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It is clear that the scientific assessment of the impact of pesticide use on human health does not stop with toxicology and epidemiology, but requires equal attention from the behavioural and social sciences. Conclusion This volume reports an impressive array of initiatives addressing various aspects of the impact of pesticide use on health in developing countries. Perhaps even more pertinent for a world perspective is the evidence presented here of a common recognition by all countries, regardless of their state of development, of the usefulness of epidemiologic techniques in assessing the impact of pesticide use. Progress in the application of toxicology, epidemiology, and social and behavioural sciences has been advanced and will be of ultimate benefit to both donor and recipient countries, as the safe development and effective use of pesticides is to everyone's benefit. Nonetheless, the present studies (with some exceptions) also reveal a relative lack of attention to contexts other than occupational exposures, a tendency that is shared with Canada and other developed countries. This phenomenon is perhaps justifiable as occupational exposures are likely to be more intense and harmful to persons directly exposed. However, a challenge for all awaits in the study of environmental exposures of groups such as families, bystanders, and consumers. Such studies are often fraught with more difficult design, measurement, and logistic problems. Designs other than those demonstrated in this series of studies are available to epidemiologists. In addition to cross-sectional surveys, there is a full spectrum from case reports to cluster analyses, the investigation of outbreaks and of accidental exposures, correlational studies, cohort analyses, cace control studies, prospective studies, and randomized trials of intervention procedures. These are noted here for the sake of completeness, although their appropriateness depends on the nature of the question or hypothesis posed. All epidemiological approaches have inherent strengths and limitations, and an adequate discussion of this reality can hardly be achieved in this brief overview. Most of the problems encountered in the assessment of pesticide impact on human populations fall into one or more of the following areas: formulation of questions or hypotheses, appropriate choice of study design, identification of plausible pathobiological endpoints (short-, medium-, and long-term), the problem of exposure measurement, identification and control of confounding variables, recognition and avoidance of bias (systematic error), sufficient sample size to be able to answer the question, appropriate choice of statistical analysis, and rigorous interpretation of resulting data. In other words, the full potential of epidemiology is available to those who address the impact of pesticide use on health in both developing and developed countries, and in making use of such potential we must strive to ensure 24
that the best possible work is done. I congratulate the participants in this conference for responding to this challenge. Bornstein, J.; Adam, E.; Adler-Storthz, K.; Kaufman, RH. 1988. Development of cervical and vaginal squamous cell neoplasia as a late consequence of in utero exposure to diethyistilbestrol. Obstetrical and Gynaecology Survey, 43(1), 15- 21. Clary, J.J.; Gibson, J.E.; Waritz, R.S., ed. 1983. Formaldehyde: toxicology, epidemiology, mechanisms. Marcel Dekker, New York, NY, USA. Gaylor, D.W.; Kadhebar, F.F.; West, R.W. 1988. Estimates of the risk of bladder tumour promotion by saccharine in rats. Regulatory Toxicology and Pharmacology, 8,467-470. Giavini, E.; Prati, M.; Vismara, C. 1982. Rabbit teratology study with 2,3,7,8tetrachlorodibenzo-p-dioxin. Environmental Research, 27, 74-78. Lilis, R. 1986. Organic compounds. In Last, J.M., ed., Public health and preventative medicine (12th ad.). Appleton Century Crofts, Norwalk, CT, USA. McDonald, J.C. 1990. Cancer risks due to asbestos and man-made fibres. in Recent results in cancer research (vol. 120). Springer-Verlag, Berlin, Germany. O'Donovan, M.R. 1990. Mutation assays of ethyl benzidine and benzo[a]pyrene using Chinese hamster V79 cells. Mutagenesis, 5 (supplement), 9-13. Redmond, C.K.; Ciocco, A.; Lloyd, J.W. 1972. Long term mortality study of steelworkers. Journal of Occupational Medicine, 14, 621-629. Taussig, H.B. 1962. A study of the German outbreak of phocomelia: the thalidomide syndrome. Journa' of American Medical Association, 180, 1 106. Thilly, W.G.; Call, K.M. 1986. Genetic toxicology. In Klaassen, CD.; Amdur, M.O.; Doull, J., ad., Toxicology: the basic science of poisons (3rd ed.). Macrrillan, New York, NY, USA. 25
Page 1 and 2: Impact of pesticide use on health i
Page 3 and 4: IMPACT OF PESTICIDE USE ON HEALTH I
Page 5 and 6: ©International Development Researc
Page 7 and 8: Contents Acknowledgments viii Forew
Page 9 and 10: Control of disease vectors: a curre
Page 11 and 12: Foreword From their first appearanc
Page 13 and 14: PART! EPIDEMIOLOGY OF PESTICIDE POI
Page 15 and 16: Although pesticides are used both i
Page 17 and 18: Table 1. Introduction of pesticides
Page 19 and 20: problem. The International Developm
Page 21 and 22: impact of pesticides on Canadian wi
Page 23 and 24: investigated further. For example,
Page 25 and 26: Conclusions The subject of this vol
Page 27 and 28: Jusoh Mamat, M.; Anas, A.N.; Heong,
Page 29 and 30: Health-risk assessment of pesticide
Page 31 and 32: especially in the absence of comple
Page 33 and 34: depends largely on external factors
Page 35: Specific situations may require spe
Page 39 and 40: doses (chronic poisoning) or delaye
Page 41 and 42: Table 1. Poisoning incidents in fou
Page 43 and 44: Pesticide research for public healt
Page 45 and 46: Current pest control practices in T
Page 47 and 48: 800- 400- 200 - 1980 1981 1982 1983
Page 49 and 50: designed 30-40 years ago (Jusoh Mam
Page 51 and 52: and tore easily. One investigation
Page 53 and 54: education, mass-communication tools
Page 55 and 56: Increase and improve training activ
Page 57 and 58: Castaneda, C.P. 1988. Pesticide poi
Page 59 and 60: Ooi, A.C.P.; Heong, K.L.; Lim, B.K.
Page 61 and 62: Investigations into acute pyrethroi
Page 63 and 64: Level of exposure To assess the lev
Page 65 and 66: Table 2. Cases of acute pyrethroid
Page 67 and 68: (in 121 subjects), usually develope
Page 69 and 70: Deltamethrin was detectable in the
Page 71 and 72: 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 and 124:
Storage site Table 3. Storage of ag
Page 125 and 126:
Table 5. Causes of agrochemical and
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
Page 175 and 176:
Region Table 3. Use of using pictog
Page 177 and 178:
of fluorinated HDPE because fluorin
Page 179 and 180:
Current initiatives, at the interna
Page 181 and 182:
inding within their jurisdictions.
Page 183 and 184:
Benefits of a hazard auditor From t
Page 185 and 186:
different agencies take to be permi
Page 187 and 188:
industry and of its serving to legi
Page 189 and 190:
Anonymous. 1988a. FAO code of condu
Page 191 and 192:
(Adam 1976; Fraser and Burrill 1979
Page 193 and 194:
in the lower price categories tend
Page 195 and 196:
Anas, N.; Jusoh Mamat, Md.; Heong,
Page 197 and 198:
Zam, A.K. 1980. Bancian pengurusan
Page 199 and 200:
Materials and methods Assessment of
Page 201 and 202:
At the end of each day's operations
Page 203 and 204:
Table 3. Number of garments chafing
Page 205 and 206:
underlines the need to change attit
Page 207 and 208:
Evaluation and management of pestic
Page 209 and 210:
target and react with some crucial
Page 211 and 212:
scientists on a contractual basis,
Page 213 and 214:
pesticides in developing countries
Page 215 and 216:
Regional information resources for
Page 217 and 218:
Table 2. Number of enquiries receiv
Page 219 and 220:
extent of this problem in developin
Page 221 and 222:
Promoting the safe use of pesticide
Page 223 and 224:
pests) is observed. Thus, the "quic
Page 225 and 226:
is one of principal agencies respon
Page 227 and 228:
Pretesting materials in training an
Page 229 and 230:
of costly medical technologies and
Page 231 and 232:
The agricultural sector has by far
Page 233 and 234:
At the community level, the extent
Page 235 and 236:
Neufeld, V. 1989. Community-based m
Page 237 and 238:
Outline for learning module using o
Page 239 and 240:
WHO (World Health Organization). 19
Page 241 and 242:
In the past decade, tremendous effo
Page 243 and 244:
Jiang-Su province Results and discu
Page 245 and 246:
As a result of deregulation, the nu
Page 247 and 248:
Table 3. Proportion of workers usin
Page 249 and 250:
Shih, J.H.; Wu, Z.Q.; Zhang, Y.X.;
Page 251 and 252:
Pesticides and wildlife: a short gu
Page 253 and 254:
Using target-specific products mini
Page 255 and 256:
specifications. Other data are asse
Page 257 and 258:
Formulation-specific concerns The e
Page 259 and 260:
mirex, and chiordecone have been ba
Page 261 and 262:
1984). The base for pesticide granu
Page 263 and 264:
e more stringently reviewed. In Can
Page 265 and 266:
For example, searching for carcasse
Page 267 and 268:
overlooked. In developing countries
Page 269 and 270:
Establish monitoring programs to de
Page 271 and 272:
Grue, C.E.; Fleming, W.J.; Busby, D
Page 273 and 274:
Schafer, E.W., Jr; Brunton, R.B. 19
Page 275 and 276:
Table 1. Prevalence and distributio
Page 277 and 278:
By 1980, resistance to at least one
Page 279 and 280:
tries. Japanese encephalitis has be
Page 281 and 282:
to the targeted larvae of mosquitoe
Page 283 and 284:
The role of the community Many prob
Page 285 and 286:
from locally available sacking mate
Page 287 and 288:
services. The project also includes
Page 289 and 290:
Maxwell, C.A.; Curtis, C.F.; Haji,
Page 291 and 292:
Botanical pesticides: optimizing pe
Page 293 and 294:
neurotoxin but a cytotoxin, cross-r
Page 295 and 296:
MoDuscicide- and pesticide-developm
Page 297 and 298:
A development plan has been identif
Page 299 and 300:
and environmental effects must be d
Page 301 and 302:
Devitt, B.D.; Philogène, B.J.R.; H
Page 303 and 304:
Endod, a potential natural pesticid
Page 305 and 306:
University in Ottawa, and in other
Page 307 and 308:
in the field (Lugt 1981), 137 500 m
Page 309 and 310:
Hutchinson, J.; Dalziel, J.M. 1929.
Page 311 and 312:
Community participation, including
Page 313 and 314:
Acknowledgment- This research has b
Page 315 and 316:
multiplication. The high temperatur
Page 317 and 318:
Because pesticides are required in
Page 319 and 320:
Africa and now East Africa. The suc
Page 321 and 322:
Integrated pest management 1PM may
Page 323 and 324:
to risk crop damage. Close involvem
Page 325 and 326:
Ramos-Ocampo, V.E.; Magallona, E.D.
Page 327 and 328:
esidues on fresh and cooked vegetab
Page 329 and 330:
Grassy strip 108 N Farmer's Experim
Page 331 and 332:
Table 1. Description and efficiency
Page 333 and 334:
Table 3. Cost (PHP) of pest managem
Page 335 and 336:
in the field. These pests were the
Page 337 and 338:
PART V APPENDICES
Page 339 and 340:
Ravindra Fernando, National Poisons
Page 341 and 342:
Frank White, Pan-American Health Or
Page 343 and 344:
ECHO abdominal ultrasonograph EEG e
Page 345 and 346:
URT upper respiratory tract USAID U
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