About 385 million cases of acute pesticide poisonings occur each year worldwide, causing around 11,000 deaths. This is the sad finding of a study published on December 7th in the peer-reviewed journal “BMC Public Health”. According to the study, unintentional, acute pesticide poisonings on farms across the globe have risen dramatically since the last global assessment 30 years ago. The systematic review was commissioned by Pesticide Action Network (PAN), a network of over 600 participating non-governmental organizations, institutions and individuals in over 90 countries working to replace the use of hazardous pesticides. “These findings underscore the urgency of reducing and eliminating the use of highly hazardous pesticides,” says Kristin Schafer, coordinator of PAN International. “These pesticides are causing the unacceptable poisoning of those who produce our food, but also chronic health effects such as cancer and ecological impacts such as the collapse of biodiversity. Time for global action is long overdue.”

In 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. The figures were calculated using data from the 1980s. It was further estimated in 1990 that there were 25 million cases of mild intoxications each year, the bulk of which were not recorded, as most farmers did not seek medical attention. Those outdated figures are still pervasive in literature today due to the lack of updated global estimates. The new study now closes this gap. The authors carried out a systematic review of the scientific literature published between 2006 and 2018, selecting 157 papers after assessing a total of 824 articles for eligibility. They extracted a total number of 741,429 unintentional pesticide poisonings from the publications, including 7,508 fatalities. Most studies had a focus on occupational poisoning in farmers and agricultural workers. In addition, mortality data from the WHO cause-of-death database was used. Thus, the study covers a total of 141 countries. Then the researchers performed country-wise synopses and estimated the annual numbers of national unintentional, acute pesticide poisonings (UAPP). Finally, the total number of UAPP was estimated based on national figures and population data for regions defined by the Food and Agriculture Organization (FAO).

The researchers arrived at an estimated 385.5 million pesticide poisonings each year, resulting in 10,881 fatalities. This means that about 44% of the global population working on farms – 860 million farmers and agricultural workers – are poisoned every year. The study found that the greatest number of non-fatal poisoning cases occurred in southern Asia, followed by Southeast Asia and East Africa. The highest single national incidence was found in Burkina Faso, where nearly 84% of farmers and farm workers experience unintentional acute pesticide poisonings each year. The prevalence is also very high in Pakistan and Kuwait with around 82% respectively. The rate was also quite high in India with 62%. The lowest rate was found in the United States where the incidence of yearly non-fatal UAPP among the farming population is only at 0.05%. Nearly 60% of all fatalities occur in India, indicating serious problems with pesticide use, according to the researchers.

The estimated number of global non-fatal unintended pesticide poisonings in the current study is significantly higher than in previous estimates from the 1990s. “It’s shocking and shameful that this problem has gotten worse rather than better over the past 30 years,” said Sarojeni Rengam, Executive Director of PAN Asia Pacific. According to the authors, this is in part because the current study covers a greater number of countries, and also because pesticide use increased by almost 81% between 1990 and 2017. In South America, the increase in the same period was even at 484% and there was a 97% increase in Asia, compared to a decrease in Europe of 3%, according to data from FAOSTAT. “So, many more farmers and workers are likely to be exposed to pesticides now globally, or more exposed through more frequent use,” the authors write. However, the researchers also assume that the true figures of pesticide poisoning and fatalities could be much higher because underreporting remains a huge problem. Many countries lack a central reporting systems or there is not a mandatory legal duty to report incidents. People suffering from acute pesticide poisoning may also not seek medical care for various reasons, such as access to transportation or lack of medical facilities or financial capacity. “We realize there are limitations in the data on pesticide poisonings,” notes Javier Souza, PAN Latin America’s coordinator. “But this study clearly shows this as a serious, global problem that warrants immediate action. Highly hazardous pesticides must be phased out by 2030 to meet global Sustainable Development Goals, and we must shift to healthier and more resilient systems like agroecology.” The study did not cover pesticide poisoning suicides but it points to a recent systematic review of data on suicides from 2006-2015, which found that pesticides accounted for 14-20% of global suicides leading to 110,000-168,000 deaths annually during the period 2010-2014. (ab)