported symptoms from two countries in Asia (Malaysia and Sri Lanka). 

Underreporting is also an issue. In many countries — including the U.S. — many people may not recognize signs or symptoms of pesticide poisoning or know who to report to. Other factors can also contribute to underreporting, such as lack of a requirement to report incidents, or physicians’ lack of familiarity with the effects of pesticide exposure. In addition, there may be fear of language barriers or fear of employer retaliation that result in workers not reporting their symptoms. Signs and symptoms of pesticide poisoning are often described as flu-like symptoms, and can be mistaken by exposed individuals or physicians for other forms of illness.

What’s a systematic review?

Systematic review is a method used to review scientific literature that involves starting with a pool of studies on a certain topic, and then further narrowing that pool after assessing the studies using specific criteria. It’s useful for reviewing literature because there is a clearly described methodology laid out. Systematic review is an important methodology recommended by scientists for informing policy and decision making, as well. 

The paper we’re discussing here started with an initial pool of 1,683 references, which narrowed to 824 articles for further assessment. Finally, 157 articles were included in the synthesis of data. A total of 141 countries were covered in the final synthesis. The study found that the greatest number of non-fatal poisoning cases was in southern Asia, followed by Southeast Asia and East Africa. For fatalities, nearly 60% of them were from just one country (India), indicating serious problems with pesticide use in that country.The global estimates were based on the data extracted from these studies and data on the farming population.

The paper relied on mostly survey-type studies that included self-reported symptoms, meaning that either study scientists or study participants assessed symptoms in a short window of time after pesticide use.


Hundreds of millions of people experiencing pesticide poisoning every year may seem shocking. Until you start to think about it. According to the paper, there has been an 81% increase in pesticide use since 1990, including a 484% increase in South America and a 97% increase in Asia, compared to a decrease in Europe of 3%. 

In some countries, there may be little agency infrastructure for the regulation or oversight of pesticides. The consequence is that some countries may have little to no ability to control the import or sales of pesticides, to support trainings, or to provide information to users. In addition, literacy levels may be low in addition to a lack of access to proper training. Thus, the farming population may not be familiar with the dangers of pesticides. 

In the U.S., certain pesticides are restricted for use by the EPA, and may require additional training in order to be used. In other countries, people may use pesticides without receiving any training at all. Anecdotally, PAN staff also hear of people in the U.S. not wearing personal protective equipment (PPE) while using pesticides. The reasons for this can range from personal choice (PPE is very uncomfortable) to worker safety issues, such as when an employer simply does not inform workers, or provide the appropriate level of PPE. 

The pesticide industry will tell you they’re not responsible for poisonings. But, the fact is, pesticide use itself increases the likelihood of accidental poisonings. As long as the industry is profiting from pesticide sales, there is not a strong impetus for them to change the way they do business.

A solvable crisis

One example of how changes to pesticide regulation can save lives is if we look at suicides by pesticides. Intentional self-poisoning using pesticides is one of the most commonly used methods of suicide in Asia. In Sri Lanka, after an increase in suicides from 1950 to1995, the government enacted restrictions on the sale of certain pesticides in 1998. As a result, 19,769 fewer suicides occurred in the years 1996–2005 as compared with 1986–1995. Lives were saved by limiting access to certain pesticides in that country — and though it’s a different issue, it is clear that we could take similar steps to prevent unintentional pesticide poisonings as well.

The best way to avoid pesticide poisonings is, unsurprisingly, to not use them. This is yet another reason to utilize pest control practices based in agroecology — you can read about real-world solutions here — so that we can live in a world where no one is poisoned by pesticides. 

Picture of Margaret Reeves

Margaret Reeves

Margaret Reeves is a PAN Senior Scientist with expertise in agroecology and soil ecology. As a long-time farmworker advocate, Margaret serves on the Board of the Equitable Food Initiative and works with partners around the country to ensure worker-protective federal and state policy. Follow @MargaretatPAN

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