Incidence of acute pesticide poisonings in Nicaragua: a public health concern.

OBJECTIVES: To estimate the cumulative incidence rate of acute pesticide poisoning in the year 2000 among Nicaraguan subjects over 15 years of age. METHODS: Data on pesticide exposure and health effects were assessed in a nationally representative survey. Based on self-reported cases, we estimated the 1-year incidence rate and the number of expected cases of acute pesticide poisonings in Nicaragua. RESULTS: Among the 3169 survey respondents, we identified 72 persons who self-reported one episode of acute pesticide poisoning in 2000. Of these, 65 cases (90%) were related to occupational exposure, five (7%) to domestic exposure and two (3%) to intentional exposure. The cumulative incidence rate/100 individuals of pesticide poisonings in Nicaragua in 2000 was 2.3 (95% CI 1.7 to 2.8). This corresponds to 66 113 cases (95% CI 51 017 to 81 210). The highest rate was found among males in rural areas, particularly among farmers and agricultural workers. CONCLUSION: This study demonstrates an extremely high risk of acute pesticide poisoning in Nicaragua. Considering this, comprehensive measures should be implemented to reduce adverse health effects.

Hazardous pesticides in Central America.

Pesticides are an extensively documented occupational and environmental hazard in Central America. Yet, severe problems persist. Toxic pesticide use in the Region increased during 1985-1999. High exposure levels and ineffectiveness of personal protective equipment evidence the difficulties for risk reduction. Acute poisonings remain a severe problem. Delayed and/or long-lasting health effects include dermatoses, cancer, and genotoxic, neurotoxic, and respiratory effects. The use of hazardous pesticides persists through deficiencies in government-driven assessment and risk management; excessive focus on regional harmonization; short-term economic interests; strong links between industry and governments; aggressive marketing; weak trade unions; and failure of universities to reach decision makers. Regulation based on local data is lacking. An agreement of the Ministries of Health for restricting the most toxic pesticides in Central America has potential for progress. The most effective way to reduce risk is to greatly reduce pesticide use. Actions needed include development of multidisciplinary strategies for local studies on health and environmental impact of pesticides; development of sustainable nonchemical agricultural technologies; evaluation of interventions; extending and sharing of expertise within the Region; strengthening of unions and communities; and redefining the role of industry toward development of safer products, with responsible marketing and reliable information.