Intoxicación por organo-fosforados entre los recolectores de algodón en el salvador

HEBREW UNIVERSITY OF HADASSA
BRAUN SCHOOL OF PUBLIC HEALTH AND COMMUNITY MEDICINE
ENVIRONMENTAL HEALTH FINAL EXAM

ORGANOPHOSPHATES INTOXICATION AMONG COTTON FIELD WORKERS IN EL SALVADOR

Xinia Annette Castro Rivera
(Student)
Elihu Richter
(Tutor)

July ‏2003

SUMMARY
Organophosphate pesticides are widely used in Central America in cotton growing. Field workers are commonlyintoxicated due to lack of equipment, training in its use, and / or the hot climatic conditions seen in the coastal areas.
In order to achieve the main goal of this intervention, that is to decrease the number of intoxications seen among these workers, an analytic survey based on retrolective data will be carried out four major hospitals of the coastal region. This will help to determinethe intoxication distribution, its main causes and sources. Risk assessment will be estimated through an observational and KABP studies. The results of these will be used to design a specific intersectorial prevention program oriented to convince the cotton industry to ban, or at least significantly decrease, pesticide use by incorporating an Integrated Pest Management approach (inclusion of cottonpests’ natural enemies, crop rotation, sanitation, prohibition of ratoon cotton and intercrop growing). The program pursues to involve the government, the pesticide and cotton industries, the cotton field workers and other potential allies.

CASE FOR ACTION

Organophosphates and other hazardous pesticides are widely used in the Central American region (1) (2). The usage of thesepesticides persists through deficiencies in government-driven assessment and risk management; short-term economic interests; strong links between industry and governments; aggressive marketing; weak trade unions; and failure of universities to reach decision-makers. On top of it all there is a lack of pesticide regulation (1).
In the coastal regions of El Salvador, Organophosphates are commonlyused in El Salvador due to the fact that these areas are used for crop growing, especially cotton.
Organophosphates are very dangerous pesticides that requires proper handling to prevent intoxication because they can lead to neurological disturbances (3), cancer (4), or in the most severe cases, they can cause death. Some Organophosphates, like Fenitrothion and Trichorlfon, have been foundto be positively teratogenic, though Parathion’s findings are still controversial on this respect (5). In addition to their role as human reproductive toxicants, pesticides are also implicated in reproductive failure of wildlife species exposed to pesticide sprays and residues (5).
Nevertheless, each year, and especially during the hottest months in El Salvador (Feb-Apr), hospitalsregister an increase of organophosphates intoxicated patients (6). These are generally young males that come from the lower socio-economic class, with poor education levels, who are hired on a seasonal, temporal basis by the big cotton-growing companies in order to spray the pesticides on the crop. The workers do not always receive adequate training for adequate pesticide handling, nor the necessaryprotective equipment. To hot climatic coastal and tropical conditions worsen the situation by making the protective clothing wearing very much uncomfortable.
Because of their hiring characteristics, these workers are not fit to be insured under the National Security System and as such they are not entitled to the protection conferred by laws. Hence, the Ministry of Labour can not actaccordingly. On the other hand, the Ministry of Environment has just recently been created but lacks the necessary manpower to conduct surveillance and monitoring of the big industries that may be performing illegal operations that endanger people and environment. The problem is worsened by the fact that these big industries practice under the table payment of governmental officers.
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