Case Study - Occupational and Environmental Aspects of Exposure to Pesticides in the Central America Isthmus

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Case Study - Occupational and Environmental Aspects of Exposure to Pesticides in the Central America Isthmus (PLAGSALUD)

Document(s) 13 of 20

Samuel Henao, Área de Desarrollo Sustentable y Salud Ambiental (OPS/OMS).

Project: Occupational and Environmental Aspects of Exposure to Pesticides in the Central America Isthmus (PLAGSALUD)

Participating countries: Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panama and Regional Level.

Background:

In recent decades, Central America has been one of the biggest importers of pesticides per capita in the world, 1.5 kilograms per person per year, a rate higher than the world average, which is estimated to be 0.6 kilograms per person per year by the World Health Organisation (WHO). This excessive use of pesticides has caused significant human health problems, both of acute poisoning and chronic effects. Environmental damage caused by pesticides in Central America includes river basin pollution, deforestation, loss of species and contamination of the food chain.

During the period of the Project, the Central American Isthmus had a population of 30 to 35 million inhabitants, half of which still lived in rural areas and 60% of which lived in a state of poverty. A significant part of the economically active population belongs to the agricultural sector where approximately 90% of imported pesticides are used, generating a high degree of exposure per capita in communities with limited access to social services or living in zones with little health coverage.

The public health and environmental problems generated by the massive use of pesticides in the sub-region were specifically addressed over a ten year period (1994-2003) jointly by Central American Governments, the Pan-American Health Organisation (PAHO) and the Danish Agency for International Development (DANIDA), through the “Occupational and Environmental Aspects of Exposure to Pesticides in the Central America Isthmus” (PLAGSALUD) Project.

Development objectives:

A 50% reduction in pesticide related disease after ten years of project operation and support for the implementation of sustainable agricultural alternatives in Central America.

Strategies:

Integral and Inter-sectorial Approach to the Pesticide Issue promoting coordination, integration and strategic partnerships with institutions, organisations, programs, projects or other initiatives with common objectives.
Application of a “bottom-up” approach. Identification of problems and needs, and their solutions, are originated at a local level, regarding both institutional and community issues.
Pursuit of actions sustainability by strengthening inter-institutional and inter-sectorial links. Resources were allocated to change processes that favoured this strategy.
Improvement of civil society’s knowledge regarding pesticide related risks and promotion of its participation in pesticide control.

Results:

The most important overall results obtained through this Project execution are, with no doubt, an increased awareness of this issue regarding prevention, control and the use of alternatives on the part of civil society, especially workers and the most exposed elements of the community, and the incorporation by Governments themselves of the pesticide issue into their agenda of priorities.

The Project’s effectiveness in terms of its intervention impact is clearly manifested in its different work areas:

Epidemiological Surveillance: All the countries established the surveillance of acute pesticide poisoning and also included it in the National Systems of Epidemiological Surveillance, allowing for a better and more relevant orientation of the necessary prevention and control actions.

Through indicators produced by the surveillance systems and the tools that they provide, it has been possible on a local level to apply interventions to risk factors that cause health and environmental damage. This information has also influenced decision-makers in the health, labour, education, agricultural and environmental sectors to promote adequate treatment for cases of intoxication, the development of prevention and control measures and the improvement of existing pesticide legislation, not only at a municipal level but also at national and Central American Regional levels.

At a sub-regional level, the statistical trend in the incidence of acute poisoning increased during the Project’s first years due to improved reporting and recording of poisoning cases (rising from 10.34 x 100,000 inhabitants in 1994 to 20.37 in 1999). The Project’s impact at a regional level manifested in the reduced incidence of poisoning cases during its last three years, when the rate fell from 19.5 to 15.82 x 100,000 inhabitants.

Alternatives to Pesticide Use: The conventional model of agricultural production has reached a crisis point because it is excessively dependent on expensive and contaminating elements and has not proved to be economically sustainable or viable for human and environmental health. In the face of this situation, new strategies for fighting pests have appeared in the form of important alternatives such as Integrated Pest Management (IPM) and Organic Agriculture. With the former, the use of synthetic chemical pesticides is reduced to the minimum necessary; with organic agriculture, ecological production is promoted, eliminating the use of pesticides.

For the implementation of alternatives, the Project, in partnership with other agencies and bodies addressing this issue, supported the development of Integral Pest Management and Organic Agriculture in each country by preparing and publishing educational material (booklets and videos) and organising workshops and seminars.

The development in several countries of “Organic Vegetable Gardens in Schools” deserves a special mention. With the aim of creating awareness in children about environmental care and the viability of cultivating agricultural products without applying chemical pesticides, the Project supported this important initiative in which, during their school years, pupils actively participate in cultivating vegetable gardens on land near to the schools especially designated for this purpose.

Inter-sectorial and Inter-institutional Coordination. One of the most effective and practical results of PLAGSALUD and its counterparts in the countries was the constitution of more than 300 Intersectorial Local Commissions on Pesticides (CLIPS) across the entire subregion. They were made up of representatives of various institutions from the Health, Labour, Education, Environment and Agriculture sectors, Municipalities, NGO’s, workers and representatives of civil society. These commissions were the most notable expression of the work done at a local level in Central America to reduce the negative effects of pesticides, educate the community about this problem and promote the use of alternatives to agrochemicals.

At a subregional level the project implemented joint actions with other bodies and agencies involved in the pesticide issue, such as: Central American Environment and Development Commission (CCAD), Regional International Body of Farming Welfare (OIRSA), United States Environmental Protection Agency (EPA), Tropical Agronomy Research and Teaching Centre (CATIE), International Labour Organisation (ILO), Central American High Council of Universities (CSUCA), German International Cooperation Agency (GTZ), Central American Pesticide Action Network (RAPAL), Radio Netherlands Training Centre and the Zamorano Pan-American Agricultural School.

Legislation. The guidelines for the improvement of pesticide legislation that were developed during the Project facilitated the following achievements:

In each of the seven countries, legislation related with pesticides was compiled and analysed. Also, with the aim of fostering and/or consolidating institutionalized civil participation and its permanent involvement in all the stages of the decision-making processes, that legislation was widely disseminated to all interested sectors.
Approval of Agreement Nº 9 covering the prohibition of 107 pesticides and restrictions on 12 more, at the 16^th Meeting of the Health Sector of Central America and the Dominican Republic (RESSCAD) in 2000. This forum incorporates the health issue in the subregion’s social development process and its main purpose is to promote the exchange and development of experiences and, above all, to obtain the commitment of member states to health and environmental care where a joint and coordinated approach is required in the spirit of Central American integration.

It is important to point out that in some countries the achievements have surpassed the range of the above-mentioned agreement, as is the case in Panama with Executive Decree Nº 305 of September 2002 that established the prerequisite of a non-automatic licence for 618 chemical products.

Education. The Project prepared and published educational material designed for the community in general, school children, workers, health professionals and agricultural experts on the following subjects: Diagnosis, treatment and prevention of acute pesticide poisoning; Health oriented surveillance of pesticides; Alternatives to the use of pesticides (Integrated Pest Management and Organic Agriculture); Pesticide legislation; Epidemiological situation of acute pesticide poisoning; Research results.

The educational material produced was widely disseminated through courses, workshops, seminars and forums in each of the seven countries and put on the Virtual Library on Health - Pesticide website and on the Pan-American Centre for Sanitary Engineering and Environmental Sciences (CEPIS) website. This material continues to be used today, not only in Central America but also in other countries of the continent.

Research. In all of the countries, both at local and national level, professionals were trained in Research Methodology. With this resource it was possible to develop research on priority aspects of the pesticide issue, generating the necessary knowledge for an appropriate situational diagnosis and for proposing pertinent interventions. Of note amongst these are the Acute Pesticide Poisoning Sub-records Study, the Knowledge, Attitudes and Practices Study, and pesticide contamination studies on superficial and underground waters in several countries of the subregion.

IPM and organic agriculture (both of which were supported by the Project in all of the countries) have made significant progress and continue to represent important alternatives to the use of pesticides in the subregion.

Sustainability

During all the phases of the Project the approach of “Sustainable Management for the Promotion of Health and Control of Adverse Effects on Human Health and the Environment of Pesticide Use” was utilised in order to ensure the sustainability of Project achievements at all stages, focusing not only on aspects of health risk prevention and control, but principally on an integral approach covering socio-economic, agricultural, environmental and health aspects.

Health, Agriculture and Environment Ministries have allocated resources to ensure the continuity of actions initiated by the PLAGSALUD Project, especially in Epidemiological Surveillance, Education, Legislation Improvement and Interinstitutional Coordination.

Based on the experience of PLAGSALUD in Central America, PAHO has initiated the “Sanitary Surveillance of Pesticides” Program in several countries of the continent, aiming to diminish the impact of these substances on health and the environment.

The sustainability elements that guarantee continuity in the Project’s principal areas of work are:

Epidemiological Surveillance: Development at national and local levels of technical capacities for notification, registration, database creation, information analysis, generation of periodic reports and decision making, especially with reference to interventions in acute pesticide poisoning risk factors. Insertion of Acute Pesticide Poisoning Surveillance in the national Epidemiological Surveillance Systems of Health Ministries. Indicators generated in the system will continue to produce the needed epidemiological evidence for understanding the effects of pesticides, orientating intervention actions and evaluating their impacts.

Pesticide Legislation: Empowerment of Municipal Authorities and of Intersectorial Local Commissions on Pesticides (CLIPS) members in their jurisdiction over the control and regulation of agrochemical use and the conservation, protection and renewal of natural resources.

The initiative presented by the Project on Pesticide Prohibition and Restriction in Central America was welcomed and approved through Agreement Nº 9 at the 16^th Meeting of Health Sector of Central America and the Dominican Republic (RESSCAD), held in Honduras in September 2000: “The effort made by the subregion’s countries for the development of programs and projects of risk prevention and control associated with health and environmental problems is evident, particularly in pesticide control management. With a view to moving forward and taking concrete action, Health, Agriculture, Environmental and Natural Resource Ministries are requested, in accordance with the legislation in force, to produce and apply measures to restrict the use of 12 pesticides acknowledged as being responsible for the greatest number of poisonings and deaths, and to take appropriate action to prohibit 107 other pesticides.”

Countries have worked hard to apply this Agreement and, in some of them, prohibitions and/or restrictions have been imposed that will protect the environment and human health into the future. Since the Project finished, countries have continued to improve their legislation.

Education: The pesticide issue was included in the curricula of primary and secondary schools, and of the Faculties of Medicine and Nursing at university level. In addition, alternatives to the use of pesticides, Integrated Pest Management (IPM) and Organic Agriculture, were included in the curricula of Agronomy Engineering Faculties. These achievements guarantee that in the future this subject will continue to be analyzed on different educational levels. The inter-sectoriality of the Training Process that facilitates an integrated approach to the pesticide issue. The educational material generated during the implementation of the Project that was designed for health personnel, farming sector technicians, workers and the community in general goes on being widely used not only in Central America but also in many other countries of the region.

The course “Diagnosis, Treatment and Prevention of Acute Pesticide Poisoning” has been included as a tutorial course on the Pan-American Centre for Sanitary Engineering and Environmental Sciences (CEPIS) website.

With the objective of disseminating information generated by the Project at subregional and national levels, the Virtual Library on Health was formed in El Salvador. Through this website it is possible to access the information generated by the Project.

Inter-sectorial and Interinstitutional coordination: The capacity of the model to articulate local resources and to strengthen the prevention of pesticide’s damaging effects through Intersectorial Local Commissions (CLIPS) can be maintained because their actions are performed at very low cost, the personnel has already had the appropriate training and national institutions support their operations.

Difficulties:

During the project’s operation the principal difficulties were: the appearance of re-emergent diseases; State reform processes; changes of government and personnel rotation; and corporate financial interests.

Case Study Information:

http://www2.ops.org/sv/plagsalud/index.htm (Virtual Library on Health – Pesticides).
http://www.paho.org/spanish/DD/AIS/bsindexs.htm (Epidemiological Bulletin, December 2001 and September 2002).
http://www.cepis-ops-oms.org (Toxicology / Self-instruction and Diagnosis Courses, Treatment and Prevention of Acute Pesticide Poisoning).

Open file : Plagsalud_ENG.doc

Document(s) 13 of 20