Managing pesticide chronic health risks: U.S. policies

This paper provides an overview of U.S. government pesticide risk management efforts over time and in recent years, relevant to chronic health risks of pesticides. Pesticides are in widespread usage in the U.S. With hundreds of active ingredients and thousands of products on the market, management of pesticide risks has been a daunting challenge. The first legislation providing federal authority for regulating pesticides was enacted in 1910. With the establishment of the U.S. Environmental Protection Agency in 1970 and amendments to the pesticide law in 1972, the federal government was for the first time given the authority to regulate health and environmental risks of pesticides. However, older pesticide risks were not addressed until legislation was enacted in 1988, requiring "reregistration" and 1996, requiring that pesticide food standards are safe for children. In result, the U.S. has seen an expansion of development of pesticide products that are registered as "reduced risk" or are biologicals. Additionally a large number of older pesticides have been cancelled or reduced from the market and/or from individual food uses. Through biomonitoring data, the U.S. may now be seeing trends in reduction of exposure to certain pesticides, the organophosphate insecticides. However, pesticide sales data through 2001 do not provide evidence for such trends.     

Occupational exposure to pesticides and health professionals' interpretation of "nervousness" among rural residents

Occupational exposure to pesticides has a strong impact on Public Health in Brazil, since the country is one of the world's largest pesticide consumers. Harm to the rural population is reflected in high pesticide poisoning and case-fatality rates. The present paper focuses on the perspective of health professionals working in districts 5 and 7 of the Municipality of Nova Friburgo, Rio de Janeiro State, in the Family Health Program, concerning rural residents' complaints of "nervousness", verifying (1) whether health professionals perceive a link between "nervousness" and symptoms of pesticide poisoning, (2) the implications of their understanding on the reporting of work-related illnesses, and (3) medication for "nervousness" (use of tranquilizers) as a potential factor of social accommodation (as occurs elsewhere in urban groups) and as a potential cause of dual poisoning among workers exposed to pesticides. The methodology included interviews, participant observation, field notes, and consultation of previous studies in the area. The study highlights health professionals' discourse in relation to the association between "nervousness" and pesticides. The authors discuss factors related to this perception and make several suggestions for future research.     

Probabilistic assessment of acute health symptoms related to pesticide use under intensified Nepalese agriculture

Agriculture intensification has pushed farmers to use pesticides for maintaining agricultural productivity and to increase income. However, pesticide use has a significant negative impact on farmers' health. In Nepal, uses of pesticides have been already documented in agriculturally intensified areas, however, little is known on health impacts. Weekly interviews were conducted during 2005 to assess the emerging pesticide problems, estimate the magnitude of pesticide-related acute illness, and identify associated risk factors. The study showed that very few farmers have adopted safety gear during pesticide spraying. The safety measures regression shows that warm temperature and drinking habits significantly reduced adoption of safety gear, whereas, integrated pest management (IPM) training and farm experience increased its adoption. The dose-response analyses showed that use of insecticides or fungicides, spray duration and mixing pesticides significantly affect farmer's health, which could be reduced either by educating farmers, increasing the use of safety gear, or reducing mixtures applications.     

Status of legislation and regulatory control of public health pesticides in countries endemic with or at risk of major vector-borne diseases

Background: Legislation and regulation of pesticides used in public health are essential for reducing risks to human health and the environment.Objective: We assessed the global situation on legislation and regulatory control of public health pesticides.Methods: A peer-reviewed and field-tested questionnaire was distributed to 142 member states of the World Health Organization (WHO); 113 states completed the questionnaire.Results: Legislation on public health pesticides was absent in 25% of the countries. Where present, legislation often lacked comprehensiveness, for example, on basic aspects such as labeling, storage, transport, and disposal of public health pesticides. Guidelines or essential requirements for the process of pesticide registration were lacking in many countries. The capacity to enforce regulations was considered to be weak across WHO regions. Half of all countries lacked pesticide quality control laboratories, and two-thirds reported high concern over quality of products on the market. National statistics on production and trade of pesticides and poisoning incidents were lacking in many countries. Despite the shortcomings, WHO recommendations were considered to constitute a supportive or sole basis in national registration. Also, some regions showed high participation of countries in regional schemes to harmonize pesticide registration requirements.Conclusions: Critical deficiencies are evident in the legislative and regulatory framework for public health pesticides across regions, posing risks to human health and the environment. Recent experience in some countries with situational analysis, needs assessment, action planning, and regional collaboration has signaled a promising way forward.     

Sources of exposure to and public health implications of organophosphate pesticides.

OBJECTIVE: To review the public health significance of organophosphate pesticide exposure in the United States of America. Since the situation of high organophosphate pesticide exposure and the concomitant health risks in the developing countries of the world is well known, this article seeks to highlight the public health significance of organophosphate exposure in the United States, where it is less common than in many other nations. Looking at the situation in the United States would serve to further emphasize the seriousness of organophosphate pesticide-related health issues in developing countries. METHODS: A search for journal articles on organophosphate pesticides and organophosphate exposure was done on the PubMed electronic bibliographic database system of the National Library of Medicine of the United States. To supplement that search, information on organophosphate toxicity, biological monitoring, and regulation of pesticides was obtained from other published articles, textbooks, and relevant Internet sites. RESULTS: Organophosphate pesticides are a group of chemicals that are mainly used in agriculture. Organophosphates inhibit the activity of both the cholinesterase (ChE) enzymes-red blood cell (RBC) ChE and serum ChE-resulting in the cholinergic features of organophosphate toxicity. A 50% reduction in serum ChE activity from the baseline is an indication of acute organophosphate toxicity. The RBC ChE activity, which is less rapidly depressed than the serum ChE activity, is a measure of chronic exposure to organophosphates. Exposures to organophosphates are broadly classified into two categories: occupational and environmental. Occupational exposures occur among agricultural workers (including migrant farmworkers), industrial workers, pest control exterminators, and other workers. Nonoccupational exposure affects a large segment of the general population in the United States. Residential exposures come from organophosphate pesticide use by exterminators and by household residents as well as from dietary and accidental exposures. Other environmental exposures occur in public places and areas close to farms, and exposures could also happen from organophosphate use in chemical warfare or terrorism. In the United States some organophosphate pesticides are restricted by the Environmental Protection Agency in order to protect humans, animals, and the environment. In addition, the Food Quality Protection Act regulates dietary exposure to pesticides, particularly for infants and children. CONCLUSIONS: Organophosphate pesticides continue to pose a risk to human health in the United States. Biological monitoring should be used to strictly regulate occupational exposures to organophosphates and thus protect the health and safety of workers. Among the public there should be an increased awareness of environmental exposure to organophosphates as well as of the threat of chemical warfare or terrorism.     

农药污染及其对健康影响的研究进展

农药的大量使用对人类的健康产生了广泛的影响,综述农药使用对人类健康影响的研究进展,以期为针对性地采取相应措施最大限度地减轻或避免农药对人体的危害提供一定的支持,保护人类的健康。     

Pesticide health and safety and the work and impact of international agencies: partial successes and major failures.

The paper explores aspects of the international role and impact of key agencies in informing regulators and users about pesticides and controlling and preventing pesticide poisoning worldwide. The WHO, IPCS, ILO, World Bank, and related organizations such as ICPS, for instance, all have effects. Particular attention is paid to the IPCS environmental health criteria documents on pesticides. Political and economic influences affect decisions about whether or not to use pesticides, and the risk assessments and data used to assess pesticides. This has significant influence on the selection and use of particular pesticides and hence on both acute and chronic pesticide poisoning cases globally. Progress has been made to correct these covert and damaging influences and imbalances, but more needs to be done to ensure proper accountability and transparency in pesticide health and safety policy and practice.     

Attitudes and behaviors about pesticide residues,susceptibility to cancer,and consumption of fruits and vegetables

Nutrition educators are encouraging increased consumption of fruits and vegetables as a source of fiber, nutrients and anti-carcinogens. However, media messages about the health effects of pesticide residues have created fear about consuming fresh produce. A survey was sent to 2,000 Washington state residents to assess attitudes and behaviors related to concern about pesticide residues, perceived susceptibility to cancer, and consumption of fruits and vegetables. The survey included questions that were developed to assess each of the attitude and behavior variables. Multiple regression analysis indicated that 41% of the residue-reducing behavior and 44% of the health concern about pesticides was explained by the variables. Individuals with health concerns regarding pesticides had higher scores for residue-reducing behaviors, environmental concern, and perceived susceptibility to cancer. Respondents with low concerns about pesticides had a higher trust in regulation and saw greater benefits for pesticide use. Concerns beyond personal health, such as environmental concern, appear to contribute to concerns about pesticide residues. Fear of pesticide residues does not appear to diminish nutrition behaviors related to fruit and vegetable consumption.     

Pesticide exposure and women's health

BACKGROUND: Research on pesticide-related health effects has been mostly focused in industrialized countries and in men. This paper discusses critical issues related to women's pesticide exposure and its effects on women's health. METHODS: The literature on pesticides was reviewed with emphasis on data related to women. Attention was focused on research suggesting different conditions of exposure or different response to pesticides by sex. Studies on cancer and reproductive effects were used as illustrative examples. RESULTS: Women are increasingly exposed to pesticides in developing countries, where women's poisoning and other pesticide-related injuries seem to be greatly underestimated. Many of the effects of pesticides in human health will be the same for men and women, but not always. Some organochlorine pesticides have been related to breast cancer in post-menopausal women. However, knowledge about other pesticides is much more limited. Epidemiological studies assessing maternal exposure to individual pesticides and abortion, fetal death, or congenital defects are not conclusive, although some suggestive associations have been observed. CONCLUSIONS: Gender-sensitive research is needed to properly address the study of women's pesticide exposures and related adverse outcomes. A better understanding of potential gender-environment and sex-environment interactions related to pesticide exposure and health effects in women is needed.     

Pesticide use by persons who reported a high pesticide exposure event in the agricultural health study

Almost 16% of the pesticide applicators in the Agricultural Health Study (AHS) cohort (a cohort that includes 52,629 private applicators) reported having a high pesticide exposure event (i.e., an incident or experience while using a pesticide that caused an unusually high personal exposure). Pesticides involved in these events were compared to the frequency with which specific pesticides were ever used by the AHS cohort. Generally, pesticides with greater acute toxicity were more frequently involved with the high pesticide exposure event than were other pesticides. Whereas it is clear that the use of acutely toxic pesticides may be related to more frequent visits to health care facilities, the reason that the spills and immersions of the high pesticide exposure events are associated with the acute toxicity of the pesticide is not intuitively clear. This analysis suggests that current practices directed at minimizing pesticide exposures may not be sufficient for acutely toxic or irritating chemicals.     

Hidden health costs of pesticide use in Zimbabwe's smallholder cotton growers

Balancing the numerous benefits that may accrue from pesticide use on cotton, farmers face health hazards. Pesticide-induced acute symptoms significantly increased the cost-of-illness in a survey of 280 smallholder cotton growers in two districts of Zimbabwe. Cotton growers lost a mean of 180 Zimbabwe dollars in Sanyati and 316 Zimbabwe dollars per year in Chipinge on pesticide-related direct and indirect acute health effects. These values are equivalent to 45% and 83% of annual household pesticide expenditures in the two districts. The time spent recuperating from illnesses attributed to pesticides averaged 2 days in Sanyati and 4 days in Chipinge during the 1998/1999 growing season. These pesticide health cost estimates represent lower bounds only; they omit chronic pesticide health effects as well as suffering and other non-monetary costs. Acute pesticide symptoms were determined in large part by pesticide use practices, notably the lack of protective clothing. Yet many smallholder farmers misunderstood pesticide health hazards, and so did little to protect themselves. Despite the use of simple color codes, 22% of smallholder cotton growers in Sanyati and 58% in Chipinge did not know how the four colored triangles communicated increasing degrees of pesticide toxicity. Better farmer education in exposure averting strategies is needed. Likewise, fuller accounting for hidden health costs in future would allow farmers to make more informed decisions about agricultural pest management.     

Exposure misclassification of household pesticides and risk perception and behaviour

The aim of this paper was to compare self-reported household pesticide use or non-use in a questionnaire with reported household pesticide use from an in-depth interview, in order to elucidate any differences, and to study any differential reporting of pesticides. In the in-depth interview we asked for pesticide use, behaviour adopted while using pesticides and risk perceptions as possible factors to explain the reporting of pesticide use. The Avon Longitudinal Study of Parents and Children (ALSPAC) was used as the sampling frame. Eight hundred and thirty one parents filled out and returned the questionnaire. A random sample of 53 users and 94 non-users took part in the interview. Almost 90% of the 94 who did not report the use of pesticides in the questionnaire reported the use of pesticides during the interview. However, those who reported pesticide use in the questionnaire were more likely to report home and garden pesticide use (P < 0.05) in the interview. The parents who reported pesticide use in the questionnaire had a tendency to perceive a lower risk and higher benefit from pesticide use, and tended to be less risk averse when compared with the groups of parents who reported no pesticide use. They bought the pesticides because 'they looked safe', while those who did not report pesticide use bought them because they 'used them before'. The latter were also more likely to state that they did not understand everything on the label and that they thought that it did not provide all the information needed. They were also less likely to feel that they knew what they are doing when using pesticides and felt that pesticide use is relatively dangerous compared with other hazards. In conclusion, pesticide use is underreported in questionnaires, and behaviour and risk perception may affect the reporting.     

Studying health outcomes in farmworker populations exposed to pesticides

A major goal of studying farmworkers is to better understand how their work environment, including exposure to pesticides, affects their health. Although a number of health conditions have been associated with pesticide exposure, clear linkages have yet to be made between exposure and health effects except in cases of acute pesticide exposure. In this article, we review the most common health end points that have been studied and describe the epidemiologic challenges encountered in studying these health effects of pesticides among farmworkers, including the difficulties in accessing the population and challenges associated with obtaining health end point data. The assessment of neurobehavioral health effects serves as one of the most common and best examples of an approach used to study health outcomes in farmworkers and other populations exposed to pesticides. We review the current limitations in neurobehavioral assessment and strategies to improve these analytical methods. Emerging techniques to improve our assessment of health effects associated with pesticide exposure are reviewed. These techniques, which in most cases have not been applied to farmworker populations, hold promise in our ability to study and understand the relationship between pesticide exposure and a variety of health effects in this population. Key words: biomarkers, cancer, epidemiology, health outcomes, immigrants, neurobehavioral, neuropathy, pesticides.     

The health impacts of pesticide use on sugarcane farmers in Fiji

A survey conducted among sugarcane farmers in Fiji found significant differences in the incidence of chronic illness and disease between users of pesticides and a nonuser control group. Though average production of sugarcane was markedly higher among pesticide users, average annual medical expenditures were also significantly higher. Advanced technological methods including chemical pesticides require a system of institutional support to provide, inter alia, information for an effective transition from traditional to modern agricultural practices. Without that support the ad hoc application of technology may result in inefficiency and, in the case of pesticides, increased health risks among the farm population. Besides practical handling and application advice farmers require information describing the chronic health impacts of pesticide exposure to allow their weighing of the full costs of pesticide use against the production benefits.     

Pesticides in the cultivation of carnations in greenhouses: Part I--Exposure and concomitant health risk.

Respiratory exposure and dermal exposure of the hands and forearms to the pesticides chlorothalonil, thiophanate-methyl, thiram, and zineb during application and during crop activities have been measured on 18 farms for carnation culture in glass-covered greenhouses in the Netherlands. Farms were selected according to a "worst case" strategy with regard to dermal exposure during cutting of flowers. For 94 workers, the geometric mean dermal exposure rate during cutting (measured on long-sleeved cotton glove monitors) was 10.1 mg/hr (active ingredient per unit of actual working time) and during sorting/bundling of these flowers by 35 workers the dermal exposure rate was 7.3 mg/hr. The average concentration in air as measured by personal air sampling during cutting after a pesticide had been dusted was 0.07 mg/m3. For the same area, spraying a pesticide exposed the applicator to a dermal exposure seven times higher than dusting. However, during dusting respiratory exposure was higher. Generally, overall exposure is higher during re-entry activities than during application. From the observed levels of dermal exposure during harvesting (re-entry) and from toxicity data, health risk occurs after application of pesticides that are relatively toxic and show relatively good skin-penetrating properties at relatively high application rates. The respiratory exposure to dusted pesticides after re-entry is about as high as during application of these pesticides and may in some situations also result in health risks. Training and education of greenhouse workers on (personal) hygiene and use of protective gloves are advocated in order to reduce exposure.     

Health costs from short-term exposure to pesticides in Nepal

Household surveys were undertaken every week for seven months in 2005 to understand acute health symptoms and to estimate health costs associated with pesticide exposure in rural Nepal. The cost-of-illness and avertive action approach was used to estimate costs of pesticide use. The probit regressions fit sickness and avertive actions with exposure to pesticides and other factors. Based on data from 291 households, the study finds that the magnitude of exposure to insecticides and fungicides significantly influenced the occurrence of acute symptoms. The predicted probability of falling sick from pesticide-related symptoms is significantly higher among individuals who apply pesticides compared to individuals in the same household who are not directly exposed. Further, the predicted annual cost of illness as a result of pesticide use is estimated to be Nepalese Rupees 144 per individual. This cost is nearly one-third of the total expenditure on health care services, but is small compared to the increase in farm production costs, thus when faced with a choice between the health care costs and increases in farm production costs, the individual opts for pesticides. However, the costs are nearly eight times higher compared to the population who were not directly exposed. This study suggests that there are acute health impacts of pesticide use; however, because of the low level of the health costs, farm workers may underestimate the effects of pesticides on the human being, and thus they may continue to use pesticides without any safety precautions.     

Impact of pesticides use on human health in Mexico: a review

Pesticides having a high adverse effect on the health and environment of inhabitants of the Mexican Republic were studied to establish the main parameters to bear in mind for their use and application. The investigation showed that Mexico is the agricultural zone with the highest health damage to its population from pesticides. The valid regulation norms for the use and application of these agrochemicals were analyzed. Case histories recorded by the public health sector in Mexico were reviewed. In this way, a strong relation was found between the health problems and the pesticides applied. Finally, the study concludes that the various Mexican States appear as a risk zone because of contamination by pesticides that are permitted by the regulation norms and by others whose use is prohibited in other countries and in Mexico. This situation causes a serious effect on the health deterioration of people who are exposed to these agro-chemicals and, in some cases, leads to death.     

Monitoring pesticide use and associated health hazards in Central America

We established methods for monitoring pesticide use and associated health hazards in Central America. With import data from Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama for 2000-2004, we constructed quantitative indicators (kg active ingredient) for general pesticide use, associated health hazards, and compliance with international regulations. Central America imported 33 million kg active ingredient per year. Imports increased 33% during 2000-2004. Of 403 pesticides, 13 comprised 77% of the total pesticides imported. High volumes of hazardous pesticides are used; 22% highly/extremely acutely toxic, 33% moderately/severely irritant or sensitizing, and 30% had multiple chronic toxicities. Of the 41 pesticides included in the Stockholm Convention on Persistent Organic Pollutants (POPs), the Rotterdam Convention on Prior Informed Consent (PIC), the Montreal Protocol on Substances that Deplete the Ozone Layer, the Pesticide Action Network (PAN) Dirty Dozen, and the Central American Dirty Dozen, 16 (17% total volume) were imported, four being among the 13 most imported pesticides. Costa Rica is by far the biggest consumer. Pesticide import data are good indicators of use trends and an informative source to monitor hazards and, potentially, the effectiveness of interventions.