Human health monitoring of pesticide-related disease in the UK

The UK government’s Advisory Committee on Pesticides (ACP) has taken almost a year to consider how current systems for human health monitoring of pesticide-related disease can be improved. The actions now proposed do not go far enough in tackling either acute or chronic incidence.

After a protracted review of monitoring effects of pesticides on human health, the ACP has failed to produce a strategic plan for the medium or long-term. However, there are some encouraging initiatives from the review, relating to acute incidents only, which include:

• improved coordination of incident-reporting with the proposed introduction of a standard form for use by a range of organisations, including Health and Safety Executive (HSE), pesticide companies, the National Poisons Information Service (NPIS), and others
• consideration of using Hospital Episode Statistics (HES) in England, and Information and Statistics Division (ISD) data in Scotland for acute cases
• consideration of a pilot study of clinical cases from NPIS acute cases; funding will be obtained from the Department of Health and the Medical Research Council
• consideration of the modification of the NPIS TOXBASE database to capture acute pesticide-related incidents
• consideration of a public web-based adverse-event reporting scheme
• formal questionnaire to pesticide companies, sent out by the Pesticides Safety Directorate in September, requesting information on adverse effects reported to them in the year 2002. The deadline for returns, to include nil data has now been extended beyond the original date of November 2003.

The ACP has avoided looking in depth at the possible health impacts, chronic and acute, of overall pesticide usage. Its chairman, Professor David Coggon, says: ‘currently there are few, if any, chronic disorders for which pesticide exposure has been established as a cause other than those that occasionally occur as long-term complications of overt acute pesticide poisoning’¹. 
    PAN UK believes a number of additional measures are important to fully address the current gaps in health surveillance including: 

• a statutory scheme, coordinated by the new Health Protection Agency, whose remit includes a national strategy for the prevention of disease from chemical hazards
• collection of baseline-data on ‘body burdens’, using a survey that identifies chemical contaminants in a biochemical test of blood (and sometimes tissue) samples. This would be similar to the component of the US National Health and Nutrition Examination Survey (NHANES), and/or an in-depth targeted study similar to that carried out by the US non-governmental Environmental Working Group in their ‘Body Burden’ report². The Working Group on the Risk Assessment of Mixtures of Pesticides (WiGRAMP) of the Committee on Toxicity identified this need
• a ‘Green Card’ scheme, a reporting system equivalent to the ‘Yellow Card’ scheme monitoring adverse effects of medicines. (AC)

1. Letter from Professor David Coggon, ACP, to Alison Craig, PAN UK, 15 July 2003.
2. Body burdens – new ground, Pesticides News 59, page 21.

[This article first appeared in Pesticides News No. 62, December 2003, page 21]