The global distribution of acute unintentional pesticide poisoning: estimations based on a systematic review

Abstract

Background Human poisoning by pesticides has long been seen as a severe public health problem. As early as 1990, a task force of the World Health Organization (WHO) estimated that about one million unintentional pesticide poisonings occur annually, leading to approximately 20,000 deaths. Thirty years on there is no up-to-date picture of global pesticide poisoning despite an increase in global pesticide use. Our aim was to systematically review the prevalence of unintentional, acute pesticide poisoning (UAPP), and to estimate the annual global number of UAPP. Methods We carried out a systematic review of the scientific literature published between 2006 and 2018, supplemented by mortality data from WHO. We extracted data from 157 publications and the WHO cause-of-death database, then performed country-wise synopses, and arrived at annual numbers of national UAPP. World-wide UAPP was estimated based on national figures and population data for regions defined by the Food and Agriculture Organization (FAO). Results In total 141 countries were covered, including 58 by the 157 articles and an additional 83 by data from the WHO Mortality Database. Approximately 740,000 annual cases of UAPP were reported by the extracted publications resulting from 7446 fatalities and 733,921 non-fatal cases. On this basis, we estimate that about 385 million cases of UAPP occur annually world-wide including around 11,000 fatalities. Based on a worldwide farming population of approximately 860 million this means that about 44% of farmers are poisoned by pesticides every year. The greatest estimated number of UAPP cases is in southern Asia, followed by south-eastern Asia and east Africa with regards to non-fatal UAPP. Conclusions Our study updates outdated figures on world-wide UAPP. Along with other estimates, robust evidence is presented that acute pesticide poisoning is an ongoing major global public health challenge. There is a need to recognize the high burden of non-fatal UAPP, particularly on farmers and farmworkers, and that the current focus solely on fatalities hampers international efforts in risk assessment and prevention of poisoning. Implementation of the international recommendations to phase out highly hazardous pesticides by the FAO Council could significantly reduce the burden of UAPP.

Regenerative Agriculture: An agronomic perspective

“…There is a danger that bans on the use of some products could lead to wider use of even more toxic ones, at least for a period before environmental controls catch up. Few could disagree with the aspiration to limit the use of chemicals in agriculture: in addition to biodiversity concerns, the misuse of pesticides in developing countries has serious negative effects on human health ( Boedeker et al, 2020 ; Jepson et al, 2014 ).…”

Commentary: Novel strategies and new tools to curtail the health effects of pesticides

“…Heavy pesticide use imposes collateral damage on farmers and workers, the environment, and public health that can become unacceptable as a result of direct costs; fines, penalties, or more costly insurance; regulation; social pressure or local controls. Examples of such damage include crop and tree losses due to dicamba and other herbicide drift [ 1 , 2 ], reduced biodiversity [ 3 – 6 ], diminished ecosystem services [ 7 , 8 ], pollinator decline [ 8 , 9 ], acute poisonings [ 9 ], the emergence and spread of resistant weeds [ 10 ] and insects [ 11 ], loss of vital drugs needed to treat human infections [ 12 ], and water contamination [ 13 , 14 ].…”

“…Although the human health impacts stemming from exposure to pesticides are not fully known or understood, an increasing number of studies describe adverse effects following acute occupational exposures [ 9 ], heightened risk of cancer [ 15 – 18 ], and residential proximity to farms heavily reliant on pesticides [ 19 , 20 ].…”

Impacts of dietary exposure to pesticides on faecal microbiome metabolism in adult twins

“…Human exposure to pesticides have been linked to a variety of diseases triggered by acute intoxication (Boedeker et al 2020), occupational exposures or residential proximity to pesticide applications (Gonzalez-Alzaga et al 2015; Gunier et al 2017; von Ehrenstein et al 2019). Whether typical low levels of pesticide exposure stemming from dietary and domestic use can contribute to disease development is strongly debated.…”