Surveillance of pesticide-related illness in the developing world: putting the data to work.

With PLAGSALUD support, pesticide illness surveillance has extended to all seven Central American countries, producing 7,000 poisoning reports in 2000, but governments' use of the surveillance data has been limited by inadequacies of data management, interpretation, and reporting and an influential pesticide industry in weak economies. Overrepresented reports of suicides minimize occupational hazards. In six countries, 32,245 questionnaire responses indicated 98% underreporting of pesticide poisonings and a regional estimate of 400,000 poisonings per year (1.9% of the population), 76% work-related. A potentially far-reaching measure to come out of this surveillance is an agreement of the ministers of health of Central America and the Dominican Republic (RESSCAD 2000) for a harmonized list of banned and restricted pesticides, including the 12 most frequently reported. The RESSCAD agreement has met considerable resistance from industry. Its achievement versus failure will disclose the ability of Central American governments to prioritize protection of human health against commercial corporate interests. Surveillance data have potential for policy reform, but a more aggressive health sector is needed, linked with the environmental sector, grass-roots organizations, and universities.

Vigilancia de las enfermedades provocadas por plaguicidas: La experiencia nicaraguense

In 1984, work designed to expanded cholinesterase screening activities and improve the reporting of pesticide poisonings was initiated in Nicaragua's León-Chinandega region as a pilot project. Using a field tintometric method, 1,960 workers were screened for whole blood cholinesterase. The percentage with low cholinesterase activity levels (50 per cent or less) increased sharply during the peak spraying season. Airfield workers were most affected, though a noteworthy share of certain agricultural workers were also found to have low levels. Workers who used certain kinds of personal protective equipment were significantly less affected (p .05). In addition to these survey findings, six deaths and 396 pesticide-related poisonings were reported in the León-Chinandega region in 1984. This indicated a relatively high rate of 74.6 poisoning cases per 100,000 inhabitants, 84 per cent of them occurring in October-December. Ninety-four percent of the cases reported via questionnaires were occupationally related, small farms being the most affected. Menthyl parathion was implicated in roughly half of these cases , two-thirds of which were due to dermal exposure. Policy recommendations derived from the initial results reported here include reduction of methyl parathion use, installation of closed systems for safer aircraft loading, provisión and use of clothing that protects the skin against exposure

Vigilancia de las enfermedades provocadas por plaguicidas: La experiencia nicaragüense

In 1984, work designed to expanded cholinesterase screening activities and improve the reporting of pesticide poisonings was initiated in Nicaragua's Leon-Chinandega region as a pilot project. Using a field tintometric method, 1,960 workers were screened for whole blood cholinesterase. The percentage with low cholinesterase activity levels (50 per cent or less) increased sharply during the peak spraying season. Airfield workers were most affected, though a noteworthy share of certain agricultural workers were also found to have low levels. Workers who used certain kinds of personal protective equipment were significantly less affected (p .05). In addition to these survey findings, six deaths and 396 pesticide-related poisonings were reported in the Leon-Chinandega region in 1984. This indicated a relatively high rate of 74.6 poisoning cases per 100,000 inhabitants, 84 per cent of them occurring in October-December. Ninety-four percent of the cases reported via questionnaires were occupationally related, small farms being the most affected. Menthyl parathion was implicated in roughly half of these cases , two-thirds of which were due to dermal exposure. Policy recommendations derived from the initial results reported here include reduction of methyl parathion use, installation of closed systems for safer aircraft loading, provision and use of clothing that protects the skin against exposure