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the delta. The total population of this area is about 7 000, most of whom live
in small dispersed villages sometimes up to 90 km from the main road connecting
Mala and Viscas.
Since 1983, the Huayuna Institute (a nonprofit organization) has carried out
health promotion and development projects in the Mala valley. To improve
the living conditions of the people of this area, a program of primary health
care (PHC) is being developed. The occupational health project is an offshoot
of the larger PHC project and is being implemented with the joint collaboration
of the Ministry of Health and the local communities.
The main economic activity in the area is the cultivation of apple trees. This
generally takes place in small family units (the average unit is I ha), although
for certain tasks casual labourers are also hired. The climate of this area is ideal
for cultivating 'Delicious Viscas', a variety of tropical apple that can be grown
year round. This allows the farmers to divide their fields and stagger production
of 'Delicious Viscas' as desired.
After many years of experience, most growers have adopted a level of cultivation
that includes the use of manure and chemical pesticides. In addition,
chemical defoliants are widely used, especially dinitro-o-cresol (DNOC). This
product also stimulates blossoming, permitting the trees to flower uniformly,
and it is a nonsystemic stomach poison and contact insecticide, killing the eggs
of certain insects and spider mites. DNOC is poisonous to man and animals,
especially by ingestion. It acts as a cumulative poison in humans, although
there is little evidence of accumulation in laboratory animals (Worthing and
Walker 1987). Acute exposure to large amounts of DNOC affects the body's
heat regulatory system causing overheating (IOCU 1986).
The climate, agricultural inputs, and regulation of flowering allow three
harvests in 2 years, instead of one harvest each year. The immediate advantage
of this intense cultivation is increased annual profits for the growers. However,
the economic gain is accompanied not only by serious problems of environmental
contamination but also by risks of moderate to severe pesticide intoxication.
(Cases of fatal intoxication are well documented, while the outcome
of moderate intoxication is less well known.)
To reduce the effect of general hyperinflation in the Peruvian economy, there
is a trend toward subdividing more land and distributing harvests over the
entire year. Depending on the overall production strategy, e.g., inaintenance
or reduction of the number of hired workers and immediate or delayed use of
various pesticide applications in other orchards, the risk of pesticide intoxication
can vary.
Moreover, because of the lack of extreme fluctuations in seasonal temperatures
in the Mala valley, there are more generations of insects and pests per season
than normally found in apple-producing countries. As a result, the Mala apple
growers depend on the use of more and more pesticides to keep pest populations
in check. The environmental consequence of this practice is a major
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