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  • 1. Susmita Dasgupta, Craig Meisner, David Wheeler, Nhan Thi Lam, Khuc Xuyen The World Bank and The National Institute of Occupational and Environmental Health, Vietnam Pesticide Poisoning of Farm Workers: Implications of Blood Test Results from Vietnam
  • 2. Pesticide consumption (metric tons) in Vietnam Source : FAO, 2004 Pesticide consumption has more than doubled in the past decade
  • 3. Alarming Composition/Application of Pesticides
    • In 2000, a nation-wide survey by PPD found:
      • 2,500 kg of banned pesticides (Methamidophos, DDT and others).
      • 4,753 litres and 5,645 kg of illegally imported/ counterfeit pesticides.
    • In 2000, another survey in the South found:
      • 96.6% of the farmers over-use pesticides
      • 95% of the farmers pour residual spray into canals/ ditches/ re-apply it on other plants/ over-apply it to the same crop to get rid of it.
  • 4. Vietnam has limited secondary data on Health Effects of pesticides
    • Survey of Rice Farmers (pesticide applicators) in Mekong delta.
    • Clinical Exam
    • Blood Test
    • Questions of Interest:
    • What is the incidence of pesticide intoxication?
    • Are self-reported data good indicators of actual intoxication?
    • What are the determinants of pesticide intoxication?
  • 5. Application of pesticides: survey evidence
  • 6. Health Effects of Organophosphates and Carbamates cited in Medical Literature
    • Acute:
    • Mild headaches
    • Flu-like symptoms
    • Skin rashes
    • Blurred vision
    • Other neurological disorders
    • Chronic:
    • Cardiopulmonary problems
    • Neurological and hematological symptoms
    • Adverse dermal effects
  • 7. Blood Test for the Detection of Acute and Chronic Pesticide Poisoning
    • Cholinesterase Enzyme (AchE)Test: (poisoning from organophosphates and carbamates)
    • Low Acute Poisoning: Reduction of numerical value of AchE in red cells and in plasma >25%
    • High Acute Poisoning: Reduction of numerical value of AchE in red cells and in plasma >33%
    • Chronic Poisoning: Reduction of numerical value of AchE in red cells >66%
  • 8. Specific Health Effects found in the Survey
    • 98% of the farmers in the survey reported health problems
    • 88% of the respondents experienced multiple health effects, with the maximum number of ailments as nine
  • 9. Blood (Cholinesterase Enzyme) Test Results
  • 10. (Correlation between each individual symptom and blood test results were conducted. The highest correlation found was 0.17) Self-reported symptoms are not reliable indicators of actual pesticide poisoning
  • 11. Determinants of Cholinesterase Enzyme Inhibition: Regression Analysis
  • 12. Determinants of Cholinesterase Enzyme Inhibition: Regression Results
    • Farmers applying more hazardous pesticides (WHO Ia & Ib) are more likely to suffer
    • Incidence of pesticide poisoning can be significantly reduced by suitable averting behavior
    • Pesticide poisoning in Vietnam revealed strong provincial pattern. This raises the concern that the environment in certain regions may have been contaminated from prolonged exposure to toxic pesticides
  • 13. Summary and Conclusions
    • Health effects of organophosphates and carbamates is serious in Mekong Delta, Vietnam
    • Self-reported symptoms have very weak associations with actual poisoning
    • Suitable averting behavior while handling pesticides should be advocated
    • Significant provincial differences in poisoning incidence implies that pesticide contamination may be pervasive in certain areas
    • Tests of pesticide residues in surface/ground water and soil is necessary
  • 14.