Farmers and other users of OPs complain of many symptoms
which are often not specific but include headache, nausea, sweating, muscle
tremors, anxiety and depression, shading into longer term neurological
complaints.
The current High Court claim of Gary Coomber, a Kent sheep
farmer, is an exception. He suffers the specific heart disease myocarditis-caused,
it is alleged, by exposure to OP sheep dip. Mr Coomber used a sheep dip
containing the active ingredient propetamphos, an OP insecticide, in 1991 and
suffered from myocarditis (akin to a heart attack) within about seven days.
Prior to the attack he suffered flu-like symptoms. The following year he again
used a propetamphos sheep dip and again within seven days suffered another
heart attack. After extensive investigations by his GP, Dr Bernhardt, the link
between Mr Coomber's heart condition and OP exposure was suspected. He was
advised to avoid sheep dips and did so the following year. However, in 1994
whilst walking though a field, he came into contact with another farmer's
flock of sheep that had, unknown to him, been dipped. Again within seven days
he suffered a heart attack. According to his GP Mr Coomber may well have died.
Professor William McKenna of St Georges Hospital London
believes Mr Coomber's illness was caused by exposure to OPs. Mr Coomber has
sued the sheep dip manufacturers and uniquely brought proceedings against both
for negligence, contending that the manufacturer was in breach of a duty of
care owed to him by failure to warn, and under the Consumer Protection Act
1987, alleging that the product was defective and unsafe within the meaning of
the Act. This is the first case of its type where it is alleged that the sheep
dip, as a licensed veterinary medicine, was an unsafe product. The
manufacturers will defend the action in respect of each count.
There were no warnings given by the
product manufacturers of the danger of myocarditis following use of sheep
dips. However there have been indications of such problems in the medical
literature-for example, 'Effects of OPs on the heart' and 'Cardiac effects of
anticholinesterase agents' in Ballantyne and Marrs(1). As early as 1966 Dr
Limaye drew attention to the heart problems of OPs(2). In the HSE publication
(MS 17 December 1980) there is mention of "slowing of the heart with
decreased cardiac output." In Israel in 1982 Dr Ludomirsky and his
colleagues referred to the problem of ventricular arrhythmias (variable
heartbeat) associated with OPs(3). In 1983, Dr Grabowski from Miami (US)
reported heart abnormalities observed in rodent studies(4). In 1984, the
Indian Medical Journal reported 'Cardiac toxicity in pesticide formulators
exposed to OP insecticides'(5). In 1985, an incident involving "seizures
and cardiac arrest in a farmhand" was reported(6). In 1979, Dr Fazekas
from Hungary reported 56 OP patients with arrhythmias(7).
Pesticides cause many different
effects. I have dealt with over 300 claims of pesticide and chemical
poisoning, most of which have been settled out of court by insurers, though
usually with no admission of liability. These are often acute injuries with
relatively short lived consequences to health and recovery. Damages are often
recovered in the range of £3,000-£5,000. One must exclude the possibility of
long term effects before settlement.
Sheep dip claims are different. In
many such cases farmers have lost everything and will be seeking substantial
damages-but long-term effects will have to be proved. Whether the courts will
find that OPs are dangerous per se and effectively impose strict
liability on the manufacturers of sheep dips will also be an issue in this
test case litigation.
The role of the Legal Aid Board (LAB)
and National Farmers Union (NFU) is crucial in assisting farmers to fund
claims to recover damages. So far the NFU has not funded a single claim on
behalf of a member despite their own survey confirming a problem nation-wide.
Perhaps the NFU's reluctance to throw its weight behind the farmers is because
they are caught on the horns of a dilemma. Its membership includes farmers who
wish to sue sheep dip manufacturers but also farmers who will be sued by
employees.
Who to sue?
Many believe that as the sheep dips are licensed as
'safe', proceedings may lie against the government. My own view is that this
is unlikely-the government relies upon the advice of experts. Steps prior to
licensing are lengthy. Unless it can be shown that those experts ignored
mounting evidence and acted irresponsibly, I doubt they will be blamed with
hindsight.
The government also relies heavily
upon information provided to them by the manufacturers. They have no
independent testing facility. It is surely for the manufacturer to inform the
government if new knowledge becomes available about the product to prompt
warnings, label changes or other action. Campaigners feel that the
government's entrenched position is now unacceptable-the government has
licensed OPs as 'safe'; has insisted upon their use; and now appears to wash
its hands of the problems. The government should, however, now accept
responsibility and establish a compensation scheme for those who have been
injured.
OPs, in the form of chemical warfare
agents, were investigated by the Chemical and Biological Defence Establishment
(CBDE) at Porton Down. CBDE has been asked to provide details of its
work-particularly on human volunteers. The issue of whether OP exposure can
cause myocarditis has already been answered by the Royal College of Physicians
in their 1991 publication Some aspects of the medical management of
casualties of the Gulf War. The 'supplementary advice' relating to a
Department of Health document Gulf contingency planning: NHS medical guide,
noted: "Nerve agents ... Experience of insecticide poisoning has
shown that after apparently successful treatment patients may deteriorate
rapidly at any time. Further respiratory failure, insomnia, psychiatric and
myocardial problems including arrythmias may occur."
How long will the farmers have to
wait for the government to heed warnings first given in the Zuckerman report
in 1951 and reiterated in the advice of the Royal College of Physicians? Has
the government itself taken sufficient action or is it exposed to challenge in
the Courts for compensation?
References
1. Ballantyne, TW and Marrs, T, Clinical and Experimental Toxicology of OPs and Carbamates, Butterworth and Heinman, 1992.
2. Limaye, MR, Acute OP compound poisoning: A study of 76 necropses, J Indian MA, 1966, Vol 47.
3. Ludomirsky, et. al. Q-T Prolongation and polymporphus ('Torsade de Pointes' ventricular arrhythmias associated with OP insecticide poisoning, American Journal of Cardiology, 1982, Vol. 47:1654-1658.
4. The electo-cardiogram of foetal and new born rats and dysrythmias induced by toxic exposure, 1983.
5. HN Siyed, SK Gupta, JP Jani and SK Kashyap, Cardiac toxicity in pesticide formulators exposed to OP insecticides, Indian Medical Journal, 1984, Vol. 80:494-498.
6. Grace, TW, Hospital Practice, June 15 1985.
7. Fazekas, & Kiss, Arrythmias in OP poisonings, Acta Cardiologica, 1979.
Alan Care is a lawyer with Leigh Day & Co and is also on the Pesticides Trust [now PAN UK] Board .
[This article first appeared in Pesticides News No. 31,March 1996, page 11]