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Table 4. Number and proportion (%) of respondents who prepared agrochemicals according to the instructions, wore protective clothing while spraying, and took precautions when handling chemical by level of education. Level of education Followed instructions 40 - 35 - 30 - 25 - 20 - 15 - 10 - 5- 0 A Wore protective clothing CHCs Organophosphates LJ Other pesticides VA 1987 1988 1989 1990 Fig. 1. Cases of pesticide poisoning reported to Kiambu District Hospital between January 1987 and April 1990. career spray operators are male, and it is possible to speculate that ready access to agrochemicals is a factor in the considerable number of suicides by poisoning. From 1987 to April 1990, among poisonings of people 21 years and over, 44 (55.7%) were of undetermined causes, 33 (41.8%) were intentional, and 2 (2.5%) were accidental. During the period of the study, 133 cases of agrochemical poisoning were treated at Kiambu I)istrict Hospital alone; there were 8(6%) deaths (Table 5). Discussion The community uses a variety of pesticides and fertilizers extensively almost all year. Community awareness of the environmental and personal health hazards posed by these chemicals, especially pesticides, is minimal. The number of poisonings treated at Kiambu District Hospital suggests that action 112 Caution with - All Certain chemicals chemicals Sample size None 64 (15.0) 96 (22.5) 116 (27.2) 259 (60.8) 426 Primary 424 (44.0) 342 (22.5) 217 (22.5) 699 (72.6) 963 High school and over 256 (62.7) 167 (40.9) 98 (24.0) 289 (70.8) 408 Total 744 (41.4) 605 (33.7) 431 (24.0) 1 247 (69.4) 1 797
Table 5. Causes of agrochemical and other chemical poisoning treated at Kiambu District Hospital from 1987 to April 1990. Age group Sex Cause of poisoning Outcome (years) M F Suicidal Accidental Undetermined Alive Dead Total 0-5 15 6 1 6 14 21 0 21 6-10 0 2 1 0 1 2 0 2 11-20 16 15 12 2 17 31 0 31 21+ 61 18 33 2 44 71 8 79 Total 92 41 47 10 76 125 8 133 is needed to remedy the situation. The belief of the majority of the population that there are no alternatives to pesticides calls for urgent steps to be taken to ensure safe handling of pesticides. The investigators, together with the district multidisciplinary team, developed a health-education curriculum for different target groups. Teams from the health centres in the region were identified to assist in this activity and to integrate the curriculum into their community-health activities. Target groups included school children, women's groups, factory workers, and the career spray operators. Pesticide manufacturers and retailers have begun to cooperate, especially in packaging chemicals in smaller and safer containers. The response of the community to the health-education curriculum has been encouraging because some of the problems are obvious. This study has motivated people to take responsibility for their own safety. Target groups, health centres, schools, coffee-factory workers, and all other members of the community have adopted safe handling practices recommended in the healtheducation program in their day-to-day activities. Acknowledgment - We acknowledge the financial support of the International Development Research Centre of Canada, which made this study possible. Akhabuhaya, J.L. 1989. Use of pesticides in agriculture. East Africa Newsletter on Occupational Health and Safety, 31 (December), 8-9. Brown, J.D.; Meme, J.S.; et al. 1982. Mercury poisoning in Kenyan children: a further report on epidemiologic aspects. East African Medical Journal, 59(2). Choudhry, A.W.; Levy, B.S. 1988. Morbidity estimates of occupational illnesses and injuries in Kenya: human and economic costs. Paper presented at the 9th Annual Medical Scientific Conference, 1-5 February 1988. Kenya Medical Research Institute and Kenya Trypanosomiasis Research Institute, Nairobi, Kenya. Youdeowei, A.; Service, M. 1983. Pest and vector management in the tropics. Longmans, Harlow, Essex, UK. 113
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Impact of pesticide use on health i
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IMPACT OF PESTICIDE USE ON HEALTH I
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©International Development Researc
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Contents Acknowledgments viii Forew
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Control of disease vectors: a curre
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Foreword From their first appearanc
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PART! EPIDEMIOLOGY OF PESTICIDE POI
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Although pesticides are used both i
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Table 1. Introduction of pesticides
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problem. The International Developm
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impact of pesticides on Canadian wi
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investigated further. For example,
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Conclusions The subject of this vol
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Jusoh Mamat, M.; Anas, A.N.; Heong,
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Health-risk assessment of pesticide
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especially in the absence of comple
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depends largely on external factors
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Specific situations may require spe
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that the best possible work is done
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doses (chronic poisoning) or delaye
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Table 1. Poisoning incidents in fou
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Pesticide research for public healt
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Current pest control practices in T
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800- 400- 200 - 1980 1981 1982 1983
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designed 30-40 years ago (Jusoh Mam
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and tore easily. One investigation
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education, mass-communication tools
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Increase and improve training activ
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Castaneda, C.P. 1988. Pesticide poi
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Ooi, A.C.P.; Heong, K.L.; Lim, B.K.
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Investigations into acute pyrethroi
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Level of exposure To assess the lev
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Table 2. Cases of acute pyrethroid
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(in 121 subjects), usually develope
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Deltamethrin was detectable in the
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pyrethroid poisoning. Therefore, th
Page 73 and 74: Gilliatt, R.W.; Willison, R.G. 1963
Page 75 and 76: Table 1. Value of imported pesticid
Page 77 and 78: Study two Twelve farmers participat
Page 79 and 80: All activities Left hand (73.2) Lef
Page 81 and 82: Acknowledgment- The three studies r
Page 83 and 84: Since the creation of Pakistan in 1
Page 85 and 86: Table 1. Incidents of pesticide poi
Page 87 and 88: Sandu, S.S.; Waters, M.D.; Simmon,
Page 89 and 90: and chlordane. Pest resistance to t
Page 91 and 92: young workers was 15.8%, 6.8%, and
Page 93 and 94: Storage of pesticides Although the
Page 95 and 96: Discussion The lowland regions and
Page 97 and 98: Pulmonary obstructive disease in a
Page 99 and 100: To investigate the presence and mea
Page 101 and 102: Age (years) Table 1. Distribution o
Page 103 and 104: was among paraquat users who smoked
Page 105 and 106: Levin, P.J.; Klaff, L.J.; Rose, A.G
Page 107 and 108: the delta. The total population of
Page 109 and 110: The successive and simultaneous rel
Page 111 and 112: on clinical studies and laboratory
Page 113 and 114: This made the collection of blood s
Page 115 and 116: Table 1. Relation between informati
Page 117 and 118: analysis, and engaging in various t
Page 119 and 120: Table 1. Value (million KSH) of pes
Page 121 and 122: To develop a health-education packa
Page 123: Storage site Table 3. Storage of ag
Page 127 and 128: Methods A pilot field survey was un
Page 129 and 130: Conclusion The practices followed b
Page 131 and 132: manufactured or formulated locally,
Page 133 and 134: However, based on individual compla
Page 135 and 136: Table 4. Acetylcholinesterase activ
Page 137 and 138: Age did not appear to be an importa
Page 139 and 140: eactions to the pesticides in occup
Page 141 and 142: Bowers, M,B.; Goodman, E.; Sim, V.M
Page 143 and 144: Extent of exposure of farm workers
Page 145 and 146: Group III consisted of 31 farmers w
Page 147 and 148: 25 - 0 Level of exposure J Group 1,
Page 149 and 150: Pesticides were stored everywhere c
Page 151 and 152: Table 2. Concluded. Question Answer
Page 153 and 154: PART II RELATING PESTICIDE DEVELOPM
Page 155 and 156: Toxicity Table 1. Requirements and
Page 157 and 158: Screening Process development Route
Page 159 and 160: Progress in improving safety Pestic
Page 161 and 162: type of formulation, and warning pr
Page 163 and 164: The pyrethroid, cypermethrin, is mo
Page 165 and 166: Studying the effects of pesticides
Page 167 and 168: of the risk is a quantitative issue
Page 169 and 170: egistry could be linked to the lice
Page 171 and 172: poisoned through mishandling of an
Page 173 and 174: no documented incident could be fou
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Region Table 3. Use of using pictog
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of fluorinated HDPE because fluorin
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Current initiatives, at the interna
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inding within their jurisdictions.
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Benefits of a hazard auditor From t
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different agencies take to be permi
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industry and of its serving to legi
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Anonymous. 1988a. FAO code of condu
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(Adam 1976; Fraser and Burrill 1979
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in the lower price categories tend
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Anas, N.; Jusoh Mamat, Md.; Heong,
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Zam, A.K. 1980. Bancian pengurusan
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Materials and methods Assessment of
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At the end of each day's operations
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Table 3. Number of garments chafing
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underlines the need to change attit
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Evaluation and management of pestic
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target and react with some crucial
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scientists on a contractual basis,
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pesticides in developing countries
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Regional information resources for
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Table 2. Number of enquiries receiv
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extent of this problem in developin
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Promoting the safe use of pesticide
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pests) is observed. Thus, the "quic
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is one of principal agencies respon
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Pretesting materials in training an
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of costly medical technologies and
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The agricultural sector has by far
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At the community level, the extent
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Neufeld, V. 1989. Community-based m
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Outline for learning module using o
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WHO (World Health Organization). 19
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In the past decade, tremendous effo
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Jiang-Su province Results and discu
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As a result of deregulation, the nu
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Table 3. Proportion of workers usin
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Shih, J.H.; Wu, Z.Q.; Zhang, Y.X.;
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Pesticides and wildlife: a short gu
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Using target-specific products mini
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specifications. Other data are asse
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Formulation-specific concerns The e
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mirex, and chiordecone have been ba
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1984). The base for pesticide granu
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e more stringently reviewed. In Can
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For example, searching for carcasse
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overlooked. In developing countries
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Establish monitoring programs to de
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Grue, C.E.; Fleming, W.J.; Busby, D
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Schafer, E.W., Jr; Brunton, R.B. 19
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Table 1. Prevalence and distributio
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By 1980, resistance to at least one
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tries. Japanese encephalitis has be
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to the targeted larvae of mosquitoe
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The role of the community Many prob
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from locally available sacking mate
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services. The project also includes
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Maxwell, C.A.; Curtis, C.F.; Haji,
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Botanical pesticides: optimizing pe
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neurotoxin but a cytotoxin, cross-r
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MoDuscicide- and pesticide-developm
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A development plan has been identif
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and environmental effects must be d
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Devitt, B.D.; Philogène, B.J.R.; H
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Endod, a potential natural pesticid
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University in Ottawa, and in other
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in the field (Lugt 1981), 137 500 m
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Hutchinson, J.; Dalziel, J.M. 1929.
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Community participation, including
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Acknowledgment- This research has b
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multiplication. The high temperatur
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Because pesticides are required in
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Africa and now East Africa. The suc
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Integrated pest management 1PM may
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to risk crop damage. Close involvem
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Ramos-Ocampo, V.E.; Magallona, E.D.
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esidues on fresh and cooked vegetab
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Grassy strip 108 N Farmer's Experim
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Table 1. Description and efficiency
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Table 3. Cost (PHP) of pest managem
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in the field. These pests were the
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PART V APPENDICES
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Ravindra Fernando, National Poisons
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Frank White, Pan-American Health Or
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ECHO abdominal ultrasonograph EEG e
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URT upper respiratory tract USAID U
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