PRACA ORYGINALNA

ORIGINAL ARTICLE

THE PROBLEM OF ACUTE PESTICIDE POISONINGS OF AGRICULTURAL WORKERS IN UKRAINE UNDER THE CONDITIONS OF THE NEW BUSINESS PATTERNS

Mykola H. Prodanchuk, Galyna M. Balan, Nataliia M. Bubalo, Petro H. Zhminko, Oleksandr A. Kharchenko, Yevgen A. Bahlei

SE “L. I. Medved’s Research Center of Preventive Toxicology, Food and Chemical Safety of the Ministry of Health of Ukraine”, Kyiv, Ukraine

ABSTRACT

Introduction: Due to introduction of new forms of agriculture and transformation of the treatment and preventive service in recent years, there has been a false impression of a sharp decrease in the level of occupational morbidity among agricultural workers 30 % to 25 % in the structure of general occupational morbidity in the 80–90s down to 0.2-0.4 %.

The aim: Summarize data on the prevalence, causes, structure of acute pesticide poisoning in agricultural workers at the current stages of its reform in order to improve preventive measures.

Materials and methods: Data on the prevalence, causes and structure of 647 cases of acute pesticide poisoning in agricultural workers over the past 25 years have been summarized; staff of the Scientific Toxicology Center took part in the sanitary-hygienic investigation and establishment of the diagnosis.

Results: The causes for the development, aetiology and structure of 647 cases of acute pesticide poisoning, among which 522 cases of acute poisoning of field beet growers with 2,4-D-based herbicides (80.7 %), 60 cases (9.3 %) of OPC poisoning, 36 cases of beet growers poisoning with sulphonylurea-based herbicides, 14 patients with acute synthetic pyrethroid poisoning, and isolated cases (15 patients) of intoxication with aluminium phosphide, dithiocarbamates, Vitavax, and Fipronil were analysed.

Conclusions: Analysis of the causes of the development and structure of poisoning has allowed to optimize the complex of preventive measures to strengthen sanitary control over the implementation of individual and public safety hygienic regulations during storage and use of pesticides.

KEY WORDS: acute pesticide poisonings, agricultural workers in Ukraine

Wiad Lek 2019, 72, 5 cz. II, 1083-1086

Introduction

Over the past 25 years, the agriculture of Ukraine is characterized by a radical reform of the agroindustrial complex (AIC). Elimination of collective and state farms, and change of the forms of ownership is at the base of these reforms. As land shares, the majority of the lands passed into the ownership of former collective farmers and state farm workers. In recent years, land shares are actively leased or bought up by the private farms and large farming enterprises. Unfortunately, small-scale land users and private farms of the AIC still function without proper sanitary control over the transportation, storage and use of pesticides (P), and they are characterized by unfavourable working conditions for workers. Unfavourable working conditions of agricultural workers (mostly hired workers to perform certain seasonal jobs) are characterized by imperfect technological process, extensive use of outdated equipment and machines, a large amount of poorly mechanized labour operations and manual labour, especially when growing sugar beet, tobacco, gardens, and vinelands [1-3]. At the same time, there is a deterioration in the provision of workers with individual protective equipment against the exposure of adverse production factors, as well as health care services due to closing-down of medical and obstetric centres and district hospitals, deterioration in the quality of preliminary and regular medical examinations, and almost complete disruption of medical examination system [1-4].

Due to introduction of new forms of agriculture and transformation of the treatment and preventive service in recent years, there has been a false impression of a sharp decrease in the level of occupational morbidity among agricultural workers 30 % to 25 % in the structure of general occupational morbidity in the 80–90s down to 0.2-0.4 % [1, 3, 4]. The decrease in occupational morbidity among agricultural workers has occurred dozens of times, despite the increase in the volume of work and production of grains, vegetable crops, sunflower, etc. [5]. Misinterpretation of the low level of occupational morbidity among agricultural workers is associated not only with the deterioration of the quality of regular medical examinations, but also with the fact that farmers often use seasonal hired workers without legal registration to work, and therefore they have no registered work experience, that does not allow to trace a connection between the developed diseases and profession. Unfortunately, the problems of social security of small-scale land users, farmers, private machine operators, who are employed, have not been solved so far. In addition, the system of deduction of contribution amounts to the social insurance fund requires improvement.

In recent decades, the structure of occupational diseases in agricultural workers has been formally represented mainly by group cases of acute pesticide poisoning [1–4]. Acute pesticide poisoning is still quite widespread, and in most cases occur due to gross violations of hygienic regulations, mainly among people of working age, cause a long-term loss of professional working ability and often persistent disability, and is accompanied by significant social and economic damage [1-6].

The aim

Objective: summarize data on the prevalence, causes, structure of acute pesticide poisoning in agricultural workers at the current stages of its reform in order to improve preventive measures.

Materials and methods

Data on the causes of development, prevalence and structure of acute pesticide poisoning in agricultural workers were summarized depending on profession and work experience. Only those cases of intoxication with pesticides among agricultural workers over the past 25 years have been analysed, in which the staff of the Scientific Center took part in the sanitary-hygienic and clinical-laboratory study of the aetiology of poisoning and clarification of the diagnosis. Unfortunately, it is not possible to summarize all cases of acute pesticide poisoning in the country, since all poisonings are still recorded in the “Other” column of the statistical reporting forms.

This paper analyses the results of sanitary-hygienic and clinical-laboratory examination of 647 cases of acute occupational pesticide poisoning among agricultural workers, with predominance of acute poisoning with 2,4-dichlorophenoxyacetic acid-based herbicides (2,4-D) — 522 patients (80.7 %) and organophosphorus compounds — 60 patients (9.3 %). Victims also included 36 patients with acute poisoning with sulphonylurea-based herbicides (Rimsulfuron), 14 patients poisoned with synthetic pyrethroids (SPs), and isolated cases of intoxication with aluminium phosphide, dithiocarbamates (TMTD), oxatiine compounds (Vitavax), and phenylpyrazole derivatives (Fipronil).

After first aid, all the victims were transferred to the clinic of the Scientific Toxicological Center, where all patients underwent standard detoxification and antidote therapy [6-7], as well as general clinical and biochemical examination according to standardized methods [8]. Classification and general principles of diagnostics set out in the guidelines for physicians by Ye. A. Luzhnikov et al. were adopted as the basis for the diagnostics of clinical syndromes of intoxications and determination of their degrees of severity [9].

RESULTS AND DISCUSSION

The composition of the examined patients and the structure of acute pesticide poisoning are presented in Table I, which shows predominance of patients with 2,4-D- (80.7 %), OPCs (9.3 %) and sulphonylurea-based herbicide poisoning (5.6 %).

In the professional composition of the examined patients, the field beet growers prevailed: out of them, 522 patients (80.7 %) with acute 2,4-D-based herbicide poisoning and 36 patients (5.6 %) with sulphonylurea-based herbicide poisoning. The professional composition of the main group of patients with acute pesticide poisoning is presented in Table II.

All 6 patients with TMTD poisoning and 4 with aluminium phosphide poisoning were workers of grain storages, who violated hygienic regulations during grain treatment. Three cases of Vitavax poisoning occurred in the workers of mixing units, two cases of Fipronil poisoning developed in workers during treatment of potatoes with a gross violation of hygiene requirements. The age of all examined patients ranged between 28 and 62 years (mean age — 36.4 ± 0.7 years). Out of the 647 cases of acute poisoning, 605 patients were females (93.5 %) — all field crop and fruit growers, winegrowers, disinfectors, and several general workers. Among 14 patients with acute SP poisoning, there were 8 females and 6 males.

Acute poisoning with 2,4-D-based herbicide in 522 field beet growers (8 cases of group poisoning, 24 to 153 victims) and sulphonylurea-based herbicides in 36 field beet growers, who performed the manual thinning of sugar beet sprouts, resulted from the driftage of herbicides from adjacent fields, sowed with cereals, which, without coordination with other land users, were treated at the same time with these pesticides. Also as a result of the driftage of pesticides from adjacent fields treated by OPC machinery operators, acute OPC (Dimethoate) poisoning also occurred in 36 female winegrowers who, at the same time, carried out manual work on a nearby vineyard in hot weather. The main cause of these poisonings was lack of consistency in plans for the use of pesticides among land users, whose lands border each other.

Out of 60 cases of OPC poisoning, in 13 cases (21.7 %) poisoning occurred under the action of karbofos, in 8 cases (13.3 %) – dichlofos, in 3 cases (5.0 %) – phosalone, and in 36 cases (60 %) – dimethoate.

Signs of OPC poisoning in the majority of victims appeared 2-3 hours after inhalation and percutaneous occupational exposure. The main complaints of the victims were increased tearing and salivation, headache, dizziness, heavy cough with profuse mucous sputum, paraesthesia in the hands and feet, cramps in the muscles of the extremities, nausea, and often vomiting and pain in the right hypochondrium or in the region of the heart. Depending on the severity of complaints and clinical-laboratory parameters, 51 out of 60 patients (85 %) had a mild degree (I) of intoxication, 6 (10 %) — moderate (II), and 3 (5 %) — severe degree (ІІІ). The test for blood serum cholinesterase (CE) and acetylcholinesterase in red blood cells showed that while their levels decreased by an average of 20-40 % in case of degree I of intoxication, then their levels decreased on average by 73.8 % and 78.8% , respectively, and returned to normal only in 30-40 days in case of degree II-III.

Patients with acute 2,4-D-based and sulphonylurea-based herbicide poisoning complained of general weakness, headache, dizziness, paraesthesia in the face, tongue, lips, hands and feet.

Among 14 patients with acute SP poisoning, in nine cases poisoning developed upon exposure to 2.5 % Decis (deltamethrin), in one — 2.5 % Arrivo (cypermethrin), in three — 20 % Sumicidin (fenvalerate), and in one case — 5 % Karate (lambda cyhalothrin). All victims after exposure to SPs noted intense headache, dizziness, general weakness, burning sensation and hyperaemia of the face, visible mucous membranes and sclera, as well as severe paraesthesia in the face, especially in the nasolabial triangle, nausea and vomiting of varying degrees of intensity. Similar complaints were noted in patients with acute TMTD, Vitavax and Fipronil poisoning.

Thus, the reform of agriculture in Ukraine, unfortunately, is not accompanied by proper and effective sanitary control over the labour conditions of the workers. Due to this, hygienic requirements for the storage and use of pesticides are often grossly violated, which is accompanied by the development of acute poisonings with agrochemicals, including group ones.

The main reason for sanitary and hygienic violations is the lack of coordination of plans for the use of pesticides among both land users and the sanitary service. Within the structure of group acute pesticide poisoning, agricultural workers, beet growers are predominantly poisoned with 2,4-D-based and sulphonylurea-based herbicides, winegrowers are poisoned with OPCs as a result of the driftage of these pesticides from adjacent fields due to lack of coordination of plans for the use of agrochemicals between the land users whose lands border each other.

CONCLUSIONS

The strengthening of sanitary control over the implementation of hygienic regulations for individual and public safety in the purchase, storage, and use of pesticides is at the basis of the developed complex of preventive measures. The necessity for land users to annually draw up work plans for the use of agrochemicals in the fields and their mandatory coordination not only with the sanitary service, but also with adjacent land users whose lands border each other has been justified. At the same time, the complex of organizational and sanitary-hygienic measures for the prevention of acute pesticide poisoning, both on an individual and collective level, has been optimized.

References

1. Kundiev YuI, Krasniuk YeP , Boiko V H.  Occupational diseases of agricultural workers. Kiev: “Zdorovia”;1989,p.271.

2. Balan HM, Serheev SH, Babich VA  etal. Acute group poisoning with Dikanit 600 herbicide based on 2,4-dichlorophenoxyacetic acid and preventive measures. Modern topics of toxicology. 2003;3:52–59.

3. Kharchenko OA. Acute pesticide poisoning under modern forms of agriculture management and their remote consequences: Abstract of the thesis for obtaining a scientific degree of the Candidate of Medical Sciences. Kiev;2014, p.23.

4. Sokolova MP. Problems of detection and registration of occupational diseases in Ukraine: Abstract of the thesis for obtaining a scientific degree of the Candidate of Medical Sciences: 14.02.01. Kiev;2009,p.20.

5. Statistical Yearbook of Ukraine. Kiev; 2018.

6. Balan HM, Prodanchuk NH , Bubalo NN.  Condition and prospects of antidote therapy of acute pesticide poisoning. Modern topics of toxicology, food and chemical safety. 2015;1-2:67-77.

7. Balan HM, Ivanova SI, Kharchenko OA  etal. Diagnostics, first medical aid and treatment of acute pesticide poisoning. Recommended practice. Kiev; 2001,p.42.

8. Kamyshnikov VS. Ins and outs of clinical laboratory tests and their diagnostic profiles. Moskow: “MEDpress-inform”;2009,p.320.

9. Luzhnikov YeA, Kostomarova LH.  Acute poisonings Guideline for physicians. Moskow: “Meditsyna”, 1989,p.432.

The work was done within the framework of the scientific-research work “Scientific substantiation of modern normative requirements for the use of pesticides and agrochemicals: forecasting of remote effects of action (carcinogenic, mutagenic, teratogenic activity, reproductive toxicity, chronic intoxication”) (state registration number 0108U007458).

Authors’ contributions:

According to the order of the Authorship

Conflict of interest:

The Authors declare no conflict of interest

CORRESPONDING AUTHOR

Galyna M. Balan

SE “L. I. Medved’s Research Center

of Preventive Toxicology, Food and Chemical

Safety of the Ministry of Health of Ukraine”

6, Heroiv Oborony Str., Kyiv 03127, Ukraine

tel: +380953182883

Received: 20.03.2019

Accepted: 02.05.2019

Table I. The structure of acute pesticide poisoning in the examined patients

Pesticides

Number of victims (n=647)

Proportion, %

1

2

3

2,4-dichlorophenoxyacetic acid-based herbicides (2,4-D)

522

80.7

Organophosphorous compounds (OPCs)

60

9.3

Sulphonylurea-based herbicides

36

5.6

Synthetic pyrethroids (SPs)

14

2.2

Aluminium phosphide

4

0.6

Dithiocarbamates (TMTD)

6

0.9

Oxatiine compounds (Vitavax)

3

0.5

Phenylpyrazole derivatives (Fipronil)

2

0.3

Table II. The professional composition of the main group of patients with acute pesticide poisoning

Professional groups

Pesticides

2,4-D

(n=522)

OPCs

(n=60)

Sulphonylurea

(n=36)

SPs

(n=14)

1

2

3

4

5

Field beet growers

522

36

Winegrowers

36

Breeders

9

Fruit growers

8

Workers of toxic chemical warehouses

2

5

Disinfectors

2

3

General workers

6

Machinery operators

3

Note: n — number of patients.