Manual for Trainers of Community Health Workers on Diagnosis and Treatment of Pesticide Poisoning
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Manual for Trainers of Community Health Workers on
Diagnosis and Treatment of Pesticide Poisoning
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Manual for Trainers of Community Health Workers on
Diagnosis and Treatment of Pesticide Poisoning
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UNDP/WHO SEARO Project on Safety and Control of Toxic Chemicals
and Pollutants in Collaboration with Malaria Research Centre
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MANUAL FOR TRAINERS OF
COMMUNITY HEALTH WORKERS ON
DIAGNOSIS AND TREATMENT OF
PESTICIDE POISONING
CONTENTS
Preface
1
SECTION I: General
3
SECTION II: Signs, Symptoms & Treatment
15
A.
Routes of entry
15
B.
Signs and symptoms - emergency treatment
20
C.
Emergency treatment - (general)
31
D.
Local treatment (general)
36
SECTION HI: Medical Treatment
38
SECTION IV: Surveillance
46
SECTION V : Application of Pesticides
50
A. Application by task
51
B. Application by equipment
56
SECTION VI: Chemistry and Biochemistry
64
A. Chemical types of pesticide
64
B. Mode of action
68
I
SECTION VII: Protection for Poisoning
71
A. Protection by hygiene
71
B. Protection according to job
76
C. Protection of parts of body
80
D. Protection by technique
83
Protection of others
88
SECTION Vm : Environment Protection
92
APPENDIX : Incidents of Human Poisoning
100
E.
ii -
I
PREFACE
Pesticide poisoning cases are reported sporadically from almost all over the country. Acute or chronic poisoning may
occur by any of the pesticides used in the protection of crops, storage of grains, control of household pests, the vectors of
human and animal diseases and the nuisance insects. The environment may be contaminated by improper disposal of insec
ticides or their containers or attempt to commit suicide or accident in the transportation or application of insecticides etc.
Large scale poisoning cases have been reported by inadvertent which have opened up for cash crop cultivation excessive use
and at times misuse of pesticides and very often careless handling of the pesticide has been observed. By and large pesticide
poisoning is due to accidents or negligent handling. Cases of poisoning may become serious or fatal due to lack of recog
nition and non-availability of emergency treatment. Fortunately, it is possible to completely avoid poisoning by preventive
methods, and if there is a case of poisoning early recognition of the symptoms of poisoning and prompt emergency treatment
can save the patient.
This course is therefore designed for the training of trainers who are medical officers on the diagnosis and treatment of
pesticide poisoning with the objective to (i) organize similar courses for medical officers and (ii) impart training to community
health workers for which a separate manual has been provided.
At the end of the course medical officers attending the course are expected to acquire adequate knowledge on various
pesticides used in the country, their toxicology and mode of action, method of application, possible ways of pesticide
contamination and poisoning, methods of safe use of pesticides, signs and symptoms for emergency treatment and follow up
action so that participants would be able to treat cases of poisoning in their areas and impart training to community health
workers. The community workers after training should in turn become proficient in recognition and emergency treatment
of poisoning cases. A community health worker should be able to acquire basic knowledge on various types of pesticides used
in public health, agriculture and protection from household pests; likely hazards associated with each pesticide; do's anddont's
in the use and safe storage of pesticides; recognition of early symptoms, administer first aid treatment and arrange immediate
medical help with full details of the source of poisoning and about the chemical and history of the patient for correct treatment
by the doctor.
1
The course is meant to be given over a 4 day period in conjunction with the following supplementary materials:
Recognition and Management of Pesticide Poisonings, D.P. Morgan
"The WHO Recommended Classification of Pesticides by Hazard"
"International Code of Conduct on the Distribution and Use of Pesticides" FAO
"WHO Recommended Drinking Water Standards for Pesticides"
"Pesticide Act"
Manual for training of community health workers on treatment and diagnosis of pesticide poisoning.
1.
2.
3.
4.
5.
6.
For further information, please contact Chief, Promotion of Environmental Health, South East Asia Regional Office,
WHO, New Delhi.
2
SECTION -1 GENERAL
CHEMICAL PESTICIDES IN LIQUID OR SOLID STATE
Definitions
'PEST AND PESTICIDE’
PEST
A PEST IS AN ORGANISM WHICH IS
TROUBLESOME, DESTRUCTIVE OR
CARRIES DISEASE TO PLANTS OR
ANIMALS
PESTICIDE
:
ANYTHING WHICH KILLS A PEST IS
A PESTICIDE
Commonly used pesticides are toxic chemical substances which should be handled carefully. There are other kinds of
pesticides such as biological agents, but these are not in common use. The rules for the safe use of these are similar in most
respects to those for chemical pesticides.
Some biological agents are:
Bacteria
Fungi
Nematodes
Protozoa
Viruses
Bacillus thuringiensis, Bacilllus sphaericus
Lagemdium gigantum, Coelomomyces species
Culicinomyces species, Leptolegnia
Romanomermis species
Nosemo algerae
Nuclear - polyhedrosis viruses
3
PESTICIDES ARE NAMED AFTER THE PEST THEY KELL
Examples:
INSECTICIDES
kill insect
LARVICIDES
kill insect larvae
kill fungi (moulds)
FUNGICIDES
RODENTICIDES
kill rats and other rodents
MITICIDES
kill mites
(Acaricides)
MOLLUSCICIDES kill snails
kill insect eggs
OVICIDES
NEMATICIDES
kill nematodes
A he above groups of pesticides are used in India.
I
This course does not cover fumigants which are chemical pesticides used as gases.
Types of exposure to pesticides*
Unintentional exposure
(dermal, oral, respiratory)
Intentional exposure
(from water, air, food)
I
Occupational
exposure
Non-occupational
exposure (from
water, air, food)
Suicides
I
Short-term Long-term Short-term Long-term
* Source WHO
II
4
Homicides
FORMULATIONS
The pesticide itself is known as the active ingredient (ai)
Usually it has to be diluted for use because:
i)
ii)
iii)
physical properties of the active ingredients are unsuitable for field use
pesticides are highly toxic in the pure form (ai), and
required doses are difficult to disperse due to high concentration.
To make dilution easy, the pesticide is made into a FORMULATION
Some formulations are:
Mixture with water/oil
i) Wettable powders (WP) also called water dispersible powders (WDP)
ii) Emulsifiable concentrates (EC)
Dry applications
i) Dusts (D)
ii) Granules (G)
iii) Encapsulated granules
Gas or vapour
i) Fumigants
ii) Smoke generators or tablets which vaporise
iii) Aerosols and pressurised sprays,
Others
i) Seed protectants (dry or liquid)
ii) Baits for rodents, slugs, cockroaches etc.
iii) Ultra low volume concentrates (ULV)
5
1. WETTABLE POWDER
Also known as a water dispersible powder (WDP). It is added to water and mixed.
Inert dusts (such as Silicon oxides and Calcium silicates) are impregnated with pesticide and a wetting agent (detergent)
is added. Resultant powder on mixing with water forms suspension.
Examples - DDT as 50% and 75% WDP
BHC as 50% WDP
Synthetic pyrethroids Deltamethrin 2.5% WP
Cyfluthrin 4.0% WP
2. EMULSIFIABLE CONCENTRATE
Pesticide is mixed with emulsifier to help the concentrate mix readily with water. The emulsifier causes oil to disperse
uniformly throughout the carrier (i.e., water). Emulsifying agents used in the formulations are sodium naphthyl sulphonate
and cetyl pyridium bromide.
Some preparations are :
Cypermethrin 25% EC
Malathion
50% EC
Abate
50% EC
For discussion
If a container is damaged, which formulation will cause more contamination:
wettable powder?
emulsifiable concentrate?
An emulsifiable concentrate will cause more contamination and toxicity, as it is liquid based and penetrates through surface
layer. It cannot be collected back unlike WDP which contaminates only upper layer of area of contact and the powder can
be scraped.
6
3. GRANULES
Granules may be floating, semi-floating or settling granules.
Usually, the active ingredient in the granule formulation is dispersed throughout the granule.
Pesticide is contained in small granules of inert material either as coating or as impregnated toxicant in the build up of the granules.
Active ingredient content varies 3% to 10% in India. Since formulation is applied in soil, granules are less harmful to beneficial insects
such as bees. Temephos granules, used for control of mosquito breeding are made with China clay. Kaolin and attapulgite as formulation
materials.
Examples:
Thimet 10-G (Organophosphate)
Furadan 3-G (Carbamate)
Bay gon bait - granules 2% propoxur (carbamate)
Fenthion (2% granules)
4. DUSTS
Dusts can be used in undiluted form or can be mixed with inert diluent.
Granules and dusts are not usually diluted but are used in the form shown. The pesticide (active ingredient) is often present in low
concentration.
Some common materials used as diluents in the dusts are
Talc
Prophyllite
Kaolin
7
For discussion:
How would dusts be affected by wind?
Insecticidal dusts can be applied by hand
operated or powder driven dust blowers from
the windward side of the site of application to
take advantage of the wind to carry the insecti
cide across the site. A change in the direction of
wind or blow-back can envelop the operator in
the insecticidal dust. Thus it is desirable for him
to wear a face mask during treatment
Id,
Do not spray or dust into the wind
8
TOXICITY
Toxicity is the ability of a pesticide to cause harmful effect or it is the property of a substance which causes adverse effects
in an organism. The term can be further split into
Acute
Chronic
Oral
Dermal
Inhalation
adverse effect in single short term use.
adverse effect through repeated exposure.
adverse effect on swallowing.
adverse effect through intact skin.
adverse effect due to absorption during respiration.
Toxicity varies with
1. The SPECIES
Obviously, a pesticide must be highly toxic to the target pest, if it is to be efficient, it may be less toxic for man.
2.
The CONCENTRATION of the toxic part (the active ingredient) in the formulation as it is handled.
For discussion
Which is more toxic:
Emulsifiable concentrate?
OR
Dust?
Emulsifiable concentrate is more toxic than dust because it is more quickly absorbed through skin or mucous membrane. But
when inhaled during application by dust blower, dusts may be as toxic as emulsifiable concentrates.
9
HAZARD
Hazard is the probability of adverse effects occurring.
Hazard = Toxicity X Exposure
Hazard and toxicity are different:
If exposure is nil, hazard is nil.
Hazard can be reduced by reducing exposure. The real concern is the risk or hazard associated with use of chemical, not
whether it is toxic or safe. Depending on use and disposition a very toxic compound may ultimately be less harmful than a
relatively non-toxic one.
How to reduce exposure is dealt with in subsequent sections.
/poison\
/poison\
/^danger^K
/^caution^X
Red
Yellow
Blue
Green
Labels convey information on hazard and toxicity
10
LABELS
National labels according to hazard class.
Pesticide are labelled according to their hazard class. Labels also give instructions according to the toxicity of the pesticides.
In India,Rule 19 of the Insecticide Act calls for warning symbols which are diamond shaped. The lower traingle is coloured to
indicate degree of toxicity of contents. Upper triangle contains signal words for cautioning.
Category
LD50 (oral)
mg/kg
Warning
word
Instructions
1. Extremely toxic
1 to 50
POISON
Keep out of reach of children if
swallowed or if symptoms of poisoning
occur, call physician immediately
2. Highly toxic
51-500
POISON
Keep out of reach of children.
3. Moderately toxic
501-5000
DANGER
Keep out of reach of children.
5000
CAUTION
4. Slighdy toxic
11
ADDITIONAL INFORMATION ON LABEL AND LEAFLET*
Every pesticide container has a label affixed on it. The word label includes not only the printed paper label stuck on the
container, but also the printing or stencilling on the container. The label on the container provides the most important facts
about the pesticide in the container.
The leaflet is a paper found inside the container or otherwise attached to it. The leaflet also contains very important
information. Both are statutorily required under the Insecticides Act, 1968 (section 18 and 19). Both the label and leaflet
and the instructions on them must be thoroughly read by the user. The information contained on the label and in the leaflet
is not only important but has been termed as the most expensive literature in the world. This is because of the expenditure
on research and development, not only on the pesticide but also on its use, bioefficacy, toxicology and safety. Considering
the effort and money spent in gathering and documenting the label information, it is important that the user appreciates the
value of the information.
As stated earlier both the label and the leaflet are statutorily required. Before a pesticide is registered for use the label and
leaflet are submitted to the.Central Insecticides Board for their approval. The Central Insecticides Board examines
thoroughly on all aspects, especially usage and safety, before according their approval. Good manufacturing practice calls
for the label and leaflet to be read by the user, and the instructions thereon to be strictly obeyed.
LABEL
Name of the insecticide including:
1.
a) brand name
b) trademark
c) common name
*Source: Manual for pesticide users published by Pesticide Association of India.
12
2.
Name of the manufacturer: The full name and address of the manufacturer is given. In case the manufacturer is different
ftom the person in whose name the insecticide is registered, the relationship between the manufacturer and the person who
has registration is normally given.
3.
Registration Number of the Insecticide: This is a number given by the Central Insecticide Board to the manufacture!
for a particular insecticide. It is exclusive for a manufacturer and insecticide.
4.
Ingredient Statement: This gives the names of the active ingredients, inert ingredient etc. with a percentage composition
of each. Generally, the common name of the active ingredient is given if a common name is not approved, the correct
chemical name is mentioned sometimes both are mentioned
5.
Type of formulation:This describes the type of formulation such as an emulsion concentrate, wettable powder, dust,
granules etc. This also states the percentage content of the active ingredient in the formulation.
6.
Net contents of the package: This indicates the quantity of the formulation in the container. This is generally expressed
in kgs., gms., litres or millilitres, the quantity given is the net weight of the package.
7.
Batch number: This indicates the quality control batch number assigned by the manufacturer. Different manufacturers
have their own standards of assigning the batch number.
8.
Date of manufacture: This is normally mentioned on each package and indicates the date on which the material was
manufactured.
9.
Expiry date: This is a date subsequent to the date of manufacture indicating the period within which the pesticide retains
its efficacy and safety. This is an indication of the shelf life of the product.
10.
Antidote statement: The antidote statment describes the specific antidote (s) applicable to the pesticide. This is given
to assist treatment in case of poisoning.
11.
Warning symbols and signal words: As mentioned earlier.
13
The label is affixed on the container in such a manner that it cannot be ordinarily removed. Furhter, most labels contain all
the information in more than two languages; Hindi and English are commonly used and other regional languages are also
used on the label. Alteration, obliteration or defacement of the label in whole or in part, other than by a manufacturer is an
offence under the Insecticide Act.
LEAFLET: For each unit pack one leaflet is provided by the manufacturer. The leaflet contains very useful information.
Limitation on the use of the pesticide is given on the leaflet. The following information is normally available on the leaflet.
1.
Particular application of the pesticide: This includes names of insects, weeds, diseases etc. for particular crops
against which the pesticide may be used.
2.
Directions for use: This indicates the dosage to be applied, the manner of spraying, the time of application and other
useful information related to the method of use of the insecticide.
3.
Warning and cautionary statement: This includes symptoms of poisoning, safety measures required, emergency
first aid treatment and antidotes. This also provides information about the flammability, irritation and other hazards.
4.
Container disposal: This includes instructions concerning the decontamination of the empty containers and thenmethod of disposal.
5.
Storage information: This includes information on the method of storage.
14
SECTION II
Signs, symptoms and treatment on an emergency basis
Pesticides are poisonous chemicals that kill insects, weeds or other pests, but they can also poison people. People may be
poisoned by getting pesticide on their skin, or by breathing in vapour, spray droplets or dust, or by swallowing.
Given below are some of the ways people may be poisoned:
if they use pesticides in a wrong way. For example, children may be poisoned if pesticides are sprayed on their bed clothes.
if they do not use protective equipment
if they eat, drink or smoke after working with pesticides.
if empty pesticide containers are used to store food or drink.
ROUTES OF ENTRY
ORAL
There are four routes by which pesticides can enter the body.
The first route is through the MOUTH
At work:
by eating and drinking while handling pesticides e.g. contaminated food, vegetables, fruits & drinking water.
by smoking while handling pesticides
15
At any time:
by taking a drink from something containing pesticide in mistake for some other liquid.
by leaving anything contaminated or containing pesticides in the way of young children.
The most common route of entry through oral route is by eating and’drinking while handling pesticides and also smoking
while handling.
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Most common mode of entry of pesticides through oral route
16
INHALATION
inc second route of entry is through the LUNGS by breathing in the pesticide.
This can be done by breathing in:
vapour
light spray
light dust
Only minute particles reach the lungs but larger particles can be absorbed through mucous membranes or coughed up
and swallowed.
The lungs are a primary route of entry for
vapours, fumes and dusts.
17
DERMAL
The third important route of entry is dermal. The human body is covered by skin, also known as epidermis. Even where
skin is intact, pesticides are capable of diffusing and crossing this bamer. In other words it is possible for pesticides to
enter the human body even through intact skin.
All areas of skin permit pesticide absorbtion. However, research has shown that different parts of body permit
different rates of absorption.
Pesticide Absorption Rate in various parts of human
skin
/'A
Body Area
Relative absorption
rate per minute
Forearm
Palm of hand
Ball of foot
Abdomen
Skull
Forehead
Scrotum
1.0
1.3
I. 6
2.1
3.7
7.0
II. 8
Other factors influencing absorption of pesticides from
dermal route are:
6
Some pesticides can be absorbed
directly through the skin
18
Skin characteristics: sores and abrasions, wetness of
skin, location on the body (absorption occurs readily
through eyes & lips)
Environmental Factors: temperature, humidity
Pesticide characterization: acidity (pH), vehicle, physi
cal, state (solid, liquid, gas), concentration of active
ingredient
When the skin is broken either due to injury or other diseases, it is much easier for the pesticide to enter the body.
Never allow pesticides to come in contact with cuts or wounds
19
Subject A signs and symptoms of intoxication : emergency treatment
1. ORGANOCHLORINES
Signs and symptoms
Poisoning by organochlorine compounds causes at first: irritation
headache
malaise (feeling of tiredness)
then:
giddiness
nausea
vomiting
muscle twitching
convulsions
respiratory depression
In acute poisoning onset is within 1-72 hrs. and death within 24 hours of the onset.
The above signs and symptoms are usually seen with the more toxic organochlorines only e.g., aldrin, dieldrin, DDT
does not cause these acute symptoms in ordinary exposure but it is stored indefinately in human tissues
DDT in dry powder and aqueous suspension forms is poorly absorbed from GIT and respiratory tract and does not
penetrate the skin appreciably. Oils, fats and lipid solvents, however, enhance the absorption of DDT from all sites including
intact skin.
No simple confirmatory laboratory test is available.
20
The clinical presentation also includes the following systemic effects.
a. Central Nervous System
Organochlorines are CNS stimulators that produce apprehension, excitability, parasthesias, dizziness and tremors pro
gressing to stupor, coma and convulsions in severe cases. They may enhance myocardial irritability leading to cardiac
dysrythmias after heavy exposures. Serious complications involve seizures with resultant hypoxemia, metabolic acidosis
and death.
b. Lungs
The solvent vehicle or organochlorine insecticides is capable of producing hydrocarbon pmeumonitis after aspiration.
c. Blood
Lindane has been reported to cause aplastic anaemia, agranulocytosis and bone marrow hypoplasia.
d. Muscle
Myoglobinuria, acute renal failure and a proximal myopathy may develop with lindane.
21
Emergency treatment
If a person seems to be suffering from organochlorine poisoning following steps should be taken.
a. if a person is not breathing
- give artificial respiration
b. if person is breathing but is not conscious
- turn on to face with head to one side
- watch breathing
- send for, or transport to medical aid
- in case of convulsions (fits) gently restrain person to avoid injury.
c. if person is breathing and is conscious
- send for, or transport to medical aid
- if person has drunk poisorj, induce vomiting
22
2. ORGANOPHOSPHATES
Signs and symptoms
Poisoning by organophosphorus compounds causes -
then:
at first: sweating
salivation
lacrimation
weakness and tremor
abdominal cramps
blurred or double vision
pin-point pupils
brachycardia
diarrhoea
vomiting
respiratory difficulty
convulsions
• coma
cardiac arrythmias and arrest
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Headache and vomiting are common symptoms of pesticide poisoning
23
In acute poisoning: onset within 72- 12 hrs, death within 48 hours recovery is complete if the dose is not fatal.
Confirmatory laboratory test:
Plasma cholinesterase activity estimation is diagnostic if plasma cholinesterase activity is less than 20% of normal or whole
blood cholinesterase is less than 60% of normal.
The poisoning due to organophosphates is due to deactivation of acetylcholinesterase enzyme. This causes accumulation
of large amounts of acetylcholinesterase enzyme. This causes accumulation of large amounts of acetylcholine. The clinical
effects can be categorized as:
a.
Muscarinic effects
Tightness in chest, wheezing, rhinitis, dyspnoea, increased bronchial secretion, cough, pulmonary oedema, cyanosis.
nausea, vomiting, abdominal tightness & cramps, diarrhoea, tenesmus, fecal and urinary incontinence.
sweating, salivation, lacrimation
brachycardia, fall in blood pressure,
miosis, blurring of vision
b.
Nicotinic effects
muscular twitching, fasciculation, weakness, cramps.
pallor, tachycardia, elevation of blood pressure.
C.
Central nervous system effects
initial stimulation followed by depression
24
Emergency treatment
If a person seems to be suffering from organophosphorus poisoning treatment is urgent
1.
If atropine is available give 2 mg I/V and repeat after 10-15 minutes if symptoms not improved.
2.
if person is hot breathing:
give artificial respiration
3.
if person is breathing but is not conscious
wash contaminated skin
turn the face head to one side
watch breathing
in case of convulsions (fits) gently
restrain person to avoid injury.
4.
if person is breathing and is conscious
if person has drunk poison, induce vomiting
wash contaminated skin
watch carefully and do not leave alone for half a day
even if the person seems to have recovered.
In all cases send for, or transport to medical aid if possible.
REMEMBER
- Prevention is better than cure
- Determine priorities quickly
- Act promptly, delay can be fatal
25
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Wash the patient thoroughly with clean water.
Spills should be wiped off when water is not
available.
26
3. CARBAMATES
Signs and symptoms
Poisoning by carbamate compounds causes:
at first: sweating
dizziness
weakness
tightness in chest
abdominal cramps
vomiting
blurred vision
tachycardia
muscle fasciculation
Note: Onset is sudden. Symptoms usually start to improve in 1-2 hours and complete recovery can occur in 12 hrs. Fatalities
are uncommon except after massive oral dosage.
The above symptoms are due to muscarinic & nicotinic effects like organophosphates.
Confirmatory laboratory test: Cholinesterase activity can be measured in severe cases but it is not usually helpful due to rapid
spontaneous reactivation of enzyme.
Emergency treatment: Keep quiet and transport to medical aid if person does not seem to be recovering.
27
4. CHLORONITROPHENOLS
Signs and symptoms
Poisoning by chloronitrophenols and cresols causes:
- Dyspnoea
- hyperpyrexia
- weakness
- hyperglycaemia and glycosuria
- coma
Onset in acute poisoning may be delayed due to slow cumulative absorption. Death is due to irreversible hyperpyrexia,
early appearance of rigor mortis.
Chronic poisoning causes:
- yellow staining of skin and hair (but not sclera)
(this colour does not wash off)
- peripheral neuritis
- agranulocytosis
- generalised weakness
- cataract
Confirmatory laboratory tests:
Compound in blood ( 4 mg/100 ml)
Emergency treatment: - artificial respiration if required
- wash the contaminated skin
28
5. BIPYRIDYLS
Signs and symptoms
Bipyridyls (paraquat, diquat) cause serious poisoning when taken by mouth.
At first:
malaise
weakness
ulceration of mucous membranes
After 48 hours: renal and hepatic dysfunction
After 14 days: dyspnoea
progressive pulmonary fibrosis
death due to respiratory failure
Condition is usually irreversible after 48 hours.
Laboratory confirmation: in urine or gastric aspirate:
to 5 ml add 0.1 g sodium bicarbonate
0.1 g sodium dithionite
Mix, blue colour positive for paraquat, yellow-green for diquat.
Splashes in eye are severely irritating to conjunctiva and cornea. Exposure of hands causes discoloration and shedding of
nails. Inhalation causes epistaxis due to ulceration of mucous membrane. Inoculation into scratches etc. causes skin
vesiculation.
29
Emergency treatmentrln case of bipyridyl poisoning take the following measures whether or not symptoms are apparent:
Induce vomiting
Wash out stomach with plenty of water and leave 7% bentonite or fuller’s earth 70% in stomach.
Send for further medical attention.
6. WARFARIN
Signs and symptoms
Warfarin, a coumarin derivative, is one of the most widely used rodenticides and has a good safety record. Rodents
must eat the bait 3-10 days before fatal levels are achieved, which means a human toxicity can develop only after repeated
doses. Multiple doses inhibit normal clotting and cause death by haemorrhage. A dose of 1-2 mg/kg wt daily over 1 week
causes severe haemorrhage.
Acute effects depend on site of haemorrhage
and include: Haemoptysis, haematuria, gastrointestinal bleeding, abdominal or back pain, haemarthrosis, chymotic lesions.
Maximum depression of coagulation factors occurs 36-72 hours after warfarin ingestion.
Laboratory confirmation:
Depression of prothrombin time.
Estimation of warfarin in blood levels.
Emergency treatment: Give activated charcoal if large amounts have been ingested.
30
EMERGENCY TREATMENT (General)
1. ARTIFICIAL RESPIRATION
Artificial respiration is given when a person is not breathing on his own.
1.
2.
3.
Make sure that airway is clear by pulling chin up and head back.
Use mouth to mouth method, through a cloth.
Fill the chest of the person with air 10 times per minute. Watch the chest rise to be sure airway is not blocked.
If medical aid is available, continue until the doctor says to stop. If medical aid is not available, and the pulse
is beating continue as long as possible. If the pulse is not beating, stop after half-an-hour.
7;
Tilt the unconcious patient’s head backward
to open his air passages.
Give the patient artificial respiration
and send immediately for medical aid.
31
co
ho
FIRST AID
Patient is
unconscious
Open the airway |
I
_____
Is the patient breathing
Yes
No
Clear vomit, food from mouth and throat
Yes
Is the patient breathing?
No
Yes
Are the lips burnt?
No
give mouth to nose breathing
2 deep breaths
Give mouth to mouth breathing
2 deep breaths
I
Yes
Is heart beating? _________
No
Give heart massage and
mouth to mouth/mouth to nose
breathing for 1 minute
I
'
Is heart beating? _________
Yes
No -
No
Give heart massage and mouth to
mouth/mouth to nose breathing
for 3 minutes
I
Is heart beating? -----------------
Yes
Stop heart massage
I
Continue mouth to mouth/mouth to
nose breathing until patient begins
to breathe by himself
1
‘
___________
Put patient in
recovery position
2 VOMITING
A).
When a person vomits it is important that none of the vomit should be breathed into the lungs.
If the person is unconscious, lie him front downwards, head downwards, head down and turned to one side.
Transport the person in this way in case he vomits. Never give anything by mouth to an unconscious person.
To induce vomiting:
- place person head downwards
- put your fingers in person's mouth and lightly tickle the back of throat
- do not give slat mixtures to induce vomiting.
Do not try to induce vomiting if the person is unconscious.
Contraindications for induction of vomiting
1. Unconcious patient
2. Convulsing patient
3. If ingested poison is strong alkali, corrosive and or kerosene.
B).
Induce vomiting in the conscious patient who has ingested highly toxic material
33
WHAT TO DO IF THE PATIENT HAS SWALLOWED POISON?
co
Is patient unconsious?|-
Yes
No
Is patient drowsy
Yes
No
Has patient had fits?
Yes
No
Do you know what the
patient has swallowed^
No
Yes
Has the patient taken a
chemical which burns?
Yes
DO NOT GIVE ANYTHING
BY MOUTH
No
Give water to drink not
more than 2 glasses
I________________
Has patient swallowed kerosene, petrol, white spirit,
or products containing these chemicals?
Yes
No
Is it less than 4 hours since patient
took the poison?
No
do not make the
patient vomit
Yes
Make the patient vomit.
keep some of the vomit in a small bottle
Does the patient need to be given medicine by mouth
(such as antidote for paracetamol or for iron)
■Yes
No
Give activated charcoal mixed with water
I
Give a laxative
Give the medicine
------------do not give
activated charcoal
3. TRANSPORTATION
If the person seems to be poisoned, transport to hospital/medical centre as soon as possible, but A)
First:
induce vomiting if pesticide taken by mouth
remove contaminated clothing and quickly wash skin,
give any other other treatment recommended.
B)
Disturb person as little as possible, i.e., do not drive very fast over bumpy roads.
C)
Take a pack of pesticide with you or a copy of label. This is particularly important to identify exactly the pesticid
used.
D)
Take a sample of vomit if available. This is for later laboratory analysis if required.
E)
Be prepared to tell the medical attendant how much and what sort of pesticide the person has handled in last few day*
35
I
C LOCAL TREATMENT (general)
1. WASHING OUT OF EYE
Pesticides splashed into the eye are rapidly absorbed and may also irritate the eye.
A splash in the eye must be washed out at once with a lot of clean water.
Water may be poured from cup or tea pot.
It is easier if a third Person holds eye open.
Continue washing for at least ten minutes.
Organophosphorus compounds splashed in the eye can cause marked blurring of vision: this is a temporary effect
which may last several hours.
Contamination in the eye must be washed
immediately with clean water.
j
36
2. WASHING SPLASHES OFF SKIN
If a man gets a drop of pesticide on his skin, or if he has a spill which soaks part of his clothing, it is important to
remember that most pesticides can be absorbed into the body through the skin.
Therefore, IMMEDIATELY
- Remove any soaked clothing
- Wash skin with lots of clean water and soap if available.
- Watch out for any symptoms of poisoning.
- If a large area of skin was splashed or was contaminated by soaked clothing, the man should stop work, at least
for the day.
How may major soakages of clothing occur and how may they be dealt with in local circumstances?
1.
2.
3.
4.
5.
Major soakages of clothing occur due to
Entry without protective clothing where aerial spraying is being done.
Spraying on crops or trees of higher elevation with high volume sprayers.
Spraying in densely grown crops or bushes
Accidental spillages due to leaks on spray tanks
Spraying against wind current
Local level measures to major soakages of clothing with pesticides.
1.
2.
3.
4.
5.
Prior notice to all the public of the area aerial spraying is going to be done and precautions to be taken during that
period should be stricdy adhered to.
A longer spray boom or lance should be used. Protective clothing should also be worn.
Protective clothing should be worn & care should be taken that crops & bushes should have proper alley ways for
moving in between for various agriculture operations including spraying of pesticides.
Sprayer tanks should be checked for leakages before use and protective clothing should also be worn.
Spraying should never be done against the wind.
37
SECTION HI: MEDICAL TREATMENT
1. HISTORY OF EXPOSURE
The diagnosis of pesticide poisoning is not always easy.
Pesticide poisoning of some types may mimic many other conditions.
Therefore some emphasis must be laid on:
History of Exposure
To what?
For how long?
When exactly was last exposure?
What was time relationship between exposure and onset?
As soon as pesticide poisoning is suspected, it is important to think - is patient still exposed? (Is clothing contaminated
or stomach full?)
n
i’
The doctor should be informed immediately
he should be shown the container and label.
38
\
■P
Cases of poisoning should be notified
to prevent recurrence.
2 GENERAL PRINCIPLES
A. Pesticide poisoning does not differ from poisoning by other chemical substances, in so far as supportive treatment is
concerned.
B.
Most pesticide poisonings (except for the bipyridyls) do not have delayed effects, and recovery is usually complete unless
there has been a prolonged period of anoxia.
Basic approach to the poisoned patient
I
Stabilization: Prevent further deterioration
II
Complete evaluation: Survey directed towards identifying the toxin, evaluation of severity, associated complications
& trauma.
III
Appropirate treatment to reduce absorption: Skin decontamination, administration of syrup of ipecac or gastric lavages
and administration of oral activated charcoal and cathartics.
IV
Appropriate measures to improve elimination of toxin: Urine pH alteration, diuresis, haemodialysis, haemoperfusion,
peritoneal dialysis.
V
Consideration of use of specific antidotes: Specific antidotes are not available for all poisonings but naloxone and
glucose can be administered to all patients exhibiting CNS depression.
VI
Continuing care and disposition: Adequate observation period should be established.
39
3. ORGANOCHLORINES
For patients suffering from organochlorine poisoning:
Treatment is symptomatic
SYMPTOMS/SIGNS
TREATMENT
- if apnoeic or cyanosed
artificial respiration
- if poison ingested
gastric lavage followed by saline purgative
(Sodium sulphate 30 g in 250 ml water)
- elimination enhancement
Use of cholestyramine (3-8 g four times a day) can
increase faecal excretion. In compounds that have
enterohepatic recirculation, activated charcoal may
also reduce half life.
- if skin contaminated
bathe with water and soap
- if convulsing
diazepam 5-10 mg slowly LV.
(adults)
0.2 mg/kg LV.
(children)
or barbiturates: both repeated as often as necessary
- other supportive treatment
10% calcium gluconate 10 ml orally 4 hourly
Vitamin B Complex
High carbohydrate, low fat diet.
correction of acidosis.
40
Contraindicated are: adrenaline, epinephrine or related drugs, all CNS stimulants, oily purgatives and fat in diet.
4. ORGANOPHOSPHATES
For patients suffering from organophosphorus poisoning:
Use antidotes: atropine and pralidoxime
Atropine : 2 mg LV. every 10 minutes as necessary: full atropinization shown by dilation of pupil, flushing of face, pulse 140+.
Repeat as necessary for 48-72 hours. (Dose for children is 0.015 - 0.05 mg/kg).
Pralidoxime : Given at same time as atropine: 1 gm in 20 ml saline by slow LV. injections, repeated hourly. Most effective if
given within 12 hours of onset. (Dose for children 20 to 50 mg/kg diluted in saline)
Precaution : Give the injection very slowly.
Convulsions may be controlled with
diazepam
5 mg I.V. (adults)
0.2 mg/kg I.V. (children)
or Phenytoin
- 150-250 mg I.V.
slowly (adults)
- 15 mg/kg I.V.
(children)
Contraindicated are: morphine, barbiturates, phenothiazine tranquillizers, antihistamines, parasympathomimetic agents.
41
Other supportive treatment as necessary
Artificial respiration
Gastric lavage if patient presents within 4-6 hours
Washing of contaminated skin
Observe at least 48 hours after the last dose of atropine
Administer fluid to replace losses
5. CARBAMATES
For patients suffering from carbamate poisoning:
Usually supportive treatment is enough.
Atropine may be given to control symptoms if these are severe: if the patient is conscious, atropine by mouth may
be sufficient. Tincture of belladonna can be used if oral atropine not available.
Contraindicated are oximes (pralidoxime, Toxigonin) of any kind.
The oximes are not effective in antagonizing the toxicity of the more rapidly hydrolyzing carbamyl ester inhibitors,
and since pralidoxime itself has weak anti ChE activity, they are not recommended for the treatment of overdosage with
neostigmine or physostigmine and are contraindicated in poisoning with carbaryl.
6. CHLORONITROPHENOLS
For patients suffering from poisoning by chloronitrophenols and cresols no specific antidote is available.
The reduction of pyrexia by tepid sponging or bathing and by antipyretics is of prime importance.
42
Convulsions may be controlled with diazepam 5 mg IV.
Contraindicated is
atropine
Other supportive treatment as necessary
artificial respiration
Oxygen
gastric lavage
washing of contaminated skin
correct fluid acidosis and electrolyte imbalance;
Note: - Watch for evidence of hepatic or renal damage
- Avoid aspirin because it enhances the uncoupling of oxidative phosphorylation.
7. BIPYRIDYLS
For patients with bipyridyl poisoning speed of treatment is essential.
Wash out stomach
Leave in stomach
Bentonite 7%
or fuller's earth 30%
If given within 2 hours, adsorption of compound in stomach may be effective.
Administer mild cathartics
Forced diuresis to eliminate compound in circulation may be helpful.
Otherwise only supportive treatment can be given and observation is required for at least 14 days.
43
Watch fluid and electrolyte balance. Watch for the development of septicemia 7-10 days post ingestion.
Local lesions are treated by cessation of contact and local palliative treatment
Once proliferative changes occur in lungs and other organs, no specific treatment has been found to be effective hence the ingestion of the compound is highly hazardous.
8. WARFARIN
Warfarin causes depression of prothrombin time, beginning in 24 hrs. and peaking between 36 and 72 hrs. The
complete blood count provides a baseline to measure blood loss prospectively.
Treatment
Activated charcoal and cathartics are ususally all that is needed unless a large intentional dose is ingested.
Antidotes are Vitamin K
10-25 mg orally (adults)
5-10 mg orally (children)
Constant monitoring is required until prothrombin time returns to normal after cessation of vitamin K thereby.
Other measures: fresh - frozen plasma and fresh blood for acute bleeding.
44
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SECTION IV: SURVEILLANCE
NOTE:The surveillance methods are not presented in detail. More information about the actual tests is available from the
manufacturers.
1. REPORTING
Under section 26of the Insecticides Act, 1968, the States Governments have been empowered to notify aperson or class
of persons for notifying all occurrences of poisoning due to pesticides'coming within the cognizance to the authorities as
notified in the said notification. For this, a proforma has been devised for sending half yearly report to the Plant Protection
Adviser to the Government of India.
The object of reporting is to prevent a recurrence of the case. The questions to be answered are:
1.
Why did the case become poisoned?
2.
Are others subject to the same hazard?
3.
How may the hazard be abolished or reduced?
PROFORMA
Half yearly return regarding poisoning cases due to pesticide under
Section 26 of the Insecticides Act, 1968
Name of the States/UTs
S.No. Nature of poisoning
Period of return from
No. of No. of
deaths poisoning
Whether
postmortem
is done in
case of
death and
its report
Analysis
of viscera
and its
report
Name
of
insecticides
Name Remark
of manu
facturers.
Batch No.
4
6
7
8
9
Accidental - Non Accidental
Homicidal +
Suicidal
1
46
2
3
to-
5
10
2. RECORDS OF EXPOSURE
When men are using moderately or highly toxic pesticides, brief records of exposure should be kept, on the lines
suggested below.
These records will be needed if a man becomes intoxicated and may be compared with the records of men who were
not intoxicated.
Week beginning:
Name
H
P
Day
Pesticide:
1
2
3
4
5
6
7
HP
HP
HP
HP
HP
HP
HP
hours worked in spraying .
pumps charges sprayed
3. TINTOMETER FIELD KIT
A tintometer field kit is used for measuring cholinesterase. Whole blood taken from a finger prick is used.
Approximately 19 tests can be done in 1 72 hours total time by a trained technician. The kit is independent except that 1
litre of freshly distilled water is required for 38 tests.
Tintometric test: Fingerstick whole blood, samples from exposed subjects and from a control (non-exposed) person
are allowed to incubcate with acetylcholine and the indicator bromothymol blue. Change in colour is compared with
standard.
47
This kit is used chiefly to follow cholinesterase levels over a period of time in men exposed to organophosphorus
insecticides.
An initial test before exposure is essential to give a baseline. This is expressed as a per cent of ’’normal” in 12.5% steps.
Later tests are compared with this level.
4. ACHOLEST TEST KIT
This kit is more suitable for diagnosis of poisoning than for routine following of cholinesterase levels.
The test uses plasma and therefore centrifugation of blood is necessary.
The result is expressed as a percentage of ’’normal" in 25% steps.
5. CHOLINESTERASE ROUTINE
The baseline test is preexposure preferably the average of 2 or 3 separate tests 1 day apart.
If a man is working with organophosphorus compounds and a routine (weekly) test is 50% of the pre-exposure value,
or less, he should be suspended from any contact with organophosphorus or carbamate pesticides.
He can be allowed to resume work when a tintometer test gives a result 12.5% below his pre-exposure value or the
Acholest test is under 20 minutes, corrected for temperature.
48
Population groups at risk of exposure to pesticides*
Suicides and mass poisoning; pesticides
formulators, mixers, applicators,
and pickers
Pesticide manufacturers,
formulators, mixers,
applicators, and pickers
/
Single \
and short-term \
very high level
exposure
Long-term,
high level exposure
All population groups
Long-term, low level exposure
The width of the triangle indicates the approximate size of the exposed groups
*Source WHO
49
SECTION V
THE APPLICATION OF PESTICIDES
Objective (s)
1.
To understand the common uses of pesticides.
2.
To recognise the equipment used to apply them.
Examples:
i.
Agriculture
Insecticide : CYMBUSH 25% EC
It is used in Agriculture against pests of cotton, brinjal & Lady's finger (Bhindi)
Equipment used for application is the knapsack sprayer fitted with fine mist nozzle.
ii.
Public Health
Insecticide : DDT (50% WP)
It is used in the control of Anopheline vectors of malaria equipment used for application is the stirrup pump.
iii.
Household Pests
Prdppxur spray-(1%)
Used to control cockroaches & other household insects.
Equipment used - Intermittent or continuous hand sprayer
50
A APPLICATION BY TASK
Number : 1 Agriculture; hand spray, low crop
Pesticides are applied in many different ways using a variety of application equipments. But these equipments are
designed to apply insecticide under certain situations. Given below are some examples of equipment and the main purpose
of application.
Equipment/technique
Purpose
1. Spraying with stirrup pumps
indoor residual spraying in malaria control
outdoor for crops
2. Spraying with hand
compression pump
spraying insecticides on crops, residual insecticides
on walls and spraying larvicides.
3. Knapsack sprayer
larviciding in public health.
4. Dust blower
Paris green larviciding
agriculture crop dusting.
5. Thermal fogging
As adulticide space
application & ULV
application
library
■
6. Aerial
ULV or dust application
7. Space spray
hand operated
motorised mist blower.
Public
health
(
*ND
L* k oocumentatjon J rn
\
V
UNfr
y
X''''S'
A L O R £'
51
Hand spraying
It is probably the most common method of
application of insecticides and herbicides.
For discussion
What kind of formulations are likely to be used?
The formulations used are In Public Health
WP and occasionally EC
In Agriculture
WDP
EC
Dusts
Granules
House hold pests
EC
Baits
Pellets
Equipment used for application:
Stirrup pumps are used for WDP
Hand compression pumps for WDP/EC
Knapsack sprayer for WDP/EC
Dust blower for dust & powder formulations.
52
2. PUBLIC HEALTH; INDOOR RESIDUAL SPRAY
Most applications are outdoor but for the control of
pests carrying disease, INDOOR RESIDUAL
APPLICATION is used.
'Residual’ means that the pesticide will remain effec
tive for weeks or months.
For discussion
Indoor residual application is used for the control of
1.
Pests
Diseases
Mosquito
Malaria
Filaria
Dengue
JE
Bed bugs
Relapsing
fever
Sandfly
Kala azar
53
3. PUBLIC HEALTH, LARVICIDING
Pesticides can be sprayed on water to kill insect larvae
that grow and feed in water. This is LARVICIDING.
1.
Larvicides are used to control the following
mosquito larvae
Anopheles
Culex
Aedes
'•7^
2.
Other methods of controlling insect larvae are:
Bioenvironmental control measures
a) Larvivorous fishes
Application of biocides
b) Minor engineering methods
- filling of pits, ditches
- trimming of margins of ponds etc.
- drainage of low-lying areas.
- mosquito proofing of overhead tanks & wells.
- use of siphons
c) Other methods - use of EPS beads in wells,
overhead tanks etc.
54
4. SPRAYING IN HOUSEHOLD
This is a HOUSEHOLD SPRAY; and is usually used to control nuisance-causing insects. The pesticide usually is of low
toxicity and short action.
In India however, householders may obtain more toxic pesticides and use them unwisely.
55
B. APPLICATION BY EQUIPMENT
1. EXTERIOR HAND SPRAY
This is frequently used on low crops.
The tank may be pressurized by hand or motorised.
Regular maintenance of pumps is important for both
efficiency and safety.
Supervisors should know how hand sprayers can be
safely used and should pass on this information to their
men.
y
What hazards unconnected with pesticide exposure occur
with motorized pumps?
2
Hazards
Fire hazard
Blasting due to high pressure
56
2. INTERIOR HAND SPRAYER
This is used for indoor residual application
The tank is usually pressurized by hand.
Regular maintenance of the pumps is important for both
efficiency and safety.
The spraymen must know how to use it properly and safely
and the supervisor must ensure that he does so.
Which parts of pump particularly require maintenance?
1.
Rubber washers wear out easily as they have to be
replaced frequently.
2.
The leather cap of plunger also gets eroded
frequently. It also needs replacement whenever it
is worn out.
3.
Nozzles get clogged up frequently and they have to
be cleaned properly before use (in case of pumps
with direct nozzle connection).
Hand compression sprayer
57
3. EXTERIOR MACHINE SPRAY
-------
This is particularly used for spraying large areas of land or for trees.
It is usually drawn by a tractor
The operator must know how to use it safely.
58
4. ULV HAND APPLICATION, EXTERIOR
ULTRA-LOW VOLUME (ULV) is a type of application
where only small quantities of highly concentrated active
ingredients are dispersed in very small droplets.
This may be done as a fog or a spray-mist. Fogs can be
seen but spray are very difficult to see.
A mist settles to the ground very slowly. The smallest
droplets may take 1-2 hours.
The picture shows a type of hand held ULV sprayer.
Some are motorized: others are electrically powered by
batteries.
All those using ULV equipment must know how to use
it safely.
59
5. LAYING RODENTICIDE BAITS
Rodents eat much of the food grown for man and are a serious pest in all country. For killing rodents, pesticides are
incorporated into various kinds of attractive baits. This is RODENTICIDE APPLICATION.
For following rodents, rodenticides are used in our country.
1.
This is RODENTICIDE APPLICATION
Rattus rattus
Indian house rat
R.norvegicus
Norwegian brown rat
Bandicota bengalensis
The mole rat
Mils museulus
House mouse.
Tatera indica
The Indian gerbil
Millardia meltada
The grass rat
Mus booduga
Indian field mouse
Funnabulis pennati
Garden squirrel
2.
What are the usual baits used?
Baits used usually
60
Acute poison baits with zinc phosphide,
chronic poison baits with warfarin.
6. ULV
This shows a large ULV SPRAYER that has to be mounted on a vehicle. It is used mostly for the control of epidemics of
dengue which is transmitted by mosquitoes.
This is a powerful machine and all those using it must be careful and use it safely.
61
7. AERIAL APPLICATION
AERIAL APPLICATION is an important means of
application, of pesticides, particularly covering large
areas of land.
A pilot must know:
- . what he is using
how he must protect himself
how his ground crew must protect themselves
how he must protect the public
and he should not forget his maintenance engineers
they also need protection
Ground supervisors and loaders must know
what they ate using
how to protect their men, including flagmen
how to load the plane without overloading.
Note: Aerial application of pesticidescan be very
dangerous if proper precautions are not taken.
62
8. GRANULE OR DUST SPREADING
They can also be distributed by machine in the same way
as dusts.
Pesticide concentrations in granules are usually low but
the operator should know what he is using.
Dusts require particular attention in use and operators
must know how to avoid drift.
This applicator is used for spreading
granules by hand.
63
SECTION: VI
CHEMICAL TYPES OF PESTICIDES
1. ORGANOCHLORINES
Pesticides can be split into several chemical groups. Most pesticides applied in agriculture and public health are
INSECTICIDES.
An important chemical group of the insecticides are the ORGANOCHLORINE compounds.
Given below are some organochlorine compounds:
Dicofol
DDT
Endrin
Fenazaflor
Methoxychlor
Aldrin
Heptachlor
Citicide
Dieldrin
Isobenzan
Endosulfan
HCH or BHC
chlordane
Toxaphene
Lindane (-HCH)
1.
2.
3.
Some organochlorine compounds are stored in the body, usually without causing any apparent adverse effect. Most
organochlorine compounds are PERSISTENT in the environment and may affect non-target wild-life. For these reasons use
of these insecticides is being discouraged.
Human exposures occur through ingestion of contaminated food or water, inhalation of vapour, or absorption through
skin. They are CNS stimulators. The presence of chlorine in their molecules has conferred on them chemical stability which
has resulted in persistent residues in the environment. The facts that these products are stored indefinitely in human tissues
has led to banning of several organochlorine pesticides. Lindane accumulaters to a lesser extent than other organochlorines.
Hepatic enzyme induction can also result from exposure to chlordane, methoxychlor, DDT, dieldrin and heptachlor.
2. ORGANOPHOSPHATES
The organochlorines have been partly replaced by ORGANOPHOSPHORUS COMPOUNDS. These are less
1.
persistent in the environment and are not stored in the body.
64
2.
There are many organophosphorus compounds. The list given below is only of selected compounds in order of
toxicity.
Demeton
Parathion
Methyl parathion
Fenthion
Diazinon
Fenitrothion
Trichlorphon Temephos (Abate)
Dimethoate Chlorppyriphos (Dursban)
Malathion
Phorate
Dichlorvos
Other compounds used in this country are:
Please note that toxicity is not the same as hazard.
Of the two groups of insecticides: organochlorines and organophosphates, the latter are highly toxic but less
hazardous because these are less persistent in the body/plants/environment.
List those compounds heard of by the group. Go through the list again and pick out those used.
Parathion
Malathion
Adulticide
Fenthion
Temephos
Larvicides
3. CARBAMATES
Another smaller group of insecticides used are the CARBAMATES such as - the order of toxicity being as before, the less
toxic down the list
65
METHOMYL (LANDRIN, NUDRIN)
PROPOXUR (BAYGON)
CARBARYL (SEVIN): Decarbofuran, Mipsin, Carbofuran, Aldicarb, Bendiocarb
Carbaryl, the most commonly used insecticide in agriculture, is safe as mammalian toxicity is low and it does not leave
residues in the environment. Propoxur (Baygon) is most commonly used for household pests. It is highly toxic to insects and
moderately toxic to mammals.
4. NITROCHLOROPHENOLS
The NITROCHLOROPHENOLS belong to an entirely different group of pesticides and are used to prevent fungal
(mould) attack on timber and as herbicides.
the best known is:
SODIUM PENTA - CHLOROPHENATE (SPCP)
Other compounds used in this country are:
PCNB - soil fungicide
(penta chloronitrobenzene)
5. BIPYRIDYLS
the BIPYRIDYL COMPOUNDS are chiefly herbicides.
PARAQUAT - Gramoxone
DIQUAT
- Reglone
These are unusual compounds as they are of very low hazard in proper use, and are not stored in the body. However,
they are HIGHLY TOXIC IF TAKEN BY MOUTH in any way.
Paraquat has low chronic toxicity because of its rapid deactivation upon soil contact, but on ingestion it can produce
multisystem organ failure and pulmonary fibrosis.
66
6. RODENTICIDES
Many chemicals of different chemical classes are used as RODENTICIDES. These include (in descending order of
toxicity for humans).
THALLIUM SULPHATE
SODIUM FLUORACETATE (1080)
ZINC PHOSPHIDE
BARIUM SALTS ESP. CARBONATE
WARFARIN
SODIUM CYANIDE
ALUMINIUM PHOSPHIDE
OTHER COMPOUNDS USED IN
THIS COUNTRY ARE
COUMATETRALY
COUMACHLO
Thallium is so hazardous that its use is not recommended. Sodium fluoracetate should only be used by specially
trained personnel.
Warfarin is the most commonly used rodenticide and is an anticoagulant of blood i.e., it stop blood clotting.
Warfarin: Rodents eat the bait for 3-10 days before fatal levels are achieved. Due to development of resistance
super warfarin compounds like difenacoum have been developed. Restrictions have now been imposed on use of these
compounds due to reported toxicity among mammals.
Zinc phosphide is also highly toxic. Serious adverse effects include pulmonary oedema, hypertension, dysrhyth
mias and convulsions.
7. OTHER PESTICIDES AND MIXTURES
The following mixtures are commonly used in this country:
1)
By mixing diazinon with DDT the bed bug problem is tackled in areas where bed bugs have developed resistance to
organochlorines.
67
Methylparathjon + DDT (1:3)
Toxaphene + DDT (2:1)
Carbaryl+ rBHC (1:1)
Methyl parathion + Carbaryl (1:4)
Piperonyl butoxide + pyrethrum (10:1)
Phosalone + DDT (1:2)
Chemicals in mixtures may exert an additive effect (the most common) or a synergistic effect where the effect is greater
than the additive effect, or an antagonistic effect where the effect is less than the additive effect.
Subject: B Mode of action
2)
3)
4)
5)
6)
7)
1. ORGANOCHLORINES
They cause: STIMULATION OF NERVOUS SYSTEM
INDUCTION IN LIVER ENZYMES IN HIGH DOSAGES
STORED IN FAT IN PROPORTION TO INTAKE
ACUTE INTOXICATION by organochlorines results in stimulation of the central nervous system.
Very high levels of exposure may be associated with induction of liver enzymes but no other effects have been described
in humans.
STORAGE
Most organochlorine compounds or their metabolites are stored in fatty tissues. The level of storage is directly related
to exposure. The level of storage has no influence on acute intoxication as far as it concerns the likelihood of its occurrence
or its severity. Acute toxic dose: Aldrin 3-7g; Chlordane 6g; Dieldrin 1.5 - 5g; Lindane 10-30 g.
2. ORGANOPHOSPHATES
ORGANOPHOSPHORUS COMPOUNDS: INHIBITION OF CHOLINESTERASE IN RED
CELLS, PLASMA AND OTHER ORGANS.
68
NOT STORED IN BODY
POSSIBLE CUMULATION OF EFFECT
1.
Organophosphorus compounds inhibit the enzyme cholinesterase, causing potentiation of the effects of acetylcholine
at cholinergic junctions.
2.
The enzyme is inhibited in red cells, plasma, the brain and other organs. Its level has to fall well below its preexposure
level (70% in plasma, 30% in red cells for a single acute exposure) before symptoms appear.
3.
Organophosphorus compounds are not stored to any extent on repeated exposure but the effects on cholinesterase may
be cumulative in a series of repeated daily exposures.
Organophosphorus compounds act as anticholinesterases (anti chE) and cause acetylcholine to accumulate at cholinergic
receptor sites and thus are potentially capable of producing effects equivalent to excessive stimulation of cholinergic
receptors throughout the central and peripheral nervous system. Certain fluorine - containing anti ChE agents e.g. DFP can
cause delayed neurotoxicity due to inhibition of neurotoxic esterase.
Chronic exposure to low levels can cause non-specific CNS symptoms, but there is no correlation between symptoms &
cholinesterase inhibition.
3. CARBAMATES
Carbamate compounds act similarly to organophosphorus compounds, that is they inhibit cholinesterase. However,
the action of the carbamates is both QUICKER AND READILY REVERSIBLE.
There is no storage in the body
There is no cumulation of their effect on cholinesterase because of the rapid reversibility.
Carbamates produce symptoms of cholinergic excess like organophosphates but in vivo spontaneous hydrolysis
of the carbamylated acetylcholinesterase enzyme leads to less severe and shorter duration symptoms.
4. NITROCHLOROPHENOLS
CHLORO/NITRO COMPOUNDS act by strongly stimulating metabolism causing an increase in metabolic rate and
hyperthermia which may become irreversible.
They are not stored in the body but their effect on repeated exposure can be cumulative.
69
5. BIPYRIDYLS
The BIPYRIDYL COMPOUNDS are highly toxic if taken by mouth accidentally or deliberately. Isolated cases of
poisoning have been reported by dermal exposure. After initial irritative action on mucous membranes and a latent period
of 7-14 days, there are irreversible proliferative changes in epithelium, especially in the lungs and kidney. These changes
continue to cause respiratory and renal failure even after all the compound ingested has apparently been excreted.
Any oral exposure to commercial 20% concentrate should be considered potentially fatal, inhalation of paraquat spray is
unlikely to produce toxic effects because of size of spray droplets. Diquat is less toxic than paraquat. Mechanism - reduction
in NADPH renders the cells more susceptible to attack by lipid hydroperoxides. This peroxidation converts molecular
oxygen to superoxide radicals which disrupt cell structure and function.
6. RODENTICIDES
The mode of action of rodenticides can be summarized briefly.
Thallium is a cellular poison.
Sodium flouroacetate (1080) is an inhibitor of enzymes concerned with tissue respiration. Monofluoroacetate
metabolite fluoroacetrate inhibits both Kreb’s cycle enzyme, aconitase, which catalyzes citrate metabolism and succinate
dehydrogenase which catalyzes succinate metabolism. Thus blockage of kreb’s cycle leading to decreased glucose
metabolism.
3. Zinc phosphide has a CNS effect similar to the anticholinesterases, and is haemolytic. Zinc phosphide produces
pulmonary oedema, hypertension, dysrhythmias and convulsions.
4. Warfarin inhibits prothrombin formation. Multiple doses are usually needed to reach a stage of symptomatic inhibition.
Usual mode of death is gastrointestinal haemorrhage. These compounds depress hepatic synthesis of vitamin K
dependent clotting factors.
1.
2.
70
SECTION: VII
PROTECTION FROM POISONING
1. EATING
No one should eat or drink’while handling pesticides without first washing hands and face in clean water (with soap).
If food is taken to the field, it should be carried in a tin with a tight fitting lid.
If a man eats or drinks without washing, by what route is he taking pesticides into his body?
The route of entry of insecticides in this case will be oral and it is called the oral exposure.
Always wash hands and face before meals
71
2. SMOKING
Those handling pesticide should never (be allowed to) smoke without first washing hands and face in clean
water (and soap.)
Cigarettes should be kept in a tightly closed tin if carried in overalls.
If a man smokes without washing, by what route is he taking pesticides into his body?
A person who smokes with pesticide contaminated hand will take pesticides into lungs through inhalation.
I■ 1r.
'it k ,
^0/4
Never smoke with soiled hands
72
I
3. CHEWING
No one should chew (or prepare things to chew) while handling pesticides without first washing hands and face in
clean water (with soap).
Never carry things to chew in overalls without using a tin with a tight fitting lid.
If a man chews without washing, by what route is he taking pesticide into his body?
A man who chew with pesticide contaminated hands, will take pesticides into the body through oral route.
73
i-
4. BLOWING OUT NOZZLE
If a nozzle is blocked, no one should ever blow it down to clear it.
Instead remove the nozzle and press it against the pressure release valve of the pump.
Blocked nozzle should be cleaned using either a thin grass stem or stick or with soap and water.
If a man clears a nozzle by mouth, by what route is he taking pesticide into his body?
Pesticides will enter the body through oral route when spray nozzle is cleaned by mouth.
Blocked nozzles should be cleaned with a pin or stick;
never blow out a clogged nozzle
74
5. WASHING HANDS AND FACE
Wash hands and face in clean water, use soap if available.
Always wash before eating, drinking, smoking and at the end of the day's work before returning to base.
If possible wash hands each time the pump is refilled.
At the end of the day, take a shower.
If there is no or little water available at the application site, it should be taken to the field in a clean drum (with a tap).
How does washing stop absorption of pesticides?
User may become contaminated accidentally by a splash or spill of pesticides. Washing will remove the chemical from
skin.
What else should be washed, other than skin?
•
Apart from the body, eyes and clothes should be washed carefully.
6. WASHING CLOTHES
Working clothes should be washed every day in clean water.
How does this stop you taking pesticides into your body?
Removing and washing clothes will prevent absorption from surface of the body.
>1 lii i
Wash clothes everyday with clean water
75
HAND SPRAYMAN - PUBLIC HEALTH
2.
When spraying a hut the spraymen should wear
(i)
(ii)
(iii)
(iv)
an overall
boots
a brimmed hat
a pair of spectacles.
Some men prefer a scarf around the face but this should not become wet.
All clothes must be washed daily. Particular attention should be given to washing inside the clothing.
/
76
Estimated overall annual public health impact of pesticide poisoning*
Single and short-term exposure
(including suicides)
3,000,000
(220,000 deaths)
Long-term exposure, specific chronic defects
735,000
Long-term exposure, nonspecific chronic
effects (cancer)
37,000
♦Source WHO
77
M
3. MIXED AND BAGGER
A mixer handles concentrated pesticide and a man who is bagging pesticides also handles concentrated pesticide
thus must take extra care.
(I) an overall
He should wear
(II) gloves
(III) boots
(IV) a clean cloth over his mouth and nose
(V) an apron.
If a man is mixing a highly toxic pesticide he also needs
(VI) a respirator containing a cartridge, which should be
replaced at least daily.
(VII) A pair of glass spectacles.
All clothes and equipment must be washed daily, inside and out.
4. SUPERVISOR
A supervisor must set a good example for his men.
He should wear an overall, boots and he should have a pair of gloves to wear if he handles pesticides.
All clothes must be washed daily, inside and out
5. MAINTENANCE ENGINEER
A maintenance engineer may look after pumps, vehicles or planes. He may also come into contact with
pesticides.
He is often forgotten.
He should wear: Overall, apron, gloves
78
n
If an engineer is to work on anything that contains pesticide, make sure that he knows this. He should also know the
precautions to be taken. He should have facilities for washing contaminated parts with which he is working.
6. FLAGMAN
A flagman, if he is to be used at all should wear:
(I)
(II)
(in)
overall
brimmed hat
boots
He should stand to the side of the swathe, on the windward side. Clothing must be washed daily and the man
must shower after work.
7. AIRCRAFT LOADER
An aircraft loader can be seriously at risk.
He must wear: (I)
(U)
(HI)
(IV)
(V)
overall
gloves
boots
apron
cloth to cover mouth and nose.
All clothing must be washed daily.
Clean water should always be available in ample quantity at airstrip.
79
N
C Protection of body
Educational objective: to define in more detail the clothing and equipment used for protection of different parts of
the body.
1. TRUNK AND PARTS COVERED BY OVERALL
An overall is probably the most convenient way of protecting the body.
A good overall covers 85% of the skin.
National dress can also be used as overall if
it is made of cotton so that it can easily be washed and dried.
it covers the body without openings.
it has long sleeves.
it is long enough to cover the top of the boots, if these are worn.
it is repaired or replaced when it becomes worn out.
2. HEAD AND NECK
If the overall covers 85% of the skin, the next most exposed area is the head and neck.
If the overall does not button up to the neck, a scarf should be worn.
If any spray or dust is liable to land on the head, a wide brimmed hat should be worn.
3. LOWER LEGS AND FEET
Pesticide can be absorbed through the skin of the lower legs and feet, especially as these are often wet by a spray
or by sprayed vegetation.
The best protection is rubber boots.
80
n
Wear overall outside the boots.
After work, wash the boots inside and out and leave upside down to dry.
If boots are not available, shoes can be used if they are in good condition and the overall reaches right down to the
top of the shoes. Sandals should not be worn.
4. HANDS
Hands must be protected particularly by those handling concentrated pesticides - baggers and mixers.
Gloves should be in good condition, waterproof and without holes. They should have a length 2-3” below the
elbow and should be worn outside the shirt sleeves so that any liquid does not wet the shirt.
They should be washed before removing. After removing soak in solution of washing soda for one hour. Then
wash them inside and out. Put on a peg, fingers uppermost to dry.
5. RESPIRATOR
1.
2.
Protection from inhalation of spray mist or dust is necessary if a highly toxic pesticide is being used, and desir
able if other pesticides are used. A clean cloth over mouth and nose can be used, so long as cloth does not be
come wet.
If highly toxic pesticides are used, a respirator containing a cartridge is necessary.
The respirator must be:
well fitting around the nose
worn whenever spraying or dusting
put down in a clean place when not in use or kept in a clean plastic bag
washed daily and hung up to dry
replaced if it becomes loose, worn or tom.
81
The cartridge must be changed daily or more often if breathing becomes difficult, particularly due to dust
The cartridge should be destroyed after use and are good only for intermittent exposure. With continued use the
absorbent layer becomes ineffective.
6. EYE PROTECTION - VISOR
Eye protection is needed for:
spraying high crops
mixing and bagging highly toxic pesticides.
A visor of clear plastic can be used, with a headframe or attached to hat.
Visors
may need to be wiped occasionally with a clean soft rag
should be put down carefully to avoid scratching
should be washed as often as possible
should be replaced when scratched or cracked.
7. WASHING PROTECTIVE EQUIPMENT
Washing of clothing and equipment daily is important.
Use clean water to wash and then more clean water to rinse.
Spread out or hang things to dry.
Dispose of washing water carefully as it contains pesticides.
82
D. Protection by technique
Educational objectives: (1) to define those factors in technique, according to the job, that provide protection and
minimize exposure, (2) to lay stress on the training functions of supervisors.
1. SPRAYMAN, AGRICULTURE
1.
2.
Protection from pesticides require good technique. Each man must be trained.
The sprayman should:
always hold the wand away from the body
always spray into the wind
always spray to one side
avoid walking through newly sprayed crop.
He should also be instructed to:
report leaking equipment
wash any drops of pesticide off the skin as soon as possible.
wash between pump charges if possible and always before eating, drinking or smoking.
2. SPRAYMAN, PUBLIC HEALTH
1.
2.
Protection from pesticides require good technique. Each man must be trained.
The sprayman should:
always hold the wand away from the body especially when spraying upper walls and eaves,
always stand to avoid spray drift from draught from doors and windows.
always spray slowly and systematically.
83
He should also be instructed to: report leaking equipment, wash off any drop of pesticide from the skin as soon as possible,
wash hands between pump charges if possible and always before eating, drinking or
smoking.
3. MIXER
The mixer should be trained to:
wear gloves
use a long paddle - never stir with his hands
stir slowly enough to avoid splash
pour carefully
not leave used containers lying around
Subsidiary points
Also he should be instructed to:
wash any drops of pesticide off the skin as soon as possible
i
<5
Always use measures, stirring roads
and gloves when mixing chemicals.
84
Never use hands for scooping
or stirring pesticides.
4. BAGGER
The bagger should be trained to:
wear gloves
weigh the pesticide carefully
put the pesticide in the bag gently to avoid dust
avoid touching the outside of the bag with gloves
put the bag on a clean surface for closure
keep the surrounding area clean.
He should also be instructed to:
wash any powder off the skin as soon as possible
always wash hands before eating, drinking or smoking
WWl'
Mixers who handle highly toxic chemicals must wear a visor
85
5. SUPERVISOR
The supervisor must set an example.
Whatever he is doing, he should always take all the precautions and use the proper technique.
He must:
train each new spray men
regularly check the techniques of all spraymen
regularly check the equipment so that faulty or leaking equipment is repaired,
always ensure a supply of clean water for washing.
The supervisor should always wash his own hands before eating, drinking or smoking.
6. PILOT
The pilot must avoid all contact with pesticide as far as possible. He should:
keep his boots clean by not walking in areas where pesticide has been split on the ground,
fly with ventilators closed while spraying.
avoid flying back through swathe, or over sprayed areas: turn into wind whenever possible.
Organophosphorus spray mist in the eye can cause double or blurred vision even though there may not be other
symptoms of poisoning. If this occurs the pilot must land immediately and not fly for at least that day. The eyes must be
washed with water.
86
JI
Pesticides should be carried in a separate locked container.
87
I
E. Protection of others
1. CARRIAGE BY TRUCK
1.
Those concerned in using pesticides must protect other people - the young, old and other people’s property,
especially chickens, ducks and other animals.
2.
Never carry pesticides in the same truck with food, especially food as flour, sugar etc. Many people have been killed
by eating food contaminated with pesticides in this way.
Any pesticide spillage in a truck should be cleaned up with a lots of water which is allowed to drain into a pit.
1)
2)
3)
4)
Open type truck should be used but ensure that goods are protected against rain.
Do not place packing under heavy loads of other items.
Do not use hooks in loading bags.
Clean vehicle after unloading.
Food
PESTICIDE
Never carry food stuffs and pesticides together.
88
I
2. CARRIAGE BY BOAT
Never carry pesticides with food in the same boat.
If pesticides are carried regularly in a small boat, always put them in the same place, and never put food in this place.
Otherwise scrub and wash the place where pesticides have been carried with plenty of water. If there are any signs
of spillage, ask a health worker how to decontaminate the area. Avoid contaminating small streams.
3. STORE
All pesticides are dangerous in large quantities and must be kept in a safe place, away from children and from anyone
else who might steal or misuse them.
All pesticide depots must have a good safe storehouse that can be closed off to prevent unwanted entry.
All pesticides must be stored in clearly labelled containers. Often the original container is the best.
Warehouses should be well-ventilated
89
4. LOCK ON STORE
All pesticide storehouses need a strong lock on the door.
The person who holds the key may often also be the person who keeps records of the pesticides that arrive and leave
the storehouse - (and making sure that older pesticides are used first).
Storehouse should be
1)
2)
3)
4)
5)
6)
7)
away from populated area
on well drained land
located away from domestic water supply.
made of non-combustible material
having impervious floor.
well ventilated
emergency exit must be available.
Stores should be locked securely.
90
5. PUBLIC HEALTH; GOODS OUTSIDE HUT
When spraying the inside of a house make sure that all food, cooking pots and bedding are brought outside.
When spraying eaves, make sure that spray does not drift on to household goods stacked outside the house, or on to
any food.
6. RE-ENTRY INTO SPRAYED AREAS
If the pesticide sprayed is of moderate or low toxicity, no one should enter the sprayed area before the spray has dried
on the crop.
If the pesticide sprayed is of high toxicity, it will be necessary for people to stay out of the crop much longer. The
time may be given on the label or the agent can be consulted. If any doubt allow two days at least
91
SECTION VID: ENVIRONMENTAL PROTECTION
Water
Many human disease vectors are controlled by spraying or treating the surface water with insecticides. Herbicides
are often applied to water in tropical areas to control aquatic weeds. In addition, water may be polluted by:
discharges of surplus pesticide, after spraying operations;
water used for washing spraying equipment being poured into rivers, ponds, or lakes.
crops to be sprayed being planted right up to the water's edge.
accidental spillage of pesticide formulations.
run-off, leakage and erosion from treated soil.
fall-out of pesticides from polluted air.
application of pesticides to rivers or ponds, to kill fish, which are then removed and eaten.
Any of these routes may lead to contamination of drinking water. Nevertheless, average exposure to pesticides from
drinking water is generally low, although serious incidents do occur occasionally.
WHO has recommended standards for drinking water for organic constituents, including pesticides.
FOOD RISKS FROM PESTICIDES MAY INCLUDE:
STORAGE IN FARMER’S KITCHENS AND SUBSEQUENT USE AS FOOD BY MISTAKE.
SPILLAGE IN STORES INTO FOOD WHICH IS SUBSEQUENTLY SOLD AND EATEN
MISTAKEN USE FROM WAREHOUSES (MARRIAGE PARTY IN U.P.)
USE ON FRUITS/VEGETABLES FOR APPEARANCE JUST BEFORE SENDING TO MARKET (BRINJAL)
92
ORGANIC CONSTITUENTS OF HEALTH SIGNIFICANCE
Remarks
Constituent
Unit
Guideline Value
aldrin and
dieldrin
ug/1
0.03
benzene
ug/1
103
benzol (a) pyrene
ug/1
o.or
carbon
tetrachloride
ug/1
3a
chlordane
ug/1
0.3
chlorobenzenes
ug/1
no health-related
guideline value set
odour threshold concentration
between 0.1 and 3 ug/1
chloroform
ug/1
30*
disinfection efficiency must not be
compromised when controlling
chloroform content
chlorophenols
ug/1
no health-related
guideline value set
odour threshold concentration
0.1 ug/1
2, 4-D
ug/1
100
DDT
ug/1
1
tentative guideline value5
93
Remarks
Constituent_____
1,2 dichloroethane
Unit
ug/l
Guideline Value
10a
1,1 -dichloroethened
ug/l
0.3a
heptachlor and
heptachlor epoxide
ug/l
0.1
hexachlorobenzene
ug/l
0.01’
gamma-HCH
(Lindane)
ug/l
3
methoxychlor
ug/l
30
pentachlorophenol
ug/I
10
tetrachloroethened
ug/l
10’
tentative guideline value6
tetrachloroethened
ug/l
30’
tentative guideline value6
2,4,6trichlorophenol
trihalomethanes
ug/l
10ac
odour threshold concentration
0.1 ug/l
see chloroform
a
no guideline
value set
These guideline values were computed from a conservative hypothetical mathematical model which cannot be experimentally verified and values should therefore
be interpreted differently. Uncertainties involved may amount to two orders of magnitude (i.e., from 0.1 to 10 times the number)
6 When the available carcinogenicity data did not support a guideline value but the compounds were judged to be of importance in drinking water and guidance
was considered essential a tentative guideline value was set on the basis of the available health released data.
c May be detectable by taste and odour at lower concentrations
dThese compounds were previously known as 1.1 -dichloroethylene tetrachloroethylene and trichloroethylene respectively.
94
1. DISPOSAL OF WASH WATER PIT
1.
It is important that the pesticide should be used where it is needed and that it should not contaminate the
surroundings elsewhere. This is particularly to protect children, birds and useful animals.
2.
The picture shows a hole
metre deep, but not so deep that it has filled with water.
In this hole are poured:
water in which hands have been washed
water in which pumps have been washed
water in which working clothes have been washed
water used to clean spills.
3.
The hole should be
more than 100 metres away from streams, wells or houses,
dry before anything is poured into it.
filled in as soon as most of the water has soaked away.
sAji - im
Wash water pit
F"
95
2. DISPOSAL OF WASH WATER - IN PUMP
If there is shortage of water, or it is not possible to dig a dry hole, washings can be stored to use the next day to make
up the pump charges, until it is all used up. It is important that the supervisor should make sure that the water is not misused
for drinking. He should mark the container and keep it closed and secure from use by any person who might not know what
it was. Treat it as if it were pesticide.
3. DISPOSAL OF CONTAINERS - BURYING
Used pesticide containers must be collected and disposed off safely. They always contain some concentrated
pesticide. The best way is to dig a pit, crush the containers and bury them. The pit should follow the same rules as the pits
for washing disposal, but will often need to be deeper. The top of the containers in the pit should be 1/2metre below ground
level.
I
What are the other rules for siting a pit?
The rules are:
The burial site should be such that leakage of buried pesticide should not contaminate surface water or pounds.
(1)
(2)
Water should be buried under minimum half a meter soil.
Pit should not be dug in an area of low water table and pit should be dry at the time of burying containers wear?
(3)
II
What clothing should the person burying containers wear?
Clothing for persons burying containers,
i) overall
ii) gloves
iii) boots
iv) cloth over mouth & nose
96
4. DISPOSAL OF CONTAINERS - BURNING
If containers cannot be buried, they should be burned.
Warning - the smoke may contain poisonous fumes
The rules are:
make fire in a shallow pit
keep at least 100 metres away from any well, river, or
house.
keep to the side where the smoke is blowing away from
the person tending the fire.
do not leave until all containers are burned.
cover pit.
>3
What clothing should a person burning containers wear?
The person should wear.
1.
An overall & fire resistant clpthing. Nylon and other synthetic
fabrics are prohibited to avoid fire hazard.
2.
Loose clothing should also be avoided to prevent fire hazard.
3.
Face should be covered over mouth and nose with clean cloth
or a respirator
4.
Boots and gloves are also essential.
97
5. DISPOSAL OF RESIDUES AND UNWANTED CONCENTRATE
1.
The disposal of large quantities of unused pesticide is more difficult, (large quantities include unopened containers).
It should never:
be put in any river, lake or sea.
given away to anybody else for any use what so ever.
used for any other use than those mentioned on the label or for which it has been purchased without the
permission of the purchaser.
2.
Possible solutions
deep burying
Observe rules for burying containers
incineration in factory boilers provided chimney is high, away from built up area, and good wind is blowing.
For burning pesticides a temperature of 1000°C or more is recommended.
storage in caves which are then sealed off.
If in doubt, discuss with public health authorities.
98
DECONTAMINATION OF DRUMS
1.
Drums may be decontaminated under some circumstances.
This can only be done with certain pesticides - especially organophosphorus compounds. 5% sodium hydroxide
solution and a lot of water is required.
2.
The rules are:
- Establish a control depot for decontamination
- make sure washings can be disposed of safely
- make sure all men wear protection - overall, apron, boots, gloves.
- obliterate pesticide labels.
- mark drums clearly 'not to be used for food or drink'.
For full details, consult manufacturers of pesticide.
99
APPENDIX
INCIDENTS OF HUMAN POISONING
ENDRIN
1.
An operator spraying endrin in the village of Bitkuli,
district Bilaspur, Madhya Pradesh, was taken ill and
removed to hospital. He recovered after treatment.
Incident occurred in September, 1964. Recorded by
Plant Protection Officer.
2.
About 100 people were taken ill and one died in
Bombay after eating rice that had been contaminated
withendrin. Incident occurred in 1964. Recorded by
Officer of the Directorate General of Health Services.
3.
100
A man was transferring endrin 20 per cent emulsifi
able concentrate from a 23 litre drum to a five litre
container by siphon, he swallowed some endrin by
accident and died after 2-3 hours. Incident occurred in
the village of Sedesinghwala, Punjab. No date given.
Recorded by the Plant Protection Officer, Pathankot.
4.
A boy died after spraying endrin continuously for 23 days. He did not remove or wash his clothes which
were soaked in the spray, or take any precautions
against skin contact or inhalation of spray. Incident
occurred in the village of Thara, Punjab. No date
given. Recorded by the Plant Protection Officer,
Pathankot.
5.
About ten People died after spraying endrin for plant
protection. Incident occurred in Ludhiana in 19.04.65.
Recorded by Office of the Directorate General of
Health Services.
6.
A farmer carried on his head a leaky 18 litre tin of
ready-to-use endrin emulsion. He was drenched with
the insecticide and died. He also smoked without
cleaning his hands. The incident occurred in the
village of Harika Kalan-Muktasar, Punjab. No date
given. Recorded by Burmah Shell.
7.
Three farmers and a woman died and several others
became unconscious in some villages of Kotkapura in
the Punjab during spraying operations with endrin on
cotton. Recorded from "Eleftheria" August, 1964.
3.
Between 15th April and Sth May 1958, at least 104
persons died eating food contaminated with parathion
in Kerala State. Contamination occurred from leak
ing containers during transport. This was the subject
of a judicial inquiry, and the findings were published
by the Ministry of Health in 1958.
4.
Three cultivators using a dust containing parathion on
their cotton crop developed symptoms of poisoning.
They received medical treatment and recovered. The
incident occurred at the village of Barwaha, Khargaon
district, Madhya Pradesh during September, 1964.
Recorded by the Plant Protection Officer.
5.
A man spraying against jute pests with parathion
fainted but recovered after medical treatment. He was
said to have chewed pan just before he fainted. The
incident occurred in Chhattia Gram Panchayat in the
Cuttack District of Orissa in 1959. Recorded by the
Deputy Director of Agriculture.
6.
From the Punjab, a few isolated casualities of workers
who used parathion emulsion for spraying cotton and
other crops, said not to have taken proper precautions
during the handling of the pesticide, are reported. No
PARATHION
1.
2.
Some cases of poisoning of spray operators of State
Agriculture Department said to be due to their not
observing the recommended precautions. These were
said to be relating to the use of gas masks, overalls and
gumboots. None were fatal, atropine and oxygen
were used in hospitals. The men were also said to have
eaten food without washing their hands. Incidents
occurred at Patna City Gaya Hazaribagh and Muzaffarpurin the State of Bihar. No dates given. Recorded
by Plant Protection Officer.
A few non-fatal cases of poisoning, when spraying
agricultural crops, were reported in Kerala State in
1963 and 1964. There were two fatal cases. One man
died in the field while spraying parathion on paddy in
the village of Vaikam. A boy aged 19 who was
engaged in spraying parathion in a tea estate felt
giddy, went home, ate his meals, vomited and died.
Recorded by the Plant Protection Officer.
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specific places, nor dates given. Not stated whether
casualities fatal. Recorded by the Locust Control and
Plant Protection Officer, Chandigarh.
7.
A labourer died while spraying parathion in the vil
lage of Sadhasinghwala in Faridkot, Punjab. No date
given. Recorded by Burmah Shell.
8.
An operator spraying parathion for an unspecified
purpose was taken ill and died shortly after admission
to hospital. The incident occurred at Bilaspur town,
MadhyaPradeshinMay, 1965. Recorded by the Plant
Protection Officer, Bilaspur.
9.
Several cases of poisoning that occurred while spray
ing cotton were admitted to hospital. Atropine injec
tions were given, one died, the others recovered. The
incident occurred in the Punjab. No places and no
dates given. Recorded by Burmah Shell.
102
DDT
1.
Two men died after eating chutney, in which, it was
stated, they had put DDT powder instead of salt by
mistake. The incident occurred at Chugran near
Jullunder in 1965, 13th June. Recorded by the Hin
dustan Times of Tuesday, 15th June, 1965.
2.
When used in malaria control operations, oil solutions
or emulsions occasionally caused dermatitis on work
ers. No dermatitis occurred with water wettable sus
pensions. Recorded from Madhya Pradesh, 1964.
Recorded from the Office of the Directorate of Health
Services, Madhya Pradesh.
BHC
1.
Reported instances of giddiness, vomiting and derma
titis in public health spraying crews using BHC in
Madhya Pradesh 1964. Recorded from the Office of
the Directorate of Health Services, Madhya Pradesh.
2.
Cases of food poisoning were reported in Bombay as
a result of eating rice stored in bags which were
reported to have been treated with 5 per cent BHC.
The incident occurred in January 1963. Reported
from the Office of the Directorate General of Health
Services, Delhi, 1965.
DIELDRIN
Reported that some of the men in the public health
1. spray crews using dieldrin and convulsions and be
ORGANO-MERCURIALS
1. Two people had greatly swollen hands and severe der
matitis after treating seed with organomercurials with
their bare hands. Incident occurred in Assam. No date
given. Recorded by the Plant Protection Officer.
COPPER SULPHATE
1.
came unconscious. Irritation to the eyes and mucous
membranes was common and troublesome. There
was some dermatitis. Recorded from the Office of the
Directorate of health Services, Madhya Pradesh, 1964.
PHOSPHAMIDON
1.
A farm worker died of phosphamidon poisoning, it
was reported that the spraying machine failed and he
started swabbing the crop with a piece of cloth which
he drenched in phosphamidon spray liquid. The
incident occurred at the village of Jangirana near
Giddenbaba. No date recorded. Recorded by Burmah
Shell.
176 people retched and vomited after a feast. All
meals were served on plantain leaves contamined with
an insecticide used for spraying coconut trees . Cop
per sulphate was detected on the leaves and in the
stomach wash. Copper sulphate is an ingredient in the
insecticide mixture used for coconut spraying. The
incident occurred in Pampady, Kerala, on 25th Febru
ary, 1963. Reported from the Office of the Agricul
ture and Rural Development Department
INCIDENTS OF TOXICITY TO DOMESTIC
ANIMALS
ENDRIN
1.
Two bullocks died in Motihari district following
103
consumption of sugarcane leaves that had been sprayed
with endrin. The leaves were fed to the cattle despite
the instruction that they should not be fed for 1.1/2
months after treatment. The incident occurred a few
years back. No place or date given. Recorded by the
Plant Protection Officer, Bihar, in 1965.
District of Maharashtra State in January, 1962. Re
corded by the Plant Protection Officer, Amravati,
1965.
7.
Large scale poisoning in farmer’s animals has been re
ported in Faridkot due to endrin spray on cotton fields.
The affected cases remained unconscious for a num
ber of days and those that recovered looked pale and
weak. It is reported that it takes weeks to regain the
original vitality. No places, no dates. Recorded from
the Directorate of Veterinary Services, Madhya Pradesh,
1965.
8.
A sick cow died after application of endrin 20 percent
to its wound. The application was intended as medi
cine to cure the wound. The application was intended
as medicine to cure the wound. The incident occurred
in the village of Mohtarai, Madhya Pradesh. No date
given. Recorded by the Plant Protection Officer,
Madhya Pradesh.
2. A buffalo and a cow died after drinking water from a
paddy field treated with endrin. The cause of death
was not proven since no post-mortem was done. The
incident occurred at Gatori, Madhya Pradesh, in August,
1964. Recorded by the Plant Protection Officer,
Madhya Pradesh, 1965.
3. Straw paddy that had been sprayed with endrin against
Gall fly was fed to cattle. The cattle became sick and
one male and one female buffaloes died. A large stock
of straw fodder was not used on account of this
occurrence. The incident occurred at Sakoli village,
Maharashtra State in June, 1964. Recorded by the
Chief Officer, Package Programme, Bhandhara,
Maharashtra, 1965.
4. One bullock was poisoned and died after drinking 0.02
per cent endrin spray mixture that was being used for
citrus psylla control in Katol village in the Nagpur
104
DIELDRIN
1.
A few instances occurred of poisoning of cattle and
domestic birds due to contamination of fodder when
spraying dielderin in houses. Noplaces, no dates. Re
corded by the Office of the Labour and Municipal
2.
Administration Department, Mysore.
General
Several instances of high mortality of poultry due to
the use of dieldrin have been noticed. No places, no
dates. Recorded from the Office of the Directorate of
Health Services, Madhya Pradesh.
1.
Cattle fed straw contaminated due to spraying with
DDT showed twitching of the muscles, convulsions,
etc. DDT was detected in the straw. No places, no
dates. Recorded form the Office of the Agriculture
and Rural Development Department, Kerala, 1965.
Two bullocks died after they were sprayed by a farm
manager in Rajasthan with parathion or similar pesti
cide to prevent nuisance of flies. The Director of
Agriculture, Rajasthan, issued a circular stating that
no such measure should be taken without knowing the
full composition of the pesticide to be used. No place,
no date given. Recorded by Agricultural Extenstion
Officer in 1963.
2.
DDT causes great mortality in cats with all the formu
lations used for public health work. It is also reported
to cause the death of young chicks when used for this
purpose. BHC produced similar effects. Recorded
from the Office of the Directorate of Health Services,
Madhya Pradesh.
Some cases of poisoning due to pesticides are noticed
when animals graze immediately after the pesticides
are used on the plants. No details, no dates. Recorded
by the Sub-divisional Animal Husbandry Officer,
Biharshariff, Patna, Bihar, 1964.
3.
Some case of non-fatal poisoning of cattle by pesti
cides other than those already recorded under endrin
are reported. They were saved after veterinary treat
ment. No details, or dates given. Recorded by the
Plant Protection Officer, Bihar, 1965.
DDT and BHC
1.
2.
3.
DDT has shown toxic effects on dogs and poultry.
Recorded from the Office of the Directorate of
Veterinary Services, Madhya Pardesh.
105
4.
5.
6.
Statement that poisoning by parathion and other allied
pesticides is increasing. When only a few animals are
killed it goes unnoticed and only when a large number
of animals dies, it is brought to the attention of the
officials. Recorded from the Veterinary Disease
Investigation Officer, Ranipet, Madras, 1964.
Statement that the recorder had investigated one in
stance of heavy mortality of sheep which was sus
pected to be due to grazing on fields contaminated
with parathion and another where the sheep had been
dosed with a vermicide suspected of being contami
nated with "Fytolon" copper oxychloride. In both
instances the animals had acute diarrhoea followed by
death. No places or dates are given. Recorded by the
Veterinary Disease Investigation Officer, (Sheep and
Goats) Madras, 1965.
(a) Fish, frogs and earthworms both in the fields and
in the neighbouring ponds and wells are dying due to
the use of pesticides like endrin, "Basudin”, parathion
BHC and DDT and diazinon.
106
(b) Mortality of human beings, animals and poultry
are noticed due to the intake of poisonous chemicals
like parathion compounds. Recorded by the Director
of Agriculture, Pondicherry.
7.
In most of the records where fish were recorded as
killed, the records also stated that frogs and snakes
were killed. These records are nearly all due to
mortality endrin and parathion.
8.
A cock died in a village in Delhi in 1959 after eating
the dead rat poisoned by zinc phosphide. Recorded by
the Plant Protection Specialist. Ministry of Food and
Agriculture Delhi.
9.
A dog died after eating a few dead rats poisoned by
zinc phosphide in a Delhi village in 1964. Recorded
by the Plant Protection Specialist, Ministry of Food
and Agriculture, Delhi.
INCIDENTS OF TOXICITY TO FISH
The fisheries development adviser states that:
"It has to be noted that since no particular attention has
been paid in India to study this aspect, the examples
cited are only a few of the total occurrences in the
country, there being no arrangements to collect the
factual data."
3.
In Jammu and Kashmir, large scale fish mortality
was observed in the ponds at Reasi and the Nehru
Stream, where DDT was used in the city drains.
4.
The Yamai tank at Islampur and one tank at
Ramtek situated in Sangli and Nagpur districts
respectively ih the Maharashtra State and heavy
mortality of fish on account of empty DDT con
tainers having been cleaned in the tank water.
5.
Mortality was observed in an acre tank in village
Kachlone, District Raipur where empty contain
ers of DDT had been washed.
(a) Incidents Recorded by the Fisheries Development
Adviser.
1.
2.
The discharge from the Hindustan Insecticides Fac
tory manufacturing DDT at Delhi has been suspected
to have caused mass scale destruction of fish in Jumna
river and the problem was referred to the Central
Public Health Engineering Institute.
In 1962, fish mortality was observed in two tanks (2
acres perennial at Kalapet and 1.1/2 acres perennial at
Lawspet). DDT and endrin had been spread in the
adjoining fields from which the drainage entered the
fish ponds. Another example in Pondicherry is of
mortality of fish due to spraying of DDT and endrin in
the nearby fields in the Pallivasal Kulam tank (one
acre perennial) and Ayyankulam tank (1.1/2 acres
perennial at Karaikal).
In Lakhan Talav (3 to 4 acres water spread)
mortality occurred on 2nd September, 1964. Investiga
tions showed that endrin was sprayed in the fields in the
catchment area two days earlier and rains occurred
immediately after spraying.
6.
At Gwalior, mortality of fish seed was ob
served on 7th September, 1963 in a nursery tank
resulting in death of 12,000 fingerlings 3 to 4 inch
long due to washing of empty DDT containers.
107
7.
8.
9.
IQ
adjoining fields. The affected fish included Rohu,
Catla and Mrigal.
Fingerlings were also killed in the Nalcha tank in the
Dhar District due to spraying of pesticides on
Singhara crop (Trapa crop) which was also cultivated
in the same tank.
In the Palace tank at Bangalore, fish mortality was
reported immediately after a rainy day and was due to
spraying of insecticides and pesticides in the garden in
the upper reaches of the pond. A similar incident
occurred in a pond near Chickballapur due to rains
carrying folidol from the garden above. Similar
incidents have been reported from Kalahandi, Korput
and the Ganjam Districts in Orissa.
In the Kuttanad area in Kerala, the Agriculturists are
using various chemicals, such as endrin, folidol and
DDt and considerable fall in the fishery wealth has
been noticed in the Vembanad Lake and the canals
lying between the paddy fields.
Large scale mortalitites of pond fish were noticed in
1961 in the premises of the Jute Agricultural Research
Institute, Barrackpore, due to the contamination of
pond water by folidol and endrin, which had been
washed into the ponds by rain water from the
108
(b)Records from other sources
ENDRIN
1.
Following aerial spraying of endrin at 2 oz. active
ingredient per acre on paddy fields near Bantumalli,
Krishna District, Andhra Pradesh in 1964, fish, crab
and snakes in small ponds and canals were found dead,
a few cranes and crows also died after eating the dead
fish. These effects are attributed to spray drift falling
on the water. Recorded by Plant Protection Officer,
Hyderabad.
2.
Following aerial spraying with endrin and aldrin fish
were found tanks near the crop field. This was
attributed to gusts of winds carrying the spray and
contaminating the tanks. The incidents occurred in tai
areas of Mokameh and Burhiya, Bihar. No date given.
Recorded by Plant Protection Officer, Patna, Bihar,
1965.
3.
Following aerial spraying of cotton with 0.02 percent
endrin, fish were killed in the stream due to spray
drift contaminating the water. The incident occurred
near Mahispur in the Amravati District in October,
1963.
4.
Heavy rain on paddy fields sprayed with endrin caused
flooding and overflow into village tanks where the fish
were killed. The incidents occurred in the villages of
Pandarwa, Gatori and Rahod, Madhya Pradesh in
August, 1964. Recorded by the Plant Protection
Officer, Madhya Pradesh.
5. During aerial spraying with endrin against sugarcane
borer a large amount of the spray material was carried
• by wind and dropped over a tank. As a result the fish
in the tank died. The incident occurred at Plassey,
. West Bengal. No date given. Recorded by the State
Entomologist, West Bengal, 1965.
6.
Recorded by the Office of the Directorate of Health
Services, Madhya Pradesh, 1964.
PARATHION
Fishes of all kinds died in fish farms after application
of parathion and insecticides of M/S Sen, Dutta and
Chapakhira, Nadia and Howrah Districts, West Ben
gal.
General
1. Some cases of fish mortality have been reported from
small step wells due to washing in them of sprayers
and other utensils used for spraying pesticides in the
wells.
2.
Poisoning of fish is common in the backwaters of the
sprayed fields are let in. Whenever a large scale
spraying campaign is organised, instructions are given
to cultivators to drain away the water before spraying
campaign is organised, and not to allow the water
from sprayed fields into common canals. Which has
been contaminated by endrin spraying or by washing
drums and sprayers used in endrin spraying. Re
corded by Plant Protection Officer, Kerala, 1965.
3.
Where pesticides like endrin and parathion are sprayed,
fish seed and fish die in large numbers in paddy fields
especially during aerial operations. In this state
After endrin was used to control rice Hispa the re
corder noticed dying of fish eight hours after spraying.
The incident occurred in Jankia Gram Panchayat in the
Puri District of Orissa in 1962. Recorded by the
Deputy Director of Agriculture, Orissa, 1965.
DDT
A few reports of fish dying when spray equipment
used by public health spray teams were inadvertently
washed in tanks containing fish. No dates given.
109
4.
(Andhra Pradesh) paddy plots are good nurseries for
multiplying fish seed and a large quantity of seed for
cultivable species are collected from the irrigation
channels every year by the fisheries department for
stocking in various water sources. In view of the
deleterious effects of endrin and similar pesticides on
fish life, the Agriculture Department makes a special
efforts to catch fingerlings. Record from the Director
of Agriculture, Andhra Pradesh, 1965.
2.
Poisoning of bees was occasionally noted when their
pasturage had been sprayed to control harmful insects.
Recorded by the Office of the Directorate of Health
Services, Madhya Pradesh, 1964.
3.
Silkworms were found to be very susceptible to DDT
during its spraying for public health purposes. Re
corded by the Office of the Directorate of Health
Services, Madhya Pradesh, 1964.
Some reports have been received of mischief makers
killing fish in ponds with endrin emulsifiable concen
trate which they poured into ponds. Recorded by the
Plant Protection Officer, Bihar, 1965.
4.
In the tea and cardamom estates adjoining reserved
forests, cases of deaths of Sambar and wild elephants
were reported in Nilgiris and Madurai (Madras). The
deaths were suspected to be due to the use of weedicides. Recorded by the Chief Conservator of Forests,
Madras, 1964.
5.
Reported that on the border of Kerala and Madras
where wild elephants were a serious menace to the
farmers crops the local farmers sprayed the banana
trees in the locality with parathion emulsion. About
forty elephants are reported to have died after eating
the bananas. Recorded from the Directorate General
of Health Services, New Delhi, 1965.
INCIDENTS OF TOXICITY TO BENEFI
CIAL INSECTS AND WILDLIFE
1.
110
Considerable mortality to bees in artificial beehives
occurred at Kumta. Parathion was being sprayed on
the summer groundnut crop in the area and was
suspected being the cause of death. The recorder
thought this was likely. Recorded by the Plant Protec
tion Officer, Dharwar, Mysore, 1965.
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