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Pesticide poisoning among agricultural workers in Bolivia C. Condarco Aguilar, H. Medina, J. Chinchilla, N. Veneros, M. Aguilar, and F. Carranza Instituto Nacional de Salud Ocupacional, Ministry of Public Health and Social Security, La Paz, Bolivia The division of Bolivia into altiplano, valleys, and lowlands, with many intermediate subregions,favours the development of different agricultural practices and the use of different agricultural chemicals. Both traditional methods, using hand tools for personal food production, and modern agroindustrial methods, primarily in the lowlands and parts of the valley regions, are used in agriculture. This report presents the results of a study of the knowledge, attitudes, and practices (KAP) of workers in the altiplano, valley, and lowland regions of Bolivia. An assessment of the health status of workers exposed to organophosphate insecticides was also carried out. The lowland areas and the mesothermal valleys were found to be the regions with the greatest problems. The factors contributing to this situation are reviezved. The well-known division of Bolivia into altiplano, valleys, and lowlands, with many intermediate subregions, has resulted in the development of various agricultural products for domestic or commercial use. Two main types of production are carried out: traditional, rudimentary, cultivation using manual tools to produce food for personal consumption (in the altiplano and parts of the valleys); and modern agroindustry (in the lowlands and parts of the valleys). With the economic crisis, which is not limited to Bolivia, agriculture is becoming the hope for improving social and economic conditions. This suggests that crop production should be increased, which is likely to lead to greater use of pesticides. From the earliest times, farmers have fought pests that, at times, destroy 30% to 50% of the crops. Between 1930 and 1940, new stronger insecticides were introduced, including dichlorodiphenyltrichloroethane (DDT), toxaphene, 76
and chlordane. Pest resistance to these chemicals has resulted in a search for more toxic products having less environmental permanence, such as the organophosphates and the pyrethroids. Although pesticides are designed to eliminate undesirable and harmful organisms that damage crops, other living beings, including humans, are susceptible to them to a varying degree, so that their use can constitute a public-health problem. In 1973, the World Health Organization (WHO) estimated that there were over 500 000 pesticide poisonings per year in the world, with a death rate of 1%. In developing countries, it is estimated that 375 000 severe cases occur annually, with 10 000 deaths; this corresponds to about one case per minute and one death per hour (Henao and Carey 1986). Some examples are: In Chinguira (Colombia), 600 cases of poisoning by parathion and 88 deaths were reported (Vargara 1984); In Brazil, out of 5 000 workers examined, 900 showed reduced cholinesterase levels (Zanaga et at. 1984); and Also in Brazil, of 1107 workers examined, 173 suffered from poisoning, 41.6% due to organophosphates (Zanaga et al. 1984). The Instituto Nacional de Salud Ocupacional (INSO) began taking action in this field in 1976. In 1978, 11 farms were visited; of the 237 workers seen, 62% showed some level of poisoning, 6.7% of the cases were children. In the valleys of Tarija in 1977, 43% of those examined showed signs and symptoms of poisoning. In the Rio Abajo valleys, 14 deaths in 1977 were due to pesticide poisoning. During the period 1975 to 1985, the hospital serving the mesothermal valleys of Comarapa treated 47 pesticide poisonings; of these 15% died and, of the total, 45% were children (INSO 1987). Other studies clearly demonstrate the extent of this problem in Bolivia (Condarco and Medina 1986a,b; INSO 1986; Malgarejo 1987). In the mesothermal valleys where tomatoes are cultivated, 25% of people examined had reduced levels of cholinesterase activity, 16% of them were under 18 years of age. Most (94%) agricultural workers had no knowledge about the safe use of pesticides. Our concern was to determine the real incidence of pesticide poisoning in the three ecological areas and what factors affect this problem, and to find suitable alternatives for pest control in the Bolivian environment. Specifically, this study examined the extent of use of organophosphates and their effect on the health of the agricultural worker and on the ecology The results of this project will provide a basis for future studies in this field, through the health-care network of the Ministry of Health. 77
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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
Page 37 and 38: that the best possible work is done
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: Sandu, S.S.; Waters, M.D.; Simmon,
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
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eactions to the pesticides in occup
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Bowers, M,B.; Goodman, E.; Sim, V.M
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Extent of exposure of farm workers
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Group III consisted of 31 farmers w
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25 - 0 Level of exposure J Group 1,
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Pesticides were stored everywhere c
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Table 2. Concluded. Question Answer
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PART II RELATING PESTICIDE DEVELOPM
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Toxicity Table 1. Requirements and
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Screening Process development Route
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Progress in improving safety Pestic
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type of formulation, and warning pr
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The pyrethroid, cypermethrin, is mo
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Studying the effects of pesticides
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of the risk is a quantitative issue
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egistry could be linked to the lice
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poisoned through mishandling of an
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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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