Pesticide exposure and poisonings in Ecuador: A call for action

Pesticide use in the Northern Andes regions soared with the ‘modernisation’ of agriculture. Although yields have increased, so have poisonings, ill-health and deaths. The least effective strategy for reducing risk is personal protective clothing, while IPM has dramatically reduced pesticide use and maintained yields. From their work in the region, Stephen Sherwood, Charles Crissman and Donald Cole call for solutions based on removing the hazard and providing alternative technologies and education.

Young boys spraying pesticides on potatoes. Local studies show that 73% of sprayers soak their skin, particularly on the back, and 87% soak their hands during spraying. Poisonings and deaths among young children are common. Photo Stephen Sherwood.

In the last decade agricultural ministries throughout Latin America have been dismembered by international policies demanding government decentralization and privatization, a process denominated ‘modernisation’. As a result, governments are increasingly incapable of advocating public concerns. Furthermore, we have found that business interests can easily influence regulatory agencies in developing countries, particularly when millions of dollars are at stake. Meanwhile, the expectation that private industry can be counted on to look after the interests of resource poor farmers seems to conflict with individual companies’ explicit modus operandi of earning profit for their shareholders. Experience in the Northern Andes shows that the outcome of this situation can be deadly.
    Since the early 1990s a number of organizations, including INIAP (Instituto Nacional Autónomo de Investigación Agropecuaria, Ecuador), CIP (International Potato Center), Montana State University (US), McMaster Institute of Environment and Health (Canada) and Wageningen University (the Netherlands) have been working with communities in the Province of Carchi in Northern Ecuador on a variety of projects to assess the role and impact of pesticide use in potato production and how to reduce its adverse impacts. These projects have both provided quantitative assessments of community-wide pesticide effects, and shown ways that may allow pesticide use to be lessened.
    Moving beyond description and analysis, the team has worked with interested stakeholders to inform the policy debate on pesticide use. Our position has evolved to be the reduction of pesticide exposure risk through a combination of hazard removal, provision of alternative technologies and education. Meanwhile, the principal position of the pesticide industry is education through ‘Safe Use’ campaigns. These conflicting objectives and encounters with representatives of the pesticide industry in this process motivate this call for international action.

Modernisation of agriculture 
The highland zone of Carchi Province in northern Ecuador is potentially among the world’s most productive agricultural regions and is characteristic of the highlands throughout Ecuador, Colombia and Venezuela. Being situated near the equator (less than one degree North) provides adequate sunlight throughout the year which, coupled with evenly distributed rainfall, means that farmers can continually cultivate their land. As a result, the province has arguably become Ecuador’s most important producer of staple foods, with farmers producing nearly 40% of the national potato crop on only 25% of the area dedicated to potato.
    Carchi is a clear example of the spontaneous spread of industrial agriculture technologies in the Americas during the so-called ‘green revolution’ that began in the late 1950s. A combination of traditional sharecropping, land reform, market access and high value crops provided the basis for rural economic development. Furthermore, as a result of new revenues from the oil boom of the 1970’s, the Ecuadorian government improved the transportation and communication infrastructure in Carchi, and the emerging agricultural products industry was quick to capitalize on the availability of a new market. 
    Smallholder potato production based on monocropping and chemical intensive technologies, in particular mechanized tillage, synthetic fertilizers and pesticides, quickly supplanted traditional farming. As a result, short-term production, both by area and by labor input, has intensified dramatically. One prominent study(1) showed that between 1954 and 1974 production increased by about 40% and worker productivity by 33%. Production per area in the province has continued to increase, from about 12 mt/ha in 1974 to about 21 mt/ha today, three times the national average(2). Nevertheless, this progress has not occurred without severe collateral consequences.

Pesticide use and misuse
Two-thirds of all pesticides used in Carchi are applied to the potato crop. Farmers use insecticides to control the tuber-boring larva of the Andean weevil (Premnotrypes vorax) and a variety of foliage damaging insects, in particular leafminer fly (Liriomysa quadrata). They also rely on fungicides to control late blight (caused by Phytophtera infestans). Among the most important pesticides (by weight of active ingredient applied) are: dithiocarbamate-metal fungicides, particularly mancozeb (81% of fungicides), organophosphate insecticides, particularly methamidophos (43% of insecticides) to control foliage pests and carbamate insecticides, particularly carbofuran (47% of insecticides), to control the Andean weevil(3,4). The dithiocarbamate family of fungicides has recently been under scrutiny in the Northern Andes due to suspected reproductive(5) and mutagenic effects on human cells(6). Similar concerns have been raised in Europe and the United States(7). Ninety percent of the insecticides applied in Carchi are highly toxic World Health Organisation (WHO) Category Ia or Ib products.
    On average, potato farmers make seven applications with three products per application to each cropping cycle, with product and application costs combined accounting for about one-third of all production costs among the small and medium producers in the region. 
    An economic study of pesticides in potato production in Carchi found that farmers used the products efficiently(8). The benefit to yields (and revenues) from using pesticides exceeds the additional costs of using them. Nevertheless, one study(9) found that farmers lose money about 43% of the time, largely due to potato price fluctuations (by factors of five to 20 in recent years) and exorbitant price increases in industrial technologies, particularly mechanized land preparation, fertilizers, and pesticides, that represent about 60% of overall production outlays. Unforeseen ecological consequences on natural pest control mechanisms – in particular parasitoids and predators in the case of insect pests and selective pressure on Phytophtera infestans in the case of disease – call into question the ultimate returns of pesticides(10). Long term profitability of pesticide use is even more questionable when associated human health costs to applicators and their families are factored in.
    Based on survey, observational and interview data, the vast majority of pesticides are bought by commercial names, with only a small minority of farmers reporting receiving information on pesticide hazards and safe practices from vendors(11). Pesticide storage is usually relatively brief (days to weeks) but occurs close to farmhouses because of fear of robbery. Farmers usually mix pesticides in large barrels without gloves, resulting in considerable dermal exposure(12). Farmers and, on larger farms, day labourers apply pesticides using backpack sprayers on hilly terrain. Few use personal protective equipment for a variety of reasons: including social pressure (masculinity is tied to ability to withstand pesticide intoxications), limited quality, availability and high cost of equipment. A recent study found that during pesticide applications most farmers wet their skin, in particular the back (73% of respondents) and hands (87%)(13). Field exposure trials using patch-monitoring techniques showed that during foliage applications on mature crops, considerable dermal deposition occurred on legs(14). Other studies have shown that additional exposure occurs in the field during snack and meal breaks, when limited hand washing is the norm.
    Family members are thus exposed to pesticides in their households and in their work via a multitude of contamination pathways. Excess mixed product may be applied to other tuber crops, thrown away with containers in the field or applied around the house. Clothing worn during application is often stored and used repeatedly before washing. Usually contaminated clothing is washed in the same area as family clothing, though in a separate wash. Extent of personal wash up varies but is usually insufficient to remove all product from both the hands of the applicator and the equipment. Separate locked storage facilities for application equipment and clothing are also uncommon. Swab methods have found pesticide residues on a variety of household surfaces and farm family clothing(15).

Pesticide health effects
Research to measure adverse neurobehavioral effects in at-risk and control samples of families in Carchi produced startling results. They showed that the entire family unit of potato farming enterprises was at risk, not just the farmer who applied products. Women, although not commonly active in field agriculture, were nearly as affected as pesticide applicators. Thus in Carchi, the at-risk population is the majority of rural dwellers or urban dwellers that for farming or other reasons handle neurotoxic insecticides. A battery of WHO tests found that nearly 60% of the at-risk sample, and by implication 60% of the at-risk population were affected. Alarmingly, both Mera-Orcés(16) and Paredes(17) found that poisonings and deaths among young children were common in communities.
    Contamination resulted in considerable health impacts that ranged from sub-clinical neurotoxicity(18,19), through poisonings with and without treatment(20), to hospitalisations and deaths(21). The results of the active pesticide poisoning vigilance system established the number of pesticide poisonings in the province among the highest reported in the world. In summary, severe human health effects included poisonings (171/100,000), dermatitis (48% of applicators), pigmentation disorders (25% of applicators), and neuro-psychological interference (peripheral nerve damage, abnormal deep tendon reflexes and coordination difficulties)(22). Mortality due to pesticides was among the highest reported anywhere (21/100,000). These health impacts were estimated to be predominantly in peri-urban and rural settings.
    Further research demonstrated that treatment costs and work days lost impose a significant financial burden on the public health system and the individual. One study(23) found that each human poisoning (not accounting for deaths) cost about six worker days. Another study(24) showed that the use of some products adversely affects farmer decision-making capacity to a level that would justify worker disability payments in other countries. The cost to quality of life is harder to measure.

Discussing sustainable production in a field school. When pesticides are used, women are nearly as affected as the men who spray, probably through exposure in the home and washing drenched clothes. Photo Stephen Sherwood.

Promise of pesticide reduction through IPM
We have been engaged with diverse stakeholders at the individual, regional, national and most recently international levels in hopes of influencing change. Initial interventions centered at the community level in three pilot sites. We supported INIAP in implementing pilot Farmer Field Schools (FFS), a methodology borrowed from the Food and Agriculture Organization’s (FAO) experience in Southeast Asia and Africa and recently introduced for adaptation to the Andes(25). FFS methodology is based on farmer participatory environmental education and purposefully seeks to change the paradigm of Integrated Pest Management (IPM), that often centers on simple rules, such as ‘economic thresholds’ and transfer of single element technologies within a framework of ongoing use of pesticides(26). In contrast, FFS prioritize group learning and organization for the implementation of knowledge and management intensive alternatives to pesticides, such as biological control, insect traps, good agronomy and other means to crop health.
    In an iterative fashion, FFS participants conduct experiments on comparative (conventional vs. IPM) small plots (in total, about 2,500 m2) to identify opportunities for improving production, decreasing costs and reducing pesticide use. After two cropping cycles, initial evaluation results in the Carchi pilot communities were impressive(27). Through the use of alternative technologies, such as Andean Weevil traps, late blight resistant potato varieties, specific and low toxicity pesticides, and careful monitoring of the ecology (beneficial insects as well as pests) before spraying, farmers were able to decrease pesticide sprays from 12 in conventional plots to seven in IPM plots while maintaining or increasing production. Amount of active ingredient of fungicide applied for late blight decreased by 50%, while insecticides used for the Andean weevil and leafminer fly that commonly receive highly toxic carbofuran and methamidophos applications, decreased by 75% and 40% respectively. Average yield for both conventional and IPM plots was about 19 t/ha, and overall productivity, after accounting for labor demands, increased by 37%. We were surprised to find even greater reductions of pesticide use on the plots of individual FFS participants, who dropped to an average of four applications.
    Overall, FFS participants have identified how to maintain the same level of potato production with half the outlays in pesticides and fertilizers, decreasing production costs from about $US104 to $US80 per tonne. Because of the high number of farmers involved in FFS plots, it was difficult to accurately include labour demands in the financial analysis. Nevertheless, farmers felt that the increased time for scouting and using certain alternative technologies, such as the insect traps, would be compensated by decreased pesticide applications, not to mention decreased medical care visits. Further investment is needed to enable these FFS’s to transition to small-enterprise production groups and to establish a farmer-to-farmer extension network.

In search of a political response
Tackling the broader context of pesticide use in agriculture requires involvement of multiple stakeholders, in particular the businesses that profit from pesticide sales. To this end, we have been instrumental in a series of initiatives to make our research results more widely known, engage in discussion of policy options and generate actions to reduce pesticide impacts. We have adopted the multiple approaches advocated in the risk management model used in industrial hygiene(28). Risk management in industrial hygiene ranks the interventions from most to least effective. The most effective intervention is to remove the source of risk. The least is personal protective equipment. Meanwhile, the promotion of personal protective equipment is the central strategy in the industry’s Safe Use campaigns.
    Initial research results led to a provincial-wide stakeholder meeting entitled The impacts of pesticides on health, production, and the environment in October 1999. One hundred and five representatives from government, industry, development organizations, communities, and the media participated. Presidents from the provincial boards of agriculture and health chaired sessions. Ministerial representatives from agriculture, health and education participated as well as the governor and mayors or representatives from each of the provincial municipalities. As one consequence of the meeting, the group formed a small committee composed of the directors from INIAP, the Ministry of Education, and the Ministry of Health, who drafted a Declaration for life, environment and production in Carchi. The Declaration included the following demands:

• Assure greater control on the part of the Ecuadorian Agricultural Health Service (SESA) of the formulation, sale and use of agrochemicals, including the prohibition of highly toxic products (WHO Category Ia and Ib).
• Introduce to the basic education curriculum content on the impact of pesticides on health, the environment and farming productivity.
• Include IPM as part of degree requirements for university level agricultural technical training.
• Commit further resources to research and training in integrated crop management with an orientation towards the reduction of pesticide use and safe use of pesticides.
• Promote awareness raising in rural communities on the collateral impacts of agricultural practices and the use of more environmental and health friendly practices.
• Demand the direct financial support of the agrochemical industry in the completion of these resolutions.

The call for the elimination of an entire category of products – the highly toxics – rang alarms in the pesticide industry, both nationally and internationally. The long-standing position of the industry has been to negotiate restrictions on individual formulations of individual products. Ironically the first resolution resonates soundly with research funded by the pesticide industry on Safe Use of Pesticides, which concluded ‘… any pesticide manufacturer that cannot guarantee the safe handling and use of its toxicity class Ia and Ib products should withdraw those products from the market.’(29) 
    The next four recommendations involved education and research initiatives for stakeholders to gradually shift the orientation of agricultural production from energy intensive inputs to more sustainable practices. The final recommendation was in keeping with a long-standing proposal for post-marketing surveillance, similar to that which is carried out on drugs, funded by agro-chemical producers(30).
    A petition was circulated and presented at a corresponding national multi-stakeholder meeting held in the capital city of Quito in May 2001, organized by the national Technical Committee on Pesticides, an inter-ministry committee composed of representatives from government and private industry. The Committee built on the Carchi declaration to develop a national action plan that amplified the scope to the national level. Unfortunately, prior to the national meeting, pressure from national and international pesticide industry persuaded government officials to withdraw support for the reduction and eventual elimination of highly and extremely toxic pesticides. Instead, the pesticide industry, in particular the Ecuador chapter of the Latin American Plant Protection Association (LAPCA) (www.lacpa.org) and Bayer Corporation, recently launched a Safe Use of Pesticides campaign in Carchi. These initiatives, while perhaps well intentioned, seem to fly in the face of a plethora of research in Carchi and elsewhere, that call for application the of industrial hygiene risk management model(31,32). 

Farmers in this field school have measured the effectiveness of sticky traps for controlling pest attacks. Field schools reduced the use of highly toxic insecticides by up to 75%. Photo: Stephen Sherwood.

A call for action
The research results in Carchi are clear: men, women and children are regularly exposed to pesticides, and this exposure leads to severe health problems and measurable farm productivity declines. Meanwhile, farmers participating in IPM FFS have demonstrated that viable alternatives for pesticide reduction, particularly of Category Ia and Ib products, exist.
    Based on over a decade of research and more recent IPM interventions, we advocate a strategy to reduce pesticide exposure risk based on a combination of hazard removal, provision of alternative technologies and education. Most immediately, this requires the elimination of the most problematic products, in particular carbofuran and methamidophos, followed by investment in effective IPM interventions. When informed of such recommendations in public fora, the agrochemical industry acted to block policy reform, and it championed pesticide safety campaigns that were arguably better designed for image protection than pesticide risk reduction. Due to such frustrated attempts to encourage policy reform, we have reached the conclusion that more responsible pesticide use will only be achieved through increased international pressure.
    PAN’s championed Dirty Dozen campaign was effective in pressuring governments to exclude the most problematic pesticides, as determined by criteria of environmental and human health toxicity. We call for further policy revision that takes into account the socio-economic situation of the rural families that use products and their associated exposure conditions. Industry studies have shown that it is not realistic to expect smallholders in developing countries to safely use highly toxic and other highly dangerous products otherwise deemed safe under industrialized world conditions(33). This strategy would demand post-marketing surveillance by international auditors, such as PAN members. Furthermore, elimination of problematic products should be accelerated when alternatives immediately exist, as demonstrated by potato farmers in Carchi. Where effective alternatives to highly dangerous products do not exist, investments in research is needed.
    Until such action is taken, the pesticide industry will continue to freely distribute and peddle its most highly dangerous products among the vulnerable families of rural Latin America, regardless of the burden this knowingly places on their health, farm productivity, and livelihood.

References
1. Barsky, O, Acumulación campesina en el Ecuador: Los productores de papa del Carchi. Colección de investigaciones, No. 1. Facultad Latinoamericana de Ciencias Sociales (FLACSO). Quito, Ecuado,. 1984. 
2. Crissman CC, Antle J, and Capalbo S (eds), Economic, Environmental and Health Tradeoffs in Agriculture: Pesticides and the Sustainability of Andean Potato Production. Lima, Peru: CIP and Kluwer Academic Publishers, ‘Natural Resource Management and Policy’ Series, Dordrecht/Boston/London, 1998.
3. ibid
4. Barrera VH, Norton G, Ortiz O, Manejo de las principales plagas y enfermedades de la papa porlos agricultores en la provincia del Carchi, Ecuador. Quito, Ecuador: INIAP, 1998.
5. Restrepo M, Muñoz N, Day N, Parra J, Romero L., Nguyen X, Prevalence of Adverse Reproductive Outcomes in a Population Occupationally Exposed to Pesticides en Colombia. Scand J Work Environ Health16, 232-238, 1990. 
6. Harari et. al, pending publication 
7. USEPA, Ethylene bisdithiocarbamates (EBDCs); Notice of intent to cancel and conclusión of Special Review. Federal Register 57(41): 7434-7539, 1992. 
8. Crissman C, Cole DC, Carpio F, Pesticide use and farm worker health in Ecuadorian potato production. Am J Agric Econ; 76 (Aug): 593-597, 1994.
9. Op. cit. 2
10. Frolick, LM, Sherwood, S, Hemphil A and Guevara, E, Eco-papas: Through potato conservation towards agroecology. ILEA Newsletter. December. pp 44-45, 2000. 
11. Espinosa P, Crissman C, Mera-Orcés V, Paredes M, Basantes L, Escudero L, Conocimientos, actitudes y practicas de manejo de plaguicidas por familias productoras de papa en Carchi. Chapter 3 in Crissman CC, Espinosa P (eds) 2001. in press 
12. Merino R, Cole DC, Presencia de plaguicidas en el trabajo y el hogar. Ch 5 in CC Crissman and P. Espinosa (eds), Impactos del uso de plaguicidas en la producción, salud y medioambiente en Carchi: un compendio de investigaciones y respuestas multidisciplinarias [The impact of pesticide use on production, health and environment in Carchi: a compendium of multidisciplinary research and responses]. Quito, Ecuador; CIP, 2002. 
13. Op. cit. 11
14. Op. cit 2
15. Op. cit. 12
16. Mera-Orcés V, Agroecosystems Management, Social Practices and Health: A Case Study on Pesticide Use and Gender in the Ecuadorian Highlands. A Technical Report to the IDRC. Canadian-CGIAR Ecosystem Approaches to Human Health Training Awards with a Particular Focus on Gender. June, 2000..
17. Paredes, M, We are like fingers of the same hand: Peasants’ heterogeneity at the interface with technology and project intervention in Carchi, Ecuador. M.Sc. thesis, Wageningen University, the Netherlands, 2001.
18. Cole DC, Carpio F, Julian J, Leon N, Carbotte R, De Almeida H, Neurobehavioural outcomes among farm and non-farm rural Ecuadorians. Neurotoxicol & Teratol, 19(4):277-286, 1997.
19. Cole DC, Carpio F, Jullian J, León N, Assessment of peripheral nerve function in an Ecuadorean rural population exposed to pesticides. Journal of Toxicology and Environmental Health, 55(2):77-91, 1998.
20. Op. cit. 8
21. Cole DC, Carpio F, León N, Economic burden of illness from pesticide poisonings in highland Ecuador. Pan American Review of Public Health, Vol. 8, No. 3, pp196-201, 2000.
22. Op. cit. 2
23. Op. cit. 21
24. Antle JM, Cole DC, Crissman CC, Further evidence on pesticides, productivity and farmer health: potato production in Ecuador. Agricultural Economics, 18:199-207, 1998.
25. Sherwood, S, Nelson, R, Thiele G and Ortiz O, Farmer field schools in potato: A new platform for participatory training and research in the Andes. Institute for Low External Input Agriculture (ILEIA). 16(4):24-25, 2000. 
26. Gallagher, KD, Community study programmes for integrated production and pest management: Farmer Field Schools In: FAO, Human Resources in Agricultural and Rural Development, Rome, pp. 60-67, 2000.
27. Barrera V, Escudero L, Suquillo J, Sherwood S and Norton G, Validación y difusión de modelos de manejo integrado de plagas y enfermedades en el cultivo de papa: Una experiencia de capacitación participativa en la provincia de Carchi, Ecuador. Special Report for the USAID IPM/CRSP Project, 2001. 
28. Murray DL, Taylor PL, Claim no easy victories: evaluating the pesticide industry’s global safe use campaign. World Development, 28(10):1735-1749, 2000.
29. Atkin J and Lesinger KM (eds). Safe and Effective Use of Crop Protection Products in Developing Countries. CABI Publishing. Oxford, UK, 2000 (see their book reviewed in PN 47).
30. Loevinsohn ME, Improving pesticide regulation in the Third World: the role of an independent hazard auditor, 1990. In Forget G, Goodman T, de Villiers A, Impact of pesticide use on health in developing countries: proceedings: Ottawa, Ontario: IDRC, 166-177, 1993.
31. Crissman CC, Espinosa P (eds) Impactos del uso de plaguicidas en la producción, salud y medioambiente en Carchi: un compendio de investigaciones y respuestas multidisciplinarias (Translation above) CIP (in press) 
32. Op. cit. 28
33. Op. cit. 29

Acknowledgement
Studies reported here were originally financed by the Rockefeller Foundation. Subsequent investigations were conducted with the support of the USAID Soil Management and IPM Collaborative Research Initiatives as well as the FAO, the Ecosystem Health Program of the Canadian International Development Research Council, and the Dutch Fund for Eco-Regional Research. 

Stephen Sherwood and Charles Crissman, International Potato Center, Donald Cole, Community Health Program, University of Toronto. Contact: Stephen Sherwood, CIP, Apartado Postal 17-21-1977, Quito, Ecuador, Email: s.sherwood@cgiar.org, Fax: +593 2 269 2604.

[This article first appeared in Pesticides News No. 55, March 2002, pages 3-6]