ACUTE PESTICIDE POISONING AMONG SMALLHOLDER FARMERS AND FARMWORKERS
Data on acute pesticide poisoning Estimates of pesticide poisonings tend to draw on official data collected by medical professionals, usually in a hospital setting. However, only a small portion of the most serious cases are seen by medical professionals and as a result, the vast majority of adverse health incidents go unrecorded. What is more, in many LMICs, reviews of hospital data are ad hoc and many hospitalized cases are missing from national data (London and Bailie6, 2001). The situation is particularly poor in Africa. A WHO survey in 2003–04 showed that while centralized collection systems for pesticide poisoning data are common in the Americas and Europe (93% and 100%, respectively), none of the nine African countries that responded to the survey had such a system in place (WHO13, 2004). Just 46% of WHO member countries have poison centres and the majority of these are in the Americas and Europe – Africa has just 12 poison centres (WHO Global Health Observation Data, 2018). Even where systems do exist, the range of data collected is often limited and of little value to policy-makers. In Tanzania, for example, the national health information management system only has one category for all cases of poisoning and important details on the type of pesticide, conditions of exposure and severity are not systematically collected (Lekei et al., 201419). The same DHIS2 health information management system used in Tanzania is used by 67 LMIC countries (District Health Information Software20), which suggests that they may all be lacking national data concerning pesticide poisoning. The lack of accurate and comprehensive data on pesticide poisoning not only hides the scale of the problem, but also hinders the development of appropriate policy measures to deal with it. If policymakers do not recognize poisoning as a significant health threat, they are unlikely to allocate adequate resources or political will to tackle it (Murray7 et al., 2002; Williamson18, 2011). Similarly, if they do not have information on which pesticides are involved in poisoning, or which practices lead to hazardous levels of exposure, they will be unable to target interventions effectively. In the absence of accurate information on the conditions under which poisoning occurs, a common response is to blame farmers, farm-workers and other end users for ‘misusing’ pesticides. This response shifts responsibility away from policy-makers and the pesticide industry on to end users and is unlikely to be effective – especially in situations where users have little-or-no access to the relevant health and safety information and are not in a position to adopt the required risk reduction behaviours (Rother21, 2018). Very often there is a lack of information about safer alternatives, including non-chemical alternatives, which may be safer, cheaper and effective.
Photo: Pesticides in Georgia illegally repacked into plastic bags with no labels, dosage or safety instructions. Credit: PAN UK
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