Planning monitoring activities, promoting the collection of data and reporting of serious health incidents caused by SHPFs at national and international level.
Some countries have struggled to find sufficient resources to establish a national incident reporting system. However, several communities and organisations have begun developing small-scale health surveys and community-based health monitoring systems. Such systems, based on self-surveillance, may provide a good entry point for countries with limited resources or a useful adjunct to established incident reporting systems.
Here you will find elements applicable to two different types of approaches to establishing a reporting system on poisoning incidents: conducting a survey to collect information and setting up a community health monitoring system.
Each of these options has their advantages and disadvantages and many of the steps undertaken are common to both. A survey has the advantage that it is a short-term activity, whereas a community health monitoring system has more effects and sustainability on the long term. Choosing the methodology depends on the immediate objectives defined and on the resources available.
Using the information collected to report on pesticide poisoning incidents can have the benefit of preventing future incidents.
In figures 2 and 3, two road maps are proposed summarizing the key steps of the survey and community monitoring methodologies to collect data on pesticide poisonings which may be used by DNAs during the planning phase.
Objective
The objective of developing an incident reporting system is to identify incidents of acute human health effects related to pesticide exposure. The system may be designed to identify high risk groups or to better understand the risks for vulnerable groups, e.g. children, pregnant women, landless agricultural workers. Results should be used to alert health and environmental authorities about risks that pesticides may pose to human health under certain conditions and to inform the pesticide regulatory authority about the possible need for risk mitigation measures.
Benefits
Community health monitoring has the important benefit of increasing the awareness of participants of the burden of illness created by overuse and misuse of pesticides. It can, therefore, provide an excellent basis for prevention activities.
Conducting a survey for specific information on pesticide poisoning incidents has the benefit of being a short-term activity that can give an immediate and general idea of the situation in the field.
The Designated National Authority may use the incident data collected to submit a proposal under Article 6 of the Rotterdam Convention regarding pesticide formulations causing problems under conditions of use in a country.
Human and financial resources
Key players to develop and carry out the programme for monitoring and reporting will need to be identified. These could include the DNAs, participants from other government ministries like Health, Environment and Agriculture, farmers associations, doctors, health clinics, poison control centres, NGOs, etc.
It is important that time is taken by key players to discuss what outcomes are to be achieved and what information will need to be collected. Every step of the activity should be planned with a common understanding.
In particular, field staff and logistics will have to be identified and organized to carry out monitoring and reporting activities. Funding sources and costs for the activities need also to be discussed and identified by key players before starting any planning phase.
Identify target group and location
Who will participate in the health monitoring system? It is important to define selection criteria for participation, criteria could include: age, gender, location, occupation (e.g. plantation worker or vegetable farmer), how frequently pesticides are used, etc. There may be a variety of reasons for selecting a target group and location. Perhaps problems have been reported in a particular location, among a particular group or in relation to a pesticide product. Or, perhaps there are concerns about the quantity of pesticides being used by a particular group.
Pragmatic reasons, such as access and transport may also influence choice of location. Resources will also dictate the scale of the monitoring system and number of participants. It should be considered if only growers themselves be included or also family members, agricultural workers and others at risk.
Identify other sources of information
The incident reporting system developed can either be limited to the collection of data from the target group, or expanded to other sources of information and data. Valuable information may be available from sources outside of the target group identified, such as medical practitioners, death certificates, poison control centres, plant protection extension services, public health vector control, labour ministry or trade unions for work-related morbidity and mortality, etc.
Identify or develop data collection tools
The information that is collected should relate to the objectives of the activity, and may include information such as the identity and characteristics of the pesticide, the exposure scenario and a description of symptoms experienced by the individual affected. Several examples of monitoring activities and reporting forms are provided on the CD, which can be used directly or adapted to local conditions as needed.
The purpose for which the data will be used must be kept in mind when designing a national form for data collection, including the circumstances of exposure and other contributing factors, such as literacy levels of respondents. Information on use of pesticides for suicide should be clearly distinguished from incidents of accidental or occupational exposure.
Ideally, data tools should be tested and refined before monitoring commences, depending on resources and practicability.
Part B of the incident report form developed by the Rotterdam Convention is a good tool for information to be collected. This form can be adapted and modified as needed. Other examples of information that could be collected include:
On the pesticide:
- the label of the pesticide that caused the incident
- information on the pesticide formulation itself, including:
- name and trade name of the pesticide formulation
- active ingredient
- concentration
- type of formulation (e.g. soluble liquid, emulsifiable concentrate, etc.)
On the pattern of use:
- duration of exposure (e.g. 3 hours per day for 5 days)
- method of application (e.g. backpack sprayer, wick, etc.)
- general conditions (e.g. season, time of day, weather conditions, etc.)
- access of applicator to protective equipment
- ability of applicator to read and understand the product label
On the incident:
- time after pesticide application that symptoms occurred
- location of the incidents
- number of persons exposed
- activity at the time of exposure
- use of protective equipment
On the symptoms:
- adverse effects
- treatment and hospitalization
Designated National Authorities are encouraged to share reports of serious incidents with the Secretariat of the Rotterdam Convention through the Rotterdam Convention incident report form for human health incidents.
While the confidentiality of personal information and data which might identify individuals must be respected, making more general information about incidents publicly available could be considered.
Reporting to the Rotterdam Convention
Reporting on pesticide incidents to the Rotterdam Convention has the advantage of making those incidents known to the world through a biannual publication called the PIC Circular. This can help other countries be informed about specific pesticide formulations causing problems in other countries, allowing them to see if risk management measures are needed. This can help prevent further incidences of poisoning.
Reporting to the Rotterdam Convention can also eventually have the advantage that the pesticide formulation could become subject to the PIC procedure, which allows for the provision of further information to other countries on the pesticide formulation and the ability for countries to take decisions on import of the pesticide formulation, allowing them to keep it out of the country if it is decided that it cannot be managed safely.