Childhood Pesticide Poisoning

childhood couverture 28/06/04 14:42 Page 1

Childhood
Pesticide
Poisoning

Information
for Advocacy
and Action

Printed in Switzerland
GE.04-00690-May 2004-2000

WHO

maquette childhood last 28/06/04 14:46 Page 1

Childhood Pesticide Poisoning
Information for Advocacy and Action

Prepared for the United Nations Environment Programme (UNEP)

The main text was prepared for the Food and Agriculture Organization (FAO), the United
Nations Environment Programme (UNEP), and the World Health Organization (WHO) by
Dr. Lynn Goldmann, Professor, Environmental Health Sciences, John Hopkins School of
Hygiene and Public Health, Baltimore, USA. These organizations wish to acknowledge
the contributions to the report from Mr. Bill Murray, FAO, Dr. Bo Wahlström, UNEP and
Dr. Jenny Pronczuk, WHO.

Published in May 2004 by
the Chemicals Programme of the United Nations Environment Programme (UNEP Chemicals)
with the assistance of UNEP’s Information Unit for Conventions.
For more information please contact
UNEP Chemicals, International Environment House,
11-13 Chemin des Anémones,
CH-1219 Châtelaine, Switzerland,
or chemicals@unep.ch.

1


I. Introduction

Pesticide poisoning is a serious health Tackling the risks to children of pesticide

Introduction
problem that disproportionately affects exposure and poisoning requires compre-
infants and children. Pesticides are hensive strategies. These strategies
designed to kill, reduce or repel insects, should be designed for the local level and
weeds, rodents, fungi, and other organ- supported nationally, regionally and inter-
isms that can threaten public health and nationally. They should include research
national economies. However, when activities on how to develop effective eco-
improperly used or stored, these chemical nomic and legal instruments. In addition,
agents can also harm humans. Key risks they should ensure that the public is
are cancer, birth defects, and damage to informed, health conditions are monitored
the nervous system and the functioning of and, where necessary, treatment pro-
the endocrine system. grams are established.
People can be exposed to excessive pes- The need for such strategies is confirmed
ticide levels while working; via food, soil, by a number of international agreements
water or air; or by directly ingesting pesti- that call for actions to protect children
cide products. Pesticides are known to and the environment from the negative
cause millions of acute poisoning cases effects of human activities. These include
per year, of which at least one million the United Nations Convention on the
require hospitalization. The number of Rights of the Child as well as Agenda 21,
which was adopted by the United Nations
children involved in such incidents is
Conference on Environment and
unknown but, based on the experience of
Development.
many countries, likely to be large. Between
one and three agricultural workers per The purpose of this document is to provide
every 100 worldwide suffer from acute you with information for advocacy and
pesticide poisoning [1, 2], and adolescents action directed at reducing pesticide
are often the victims.[3, 4] The contribution poisoning and addressing its effects on
of pesticides to chronic diseases, on the children and women.
other hand, is unknown.
2 3


Selected extracts from the 1989 Selected extracts from Agenda 21, adopted
Convention on the Rights of the Child in 1992 by the United Nations Conference
dealing with the environment on Environment and Development, that deal
with children are:
Preamble
Chapter 6: Protecting and Chapter 25: Children and youth in
The States Parties to the present ledge of child health and nutrition, the
advantages of breastfeeding, hygiene and promoting human health sustainable development
Convention,
environmental sanitation and the preven- 6.1 Action items under Agenda 21 must 25.12. Children not only will inherit the
…Convinced that the family, as the funda-
tion of accidents; address the primary health needs of the responsibility of looking after the Earth,
mental group of society and the natural

Introduction
world's population, since they are integral but in many developing countries they
environment for the growth and well-
being of all its members and particularly
Article 29 to the achievement of the goals of sus- comprise nearly half the population.
1. States Parties agree that the education tainable development and primary envi- Furthermore, children in both developing
children, should be afforded the neces-
of the child shall be directed to: ronmental care… and industrialized countries are highly
sary protection and assistance so that it
vulnerable to the effects of environmental
can fully assume its responsibilities (e) The development of respect for the 6.19 The health of children is affected
degradation. They are also highly aware
within the community … natural environment. more severely than other population
supporters of environmental thinking. The
groups by malnutrition and adverse envi-
specific interests of children need to be
Article 24 ronmental factors…
taken fully into account in the participatory
1. States Parties recognize the right of the 6.24. Specific major goals for child sur- process on environment and development
child to the enjoyment of the highest vival, development and protection were in order to safeguard the future sustain-
attainable standard of health and to facil- agreed upon at the World Summit for ability of any actions taken to improve the
ities for the treatment of illness and reha- Children and remain valid also for Agenda environment.
bilitation of health. States Parties shall 21. Supporting and sectoral goals cover
25.13. National governments, according
strive to ensure that no child is deprived women's health and education, nutrition,
to their policies, should take measures to:
of his or her right of access to such health child health, water and sanitation, basic
care services. education and children in difficult circum- a. Ensure the survival, protection and
stances. development of children, in accordance
2. States Parties shall pursue full imple-
with the goals endorsed by the 1990 World
mentation of this right and, in particular, 6.27. National Governments, in coopera-
Summit for Children.
shall take appropriate measures: tion with local and non-governmental
(c) To combat disease and malnutrition, organizations, should initiate or enhance
including within the framework of primary programmes in the following areas:
health care, through, inter alia, the appli- a. Infants and children:
cation of readily available technology and i. Strengthen basic health-care services
through the provision of adequate nutri- for children in the context of primary
tious foods and clean drinking-water, health-care delivery, including prenatal
taking into consideration the dangers and care, breast-feeding, immunization and
risks of environmental pollution; … nutrition programmes;
(e) To ensure that all segments of society, iv. Protect children from the effects of
in particular parents and children, are environmental and occupational toxic
informed, have access to education and compounds;
are supported in the use of basic know-
4 5


II. What do we know
about pesticide
poisoning and why
are children at
greater risk?

Unintended – but harmful – effects countries, where safeguards typically are

What do we know about pesticide poisoning?
Summary Hazardous by design
inadequate or lacking altogether.[6][1]
Children are often more vulnerable Pesticides are toxic substances designed The unintended but harmful effects of
Although developing countries use
than adults to the effects of pesticides to kill, repel or inhibit the growth of living pesticides have become clearer in recent
25% of the world’s production of
as a result of several risk factors. organisms. They are used against insects, decades, which has increased the
pesticides, they experience 99% of the
These include their smaller size; mammals, plants, fungi, nematodes and urgency for taking action. For example,
deaths.[1]
greater rates of exposure to food, other creatures that can pose problems if used on a broad scale, pesticides can
soil, water, and air; differing for agriculture, public health, or homes, disrupt the ecological balance of agricul- The total health impact of pesticide expo-
metabolism; and rapidly growing schools, buildings and communities.[6] tural areas by killing natural biological sure is probably much greater than these
and developing organ controls; this can lead to outbreaks of figures suggest. The symptoms of pesti-
Pesticides impair the functioning of
systems. They tend to explore their pests that were previously of minor impor- cide poisoning, which may involve a skin
biological processes essential for life,
immediate environment more than tance and consequently to lower crop rash or mild gastroenteritis, are frequently
such as the nervous and reproductive
adults do and to put things in their yields. Once used, pesticides may accu- similar to other health problems, so the
systems. Very often, these processes are
mouths. Inexperience, lack of mulate in the air or water or on land, link to pesticides may go undetected.
similar among different organisms,
maturity, illiteracy and an inability whether insects or humans, adults or chil- where they can harm non-target species People suffering from acute poisoning
to assess risk make children more dren. and diminish biodiversity. By contaminat- may lack access to medical care and may
likely to accidentally ingest ing groundwater, lakes, rivers, and other not even report the illness to the medical
pesticides. Children who work Many pesticides have similar chemical bodies of water, they can pollute drinking system. Health personnel may lack the
around pesticides face additional structures and thus may act in the same supplies, fish and other resources that training for recognizing pesticide poison-
opportunities to be severely poisoned. way. For example, the organophosphate can be vital for human well-being. By ing or the means to report it to national
[3, 4] Because children are at and carbamate insecticides poison polluting soil, they can endanger children authorities, which may themselves lack
greater risk, they need greater insects by inhibiting the enzyme acetyl at play or at work and make it difficult to reporting systems. Moreover, it is difficult
protection.[5] More awareness-raising cholinesterase. This mode of action can use the land later for other purposes. to associate chronic health effects with
is needed about risks, especially also be toxic to people. By regulating
Pesticides are harmful to human health. It pesticides for several reasons. Chronic
from the most acutely toxic pesticides one at a time we may be under-
has been reported that an estimated 1 million disease tends to result from lower expo-
pesticides, since adverse effects estimating the cumulative impact of
to 5 million cases of pesticide poisonings sure levels than do acute illnesses. There
on children are completely pesticides of similar toxicity.[5]
occur every year, resulting in 20,000 fatal- is a time lag between the exposure and
preventable. ities among agricultural workers. Most of the disease, and in individual cases it is
these poisonings take place in developing usually impossible to make a firm link.
6 7


research, and reported incidents involving abnormalities in laboratory animals.[11]

Acute poisoning
human exposure to different doses of Certain organophosphorus compounds
herefore we know very little about the Acute poisoning can cause a range of pesticides all support the following points: have caused long-term neurological
chronic health impacts of pesticides and symptoms in adults and children, depend- disabilities in farm workers who have
ing on the type of pesticide. For example, Developmental and reproductive effects.
must rely on animal tests and epidemio- suffered acute poisoning.[12]
commonly used organophosphorus and Certain pesticides are believed to cause
logical studies to understand what the
carbamate compounds can produce neu- reproductive problems, such as sponta- Carcinogenic effects. A number of pesti-
magnitude of those effects might be.
robehavioral effects, such as fatigue, neous abortions, stillbirths, lower birth cides cause cancer in laboratory animals,
The impact of an exposure to pesticides weights, birth defects and early neonatal and several have been associated
dizziness, and blurred vision; intestinal
on human health depends on a number of deaths.[8, 9] with cancer in humans. The concern for
effects, such as nausea; respiratory
factors, including the class of pesticide children is twofold. First, cancers in
effects, such as dry throat and difficulty Endocrine disruption. Many pesticides
involved, the specific chemical and for- children, including leukemia, sarcomas,
with breathing; effects involving skin and have been shown to disrupt natural
mulation, and the amount, route, lymphoma, and brain cancer, have been
mucous membranes, such as stinging endocrine systems in pests, wildlife and
timing and duration of the dose. The route associated with parents or homes that
eyes, itchy skin, and a burning nose; and laboratory animals. In small doses these
of exposure can be via breathing, drinking have been exposed to pesticides.[13]
muscular symptoms, such as stiffness pesticides are able to mimic or block hor-
or eating, or through the skin or mucous Second, people may face an increased
and weakness.[7] mones or trigger inappropriate hormonal
membranes. Other factors include risk of developing cancer during their
Acute pesticide poisoning can result in activity. At high enough doses during crit-
the health of the person poisoned. lifetime if they have been exposed to
death, either rapidly or over the course of ical times of development such exposures
Malnutrition and dehydration, for example, carcinogens in their childhood.
weeks, depending on the characteristics have the potential to interfere with impor-
increase the sensitivity to pesticides.
of the product and type of exposure. tant developmental and reproductive Immunological effects. In animal exper-
Children who are malnourished and dehy-
functions and may cause sterility, lowered iments, certain pesticides have been
drated are at greater risk, and the risk for
Long-term health effects sperm counts, cancer of the reproductive proven to compromise the immune
such children working in agriculture is
organs and other effects.[10] system. A weakened immune system,
still higher. Furthermore, where access to Some health effects caused by pesticides
Neurobehavioral effects. Impaired devel- particularly in growing children, exacer-
quality medical care is lacking, poisoning only become apparent over a longer period
opment of the nervous system can cause bates the risk of infectious disease and
cases may go undiagnosed or untreated. of time. Controversy continues over the
lowered intelligence and behavioral cancer, thus increasing mortality rates.
Treatments such as antidotes and nature and severity of the health impacts
abnormalities. Although these impacts This would be especially menacing in
removal from the source of exposure may from long-term exposure to pesticides.
have not been studied in humans, developing countries, where children
not be available. However, studies of laboratory animals,
exposure to certain pesticides in utero face greater exposures to infectious
a growing body of epidemiological
8 causes developmental and neurological agents and may already have compro- 9


mised immune systems due to poor nutri- not always be the case in developing or spill. Clothing can occlude the skin, on or near contaminated soil and using

tion and other factors. [14] At present, countries. For indoor applications, ade- which enhances its ability to absorb pesti- contaminated water on crops or for
there are no standardized tests for quate ventilation is essential, but not cides. When clothes are brought home for washing puts people – and children in
developmental immunotoxicity. always practiced. laundering, those doing the washing are particular – at risk.
also exposed to the pesticides. Residues Farmers and others may store pesticides
In many countries pesticides must under- The use of pesticides can expose people to
from laundering contaminate water and in or around their homes where household
go comprehensive toxicity testing. Even risks at different stages of the application
soil, further extending the chain of risk.[15] members can accidentally gain access to
so, most pesticides have not been process, from the purchase of products
Clothing may also be purposely treated them, or where these toxic substances
assessed for one or more hazards rele- and the preparation and mixing of solutions
with pesticides; recently lindane was can contaminate food or water that is
vant to the health of children, especially to spraying, handling of pesticide-treated
identified in shipments of leather from stored nearby. Used pesticide containers
developmental neurotoxicity and immuno- items and disposal.[1, 2] Protective equip-
Africa.[23] are often reused to store water and food.
logical effects. While unnecessary testing ment is often impractical in hot tropical
should be minimized, it is important to climates and not affordable for many Pesticide spills are common and can
assure that risks to children are included farmers.[15, 16] occur at different stages and places, The greater vulnerability of
in safety assessments of pesticides.[5] including manufacturing, processing, children
Not only workers but nearby residents
packaging, transport, storage, mixing,
and children can be exposed to pesticides Although exposure to pesticides may
General exposure – frequent and sprayed on fields. Field workers entering
field application and disposal.
present a risk to all people, children
often unknowing an area treated by pesticides often face a Once used or spilled, pesticides may generally face higher risks than adults.
higher risk of harm, particularly if the time contaminate water used for drinking or Children may be more susceptible than
Pesticides are readily available and widely
between application and entry is short bathing. They can also pollute soil, either adults to certain pesticides, and they may
applied. They are used by farmers to
and if they lack protective clothing. Older from agricultural use or as a result of spills be more greatly exposed than adults.
spray crops and treat livestock. They are
children and adolescents may be directly during manufacturing and processing. They thus bear a disproportionate burden
used in public health programmes, which
exposed as field workers, while younger Sediments in rivers, lakes and bays can be of risk and need additional protection.[5]
can include indoor spraying of houses or
children may be brought into treated fields contaminated by runoff from pesticide
public places. They are applied in all Children are often more exposed to pesti-
to accompany their parents[3, 4, 17-22] production and use. Cleaning up contami-
types of buildings, including schools. cides. For example, when a mother is
nated water, soils, and sediments can be
They are also used by trained applicators, Work clothes often carry pesticide exposed to pesticides, the child often
difficult and expensive and require years
maintenance workers, building residents, residues, exposing both workers and fami- becomes exposed as well. Children may
of treatment.
farmers and farm workers. The most haz- ly members. Workers can be exposed for even be exposed to pesticides before
ardous pesticides should be applied only a prolonged time if they do not remove One of the most important sources of birth, while still in the womb. This occurs
by professional applicators, but this may and wash clothes after each application exposure is food residues. Growing food when pesticides are transferred to the
10 11


figure 1 figure 2 figure 3 figure 4

fetus via the placenta. such as meat, milk, eggs and fish. Similarly, sure to pesticides. In addition to playing treated with pesticides. The result can be

During early infancy, children also pesticides in fruits and vegetables are also closer to the ground, children may be even higher exposure to pesticides.
come into contact with persistent and passed on to children at high levels, exposed to more pesticides in dusts and Pesticide-related illnesses in children
bio-accumulative pesticides that are including in processed foods. soils due to normal hand-to-mouth activity; employed in farm work have been
passed on to them through breastfeeding. Children may have completely different figure 4 compares the amount of soil eaten documented in many countries.[3, 4]
This can be a major source of exposure. eating patterns than adults, making each day by children and adults.[25]
Because breast milk is the best source of their potential exposure to pesticides Children frequently put toys or other objects High-risk exposure scenarios for
nutrition for infants and recommended by even more disproportionate. Their diet is into their mouths as well, and as a conse- children
the World Health Organization, protecting much less diversified, resulting in a larger quence may receive significant doses of
The fact that children will receive higher
mothers from exposure to toxic contami- relative consumption of certain foods. pesticides from contaminated objects, such
doses of pesticides compared to adults
nants is crucial.[24] For example, in the US infants consume as those found in agricultural areas, homes
may be of particular concern in certain
much more of certain fruits like apples or gardens.
As they grow, children drink more water, situations. These include the consumption
kilo for kilo, than do adults. Figure 1 per body weight than adults do. As a Because children have different metabo- of fish and other food that is highly con-
shows the consumption of drinking water consequence, diet can be a major source lisms than adults, they may have different taminated with pesticides, subsistence
for several different age groups. As can of pesticide exposure for children, and capacities for breaking down or metaboliz- farms that use large quantities of pesti-
be seen, infants under one year of age greater relative to their size than for ing, excreting, activating or deactivating cides, and pesticide-spraying pro-
who are fed reconstituted infant formula adults.[5] pesticides. Such processes change dramat- grammes. For example:
consume more than twice as much water Figure 3 compares daily breathing rates ically from birth until adulthood. These
• Indoor pesticide sprays, fogs or dusts
as adults. This means that, if the water from several different age groups.[25] factors can cause pesticides to have more
can be misapplied, creating hazardous
contains residues of pesticides, infants It shows that when pesticide residues are pronounced toxic effects in children, or
levels of pesticides in the air and the
will receive more than double the dose of present in the air or in airborne dust, possibly lead to somewhat different
build-up of pesticides in foam articles
pesticide as an adult drinking the same infants can receive higher doses than poisoning symptoms than those seen in
such as bedding and children’s toys.[26]
water.[25] older children and adults. In addition, adults.
• Mispackaged pesticides can lead to
Children consume more food, per body children play closer to the ground, Poverty can put children in a number of
children accidentally ingesting pesti-
weight, than do adults. Figure 2 shows US where many pesticides may be present potentially high-risk situations. Children
cides.[27] The most hazardous pesticide
data on the consumption of various foods at higher concentrations. may help out on family-owned farms
packages are bottles that look like those
in which persistent and bio-accumulative Children behave and play differently than where pesticides are used. They may
containing soft drinks or other bever-
pesticides may be present at high levels, adults, resulting in greater potential expo- work for local concerns, carrying goods
ages.
12 13


Exposure in urban settings Spraying of pesticides for vector control in

• Highly toxic pesticides may be viewed • Pesticides can contaminate nearby
by older children as a convenient means groundwater and surface-water. Conta- interior spaces, including living quarters,
In developing countries, the marketing of
of attempting suicide.[28] minated water is more likely to be con- takes place regularly, and reentry times
pesticides is sometimes uncontrolled or
• Highly concentrated and acutely toxic sumed by small children, who tend to are not observed. Some pesticides break
illicit. Misbranded or unlabelled formula-
pesticides can cause severe illness or drink water from any source. down slowly, and exposure continues
tions, including ready-made solutions in
death even if ingested in very small quan- • Locally grown food may not be properly despite the observance of re-entry times.
soft drink bottles and other unlabelled
tities – for example, a single swallow.[29] monitoring or controlled for residues of liquid containers, are sold at open stands. Infants who are still being breastfed are
Concentrates are also hazardous around pesticides. Because food sold at the Industrialized countries have also experi- carried by their mothers in the fields
the home because they must be reconsti- farm gate often has higher residue levels enced the fraudulent marketing of agricul- during spraying operations. Older children
tuted in another container, one that may than food distributed later, families who tural pesticides for indoor use, which are allowed to play around treated fields.
be easily confused as being safe by a eat directly from fields may have higher causes children to face further expo- Pesticides or ready-to-use solutions are
young child. pesticide exposures. sures.[31] kept in the home in unlabelled containers
• Household pesticide contamination • Containers for pesticides in low- or are labelled in a language other than
(caused by insecticides that are used for income countries and areas are often Exposure in rural settings the local one. Illiteracy compounds the
sanitation or vector control, carried into used and re-used for other purposes, Soil is contaminated by pesticides risk of exposure.
the home by parents or tracked into including storing and transporting food sprayed on neighboring fields or spilled
the house through contaminated soil) and water. near living quarters while equipment is
can be especially hazardous to children
Exposure and developing coun-
• Grain storehouses are continually being filled. tries
who display “pica” behavior. Such treated with rodenticides to limit crop Contaminated equipment is left after Many situations involving pesticide expo-
young children have a propensity for losses. Bait can easily be mistaken for working hours near areas used by sure are linked to education and certain
peeling off and eating paint chips, normal grain, which is particularly dan- children for playing. socio-economic conditions. These condi-
wallpaper, and other materials; it is gerous for children because they have lit-
most common among children with a Family members working with spraying tions tend to occur more often in develop-
tle protection against most rodenticides.
nutritional deficiency – the same chil- equipment do not wash and change their ing countries, thus resulting in increased
Looting of baited grain by children from
dren who are likely to be more vulnera- clothes after work or they leave their risk to children.[34]
families with low incomes can lead to
ble to the effects of toxic pesticides. contaminated clothes lying around.[32] Stockpiles of unwanted or obsolete pesti-
severe poisonings.
Such children would thus be more Spraying of field pesticides occurs close cides, which are unprotected and uncon-
exposed to DDT and other pesticides • Pesticides are too often stored in house-
to living quarters or drifts into neighboring trolled and often lack legible labeling,
holds where they are in easy reach of
14 sprayed on the walls.
children.[16, 30]
fields, homes, or schools.[4, 33] 15


Excerpt from Final Report of Fourth
Session of Intergovernmental Forum on
Chemical Safety,

Bangkok, Thailand, 1-7 November 2003

Children and chemical safety Governments should, when setting
1. When assessing the protection of acceptable levels or criteria related to
children, consideration should be given to chemicals, take into consideration the
chemical exposures that can occur during potential enhanced exposures and/or
preconception, throughout gestation, vulnerabilities of children.
infancy, childhood and adolescence. 4. WHO is requested to support, collabo-
may be found close to living quarters or Pesticide users, particularly on subsis- rate with, and coordinate among research

2. Governments should prepare, through
to areas where children play or work. tence farms, often lack access to training. multi-stakeholder consultation, initial organizations and those supporting
This can lead to pesticides being used national assessments of children’s envi- research (such as the European
Seeds coated with pesticide for planting,
carelessly, including in the presence of ronmental health and chemical safety. Commission, Science NGOs, the Global
or pesticide-treated grains for use as bait,
children.[15] These assessments should identify the Health Research Forum, governments and
are often stored without proper labeling
priority concerns and provide a basis for others) to develop mechanisms to facili-
and protective measures. In times of eco- The lack of education for girls has
developing action plans to address those tate collaborative national and interna-
nomic stress or food shortage, people may particularly significant consequences.
concerns. Governments should provide a tional research and share technology.
be tempted to eat such seeds. When girls grow up they go on to shoulder
responsibilities for household chores, progress report to Forum V. 5. Governments and stakeholders should
Any spraying equipment used by subsis-
water provision, education of family mem- WHO is requested to develop, through commit to sharing information on options
tence farmers tends to be low-end
bers, and work in agriculture and other multi-stakeholder consultation, guidance for taking effective action to protect
technology. Manual equipment used by
areas where pesticides play a role. tools, and to assist at least three countries children from established chemical
an individual results in imprecise spraying
in different stages of economic develop- threats and from chemical risks where
and substantial drift of pesticides to
ment in each region to prepare the there is a degree of uncertainty. WHO is
nearby living quarters.
assessment and action plans by 2006. requested to convene a multi-stakeholder
Pesticide users, including teenagers, may meeting to explore the mechanisms
lack access to protective equipment such 3. Governments, with support from stake- for collecting data and disseminating
as gloves and masks, which is required holders, particularly WHO and UNICEF, information that could be used to reduce
to assure the safety of the pesticide should promote education and training on uncertainty in risk assessment.
product.[16] children’s chemical safety, and where
risks are identified, governments and 6. In addition, Forum IV requests the IFCS
stakeholders should commit to taking President to convey these recommenda-
action to prevent or reduce exposure. tions to other meetings and fora.
Governments should also promote harmo- In carrying out the recommendations
nized data collection, research, legislation set out in this priority, the stakeholders
and regulations, and consider the use of concerned should be guided by the full
indicators of children’s environmental decision document and companion infor-
health, and report back to Forum V in 2006. mation paper that were developed by the
Forum Working Group.
16 17


III. What can be done
to prevent
pesticide
poisoning
of children?

• Ensure hygienic conditions, especially be used in the safest manner possible.

What can be done to prevent pesticide poisoning?
Strategies to prevent At the local level
pesticide poisoning must be designed for when storing food and water, and wash food Pesticides that have restrictions for use,
The risks posed by pesticides can be best prior to eating it. such as requirements for special protective
local conditions while drawing support
avoided by minimizing the use of pesticides, gear, should only be applied by such trained
from the national and international levels. • Minimize the unnecessary use of pesti-
especially the most hazardous ones, and by professionals.
These strategies should be sensitive cides around children by practicing inte-
taking measures to reduce exposures
to differing cultural, political, economic, grated pest management in homes and • Pesticide manufacturers and governments
where it is not practical to eliminate use
technological and schools. Where pesticides are used, strictly should follow the voluntary FAO
altogether. Everyone responsible for caring
development circumstances. follow instructions about application rates International Code of Conduct on the
for children or who is involved with pesti-
cide use should be aware of the problems and re-entry intervals.[35] Distribution and Use of Pesticides. The Code
caused by pesticides and be encouraged to: • Health care providers need to know how to outlines measures for ensuring the safety of
recognize and treat cases of pesticide pesticides through the testing, manufactur-
• Reduce and eliminate possible sources ing, advertising, labeling, and distribution
of pesticide exposures to children (in food, poisoning. They can also help to educate
farmers and others about the adverse phases.[36] It calls on manufacturers to sup-
water, dust, and soil and in the home and ply information and instructions in a form
the work environment). effects of pesticides and how to prevent
pesticide exposures, and they should docu- and language adequate for ensuring safe
• Reduce unnecessary uses of agricultural ment and report any cases of pesticide and effective use. It also asks them to retain
pesticides by adopting strategies that can poisoning. an active interest in following their products
reduce pesticide use, such as integrated to the ultimate consumer, keeping track of
pest management and crop rotation. • Pesticide users and their families need to major uses and any problems that may arise
Where pesticides are needed, encourage be better educated about how to recognize, during the actual use of their products.
the use of safer pesticides. prevent and treat pesticide poisoning, in This information can then be used for deter-
particular mothers with small children who mining whether any changes are needed in
• Keep pesticides out of children’s reach live in areas where pesticide exposures may
and store them securely in containers that labeling, directions for use, packaging,
be high. Such information could be included formulation or product availability.
do not resemble those used for food or in school curricula.
drinks, are properly labeled and use child-
proof tops. Do not store any highly toxic • Where hazardous pesticides are used,
pesticides or pesticide concentrates in the communities need a cadre of trained pesti-
home.[35] cide applicators so that the pesticides will
18 19


FAO International Code of Conduct on the 3.4.2 in close cooperation with procurers
Distribution and Use of Pesticides of pesticides, adhere closely to
provisions of FAO guidelines on tender
3. Pesticide management procedures (4);
3.1 Governments have the overall
responsibility to regulate the availability, 3.4.3 pay special attention to the choice
distribution and use of pesticides in their of pesticide formulations and to presen-
countries and should ensure the allocation tation, packaging and labelling in order
of adequate resources for this mandate. to reduce risks to users and minimize
adverse effects on the environment;
3.2 Pesticide industry should adhere to
the provisions of this Code as a standard 3.4.4 provide, with each package of pes-
for the manufacture, distribution and ticide, information and instructions in a
The OECD has documented the fact that

At the national level advertising of pesticides, particularly in form and language adequate to ensure
the riskiest type of chemical products are countries lacking appropriate legislation
Pesticides can pose risks anywhere in often exported from industrialized to effective use and reduce risks during
the world. The problem is greatest, how- and advisory services. handling;
developing countries. Moreover, busi-
ever, in developing countries where low nesses that are involve in formulation
retail prices promote pesticide use but of pesticides are more common in devel- 3.3 Governments of pesticide exporting
weak legislation and inadequate law 3.4.5 be capable of providing effective
oping countries than pesticide manufac- countries should, to the extent possible: technical support, backed up by full
enforcement fail to control risks. Such turers; pesticide formulation has serious
countries should establish systems for product stewardship to field level,
potential for risks to health and the including advice on disposal of pesti-
collecting data on cases of pesticide 3.3.1 provide technical assistance to
environment, unless adequate safeguards cides and used pesticide containers, if
exposure. A number of software systems other countries, especially those lacking
are taken. necessary;
are readily available for this purpose, technical expertise in the assessment of
including the INTOX Programme pro- The following sections of the voluntary the relevant data on pesticides;
duced by the International Programme on FAO International Code of Conduct on the
3.3.2 ensure that good trading practices 3.4.6 retain an active interest in follow-
Chemical Safety (IPCS). Distribution and Use of Pesticides are
are followed in the export of pesticides, ing their products to the end-user, keep-
particularly applicable to actions on the
Awareness of pesticide risks and how to especially to those countries with limited ing track of major uses and the occur-
national level:
manage them should be promoted or no regulatory schemes. rence of any problems arising from the
through information and education use of their products, as a basis for
campaigns, including via television and determining the need for changes in
3.4 Pesticide industry and traders labelling, directions for use, packaging,
radio programs. Risks related to pesticide
should observe the following practices in formulation or product availability.
production may not be relevant in many
pesticide management, especially in
developing countries, but in those coun-
countries without legislation or means of
tries that do have manufacturers, weaker
implementing regulations: 3.5 Pesticides whose handling and
laws and enforcement may increase the
application require the use of personal
likelihood that workers and nearby
protective equipment that is uncomfort-
communities could be exposed. 3.4.1 supply only pesticides of adequate able, expensive or not readily available
quality, packaged and labelled as appro- should be avoided, especially in the case
priate for each specific market (3); of small-scale users in tropical climates.
20 Preference should be given to pesticides 21


3.11 Governments, pesticide industry and 5.1.5 establish national or regional
national and international organizations poisoning information and control
should collaborate in developing and pro- centres at strategic locations to provide
moting resistance management strategies immediate guidance on first aid and
to prolong the useful life of valuable pesti- medical treatment, accessible at all
cides and reduce the adverse effects times;
resulting from the development of resist- 5.1.6 utilize all possible means for col-
ance of pests to pesticides. lecting reliable data and maintaining sta-
tistics on health aspects of pesticides
4. Testing of pesticides
and pesticide poisoning incidents, with
4.2 Each country should possess or the objective of establishing the WHO
have access to facilities to verify and harmonized system for identifying and
that require inexpensive personal protec- extension agents, crop consultants, food recording such data (25). Suitably
exercise control over the quality of pesti-
tive and application equipment and to industry, manufacturers of biological and trained personnel and adequate
cides offered for sale or export, to estab-

procedures appropriate to the conditions chemical pesticides and application resources should be made available to
lish the quantity of the active ingredient or
under which the pesticides are to be equipment, environmentalists and repre- ensure the accuracy of information
ingredients and the suitability of their for-
handled and used. sentatives of consumer groups should collected;
mulation, according to FAO or WHO spec-
play a proactive role in the development
3.6 National and international organiza- ifications, when available. 5.1.7 provide extension and advisory
and promotion of IPM.
tions, governments and pesticide industry services and farmers' organizations with
5. Reducing health hazards adequate information about practical IPM
should take coordinated action to dissem- 3.9 Governments, with the support of
inate educational materials of all types relevant international and regional organ- 5.1 Governments should: strategies and methods, as well as the
to pesticide users, farmers, farmer organizations, should encourage and promote range of pesticide products available for
izations, agricultural workers, unions and research on, and the development of, 5.1.1 implement a pesticide registration use;
other interested parties. Similarly, users alternatives posing fewer risks: biological and control system along the lines set out 5.1.8 ensure, with the cooperation of
should seek and understand educational control agents and techniques, non- in Article 6; pesticide industry, that where pesticides
materials before applying pesticides and chemical pesticides and pesticides that are available through outlets which also
should follow proper procedures. are, as far as possible or desirable, tar- 5.1.2 periodically review the pesticides
deal in food, clothing, medicines or other
get-specific, that degrade into innocuous marketed in their country, their accept-
products for consumption or topical
3.7 Concerted efforts should be made constituent parts or metabolites after use able uses and their availability to each
application, they are physically segre-
by governments to develop and promote and are of low risk to humans and the sector of the public, and conduct special
gated from other merchandise to
the use of IPM. Furthermore, lending environment. reviews when indicated by scientific
prevent contamination and/or mistaken
institutions, donor agencies and govern- evidence;
identity. Where appropriate, they should
ments should support the development of 3.10 Governments and the application 5.1.3 carry out health surveillance pro- be clearly marked as hazardous materials.
national IPM policies and improved IPM equipment industry should develop and grammes of those who are occupationally Every effort should be made to publicize
concepts and practices. These should promote the use of pesticide application exposed to pesticides and investigate, as the dangers of storing foodstuffs and
be based on scientific and other strategies methods (6, 7) and equipment (8, 9, 10, 11) well as document, poisoning cases; pesticides together;
that promote increased participation that pose low risks to human health and
of farmers (including women's groups), the environment and that are more effi- 5.1.4 provide guidance and instructions 5.1.9 utilize all possible means for collect-
extension agents and on-farm researchers. cient and cost-effective, and should con- to health workers, physicians and hospi- ing reliable data, maintaining statistics on
duct ongoing practical training in such tal staff on the treatment of suspected environmental contamination and
3.8 All stakeholders, including farmers activities (12). pesticide poisoning; reporting specific incidents related to
and farmer associations, IPM researchers, pesticides;
22 23


5.1.10 implement a programme to moni- prior to domestic use and ensure that 7.3 Two methods of restricting availability
tor pesticide residues in food and the each pesticide product is registered can be exercised by the responsible
environment. before it can be made available for use authority: not registering a product or, as a
(29, 30, 31); condition of registration, restricting the
5.3 Government and industry should availability to certain groups of users in
cooperate in further reducing risks by: 6.1.3 conduct risk evaluations and make
risk management decisions based on all accordance with a national assessment of
available data or information, as part of the hazards involved in the use of the
5.3.1 promoting the use of proper and the registration process; product.
affordable personal protective equip- 6.1.8 collect and record data on the 7.4 Governments and industry should
ment; import, export, manufacture, formula- ensure that all pesticides made available
5.3.2 making provisions for safe storage tion, quality, quantity and use of to the general public are packaged and
of pesticides at both warehouse and pesticides in order to assess the extent labelled in a manner which is consistent
farm level; of any possible effects on human health with the FAO guidelines on packaging and

5.3.3 establishing services to collect or the environment, and to follow trends labelling (3) and with appropriate national
and safely dispose of used containers in pesticide use for economic and other regulations.
and small quantities of left-over pesti- purposes;
cides; 7.5 Prohibition of the importation, sale
and purchase of highly toxic and haz-
5.3.4 protecting biodiversity and mini- 7. Availability and use ardous products, such as those included
mizing adverse effects of pesticides on in WHO classes Ia and Ib (34), may be
the environment (water, soil and air) and desirable if other control measures or
on non-target organisms. 7.1 Responsible authorities should give
special attention to drafting rules and regu- good marketing practices are insufficient
6. Regulatory and technical requirements: lations on the availability of pesticides. to ensure that the product can be handled
These should be compatible with existing with acceptable risk to the user.
6.1 Governments should: levels of user training and expertise.
6.1.1 introduce the necessary legislation The parameters on which such decisions 8. Distribution and trade
for the regulation of pesticides and on availability are based vary widely and
make provisions for its effective enforce- must be left to the discretion of each
ment, including the establishment of government. 8.1 Governments should:
appropriate educational, advisory, exten- 8.1.1 develop regulations and implement
sion and health-care services, using 7.2 In addition, governments should take
licensing procedures relating to the sale
FAO guidelines as far as possible (2, 29, note of and, where appropriate, use the
of pesticides, so as to ensure that those
30). In so doing, they should take full WHO classification of pesticides by haz-
involved are capable of providing buyers
account of local needs, social and eco- ard (34) as the basis for their regulatory
with sound advice on risk reduction and
nomic conditions, levels of literacy, cli- measures and associate the hazard class
efficient use (26);
matic conditions and availability of with well-recognized hazard symbols.
When determining the risk and degree of 8.1.2 take the necessary regulatory
appropriate pesticide application and measures to prohibit the repackaging or
personal protective equipment; restriction appropriate to the product,
the type of formulation and method of decanting of any pesticide into food or
6.1.2 strive to establish pesticide regis- application should be taken into account. beverage containers and rigidly enforce
tration schemes and infrastructures punitive measures that effectively deter
under which products can be registered such practices;
24 25

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