Circumstances where the risks for acute poisoning are high arise from different factors: specific substances that can cause adverse biological effects, specific situations with a potential for accidents or increased exposure, and involvement of population groups that are more susceptible to toxic chemicals (older people, children and pregnant women in particular, besides people who have ill health or are affected by low standards of living) (WHO 1987). In developing countries children and adolescents frequently experience acute pesticide poisoning, either accidentally or while working (UNEP 2004). Women suffer pesticide poisoning both as workers or spouse of a farmer (Rother 2000). Highrisk circumstances are situations where the combination of factors significantly increases the risk of acute poisoning. Fifteen years ago the World Health Organization concluded that in some countries the problem of poisoning with pesticides (all types) was so serious that urgent action was required, and that countries should be supported in assessing the effectiveness of intervention measures (WHO 1990). It was recommended that national authorities, non-governmental organisations and the industry unite their efforts to deal with this problem, by providing education and information on the usage of pesticides, adopting and harmonising the regulation of pesticide use and providing the necessary means to implement it, developing systems that allow to combine the epidemiological data on acute pesticide poisoning and to establish prevention programmes (especially regarding suicide attempts) (WHO 1991). Acutely toxic pesticides have come into increasing use in many countries, but the farmers continue to have inadequate protec-tion or training and national regulatory measures are deficient or totally lacking in some places (FAO 1994). It was concluded that the IPM programs of the FAO in several African countries of the Sahel region resulted in a reduction of risks for health and of quantities of insecticides used, but that it is difficult to measure the impact of training and education on risk reduction in most countries (FAO (no year)). The industry has carried out programmes to train farmers in less hazardous practices of pesticide use, however, safety training cannot guarantee reduced exposure in tropi-cal climates and developing countries; prevention of poisoning has been defined as low use or no use of only the least hazardous products (in WHO class III or class U) (Murphy et al 1999).

Agriculture is one of the three most hazardous industries, together with mining and construction; a large number of workers suffer pesticide poisoning, besides injury from accidents, especially seasonal and migrant workers who increasingly have replaced yearround workers on plantations (ILO 2004). Although the standards for occupational health and safety are usually relatively high “on the books”, workers in the field applying pesticides often do not have or use effective equipment for protection or they are not trained in its use. Workers reentering sprayed fields may be highly exposed and even labour contractors often do not know what pesticide was sprayed (Bade 1999). It must be kept in mind that it is generally much more difficult for workers in the South to protect themselves adequately from toxic pesticides than for workers in the North. In countries of the South agricultural workers only use partial personal protection. In a survey in Cambodia 96% of interviewed farmers had experi-enced symptoms or signs of acute pesticide poisoning; 89% reported wearing a long-sleeved shirt and long pants during spraying, 11% wore shorts, 61% wore no protective mask (the cotton masks in use may have a limited efficiency) and 79.2% wore no boots (CEDAC 2004). Even if protective clothes are worn they do not prevent acute poisoning from occurring, as they do not cover all the body or become soaked in pes-ticide. Acutely toxic pesticides such as paraquat pose a serious risk to health, all the more when applied with hand-held sprayers by insufficiently protected workers. Paraquat is especially dangerous because there is no antidote and as it has a delayed effect on the lung (Madeley 2002). It has caused poisonings all over the world and presents inacceptable health risks under the working conditions that are normally encountered in many countries.

References:

Bade BL, Is there a doctor in the field? Underlying conditions affecting access to health care for California farmworkers and their families, CPRC report, University of California 1999

Centre d’Etude et de Développement Agricole Cambodgien (CEDAC), Pesticide use consequence in Cambodia, Phnom Penh, Cambodia 2004

Food and Agriculture Organization of the United Nations (FAO), Analysis of government responses to the second questionnaire on the state of implementation of the International Code of Conduct on the Distribution and Use of Pesticides, Safe management of pesticides: Global monitoring of pesticide management practices, Rome 1994 (quoting from General conclusions)

Food and Agriculture Organization of the United Nations (FAO), FAO/OECD Pesticide risk reduction survey, Safe management of pesticides, Rome (no year) (quoting from section: Promoting sustainable farming methods)

International Labour Office (ILO), Towards a fair deal for migrant workers in the global economy, International Labour Conference, 92nd session, report VI, Geneva 2004

Madeley J, Unsuitable for use – profile of paraquat, Pesticides News 56, 3-5, 2002

Murphy H, Sanusi A, Dilts A, Djajadisastra M, Hirschhorn N, and Yuliantiningsih S, Health effects of pesticides use among Indonesian women farmers: part I: Exposure and acute health effects, Journal of Agromedicine 6(3), 61-85, 1999

Rother HA, Influences of pesticide risk perception on the health of rural South African women and children, African Newsletter on Occupational Safety and Health 2, 42-46, 2000

United Nations Environment Programme (UNEP), Childhood pesticide poisoning, Geneva 2004

World Health Organization (WHO), Safe use of pesticides, WHO technical report series 813, Geneva 1991

World Health Organization (WHO), and United Nations Environment Program (UNEP), Public health impact of pesticides used in agriculture, Geneva 1990

World Health Organization (WHO), Regional Office for Europe, Prevention of acute chemical poisonings: highrisk circumstances, Report on a Joint WHO/IPCS/CEC meeting, Münster, 8-12 December 1986, Copenhagen 1987