An official government scheme used mainly by
sheep farmers to report illness linked with organophosphorous (OP) chemicals is
failing and needs a re-think.
At a seminar on OPs arranged by DEFRA, a former chairman of
the veterinary products committee (VPC) said scientists are trying to come up
with improvements to the Suspect Adverse Reaction Surveillance Scheme (SARSS).
This scheme is used by farmers to report illness associated
with OPs to the Veterinary Medicines Directorate (VMD), the government agency
which licences OPs and other veterinary medicines. The VPC gives advice to
Ministers on the safety, quality and efficacy of veterinary medicines.
The OP seminar was organised by the government’s chief vet,
Jim Scudamore, to update journalists on OP research. Last year, Environment
Minister Ben Bradshaw had alarmed sheep farmers and campaigners by cancelling an
OP seminar. But Mr Scudamore, who chairs the government’s inter-departmental
group on OPs, said the seminar had not been cancelled but merely postponed
because two important pieces of research were not ready.
During the seminar, Professor Ian Aitken, former chairman of
the VPC, was asked whether the existing SARSS scheme was working as well as it
should. He said: ‘The answer is quite definitely no. It can be improved and we
have been trying to devise ways of improving the scheme.’
Why the numbers using SARSS have fallen
Hardly any farmers are using SARSS now compared with a few
years ago. In November last year, there were 17,508 certificates issued to
farmers who had completed the national proficiency test council certificate of
competence in sheep dipping. Whilst more than one of these may have been issued
to the same farm, the figure gives a good idea of the number of sheep farmers
still using OPs. Yet in 2002/03, there were just two reports in each of these
years of adverse effects on people from using the chemicals, three of which are
still on the market. In the three years 1991-93, 436 people reported effects
when there was great interest in the possible links between OPs and ill health.
Professor Aitken said the figures had fallen so dramatically
because there was heightened publicity between 1991-93 about OPs and illness;
then there was the introduction of a certificate of competence which made
farmers and OP users much more aware of the precautions they had to take; and,
more recently, the introduction of a closed system for pouring dip into dip
baths.
Although some practical improvements may have been made to
the ways in which OP dip is used, the SARSS scheme remains a poor instrument for
gauging the extent of possible poisoning among farmers. It was roundly
criticised by the Committee on Toxicity under Professor Frank Woods in 1999
which concluded that SARSS ‘… yielded so few relevant data and that little
progress had been made in establishing a relevant clinical database.’
How SARSS could be improved
Professor Aitken was asked what needs to be done to improve
SARSS so that it is used effectively by farmers reporting illness. ‘The
veterinary products committee set up a small working group last year to try to
devise methods of improving the reporting system. The working group has come
forward with a number of proposals and recommendations which are still subject
to consultation and will be going forward to Ministers.’ At the heart of this
package is an attempt to try to make more people aware of SARSS and to persuade
more people to use it promptly rather than waiting several months.
Unfortunately, the history of SARSS has left farmers thinking
that if they do report illness, little or nothing will be done. This is why they
have preferred to use other organisations – such as Elizabeth Sigmund’s OPIN
(OP Information Network), PAN UK, NIOPSA (the Northern Ireland OP Sufferers
Association) and OPUS (the OP Users Support Group) – to report their
conditions. ‘The working group is very conscious of this and I think you will
find when their report is published that members have taken account of this
matter,’ said Professor Aitken.
Research still unfinished
Dr Len Levy, head of toxicology and risk assessment at the
Medical Research Council’s Institute for Environment and Health, based at
Leicester University, told the seminar which pieces of research were still
unfinished when Mr Bradshaw cancelled the OP seminar. One was the study begun by
Professor Nicola Cherry at Manchester University on genetic susceptibility to OP
poisoning; and the other was the SHAPE study (Survey of Health and Pesticide
Exposure), by Dr Tony Fletcher and Rachel Maclehouse of the London School of
Hygiene and Tropical Medicine, looking at how the symptoms of people reporting
OP poisoning have been categorised. This involves collecting data from groups
such as OPIN which have supported farmers who have avoided SARSS or used the
scheme and found it unsatisfactory.
Alison Craig, coordinator for the PEX project of PAN UK,
said: ‘The effectiveness of any surveillance scheme depends on good clinical
information. People reporting symptoms should be examined promptly and records
made. Otherwise, the scheme is just a paper exercise.’ She added that the
support groups give advice and contacts whereas the SARSS scheme doe not contact
the people sending in forms. PAN UK wants to see reporting of pesticide related
ill-health improved so there is a mandatory centralised scheme, a website and
hotline number of the scheme on all product packaging, and standards for prompt
biochemical investigation.
[This article first appeared in Pesticides News No. 63, March 2004, page 11]