[The UNESCO brand in the prosecco hills: opportunity or new health risk?] / Il marchio UNESCO sulle colline del prosecco: opportunità o nuovo rischio per la salute?

The historical hill-site zone of Prosecco's wine production was recognised as a UNESCO World Heritage Site. This area is part of the province of Treviso, an area where in recent years many lands have been occupied by the viticulture to produce this type of wine, due to a growing demand of prosecco, especially on international markets. Currently viticulture occupies 31% of the total agricultural area of the province. This is determining an important alteration of the landscape of the area, with serious loss of biodiversity. Even more, this intensive cultivation requires the use of many pesticides (in 2018, 4,622 tons were sold, equivalent to more than 36 kg per hectare of arable land), that are harmful to the health of the population. They can cause acute effects by inhalation or contact during the treatment of the vines, and chronic effects for the continuous intake of small doses through contaminated waters. To safeguard the environment and health, two actions are needed: to reduce the use of pesticides by promoting organic production; to restore biodiversity by promoting other crops besides the vineyards. Our hope is that belonging to the UNESCO heritage world list favours these actions.

Challenges and opportunities in suicide prevention in South-East Asia.

Suicide is a global public health problem, with over 800 000 people worldwide dying by suicide in 2012, according to the World Health Organization (WHO). The WHO South-East Asia Region is especially affected, with 39% of global suicides occurring in the 11 countries in this region. Women are a particularly vulnerable population, for a variety of social and cultural reasons. In India specifically, deaths by suicide for women peak in the age range 15-29 years. There is sufficient evidence to show that reduction of easy access to means of suicide is an effective prevention strategy. A common method of suicide in the region is by ingestion of pesticides. Strategies that have targeted limiting access to pesticides as a means of preventing suicide, such as the use of central storage and locked boxes, have shown promising results. Given the limited human and economic resources in these countries, it is essential to involve all stakeholders, including health services, voluntary and community organizations, teachers, social workers, traditional healers and other gatekeepers, in suicide prevention. A multisectoral approach, specifically targeting women and reducing easy access to pesticides, should be the way forward to reducing suicides in this region. In addition, more research is needed, to identify cost-effective and sustainable strategies.

Regional variation in suicide rates in Sri Lanka between 1955 and 2011: a spatial and temporal analysis.

BACKGROUND: Between 1955 and 2011 there were marked fluctuations in suicide rates in Sri Lanka; incidence increased six-fold between 1955 and the 1980s, and halved in the early 21st century. Changes in access to highly toxic pesticides are thought to have influenced this pattern. This study investigates variation in suicide rates across Sri Lanka's 25 districts between 1955 and 2011. We hypothesised that changes in the incidence of suicide would be most marked in rural areas due to the variation in availability of highly toxic pesticides in these locations during this time period. METHODS: We mapped district-level suicide rates in 1955, 1972, 1980 and 2011. These periods preceded, included and postdated the rapid rise in Sri Lanka's suicide rates. We investigated the associations between district-level variations in suicide rates and census-derived measures of rurality (population density), unemployment, migration and ethnicity using Spearman's rank correlation and negative binomial models. RESULTS: The rise and fall in suicide rates was concentrated in more rural areas. In 1980, when suicide rates were at their highest, population density was inversely associated with area variation in suicide rates (r = -0.65; p < 0.001), i.e. incidence was highest in rural areas. In contrast the association was weakest in 1950, prior to the rise in pesticide suicides (r = -0.10; p = 0.697). There was no strong evidence that levels of migration or ethnicity were associated with area variations in suicide rates. The relative rates of suicide in the most rural compared to the most urban districts before (1955), during (1980) and after (2011) the rise in highly toxic pesticide availability were 1.1 (95% CI 0.5 to 2.4), 3.7 (2.0 to 6.9) and 2.1 (1.6 to 2.7) respectively. CONCLUSIONS: The findings provide some support for the hypothesis that changes in access to pesticides contributed to the marked fluctuations in Sri Lanka's suicide rate, but the impact of other factors cannot be ruled out.

Farmers' use of personal protective equipment during handling of plant protection products: Determinants of implementation.

Understanding factors affecting the use of personal protective equipment (PPE) during handling of plant protection products (PPPs) is of major importance for the design of tailored interventions to minimize exposure among farmers. However, data regarding this issue are highly limited. Factors related to the use of PPE during handling of PPPs were explored in a survey of cotton farmers in northern Greece. Data were collected through face-to-face interviews with the farmers based on a questionnaire with structured items on the frequency of use of various personal protective devices during handling of PPPs. New evidence on patterns of PPE use and potential exposure of farmers to PPPs is provided. Most farmers (49.3%) showed potentially unsafe behaviour with respect to PPE use. Hat and boots were the most commonly used protective items during PPPs use, but most of the farmers surveyed reported low frequency of use for gloves, goggles, face mask, coveralls, and respirator. Especially the respirator was reported to be the least used PPE item amongst farmers. Farmers who perceived PPPs as harmful substances or those who had an episode of intoxication in the past reported more frequent use of several PPE items. Stepwise multiple regression analysis revealed that the variable episode of intoxication in the past exerted the strongest positive influence on PPE use, followed by the perception of PPPs being hazardous substances, upper secondary education, previous training on PPPs (i.e., spraying equipment, application parameters, risks to human health and environment, safety issues) and farm size under cultivation. Old age exerted a significant negative influence on PPE use, namely, elderly farmers tended not to use PPE. Strategies to maximize the protection of applicators of PPPs from hazardous exposures still require innovation to achieve increased effectiveness. Emphasis on lifelong training and education of farmers about hazards and risks of PPPs is crucial for changing wrong behaviours in handling of PPPs.

A public health initiative for reducing access to pesticides as a means to committing suicide: findings from a qualitative study.

Widespread use of pesticides among farmers in rural India, provides an easy means for suicide. A public health initiative involving storage of pesticides in a central storage facility could be a possible strategy for reducing mortality and morbidity related to pesticide poisoning. This qualitative study explored community perceptions towards a central pesticide storage facility in villages in rural South India. Sixteen focus group discussions held with consenting adults from intervention and control villages were followed by eight more a year after initiation of the storage facility. Analysis revealed four themes, namely, reasons for committing suicide and methods used, exposure to pesticides and first-aid practices, storage and disposal of pesticides, and perceptions towards the storage facility. The facility was appreciated as a means of preventing suicides and for providing a safe haven for pesticide storage. The participatory process that guided its design, construction and location ensured its acceptability. Use of qualitative methods helped provide deep insights into the phenomenon of pesticide suicide and aided the understanding of community perceptions towards the storage facility. The study suggests that communal storage of pesticides could be an important step towards reducing pesticide suicides in rural areas.

Environmental hazards associated with pesticide import into Costa Rica, 1977-2009.

Raw pesticide import data from 1977 to 2009 obtained from the Ministry of Agriculture in Costa Rica were processed and analyzed. The quantity of specific active ingredients (a.i.), and chemical groups were calculated by year and presented in ten-year periods. Three sets of environmental hazard indicators were constructed: one for general pesticides exposure to monitor tendencies in time, including total quantities imported divided by significant denominators, such as hectares of protected and wetland areas. The second indicator calculates pesticide use on the Pacific or Caribbean slope. The third one is an assessment of environmental hazards intended to estimate fate and toxicity to aquatic biota. A review of Costa Rican aquatic ecosystems' contamination with pesticides is presented. The annual average import as well as the quantity of pesticides capable of reaching water bodies increased during the analyzed period. The same was observed for harmful a.i., 98% of the pesticides imported were classified as acutely toxic for fish and crustaceans and 73% for amphibians. Approximately 8.4 kg of a.i. were imported per hectare of protected areas and 24.3 kg of a.i. per hectare of wetlands. The contamination of aquatic systems over time by specific pesticides matches quite well the list of imported ones. We recommend using data of pesticide imports as a source of information to evaluate environmental risk exposure and promote changes to reduce impacts on aquatic systems.

Management and control of agri-chemical pesticides: any progress?

Issues related to agri-chemical pesticides usage and poisonings in South Africa have been well documented. Under-reporting of information required to determine the size of the problem complicates current surveillance and prevention programmes. The study aimed to determine: the procedure for reporting and follow-up of cases of agricultural pesticide poisonings; which factors contributed to the poisoning cases; and whether a biological monitoring programme was in place at the time of 110 reported cases of agri-chemical poisonings on farms in the Boland Health District between 1997 and 2000. A retrospective descriptive survey design involving a record review was applied. The study found that the cases were poorly reported. The follow up system at the local level between local government officials and the farmers was not efficient for the prevention of agrichemical poisonings. The contributory factors were insufficient information and training; the incorrect use of personal protective equipment; the lack of safety of the agri-chemical store; and the absence of a monitoring system on the majority of farms. This study demonstrated that the notification of agricultural chemical poisoning was applied in a fragmentary manner between the different governmental levels and departments

Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions.

BACKGROUND: Pesticide self-poisoning causes one third of global suicides. Sri Lanka halved its suicide rate by banning WHO Class I organophosphorus (OP) insecticides and then endosulfan. However, poisoning with Class II toxicity OPs, particularly dimethoate and fenthion, remains a problem. We aimed to determine the effect and feasibility of a ban of the two insecticides in one Sri Lankan district. METHODS: Sale was banned in June 2003 in most of Polonnaruwa District, but not Anuradhapura District. Admissions with pesticide poisoning to the district general hospitals was prospectively recorded from 2002. RESULTS: Hospital admissions for dimethoate and fenthion poisoning fell by 43% after the ban in Polonnaruwa, while increasing by 23% in Anuradhapura. The pesticide case fatality fell from 14.4% to 9.0% in Polonnaruwa (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.41-0.84) and 11.3% to 10.6% in Anuradhapura (OR 0.93, 95%CI 0.70-1.25; p = 0.051). This reduction was not sustained, with case fatality in Polonnaruwa rising to 12.1% in 2006-2007. Further data analysis indicated that the fall in case fatality had actually been due to a coincidental reduction in case fatality for pesticide poisoning overall, in particular for paraquat poisoning. CONCLUSIONS: We found that the insecticides could be effectively banned from agricultural practice, as shown by the fall in hospital admissions, with few negative consequences. However, the ban had only a minor effect on pesticide poisoning deaths because it was too narrow. A study assessing the agricultural and health effects of a more comprehensive ban of highly toxic pesticides is necessary to determine the balance between increased costs of agriculture and reduced health care costs and fewer deaths.

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.

Hexachlorocyclohexane (HCH) as new Stockholm Convention POPs--a global perspective on the management of Lindane and its waste isomers.

PURPOSE: Hexachlorocyclohexane (HCH) isomers (α-, ß- and γ- (Lindane)) were recently included as new persistent organic pollutants (POPs) in the Stockholm Convention, and therefore, the legacy of HCH and Lindane production became a contemporary topic of global relevance. This article wants to briefly summarise the outcomes of the Stockholm Convention process and make an estimation of the amount of HCH waste generated and dumped in the former Lindane/HCH-producing countries. RESULTS: In a preliminary assessment, the countries and the respective amount of HCH residues stored and deposited from Lindane production are estimated. Between 4 and 7 million tones of wastes of toxic, persistent and bioaccumulative residues (largely consisting of alpha- (approx. 80%) and beta-HCH) are estimated to have been produced and discarded around the globe during 60 years of Lindane production. For approximately 1.9 million tones, information is available regarding deposition. Countries are: Austria, Brazil, China, Czech Republic, France, Germany, Hungary, India, Italy, Japan, Macedonia, Nigeria, Poland, Romania, Slovakia, South Africa, Spain, Switzerland, Turkey, The Netherlands, UK, USA, and former USSR. The paper highlights the environmental relevance of deposited HCH wastes and the related POPs' contaminated sites and provides suggestions for further steps to address the challenge of the legacy of HCH/Lindane production. CONCLUSION: It can be expected that most locations where HCH waste was discarded/stockpiled are not secured and that critical environmental impacts are resulting from leaching and volatilization. As parties to the Stockholm Convention are legally required to take action to stop further POPs pollution, identification and evaluation of such sites are necessary.

Characterization of residential pest control products used in inner city communities in New York City.

The Columbia Center for Children's Environmental Health (CCCEH) previously reported widespread residential insecticide use in urban communities in New York City. Research suggests that pyrethroids are replacing organophosphates (OPs) in response to 2000-2001 US EPA pesticide regulations restricting OP use. A systematic assessment of active ingredients used for residential pest control is lacking. We queried a database of pesticide applications reported by licensed applicators between 1999 and 2005 and surveyed pest control products available in 145 stores within 29 zip codes in the CCCEH catchment area including Northern Manhattan and the South Bronx. Pyrethroids, pyrethrins, piperonyl butoxide, and hydramethylnon were the most common insecticide active ingredients reported as used by licensed pesticide applicators within the 29 zip codes of the CCCEH catchment area between 1999 and 2005. Use of certain pyrethroids and some non-spray insecticides such as fipronil and boric acid increased significantly by year (logistic regression, OR>1.0, P<0.05), whereas use of OPs, including chlorpyrifos and diazinon decreased significantly by year (logistic regression, OR<1.0, P<0.05). Among pesticide applicators, the most commonly applied active ingredients were formulated as spray applications. With 145 stores in the catchment area, 120 (82.5%) carried at least one insecticide. Spray cans were most common (114/120 stores, 95%); gels were least common (31/120 stores, 25.8%). Among spray formulations, pyrethroid insecticides were the most common pesticide class and permethrin, a pyrethroid, was the most common individual active ingredient. In 2007, one store carried a product containing chlorpyrifos and one store carried a product containing diazinon. This survey suggests that certain pyrethroids and non-spray insecticides replaced OPs for pest control in this area. Chlorpyrifos and diazinon have nearly been eliminated from products marketed for residential pest control.

DDT and personal violence (suicide and homicide).

For 12 industrialized nations in 1965, suicide and homicide rates were not associated with the per capita use of DDT.

Does 'no pesticide' reduce suicides?

INTRODUCTION: Ingestion of pesticides is the most common method of suicide, particularly in China, Sri Lanka and India. Reported pesticide suicides in India numbered 22,000 in the year 2006. METHOD: Four villages in the state of Andhra Pradesh in India that had stopped using chemical pesticides in favour of non-pesticide management (NPM) were visited to assess any change in suicide incidence before and after discontinuation of chemical pesticides. Four similar villages in the same region that continued to use chemical pesticides were used as controls for comparison. RESULTS: In the pesticide-free villages there were 14 suicides before introduction of NPM and only three suicides thereafter. The percentage of suicides not reported to authorities was 47%. CONCLUSION: Restriction of pesticide availability and accessibility by NPM has the potential to reduce pesticide suicides, in addition to psychosocial and health interventions.

Pesticide use patterns among small-scale farmers: a case study from Phitsanulok, Thailand.

In this study, 130 small-scale farmers were surveyed regarding pesticide use patterns in rural Phitsanulok, northern Thailand using a structured questionnaire administered via personal interviews and an observational checklist of farmer pesticide storage practices. The survey was conducted during December 2007-January 2008. The results indicate pesticides are readily available and widely used in crop production. This includes the use of endosulfan which has been banned by the Thai government since 2004. Overall, pesticide use was inappropriate. Farmers did not wear suitable personal protection, apply pesticides in an appropriate fashion, or discard the waste safely. They frequently relied on commercial advertisements for the best pesticide to use. Pesticide use patterns among small-scale farmers in Thailand need improvement. Educational interventions are essential for promoting safety during all phases of pesticide handling. Public policies should be developed to encourage farmers to change their pest management methods from chemical based to methods that are healthier and more environmentally friendly.

The global distribution of fatal pesticide self-poisoning: systematic review.

BACKGROUND: Evidence is accumulating that pesticide self-poisoning is one of the most commonly used methods of suicide worldwide, but the magnitude of the problem and the global distribution of these deaths is unknown. METHODS: We have systematically reviewed the worldwide literature to estimate the number of pesticide suicides in each of the World Health Organisation's six regions and the global burden of fatal self-poisoning with pesticides. We used the following data sources: Medline, EMBASE and psycINFO (1990-2007), papers cited in publications retrieved, the worldwide web (using Google) and our personal collections of papers and books. Our aim was to identify papers enabling us to estimate the proportion of a country's suicides due to pesticide self-poisoning. RESULTS: We conservatively estimate that there are 258,234 (plausible range 233,997 to 325,907) deaths from pesticide self-poisoning worldwide each year, accounting for 30% (range 27% to 37%) of suicides globally. Official data from India probably underestimate the incidence of suicides; applying evidence-based corrections to India's official data, our estimate for world suicides using pesticides increases to 371,594 (range 347,357 to 439,267). The proportion of all suicides using pesticides varies from 4% in the European Region to over 50% in the Western Pacific Region but this proportion is not concordant with the volume of pesticides sold in each region; it is the pattern of pesticide use and the toxicity of the products, not the quantity used, that influences the likelihood they will be used in acts of fatal self-harm. CONCLUSION: Pesticide self-poisoning accounts for about one-third of the world's suicides. Epidemiological and toxicological data suggest that many of these deaths might be prevented if (a) the use of pesticides most toxic to humans was restricted, (b) pesticides could be safely stored in rural communities, and (c) the accessibility and quality of care for poisoning could be improved.

Pesticide regulation, utilization, and retailers' selling practices in Trinidad and Tobago, West Indies: current situation and needed changes.

OBJECTIVE: To explore pesticide regulation in Trinidad and Tobago, and to ascertain pesticide utilization and retailers' selling practices on Trinidad, which is the larger of twin islands that constitute the republic of Trinidad and Tobago. METHODS: Between February and June 2005, agrochemical retailers in Trinidad were surveyed about the most frequently sold pesticides and their knowledge and practices of pesticide sale. The Poisons and Toxic Chemicals Control Board of the Ministry of Health informed on legislature. RESULTS: Of 107 actively trading licensed pesticide outlets, 97 participated (91% response rate) in the survey. Currently only 2.9% (21) of 720 registered products from four chemical classes are frequently utilized. Paraquat, methomyl, and alpha-cypermethrin (respective trade names are Gramoxone, Lannate, and Fastac) from World Health Organization (WHO) Hazard Classes I and II, and glyphosate isopropylamine (Swiper, Class U) are the most frequently purchased pesticides. Pet shops constitute 39.2% (38) of retail shops selling pesticides. No regulations guide pesticide sale to agriculturists, and children may purchase them. Inadequate human and technical resources render legislative controls ineffective and disciplinary action against offenders is weak. Extensive governmental resources are employed in legislative procedures and product approval for the very low, 2.9% utilization rate, negatively impacting on monitoring pesticide sales. The Poisons Information Centre (PIC) does not liaise with the Poisons and Toxic Chemicals Control Board or provide educational interventions for the community. As a result of this survey, it was possible to develop the first database to include the chemical, brand, and colloquial names of pesticides used in Trinidad and Tobago; WHO classification of approved pesticides; manufacturers; packaging; and antidotes and their availability for use by the Board and health professionals in Trinidad. CONCLUSIONS: Urgent critical evaluation of legislation regarding pesticide imports and use, and partnership with the Rotterdam Convention are recommended for Trinidad and Tobago. A strengthened Poisons Information Centre can provide educational initiatives and information on early management of pesticide exposure.