|
Other
written information includes identifiers such as name,
address, date, gender, pregnancy status if female, number
of tanks used, crops, and pesticides used. Any other
symptoms experienced but not on the picture can be added. The numbers of mild moderate and severe signs
or symptoms (S&S) are totaled as well as the illness
category - a mild, moderate, severe or non- illness
event.
Weekly
the forms are collected and tabulated. Monthly the data is
summarized and graphed for community inspection and
discussion. The local doctor adds the number of pesticide
poisoning cases seen that month as well.
The
following parameters are tracked monthly:
 |
·
Average
spray events per farmer |
|
·
Average
number mild, moderate, severe S&S per spray |
|
·
Number
or percent of spray events associated to no illness,
mild, moderate, or severe illness |
|
·
Number
of cases seen in the local health facility |
The
reporting system has an automatic impact evaluation built
into the design. By looking at the spray frequency trends
and the choice of pesticides used, we will know if monthly
reporting on acute effects changes farmers’ behavior.
Controls matched by crops are interviewed weekly on spray
frequency and pesticide choices to rule out other crop
related reasons to change these above parameters.
Results: In
September 2001, a community of 50 farmers in North Vietnam
completed a yearlong surveillance pilot. IPM graduates managed the data collection,
analysis and monthly community meetings. The local doctor
served as a resource person and provided data on the cases
seen at the community health facility.
Data from the first month pilot revealed the
following:
|
·
4.2 average
spray events per farmer (mode 5) |
|
·
34% use a
cocktail of 3 or more pesticides/tank |
|
·
A Ib (highly
hazardous) banned chemical was used in 28% of the spray
events |
| ·
Up to 10% of
spray operations were associated to verifiable signs of
neurotoxicity |
|
·
2% of the
spray operations were asymptomatic, 25% associated to mild
effects and 73% moderate effects (observed signs and
subjective symptoms combined). |
In
Thailand, the Ministry of Public Health, Department of
Occupational Medicine has plans to adopt this system to gather
community based information on the number of pesticide
poisoning cases not seen by their health care system. A pilot
project is being planned in a few high pesticide using sentinel
sites. The project will be a collaborative effort among the
agriculture, health and education sectors. Under the
supervision of schoolteachers and village non-formal education
staff, a school class will gather the forms weekly, and do the
monthly data analysis. Agriculture and health personnel will
attend the monthly community meetings. The raw data forms will
be forwarded to the local health care facility that will add
the information to their own surveillance data.
II.
Farmer to Farmer Health Studies
Rationale:
Under an earlier IPM project in Indonesia, two studies
documented the human health risks of pesticide use:
a)
The first was conducted among Javanese shallot farmers
and demonstrated that 21% of all spray operations were
associated to 3 or more signs and symptoms of acute pesticide
poisoning. Spraying on a weekly basis, use of class Ia, Ib and
II pesticides (extreme, high and moderately hazardous products
as classified by the World Health Organization[1]),
applying more than one organophosphate cocktail concentrate,
and skin exposure especially though clothing soaked in
pesticides were all risk factors for illness[2].
International Programme of Chemical Safety. The WHO
Recommended Classification of Pesticides by Hazard and
Guidelines to Classification 1998-1999. WHO/PCS/98.21.
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