Unsuitable for use – Profile of paraquat

New publication from PAN Asia Pacific reveals plantation hazards.

New research has found that the herbicide paraquat causes unacceptable injuries, especially under the poor conditions of use in developing countries. John Madeley reports on a phase-out call to the manufacturers Syngenta by public interest groups.

Syngenta is the world’s largest agrochemical corporation, with approximately 20% of the global pesticide market. The company was formed when the Swiss company Novartis and Swedish-British AstraZeneca decided to merge their agrochemical and seeds interests, setting up the first global, dedicated agribusiness company(1). Syngenta’s interests cover a wide range of agrochemical products and seeds, particularly genetically engineered varieties. Despite what the company described as ‘a difficult market’ in 2001(2), sales totalled US$6,323 million (see table 1). One of Syngenta’s most successful products, the herbicide paraquat, first marketed in the 1960s, is also its most controversial.
Herbicides account for almost half the value of the global agrochemical market, with sales in 2001 reaching approximately $13 billion(3). Herbicide sales form 38% of the Syngenta business, which give it a 17% share of this market, through its sales of both selective and non-selective herbicides that will kill most plants. Syngenta describes paraquat, sold mainly under the trade name Gramoxone in over a hundred countries, as the world’s second largest selling agrochemical. The lion’s share of company sales come from the two non-selective herbicides, paraquat and glyphosate-trimesium (sold as Touchdown) which together totalled US$687 million, about 11% of the 2001 revenue.

Table 1. Syngenta sales of pesticides and seeds 2000 and 2001 (US$ million)
Pesticide sales by region(4)	2001	2000
Asia and the Pacific	951	1,039
Latin America	677	850
Europe, Africa and Middle East	1,870	1,991
NAFTA countries (US, Canada, Mexico)	1,887	2,008
Total pesticides	US$5,385	US$5,888
Seeds	938	958
Total pesticides and seeds	US$6,323	US$6,846
Herbicide sales(5)
Selective herbicides (killing specific weeds)	1,722	1,841
Non-selective (including paraquat)	687	760
Herbicides as a per cent of sales	38%	38%
Profits from pesticides and seeds(6)	2001	2000
Gross profit - pesticides	2,645	2,874
Operating income - pesticides	738	866
Gross profits - seeds	479	462
Operating income - seeds	71	3

The market for paraquat in developing countries is an important source of profits for the company. Although figures are considered ‘commercially sensitive information’(7), in 2000 Syngenta reported that: ‘Market expansion due to the substitution of manual labour in Asia and increases in herbicide-tolerant crop plantings in the US market continued to drive sales of Gramoxone and Touchdown.’(8)

Paraquat concerns
A profile of paraquat describes symptoms of poisoning: ‘If swallowed, burning of the mouth and throat often occurs, followed by gastrointestinal tract irritation, resulting in abdominal pain, loss of appetite, nausea, vomiting, and diarrhoea. Effects due to high acute exposure to paraquat may include excitability and lung congestion, which in some cases lead to convulsions, incoordination, and death by respiratory failure. Other toxic effects include thirst, shortness of breath, rapid heart rate, kidney failure, lung sores, and liver injury.’(9) Respiratory adult distress syndrome due to lung fibrosis is usually the cause of death. There is no antidote, though it is recommended that victims swallow Fullers Earth to soak up the poison(10).
Continued exposure to paraquat by workers regularly using the pesticide, can affect the skin, eyes, nose and fingernails. Skin problems include mild irritation, blistering, ulceration, peeling, necrosis (cell death in skin tissue), dermatitis of the hand and blistering in scrotal areas (from leaking sprayers soaking trousers). Severe exposure on hands has resulted in nail damage, ranging from localised discolouration to temporary nail loss. Eye injuries include blepharitis (eyelid inflammation), conjunctivitis, ulcerations or keratosis (wart-like growth) of the cornea. Nosebleeds can also occur. Skin, nail, and eye lesions have been reported, including in children.(11-17)

Production phase out urged
In a report launched for the Syngenta Annual General Meeting by five public interest organisations (Berne Declaration, Foro Emaus, PAN Asia Pacific, PAN UK and the Swedish Society for Nature Conservation [SSNC]) in April 2002, the company was urged to phase out the production and use of this hazardous pesticide.
Accidental poisoning is triggered by a variety of circumstances(18). In occupational use, poisoning can occur through the skin, sometimes during knapsack spraying. The presence of scratches, cuts or sores on the skin substantially increases the risk. The greatest risk to workers of fatal and serious accidents is during mixing and loading where contact with concentrate occurs. Conditions of use in many developing countries make it difficult to follow label instructions and recommendations.
The head of Syngenta regulatory affairs, Georg Diriwaechter, says that the product can be used safely and has many benefits: ‘The product acts quickly, is rapidly inactivated in soil and won’t contaminate ground or surface water … If you follow the instructions, you are safe. That’s why we do not discuss a ban on the product.’(19) However the studies point to the need for far-reaching changes in the use of pesticides products, and particularly paraquat, and their application techniques in developing countries.

Problems on plantations
New studies from Malaysia and Costa Rica show that workers and farmers regularly exposed to paraquat experience serious problems with their health.

Malaysian plantations – women workers at risk
Poisoned and Silenced: A study of pesticide poisoning in the plantations(20) by the Malaysian public interest groups Tenaganita and PAN Asia Pacific, investigates the impacts of pesticide use on the plantations. The market for pesticides in Malaysia was approximately $86 million in 1997. Herbicides account for three-quarters of pesticides used and are sprayed on four million hectares of plantation crops – palm oil, rubber and cocoa. Paraquat is one of the most frequently used herbicides.
Most sprayers on the Malaysian plantations are women. Herbicide applicators on plantations average 262 spraying days a year. A woman sprayer carries an average of a four-gallon load on her back. It appears to be common practice on the plantations studied not to disclose the names of the pesticides to the sprayers. Sometimes labels are missing from containers. Where the sprayers were able to identify the compound, they reported that the most frequently used was paraquat, (followed by metsulfuron, glyphosate, 2,4-D and glufosinate ammonium). Most plantation workers do not use protective clothing: it is not supplied and is too uncomfortable in hot weather(21).
The report suggests that the Malaysian government’s ‘seeming lack of urgency in reducing the amount of pesticides used in the plantations is a cause for concern, especially with regards to the safety and well-being of women workers, particularly those employed as pesticide sprayers and applicators’. It continues: ‘Poisoning due to paraquat is clearly demonstrated in the surveys and interviews with workers and indicated in the medical examinations … because of its effects to workers and users of paraquat, Malaysia has already restricted its use and classified it as Class 1 pesticide. However, more needs to be undertaken, given the extent of poisoning … it is urgently required that Malaysia bans paraquat.’

Banana plantations in Costa Rica
In Costa Rica, hundreds of paraquat injuries occur each year, most of them in the banana producing Atlantic Region. In 1996, 45 kg of active ingredients were applied on each hectare of banana cultivation, equivalent to 65 kg per banana worker(22). Over 60% of reported pesticide poisonings in the country are from banana plantation workers(23). The most recent survey found that 60% of victims suffer from skin burns or dermatitis and 26% from eye injuries. The remaining 14% had systemic poisonings, nosebleeds and nail damage(24).
Even on plantations where efforts had been made to reduce risks, dangerous situations and inadequate handling have been registered(25,26). Exposure occurred via splashing during preparation of the spray solution, spray drift, contact with spray solution when filling knapsack, leaking of knapsack on back and groin, adjustment of spray equipment, and walking through sprayed vegetation.
Over a quarter of the poisoning incidents reported between 1995 and 1997 involved paraquat; fourteen of these incidents involved workers under 18 years old, whom the law says should not be handling these pesticides(27). Of herbicide-related illnesses in 1996, for which compounds were specified, 71% concerned paraquat(28). In June 2000, a coalition of non-governmental organisations, including Foro Emaus, and trade unions in Costa Rica, Germany and France launched a national and international campaign to ban the use of paraquat on banana plantations in the Latin American region.

Chronic health concerns
The signs of pesticide poisoning described here are largely observable. However there has been concern about the effect on the lungs of long-term exposure. A recent study of 126 workers on fruit farms in the Western Cape area of South Africa used a new test for measuring respiratory effects on the lungs of workers with long-term exposure to paraquat(29). After eliminating confounding factors such as smoking history, alcohol consumption, age, weight and height, the study found that the lung capacity of workers exposed to paraquat was consistently 10-15% lower than a reference population.

Fatal accidents and suicides
Because of its dark colour, paraquat was often confused with drinks like coffee or coke. In the late 1980s, the manufacturers added a blue pigment, a stenching compound (strong smell), and an emetic to many formulations of paraquat to help avoid these severe unintentional poisonings.
An overview carried out in 2000 of the major public health problems of pesticides as a result of both accidental and intentional exposure found that paraquat has been reported to be a problem in many parts of the world(30). Sadly, pesticides are readily available to people suffering acute depression or humiliation, with heavy and unpayable debts for example. Recent data from developing countries indicate that in spite of the additions of dye, emetic and strong smell, both suicides and unintentional poisonings continue: an increase in paraquat suicides has been documented in Costa Rica(31) and numbers are beginning to rise in Samoa(32).

Testimonies of workers recently injured by paraquat

Interviews carried out on 4 and 11 April 2002 in Cariari de Pococi, Atlantic Region of Costa Rica, by Catharina Wesseling, MD, PhD, Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia, Costa Rica. The workers gave permission to use their names.

Costa Rican testimony

Testimony 1. Marco Tulio Hernandez, age 48.
This worker was spraying Gramoxone on a banana plantation on 25 November 2000. His backpack was leaking on the top and the liquid fell on his arm. After three hours he noted a burning sensation and redness on the inner surface of his upper right arm. He stopped working and showered thoroughly. Next day, the foreman sent him out spraying again with the same defective backpack, because there was no other available. He sprayed another three hours and when the pain worsened he interrupted the spraying with nausea, burning sensation in the mouth, and abdominal pain. The local doctor told him to put toothpaste on the wound until he could be seen at the occupational health service. On the fourth day he was attended there with a blistering lesion of 15 by 20 cm. The wound did not heal and he had to be hospitalized twice for a skin transplantation. He was on sickleave for nine months. Back on the job he was sent out to spray again, but when he refused he was fired.

Testimony 2. Jose Francisco Saenz, age 17.
Although in Costa Rica children under 18 are not allowed to work with pesticides, this young worker has been in contact with pesticides since he was twelve. In January 2002 he suffered burns (redness, swelling and blisters) on his back, buttocks, testicles and both thighs after paraquat spraying with a leaking backpack on a watermelon farm. He also presented nausea, vomiting and shortness of breath. He had no medical attention and the lesions took two weeks to heal.

Testimony 3. Roman Sosa, age 24.
This migrant worker from Nicaragua was spraying Gramoxone in September 2001 on a banana plantation. The top of the backpack was broken and the liquid was leaking on his back, down to his groin, legs and feet for two consecutive days. He sprayed seven hours a day. After the first day he noted pain and burning sensation with nausea, headache, abdominal pain and fever. He was put on sickleave for nine days, but he had to go back to work when the wounds on his testicles were still not cured. Later the nails of his toes fell off and he has a permanent scar on his testicle.

Testimony 4. Jose Lara, age 50.
This worker has been a herbicide sprayer for three years. He has lost his toenails twice and the ones he has grown now are damaged. He has had splashes in the eyes on three occasions, with mild redness after rinsing them with urine. He started to develop chronic general malaise with headache, vomiting, blurred vision, and lack of appetite. He recently stopped working with Gramoxone and his health has improved.

Malaysian testimony

Arjunan Ramasamy, 56, was a plantation worker on Malaysian oil palm estates for 33 years, and a union leader for 20 years. He presented his story at a Press conference in Basle, Switzerland, 19 April 2002.
    ‘Today more and more women are working as pesticide sprayers. Malaysia has about 30,000 women pesticide sprayers. More than half of the workers in the plantations are Indian women. There is very high usage of pesticides, especially herbicides, in oil palm plantations. One of the most commonly used is paraquat.
    Some of the common symptoms are back pain, giddiness, difficulty in breathing, skin problem, nausea, eye irritation, headache and tight feelings in the chest and fatigue. I know that women sprayers have suffered very much. Many have complained of stomach pains, of headaches, bad back pains and also prolapsed womb. I know of women who have had miscarriages and lost their babies. Women sprayers have suffered from breast pains and also their breasts swelling or pus developing in their breasts.
    Medicines like calamine lotion for itchiness and panadol for pain are prescribed. When the women sprayers requested a different kind of job because they could not take the exposure to pesticide chemicals, they were told to resign. Pesticide sprayers have to work for eight hours daily. They have to endure terrible heat under the hot sun.’

Bans or restrictions on paraquat
Under the early warning system promoted by the Rotterdam Convention on Prior Informed Consent (PIC), governments are asked to notify control actions taken on pesticides, and ten governments have notified the Secretariat of bans and restrictions – Austria, Denmark, Finland, Hungary, Indonesia, Republic of Korea, Kuwait, Slovenia, Sweden and Togo(33). The bans primarily reflect concern with acute toxicity, absence of antidote, health and environmental effects. In other countries strict guidelines are applied, for example the US Environmental Protection Agency allows its purchase and use solely by certified applicators(34).

Recommendations
Because of its leading role as a producer of paraquat, the five organisations launching the report called on Syngenta to:

1. Within three years, and starting immediately, phase out the promotion and sale of paraquat products in developing countries.
2. Cooperate with national initiatives to ban paraquat taken on the basis of health or environmental concerns, and support the inclusion of paraquat in PIC to alert governments to concerns under adverse conditions of use.
3. Increase the hazard alert by collaborating with the WHO to place paraquat in its ‘extremely’ or ‘highly’ hazardous classification (rather than the present ‘moderately hazardous’ classification).
4. While sales remain in developing countries: implement a system of returnable containers; ensure that only the ‘warning’ formulations are sold; ensure the limited safeguard of Fuller’s Earth can be guaranteed to be immediately available; and ensure that all users have ready access to affordable independent medical facilities.
5. Allocate greatly increased resources to develop agricultural products that contribute to ecological, sustainable agricultural production, and phase out the production of paraquat and other hazardous pesticides.

References
1. Novartis was itself a merger of Ciba Geigy and Sandoz, and AstraZeneca a merger of Astra and Zeneca, which had formerly been ICI.
2. Syngenta Annual Report, 2001, page 7.
3. Syngenta website, www.syngenta.com
4. Syngenta, Op. cit. 2., The company’s regional breakdown makes sales to developing countries difficult to ascertain. They could be estimated at about a quarter to a third.
5. Syngenta, page 12, Op. cit. 2.
6. Syngenta, page 39, Op. cit. 2.
7. Syngenta spokesperson to John Madeley, March 2002.
8. Syngenta, page 21, Op. cit. 2.
9. Pesticide Information Profile, Pesticide Information Project of Cooperative Extension Offices of Cornell University, Oregon State University, the University of Idaho, University of California at Davis and the Institute for Environmental Toxicology, Michigan State University, 1996.
10. For an example of unsuccessful attempts to treat paraquat poisoning, see Zoppellari R, Brunaldi V, Righini F, Mantovani, Avato FM, and Zatelli R, ‘Evaluation of the Effectiveness of Hemoperfusion in paraquat poisoning: a clinical case’, Human Toxicol, 1987.
11. Howard JK, A clinical survey of paraquat formulation workers, Br J Ind Med 1979, 36: 220.
12. Hoffer E and Taitelman U, Exposure to paraquat through skin absorption: Clinical and laboratory observations of accidental splashing on healthy skin of agricultural workers, Human Toxicol 1989, 8: 483-5.
13. Villa L, Pizzini L, Vigano G, Ferioli A, Maroni M, Ruggeri R, Barlassina C and Vannini P, Paraquat-induced acute dermatitis in a child after playing with a discarded container, Med Lav 1995, 86: 563-8, in Italian.
14. Vlahos K, Goggin M and Coster D, Paraquat causes chronic ocular surface toxicity, Aust N Z J Ophtalmol 1993, 21: 187-90.
14a. Wesseling C, de la Cruz E and Hidalgo C, Epidemiological study on pesticide poisonings in Costa Rica (Estudio epidemiológico de intoxicaciones con plaguicidas en Costa Rica), Technical report of Pesticide Program to PAHO/WHO, Heredia: Universidad Nacional, 1988.
15. George AO, Contact leucoderma from paraquat dichloride? Contact Dermat 1989, 20: 225.
16. Hearn CED and Keir W, Nail damage in spray operators exposed to paraquat, Br J Ind Med, 1979, 28, 399.
17. Cant JS and Lewis DRH, Ocular damage due to paraquat and diquat, Br Med Bull 1968, 25, 224.
18. Wesseling C, van Wendel de Joode B, Ruepert C, Leon C, Monge P, Hermosilla H and Partanen T, ‘Paraquat’, Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica et. al., 2001.
19. ‘Syngenta urged to pull herbicide on health concerns’, 22 April 2002, New York, Bloomberg press agency, mshearmur@bloomberg.net.
20. Fernadez I, et. al., ‘Poisoned and silenced: A Study of Pesticide Poisoning on the Plantations’, Tenaganita and PAN Asia and the Pacific, Malaysia, March 2002.
21. Consumers Association of Penang, 1996, Pesticide Contamination Continues, Utusan Konsumer, mid-July 1996, page 5.
22. Wesseling C, van Wendel de Joode B and Monge P, Pesticide-related illness among banana workers in Costa Rica: A comparison between 1993 and 1996, Int J Occup Environ Health 2001, 7: 90-7.
23. Smith, Alistair, The modern banana plantation ‘Still a green prison’, Pesticides News 48, June 2000.
24. Wesseling, Op. cit. 22.
25. Van Wendel de Joode BN, de Graaf IAM, Wesseling C and Kromhout H, Paraquat exposure of knapsack spray operators on banana plantations in Costa Rica, Int J Occup Environ Health, 1996, 2: 294-304.
26. Spruit O and van Puijvelde, Evaluation of the protective equipment used during herbicide application on banana plantations, 1998, Internal report 1998-304, Wageningen Agricultural University.
27. Educational video, ‘Bananas Unpeeled’, Banana Link, Norwich.
28. Wesseling, van Wendel de Joode and Monge, Op. cit. 22.
29. Dalvie MA, White N, Raine R, Myers JE, London L, Thompson M and Christiani DC, ‘Long term respiratory health effects of the herbicide, paraquat, among workers in the Western Cape,’ Occupational Environmental Medicine 1999, 56: 391-396.
30. Eddleston, M, ‘Patterns and problems of deliberate self-poisoning in the developing world’, Original papers, QJ Med, 2000, 93: 715-731.
31. Wesseling, et. al., Op. cit. 18.
32. Bill Cable, regulator, Samoa, personal communication to Barbara Dinham, March 2002.
33. PIC Circular X, Synopsis of notifications of control actions received before 11 September 1998, Interim Secretariat for the Rotterdam Convention on the Prior Informed Consent (PIC) Procedure, December 1999.
34. US EPA, Reregistration Eligibility Decision (RED), Paraquat dichloride, Office of Prevention, Pesticides and Toxic Substances, EPA 738-F-96-018, 1997.

[This article first appeared in Pesticides News No. 56, June 2002, pages 3-5]