PESTICIDE USAGE

AND

ASSOCIATED HEALTH HAZARDS

IN

MAURITIUS

Descriptive Report

DR. I. LANIECE

MAURITIUS INSTITUTE OF HEALTH UNIVERSITE DE BORDEAUX 11

ACKNOWLEDGMENTS

We are grateful to Dr R. Sibartie, President of the Pesticides Control Board and Head of the Occupational Health Unit of the Ministry of Health, who shared generously his knowledge and experience. The support of his team, coming specially from Dr S.Sivapragasam, Mr H.Bhugwandass and Mr A.Raheem was greatly appreciated during the data collection process and the field investigations.

Special thanks are extended to Mr Brissonnette and Mrs Roussety, from the Medical Statistical Section of the Ministry of Health. Numerous experts from the University of Mauritius, the Ministry of Agriculture and the Mauritius Sugar Industry Research Institute have also contributed to provide helpful information for the development of this study.

We are indebted to Pr R.Salamon, Dr C.Laniece and Dr J.C.Mohith for their constructive comments on the early drafts. Finally, we would like to thank the personnel of the Mauritius Institute of Health for their input in the secretarial and editorial work.

EXECUTIVE SUMMARY

This descriptive study conducted in collaboration with tbe Occupational Health Unit of the Ministry ofHealtb and tbe Research Unit oftbe Mauritius Institute of Health had as objective to provide an insight in the pesticides related healtb problems among the Mauritian population.

This situation analysis shows that contact opportunities witb tbese chemicals are numerous in .' Mauritius due to tbree main factors:

- first, tbe quantity of circulating products is high because of their intensive use in tbe agricultural sector. Mauritius was ranked second only after Japan, witb regard to intensity of pesticides usage at the beginning of the nineties. All tbcsc chemicals are imported; tbey represent roughly 130 different compounds, among which 61% are herbicides. Besides tbe large quantities used, hazardous pesticides use practices have been observed, specially in the small vegetable growers conununity, such as frequent excessive pesticides dosages, inappropriate cocktails, untimely sprayings, no respect of safety intervals and poor observance of protective measures.

- secondly, there is an easy access to pesticides, due to a large distribution network, partially controlled. Around !50 private selling points need an annual official retail license, while substances, sometimes very potent ones, are illegally available on rural as well as urban markets.

- finally, the demand of pesticides is high in the general public as, besides workers manipulating tbese compounds in their main occupation, numerous people have an agricultural activity as a part time job, based on a large use of agrochemicals. Moreover, pest control in and around buildings, conducted most often by inhabitants and sometimes by specialists, has made pesticides present in most households.

In tbis context of high penetration of tbe pesticides in tbe Mauritian society, tberc arc two worrying situations: tbe presumed high exposure occurring in tbe occupational environment, leading to mostly unknown, underestimated deleterious effects and tbe frequent serious acute pesticide poisonings observed among adolescents and young adults.

Roughly 19,000 people are considered as occupationally exposed to pesticides, among whom 18,000 in tbe agricultural sector. The most exposed, due to tbeir hazardous pesticides use practices, are tbe 5 to 6,000 small vegetable growers. Scarce data are currently available on their healtb status: 1983 and 1988 cross-sectional surveys among samples of 200 small planters reported tbat at least 20% of tbem complained from mild signs of pesticides poisonings. The blood levels of acetylcholinesterase (ACE) determined annually in a fraction of workers (not randomly chosen, likely to be tbe less exposed and to receive tbe best medical follow-up) showed that nowadays, I% of tbe screened workers have a blood ACE inhibition exceeding 25%. In healtb statistics, occupational poisonings are not distinguished from other circumstances of exposure. The true magnitude of health side effects following occupational

' ·-··o... exposure to pesticides is then underestimated and largely unknown. Accidental and intentional poisonings by pesticides are notified when they have led to an

hospitalisation in tbe public sector. These severe cases represent around 300 admissions annually and rank as third in tbe causes of poisonings. From 1981 to 1994, tbe highest incidence rates were found among tbe 15 to 19 years old (61/105/year) and tbe 20 to 44 years old (45/105/year). Males are m9re at risk tban females, except among tbe teenagers. Intentional ingestion is said to be the main cause of poisonings. Organophosphatcs are mainly responsible for the cases of suicides attempts, while paraquat is tbe substance involved tbe most frequently in fatal issues. As far as mortality is concerned, t11e prognosis of pesticides poisonings is severe, with an average fatality rate at 12%, tbat is 5 times higher tban tbe one for tbe otl1er causes of poisonings. Implicated in 14% of incident cases of poisonings, pesticides are responsible for 70% of tbe letbal cases. From 1981 to 1994, tbe age-specific mortality rates by pesticides poisonings have been tbe highest among tbe teenagers (3 .3/105/an) and the 20 to 44 years old (4.8/105/an). The mortality burden, 4% of the deaths among teenagers, has been as heavy as tbe one related to infectious and parasitic diseases in this age group.

RESUME

Cette etude descriptive conduite en collaboration avec la division de Medecine du Travail du Ministere de la Sante Mauricien et !'unite de recherche de l'Institut de Sante avait pour objectif d'apprehender l'ampleur des problemes de sante lies a !'exposition aux pesticides. Ce travail, realise a la requete du gouvetncment mauricien, a ete finance par la Cooperation Fran9aise .

. Les opportunites de contact avec les pesticides sont nombreuses a Maurice du fait de trois facteurs essentiels. Tout d'abord, la quantite de produits circulants, tons importes, est importante du fait d'un usage intensif dans le secteur agricole; Maurice se pla<;ait ainsi au deuxieme rang mondial derriere le Japon en 1991, au regard des qu~tites de matiere active utilisee a !'hectare. Deuxiemement, l'acces a ces substances est facile, du fait d'un large rcseau distribution, partiellemcnt controle, offrant une vaste gamme de produits dont certains extremement toxiques. Enfin, il existe une forte demande de pesticides dans !'ensemble de la population, car, outre les travailleurs les manipulant au titre de leur activire principale, de nombreuses personnes pratiquent une activite agricole a temps partiel, s'appuyant sur un large usage de produits; de plus, la lutte contre les multiples nuisances dans les habitations et les jardins a fait penetre les substances a usage domestique dans la plupart des foyers.

Dans ce contexte de forte penetration et banalisation des pesticides dans la societe mauricienne, deux situations sont preoccupantes: la forte exposition presumee se produisant en milieu professionnel dont lcs consequences sur la saute des travaillcurs sont mal connues ainsi que la frcquence et gravite des intoxications severes chez les adolescents et adultes jeunes.

Environ 19,000 personnes sont considerees comme potentiellement professionnellement exposees, dont 18,000 dans le secteur agricole. Les plus exposes, du fait de pratiques d'application dangereuses, sont les 5 a 6,000 petits planteurs de cultures vivrieres. Des donnees tres limitees sont actuellement disponibles sur l'etat de sante des travailleurs exposes: au cours d'enquetes transversales conduites en 1983 et 1988 parrni des echantillons de 200 petits planteurs, au moins 20% d'entre eux se plaignaient de signes d'intoxieation moderee; le dosage sanguin d'aeetylcholinesterase realise chaque annee parmi une fraction de travailleurs (les travailleurs les mieux suivis medicalement et probablement les moins exposes) rapporte que l% des depistes presentent un taux d'inhibition superieur a 25%.

Les intoxications accidentelles ou intentionnelles par les pesticides sont notitlees lorsqu'elles ont donne lieu a une hospitalisation dans le secteur public. Ces formes severes representent environ 300 cas par an et occupent le troisieme rang dans les causes d'empoisonnements. De !981 a 1994, les taux d'incidence les plus eleves ont ete rencontres chez les 15-19 ans (61/105/an) et les 20 a 44 ans (45/105/an). Le sexe masculin est plus a risque, sauf chez les adolescents. L'origine intentionnelle serait la plus souvent en cause. Les organophosphores seraient les produits le plus souvent impliques, le paraquat etant le grand responsable des formes mortelles. En termes de mortalite, le pronostic des empoisonnements par pesticides est sombre, avec un taux moyen de letalite de 12%, soit 5 fois plus

: eleve que pour les autres causes d'empoisonnements. Impliques dans 14% des cas d'empoisonnements, · 1es pesticides sont responsablcs de 70% des deces par empoisonnements. De 1981 a 1994, les taux de mortalite specifiques par intoxications par les pesticides ont ete les plus forts chez les adolescents (3.3/105/an) et les 20 a 44 ans (4.8/105/an). La part de mortalite, 4% des deces chez lcs adolescents, a ete equivalente a celle des maladies infectieuses et parasitaires dans cette tranche d'age.

TABLE OF CONTENT

INTRODUCTION Pages

11 PESTICIDES FLOW IN MAURITIUS

I/ A. PRODUCTION AND IMPORTATION

11 B. PESTICIDES DISTRIBUTION

I/ C. EXPORTATION

Ill PESTICIDES USAGE

Ill A. PESTICIDES USE IN AGRICULTURE

III A. I Sugar cane production

Ill A.2 Food crop production

Ill B. PEST CONTROL IN AND AROUND BUILDINGS

Ill C. USE OF PESTICIDES IN PUBLIC HEALTH

Ill D. SOME OTHER USES OF PESTICIDES

Ill/ INSTITUTIONAL ASPECTS OF PESTICIDES MANAGEMENT·. IN MAURITIUS AND CONTROL PROCEDURES ON PESTICIDES FLOW AND USE

Ill/ A. MINISTRY OF HEALTH

Ill/ B. MINISTRY OF LABOUR AND INDUSTRIAL RELATIONS

Ill/ C. MINISTRY OF AGRICULTURE AND NATURAL RESOURCES

Ill/ D. MINISTRY OF ENVIRONMENT AND QUALITY OF LIFE

IIII E. RESEARCH INSTITUTIONS

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7"

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IV/PESTICIDES AND HEALTH IN MAURITIUS

IV/ A. UNINTENTIONAL POISONINGS

IV I A.l Occupational exposure

IV/ A.2 Accidental non occupational exposure

IV/ B. INTENTIONAL POISONINGS

IV/ C. DESCRIPTION OF THE CASES OF PESTICIDE POISONINGS HOSPITALIZED

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16

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19

20

IN THE MAURITIAN PUBLIC HOSPITALS FROM 1981 TO 1994 21

IV/ C. I Morbidity data 21

IV/ C.2 Mortality data 23

CONCLUSION 28

BffiLIOGRAPHY 30

ANNEX

INTRODUCTION

Pesticides have been used for a long time in Mauritius. As far as insecticides are concerned, inorganic and botanical insecticides have been introduced in 1932 for the control of important sugarcane pests of the day. Organochlorines including DDT have won the Mauritian market durinl< the tlfties, \Yh.ile the use of' organopbosphates, carbamates and synthetic pyrethroids have steadily increased since 1960.

At the beginning of the nineties, Mauritius was ranked second only after Japan with regard to intensity of pesticides usage. The large use of and access to these chemicals toxic to living organisms have repercussions on human health among agricultural workers and in the general public. The frequency of severe pesticides poisonings is alarming in young adult population while the magnitude of the harmful effects is for a large part underestimated and unknown among the occupationally exposed people.

If PESTICIDES FLOW IN MAURITIUS

If A. PRODUCTION AND IMPORTATION

Some 130 different pesticide compounds have been on sale in 1994 in Mauritius, under roughly 210 trade names. No pesticide is produced locally; 1,507 tons of pesticides have been imported in 1994, in formulated concentrates for most of them (1). The quantities used are not available and have to be estimated from the importation statistics. Diagram 1 shows the pesticides imports over the last eighteen years, according to their main targets (herbicides, insecticides, fungicides and other compounds including rodenticides, nematicides, molluscicides, plant growth regulators, wood preservatives ... ).

4

Compared to some other Asian developing countries (Korea, Nepal, Pakistan, Philippines, Thailand) where insecticides are the largest class used (2), in Mauritius, herbicides and fungicides are predominant.

With regard to the importation patterns in terms of each chemical group during the years 1990 to 1994, data from the Pesticide Control Board report the following trends ( cf detailed data in annex 1):

- for herbicides: phenoxy acids, substituted ureas, triazines, anilides, amine acids and bipyridils are the main chemical families in use; organo-halogenated acids are gradually replaced by other compounds, such as pico!inic derivatives, amides and others.

- for insecticides: organophosphates and carbamates, while in decreasing quantities, are the main used insecticides. Pyrethroids are in increasing use, while organochlorates are progressively abandoned. Biological control, by bacillus thurigiensis, has been introduced.

- for fungicides: dithiocarbamates, inorganic compounds ( sulfur and copper derivatives) and carbamates are the main chemicals involved in fungi control. Phtallic derivatives encounter an increasing success.

- among other pesticides: as nematicides, potent dithiocarbamates and carbamates are available; coumarins and indanediones are in use to fight rodents ; some carbamates constitute the molluscicides. Ethylene generators and auxines are increasingly sought as plant growth generators. An arsenical compound is still in use, in restricted conditions, as wood preservative.

Apart from these data, there are insecticides used in public health: specially DDT and temephos used in malaria control.

As formulation type, most of the substances are in the forms of emulsifiable concentrates and wettable powders for field sprayings.

If B. PESTICIDES DISTRIBUTION

Among around 30 firms importing pesticides in Mauritius, 6 ones control large volumes: Ireland Blyth L TD, Roger Faidherbe and Co, Matikola, Robert Le Maire Co Ltd, Coroi Maurice Ltee, Hardy Henry Ltd.

Four of the main importation firms make packing in small units, before the distribution of the products; only Roger Faidherbe and Co does formulation, for only three herbicides (hexazinon, atrazine and diuron). In total, the official activity of packing may concern some 40 persons and the one of formulation, 4 people.

5

There is no public or private pesticides testing laboratory to assay the quality of imported or repackaged/formulated pesticides.

The distribution occurs through the following network:

- direct sale of large quantities to the 18 sugar estates which farm about 45% of the cultivated land in the island of Mauritius;

- some 150 private selling points located all-over the island, have an official agreement for retailing sales from the Pesticide Control Board, but are not allowed to repack the chemicals;

- sales through the 7-8 governmental farm centers; - illegal sale of repacked substances, even of banned or restricted compounds

on rural and urban markets.

Substances handling in this distribution chain may concern around 500 people.

I! C. EXPORTATION

There is neither production or exportation of pesticides in Mauritius.

8

plantations, pesticides application is generally done manually by use of a knapsack, most often by the planter himself, rather than by a specialised team. Large volumes of 600 to 1,000 Vhectare are usually sprayed. No medical follow-up is institutionalised.

Ill A.2. Food crop production

72,070 tons of food crops have been produced in I 992, fated mainly to domestic consumption and covering on average 70% of the domestic needs (with fluctuations in the coverage according to the specific foodcrop: from 0% for pulses to 100% for tomatoes). Despite a growing production, Mauritian imports of fruits and vegetables are increasing while exports are decreasing, corresponding to an inflating demand in the domestic market (3).

Main food crops production in 1992 (3): - I 9,175 tons: potatoes - I 0,220 tons: tomatoes - 8,530 tons: bananas - between 2,000 and 3,500 tons: pumpkins, cabbage, omon, cucumber, calabash, pineapple, - between I, 000 and 2, 000 tons: maize, chouchou, carrot, brinjal, groundnut, cauliflower, petsai, beans, -between 500 and 1,000 tons: chilies, lettuce, patole, pipengaille, squash, - less than 500 tons: beet, bittergourd, taro, garlic, ginger, green peas, leek, ladies finger, manioc, rice, sweet pepper, sweet potato, voehm.

Food crops production is disseminated all over the island, but is specially intensive in the districts of Savanne, Plaine Wilhems and Moka. Inter -rows plantations with su!Sar cane is developing, specially for potatoes, maize, groundnut, beans, tomatoes.

The size of the farmings is variable: "small" land holdings cover less than 1 Ha, " middle" ones cover I to 10 Ha and "large" ones cover more than I 0 Ha.

Besides a few large orchards, food crops are grown in small establishments, by the community of"small planters". There are 5,000 to 6,000 planters/owners who have been registered by the Ministry of Agriculture; the exact number of agricultural workers in these small plantations is hard to know, as their activity often constitutes only a part time job, limited to one harvest sometimes.

These small vegetable growers usually conduct multiple-croppjng (2 to 3 crops generally, all the year round) and are intensive users of pesticides. Up to 6kg of active ingredient of insecticides may be used per hectare, per crop cycle, for leafY vegetables; and massive amount of fungicides (specially mancozeb) are applied for some crops (example: around 25 kg of active ingredient per hectare for a cycle of potato) ( 4).

Application of pesticides is usually done by the planter himself, using an hydraulic sprayer, most often of a knapsack type. Around fifteen products are usually manipulated; the quantities of pesticides applied are superior in the humid season: summer.

9

Protocols of treatment are proposed by the Ministry of Agriculture, and partially followed. Other important sources of information are the pesticides' retailers, other planters and own observations emerging from empirical practices. Insecticides and fungicides which are recommended to be used on a curative schedule, are most often weekly applied on a prophylactic basis, as an insurance to get healthy crops. 10 to 20 sprayings may occur on one crop. The cost of pesticides may represent 25 to 30% of the crop production cost; a vegetable grower may spend Rs 4,000 to 10,000 per hectare, for one crop (6).

Previous surveys conducted among the small vegetable planters, have assessed the effectiveness and impact of their pesticides application practices (7,8,9). The main observations were the following from the first surveys conducted among 134 planters in 1979 and 1980 (7):

- the interviewed growers were often middle or old people, characterised by a low education status and small size holdings.

- source of purchase of agrochemicals: half of the growers bought their products from the importers' selling points, which was positively correlated with a good quality of advice. Problems of counselling quality and conformity of containers were reported for the sales coming from other retailers.

- range of chemicals: a wide range of chemicals were in use, with a large array used for the same crop and for the same pest, either alone or in mixtures; access to restricted and even banned pesticides (ex: DDT) has been observed. Pyrethroids were encountering a growing success. The most used insecticides in 1979 were: deltamethrin (34% of growers), trichlorfon (32%), methamidophos (30%), monochrotophos (29%), parathion (20%) and methomyl (15%).

- information and advice: a felt need of advice was reported among 71% of planters; advice had been sought in practice by 43% of growers, in half of the cases from the neighbours and in third of them from the official Extension Service of the Ministry of Agriculture .

- pesticide dosage and use of mixtures: a third of planters relied on previous experience or neighbours' opinions to set up the dosage. 60% of them in practice do not follow the recommended dosages, with a third of planters using excessive doses. 70% of growers made irrational mixtures (using 2 insecticides or more), specially on tomatoes, creepers and onion plantations.

-observance of the safety interval: 93% of planters claimed they respect it, but in 50% of the cases, it was shorter than the recommended one. They invariably mentioned 7 days as being the safety interval, as it suited their weekly harvesting pattern, and to a greater extent also their weekly spraying frequencies.

- pesticide spraying operations: Only 17% of planters used a reliable measuring device; Protective devices: 60% of small growers did not wear any. Rubber boots were worn by 38% of the planters and gloves by 25%; Mixing sometimes occurred with bare hands; 92% of the sprayings took place in the mornings or evenings; 15% of the planters might eat, drink or smoke during spraying; 14% of them washed their spraying equipment in a way to minimise water pollution; 9% of them burned or buried the empty containers. Recommended frequencies of spraying were not observed, intervals being most often shorter.

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- pesticides storage: 59% of planters stored the chemicals in locked or special rooms; 31% still kept them at home.

Mrs. S.Facknath studied the trends in pesticide perception and management among vegetable growers in Mauritius from 1979 to 1990 (9), using figures from four subsequent surveys conducted respectively in 1979, 1983, 1988 and 1990. Her conclusions were the following:

- the current population of farmers seems younger and better educated. - the usage of pesticides is still intensive with 100% of the growers doing

applications on their crops. - the felt need for advice has decreased, with the level of trust and confidence

in the Extension Service being again low in 1990 after a period of more acknowledgement in 1988. Agrochemicals firms are still recognised as a good source of advice.

- in 1990, still 42% of the interviewed planters were doing their dosages in reference to their own experience.

- conditions of pesticides storage have improved, with only 2% of the chemicals being kept at home.

-in I 988, still 35% planters made inappropriate cocktails. - while insecticides' spraying is recommended in case of pest attack only, 89%

of the growers realised it in prevention, on a routine basis, in I 988 (untimely sprayings). Knapsacks were used by 87% of the planters, while motorised sprayer users were only 4%.

- adequate measuring devices were used by 78% of the planters in 1990. The tendency to use higher dosages than recommended ones was nevertheless still observed in 1990.

- around I 4% of sprayermen did not wear any protective clothing in the 1990 survey.

- drinking and eating seemed refrained while spraying in 1990. - washing of the equipment still occurred in rivers or canals in 25% of the cases

in 1990. - 26% of empty containers were buried or burned in 1990. Less dumping was

observed in the last years.

Frequent failures in pest control have convinced the farmers that higher dosages and mix formulations are necessary; they put forward either pest resistance or little faith in label recommendations, in extension staff counselling or seller's advises and some of them suspect variations in active ingredient owing to suspect market practices (5). In conclusion, farmers' perception and practices have been improving at a small pace during the last fifteen years. No medical follow-up .neither biological monitoring has been conducted among them.

The pest control unit of the Ministry of Agriculture conducts two programs for the protection of fruit trees in orchards from the damage of fruittly and plant diseases. 23 sprayermen/Iabourers are included in the 6 mobile units (9). This trained personnel usually wears protective clothing during the 6 to 9 weekly hours of spraying and undergoes regular cholinesterase test checking. Around 20 other sprayermen are employed in the Ministry of Agriculture, in demonstration centers.

The high and likely excessive use of pesticides as agrochemicals in Mauritius is becoming economically wasteful, while it can lead to reduction of soil fertility, appearance of pesticide-resistant species (ex: fruittlies) and side effects on non-target

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organisms. Besides agricultural productivity and environment quality, it also affects human health.

II! B. PEST CONTROL IN AND AROUND BUILDINGS

The main pests acting in buildings are: mosquitoes (specially during the warm half of the year), home flies, cockroaches, ants, rodents, mites, termites. Although mosquitoes are no more vectors of severe endemic diseases, they are the major fought pest, specially with pyrethroids.

Although no survey has been conducted, the major available insecticides for this usage belong to the following chemical families: carbamates (propoxur), pyrethroids (alletfirin, cyfluthrin, deltamethrin, permethrin, tetramethrin), cravenite (miticide) as well as coumarins and indanediones as rodenticides. A few companies (Hardy Henry Ltd, Exterminators, Ireland Blyth Ltd) conduct pest control activities in and around buildings (sprayings, placing of baits). Most of the household control is done by the inhabitants themselves, by use of antimosquitoes pads electrically heated, mosquitoes coils, baits for rodents, aerosols and rarely indoors insecticides sprayings.

li/ C. USE OF PESTICIDES IN PUBLIC HEALTH

Mosquitoes' control: although a wide variety of mosquitoes are present all-over the island (anopheles, culex, aedes), malaria is the major vector borne disease for which there is an active control. No endogenous case of malaria has been reported for several years but the vectors are still abundant. The activities of the malaria control program include periodical sprayings of DDT around the airport in Plaisance and the harbour in Port Louis. Home sprayings have not been conducted since several years due to the disappearance of endogenous cases. Outdoors sprayings of temephos (an organophosphate insecticide) are occasional in the water reservoirs, when entomologists detect high levels of vectors'infestation.

Molluscs'control: molluscicides have been employed until recently to control remaining endemic pockets of schistosomiasis' transmission. The program has been stopped since 1994.

As regards to hospital hygiene, deltamethrin is sprayed regularly to minimise the presence oft1ying and crawling insects. Rodenticides are used as well.

Spraying activities are conducted by the district teams of the Ministry of Health. A hundred people may be involved nation-wide in these operations.

The Ministry of Work, the Ministry of Local Governments, Regional RHD, the district councils and the municipalities also employed a hundred sprayermen for pest control.

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II/ D. SOME OTHER USES OF PESTICIDES

An arsenical compound is still imported for restricted use as a wood preservative.

Various fungicides, bactericides and algaecides are added to paints in paint manufacturing factories.

III/ INSTITUTIONAL ASPECTS OF PESTICIDES MANAGEMENT IN MAURITIUS AND CONTROL PROCEDURES ON PESTICIDES FLOW AND USE

Several mm1stries are involved in the different aspects of pesticides management, so that consistent activities require large intersectoral coordination and strong linkages. The Ministry of Health plays a central role as having in charge the administration of the Pesticides Control Act and the prevention, investigation and management of poisoning cases either among workers or in the general public. The Ministry of Labour and Industrial Relations, through the application of the Occupational Safety, Health and Welfare Act, controls the working conditions in big industrial and agricultural establishments. The Ministry of Agriculture and Natural Resources, inter alia, provides educative and informative messages to the farmers on efficient and safe pest control practices; it is involved in various research studies and in pesticide residues monitoring in vegetables. The Ministry of Environment and Quality of Life will set up standards for pesticides residues levels in environmental media and will have a consultative and watching role regarding to the environmental impact of pesticides use.

III/ A. Ministry of Health

While pesticides have been used for several decades in Maurifi~s, the Pesticides Control Act (PCA) was passed in the legislative assembly in 1972 and has undergone subsequent amendments. It is administered by the Ministry of Health. The Pesticide Control Board, comprising 15 members, was established in 1972 under the PCA, and controls the importation, formulation, manufacture, storage and sale of pesticides. Its President and its Secretary are officers of the Ministry of Health. The Board grants or refuses the permits for manufacture, import, sale or distribution of any pesticide. Pesticides import firms have to apply for a permit for each chemical included in each consignment. Control visits are conducted by the 115 Health Inspectors at the officially registered 150 retail selling points, before any delivery or renewal of an annual sale permit. The list of banned and restricted pesticides is periodically updated by the Board; it includes currently 62 banned and 27 restricted pesticides ( cf annex 2). The PCA also stipulates the required features of the labelling. Basic national exposure­assessment data (i.e. types and amounts of pesticides imported, formulated and sold) are not yet routinely produced by the Board, except aggregate importation data

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reported for the main classes of pesticides: herbicides, insecticides, fungicides and others.

The PCA (I 0) makes also provisions for the protection of workers and general public against contamination by pesticides. With regard to the protection of workers involved in handling/spraying pesticides or in handling contaminated devices: preemployement medical examination with dosage of blood acetylcholinesterase (ACE) is required, full protective clothing is mandatory, hours of work are regulated, appropriate hygiene practices are specified. A sprayerman must also undergo a dosage of ACE at least every 6 months. With regard to general public protection: recommendations are given to ensure that toxic residues in commodities for human or animal consumption are kept at a safe level, that safe intervals are respected before application of pesticides and marketing of a crop, that transport of the substances takes place in safe conditions. No details about implementation of control procedures about these last aspect~ .. are mentioned. As regards to environmental protection, few provisions are provided, except through the impact of the previous recommendations.

The weakness relating to the above legislation, however, resides at the level of implementation ( 4,11 ), owing to a shortage of staff and adequate toxicological and analytical facilities. Imports are quite well under control, under the aegis of the PCB, while enforcement of control measures on the distribution chain is weak. A pesticides assay laboratory is in project and will support the quality control of imported and locally transformed pesticides. With regard to the protection of workers, a poor description of the required medical follow-up is provided; the recommended determination of blood ACE level seems to be the key examination for the screening and follow-up, while it is only a biological marker of a recent overexposure to organophosphates and carbamates and does not provide any information on cumulative exposure to these insecticides neither on exposure to other substances (specially herbicides and fungicides). The legislation does not contain specific provisions for the protection of the environment. The fate of empty pesticides containers is touched on but measures for the disposal of large quantities of expired or altered substances are not provided; monitoring of toxic residues in environmental media is not mentioned.

The Ministry of Health is also in charge of investigating any complain of workers of pesticides overexposure through the Health Occupational Unit and to provide curative care to any case of pesticide poisoning. Since 1976, the Government Analyst Division of the Ministry of Health conducts the ACE check program which concerns personnel involved in pesticides handling in government, parastatal bodies, municipalities and large private firms (sugar estates and big importers) and also realises this laboratory test on the request of medical personnel. Around 2, 000 tests are routinely performed each year.

lW B. Ministry of Labour and Industrial Relations

It is in charge of the enforcement of another legislation, the Occupational Safety, Health and Welfare Act, passed in 1988, which makes provisions of preventive and control measures in the protection of workers in industrial environments. It is enforced by the Factory Inspectorate Department, under the aegis of the Ministry of Labour and Industrial Relations. Any health problem reported by a worker as presumably of an occupational origin or observed by a Factory Inspector, is referred the Occupational Unit of the Ministry of Health, which is also concerned with the

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curative part. Sugar industries as well as big firms importing pesticides are followed by the Factory Inspectorate, which should ensure acceptable standards of safety at this work place. In private firms employing more than 100 persons, Health and Safety Managers assist the firm managers on safety and health matters but do not conduct any individual follow-up; these big firms also frequently have part time firm physicians, not always specialised in occupational health; no standard follow-up has been established for workers exposed to pesticides, except regular dosage of ACE.

IIII C. Ministry of Agriculture and Natural Resources

In the agricultural sector, recommendations for pesticide utilisation are embodied in a guide "Guide des cultures vivrieres et potageres" produced by the Ministry of Agriculture, in the collaboration with the advisers of the private sector. The Mauritius Sugar Industry Research Institute issues "Recommendation sheets" and/or "Advisory bulletins" for the production of 6 crops: sugar cane, maize, beans, groundnuts, tomatoes and potatoes.

The Crop Extension Division of the Ministry of Agriculture is inter alia responsible for the education of farmers in good pest control practices and proper handling of pesticides. 25 field assistants supervised by 15 technical officers are in contact with the small vegetable growers. They do not have individual follow-up ofthe planters', practices but deliver advises in the fields and realise demonstrations in 7 demonstration centers. Their education campaigns need to be strengthened, including matters of general Integrated Pest Management. These officers have to face the marketing strategies of the large agrochemical importing firms for the sale of their own products and need to be better acknowledged in the rural community.

The Agricultural Chemistry Division of the Ministry of Agriculture carries out since 1985 monthly market basket surveys. From 1985 to 1994, between 10 to 15 samples of some seasonal vegetables have been picked from four urban markets (Curepipe, Vacoas, Rose Hill and Port-Louis). Since 1994, sampling has been enlarged to rural areas (Flacq, Mahebourg .. .). Residues of 32 insecticides belonging to the carbamates, organophosphates and pyrethroids are sought by the method of gas liquid chromatography. The standard maximum residue limits established by the Codex Alimentarius Commission are used as references. The limitations of this monitoring are the following: few number of samples from a limited number of sampling places, limited types of crops screened (fruit, potatoes, onions, root vegetables are not investigated), herbicides as well as fungicides not searched in the samples, absence of identification of the seller and grower and lack of reactive measures when insecticides excess is found. Appropriate steps to identifY the cause and prevent recurrence of residues excess cannot not be taken.

15

Ill! D. Ministry of Environment and Quality of Life

The recent Ministry of the Environment has mainly a role of consultation, watching, assessment and inter-agencies coordination in the area of pesticides management. It is coordinating a project related to pesticides' disposal (empty contaminated containers, altered substances) and is in charge of the set up of environmental maximum residue limits, which will be soon promulgated. A coming laboratory under the aegis of this Ministry will have the capacity for pesticides' residues detection in various media, for research and watching purposes. Monitoring of pesticides residues will be reinforced and entrusted to other Ministries or parastatal bodies: Ministry of Agriculture for foodcrops and soil samples, Central Water Authority for water, Ministry of Health for imported food and local food other than fruit and vegetables.

With regards to levels of pesticides residues in soil and water, data are scarce, no monitoring is set up yet while concern has been expressed about accumulation of pesticides in the environment and their biomagnification in the food chain. A recent survey has been conducted in 1995 by Central Water Authority on herbicides and fungicides levels in ground and surface water, with sampling all-over the island. It is the first survey on pesticides levels in water. Water effluents from firms doing packing or formulation has not been monitored. In soil, no systematic or comprehensive sampling for pesticides residues dosage has been done.

Accumulation of pesticides in the lagoon water has been implicated in cases of fish killings ( 4).

Ill! E. Research Institutions

Research institutions in the area of pesticides bioefficacy are the Ministry of Agriculture, the University of Mauritius and the Mauritius Sugar Industry Research Institute (MSIRI). The findings of their experimentations are spread mainly through the literature (advisory bulletins, recommendations sheets) and hardly reached the planters. The University as well as the Ministry of Agriculture have been involved in the monitoring of pesticide usage, by conducting subsequent studies among the small growers since 1979. A descriptive study is currently conducted among the small planters on their perception of pesticides usage.

Regarding to the health impact of pesticides'use, besides the data routinely collected from the public hospitals and in the Acetyl Choline Esterase Check program, some subjective symptoms have been reported. among the small vegetable planters in the surveys conducted by the University and the Ministry of Agriculture. No deeper investigation on biological effects and objective clinical symptoms has been conducted for the moment among the exposed people.

16

IV/ PESTICIDES AND HEALTH IN MAURITIUS

The pesticides currently in use in Mauritius involve a large variety of chemicals, with great differences in absorption, metabolism, types of effects, accumulation and toxicity for humans. While the main circumstances of exposure can be individualised, people are usually exposed in more than one way.

In Mauritius, there is a dearth in quantitative data on circumstances of exposure. We will then describe the existing potential sources of exposures, estimate the size of the population subgroup at risk and provide the available data.

IV I A. Unintentional poisonings

Unintentional poisonings result, in other countries, mostly from occupational exposure (60-70% of the acute accidental poisonings cases) while the remaining of the cases occur in the general public (2).

IV/ A.l. Occupational exposure

Workers doing packing, formulation, loading, handling, ffi!Xmg, spraying or. picking are unintentionally exposed through two major routes of exposure: principally dermal (skin, eyes) and respiratory. These workers (including the families of the farmers) may be exposed both to high doses and long term low doses of various substances, leading to the occurrence of acute severe poisonings usually well notified or of chronic adverse effects, poorly documented up to now, specially in developing countries. This sub-group of population constitutes usually the risk group the most exposed, regarding to cumulative dose specially.

In Mauritius, the size of this population subgroup may be estimated as around 19,000 people: 18,000 people in the agricultural sector, 600 persons in the transformation and distribution chain and 300 people involved in spraying operations other than for agricultural purpose.

Among these workers, the exposure is very heterogeneous in the nature of the manipulated substances, the frequency and duration of this contact, the conditions of workers protection and supervision: ~

-the 4 people involved in formulation handle 3 herbicides and solvents, - the 41 people involved in handling and packing manipulate all classes of

pesticides, as well as the 500 people involved in the distribution chain, - the 11,000 small sugar cane planters handle primarily herbicides and

fungicides, as well as the 1, 000 workers on the sugar estates who use insecticides too, on the diversification crops,

- the 6, 000 small vegetable planters use a wide array of pesticides, insecticides specially.

Available information on health effects following occupational exposure to pesticides in Mauritius:

- There is no separate notification of cases of occupational poisonings to the Ministry of Health.

17

- Our interviews of managers and workers involved in handling and packing during visits conducted by the main importers in September and October 1995 report a few number of health complaints. Two cases of acute eczema in relation to exposure to an arsenical compound, mild skin symptoms, weakness, one case of polyneuropathy having a history of mixed exposure to both pesticides and alcohol, were reported. Response to our mail questionnaires sent to the Health Inspectors, the Factory Inspectors and the Health and Safety Managers in July and August 1995 do not report any quantified information about cases of occupational poisonings; symptoms notified among the small vegetable planters were the following: breathless, skin and eye irritation and one suicide attempt .

- Descriptive data in surveys conducted by the University among samples in the community of small planters in 1983 (8) and 1988 (9) report the following decreasing incidences of adverse health effects:

..,,,._

nothing burns itchy nausea vomiting headaches skin

1983 n=l93 39% 52% ? 7% 8% 21%

1988 n=l90 81% 17% 1% 1% 3% 3%

- Active detection of cases of occupational overexposure in Mauritius:

Biological monitoring of exposure by blood ACE assessment ( cf Ill/ A.) is regularly (twice a year) carried out on people handling pesticides in big importation firms, and on sprayermen belonging to the Ministries and the large agricultural estates, that is on around 2, 000 persons among the I 9, 000 potentially exposed, representing a small coverage. This blood test is generally the core of the medical follow-up, for which no standardised clinical check-up has been set up; its limited value, in terms of detection of pesticides adverse health effects has to be pointed out, as only recent high exposure to carbamates and organophosphates can be identified and exposure to the other numerous substances remains silent regarding to this test.

Results of the acetylcholinesterase check program: the number of overexposed cases (having ACE blood levels below 7 5%) has regularly decreased, while the total number of tests performed increased over the last 18 years (cf diagram 3, with missing data for the years 1980 to 1986). This can be related with an improvement of

18

protective measures and maybe a qualitative shift in the exposure (handling of less toxic compounds among the carbamates and organophosphates and use of other chemical families).

!BLOOD cHOLINESTERASE CHECK PROGRAM . Nu.iviBER oF resrs PERFOR.MeO AND I I PROPORTION OF C~SES WITH CHOLINESTERASE INHIBITION EXCEEDING 25%. . .. .1

3000. 40%

2500 . 35%

30% 2000

25% Proportion of tests with Number of tests

perfonned 1500 ZOO/c cholinesterase

0 inhibition greater than

15% 25%

10%

5%

0%

Years

Diagram 3 Source of data: Ministry of Health

Moreover, diagram 4, for which data miss from 1980 to 1989, shows that the decreasing occurrence of cholinesterase inhibition exists for each subcategory of inhibition (mild to severe). Currently, around 1% ofthe tested workers have an ACE inhibition exceeding 25%.

f ........ DISTRIBUTION OF THE LEVELS OF BLOOD .l !ACETYLCHOLINESTERASE AMONG WORKERS SCREENED i

I DURING THE PERIOD 1981·1994. I i,_, ___ .. _,_, ___ ,_, __ ,_ -.. __ 1

Blood cholinesterase

levels

100% 90% 80% 70% 60% 50% 40% 30% 20%

- 10% 0%

iD Blood ACE > --75%~--

l

i.50%<=Biood ACE <75% 11125%<= Blood ACE <50% 1i!1J Blood ACE <25% _____ ,, ____ _j

N

8il - - -Years

Diagram 4 Source of data: Ministry ~f Health

21

IV I C. Description of the cases of pesticide poisonings hospitalised in the Manritian public hospitals from 1981 to 1994

IV/ C.l Morbidity data

The annual number of hospitalised pesticides poisonings has fluctuated from 243 to 352 during the period 1981-1994, with a decreasing trend of these absolute numbers during the last five years ( cf diagram 5). A 27% drop is noticed in the annual incidence rates from around 34 per 105 persons-years for 1981-1989 to around 27 per 105 persons-years for 1990-1994.

TOTAL NUMBER OF PESTICIDES POISONINGS TREATED IN PUBLIC HOSPITALS AND CASE FATALITY RATE FOR THE

1981 TO 1994 PERIOD.

400

Number of 300 hospitalized

pesticide 200 poisonings

100

0

15%

10% Case fatality

5% rate

Ye a rs

I,~ T ota I number ofP"6 sticid e s poisoning s tre a te··cr·-in pub lie hasp ita Is I

~case fatality "r~ .. ~-.. :~ .... -... ..... .. _j

Diagram 5 Source of data: Ministry of Health

According to sex, the annual incidence rates of pesticides poisonings having required hospitalisation among males have been continuously 41% higher than those among females ( cf diagram 6). However, when age is taken account, this observed higher male risk is constant except among the 15 to 19 years old, where females have a risk 67% higher than young male teenagers.

22

~----~~-----::::=============== INCIDENCE RATEs oF PESTICIDE POISONINGSHOSPITAuzs:iilll PUBLIC HOSPITALs:

45

~ 40 Q. ~

.!] ~ 35 ~

~ "" 30 w

~ c 25 " 0 c ~ ~ ~ 20 :'2 c.

g 0 15 ·- 0 - 0 ~ ' 10 ~ 0 c 0 c ~ 5 <{

0 1980

ACCORDING TO SEX DURING THE PERIOD FROM 1981 TO 1994. i

1983 1986 1989

Years

-~----~ .. ~·---~'

1992

.---------! -5!1- Total population

1----m---- Male population

~.~le pop~~tion j

------ ~~~··· ---------~

Diagram 6 Source of data: Ministry~~ Health

According to age ( cf diagram 7), pesticide poisonings having lead to hospitalisation are the most common in the 15 to 19 years old age group, with a decreasing incidence in the last five years (annual incidence rates dropping from around 65 per 105 persons-years for 1981-1989 and to around 54 per 105 persons-years for the 1990-1994). The highest incidence rates over the 1981-1994 period, have been observed among the female teenagers and the males aged 20 to 44 years old with respective values around 77 and 57 per 105 persons-years; suicide attempts have been presumably responsible for a large part of these hospitalisations. In Jordan, the same

~------:====================== ----1 INCIDENCE RATES OF PESTICIDE POISONING$ HOSPITALIZED IN PUBLIC HOSPm\l.sl

:;; "' "-~

"' .. Cl ~ E "' Cl c

" 0 c ~ Cl Cl :sl c. "o .5o iU 0~ ,o c 0 c ~ <{

I ACCORDINGTOAGEDURINGTHEPERIODFROM 1981 T01994. ____ i

80'

70 ~ '

60 J ' '

50 1 40 J

30 i 20 i

1980 1983 1986 1989 1992

Years

··--~~--

-m- Under 5 years old ~. ~ ... ---m- 5 to 14 years old i :

I ; -ii-15to19yearsoldi ·

! -o- 20 to 44 years old i ' ' ' !

1

----m---- 45 to 64 years old !

----s- O~er 64 years ol~

--------- ---·--------~···.J

Diagram 7 Source of data: Ministry of Health

23

pattern of highest incidences of pesticides suicides among these two population subgroups has been recorded during the period 1973-1985 (12)

The only class of age for which incidence of pesticides poisonings seems to have increased recently, is the one of the underfive (8% increase of the incidence rate over the last five years). The children 5 to 14 years old as well as the elderly seem the subpopulations the least at risk regarding to occurrence of pesticides poisonings.

IV I C.2 Mortality data

I. Fagoonee reported in 1984 (7) that between 1971 and 1979, there has been a 400% increase in the number of cases of lethal poisonings, among which 80 to 90% were attributable to pesticides, specially endosulfan, organophosphates and paraquat. In the period 1981-1989, the absolute annual number of lethal cases of pesticides poisonings has fluctuated from 20 to 44; during the 1990 to 1994 period, it has dropped by 33%. Pesticide poisonings has represented 0.4% of all causes of deaths during the last 14 years, but among the teenagers (15 to 19 years old) and the young adults (20 to 44 years old), this share of mortality rose up to 4% and 2% respectively. Organophosphates are now the major responsible for the cases of attempted suicides, while paraquat is the major substance involved in "successful" suicides ( 4).

Pesticides poisonings specific mortality rate: in the whole population, it has lessened by 42% over the 1981-1994 period ( cf diagram 8), with an average annual pesticide poisonings specific mortality rate of 3. 4 per 105 persons-years in the years 1981-1989, dropping to 2.4 per 105 persons-years in the years 1990-1994.

r ; MORTALITY RATES AssociATED WITH PESTICIDE F>o1soii11No& Acco~mNG To AGE I

1983

DURING THE PERIOD FROM 1981 TO 1994. I

1986

Years

1989 1992

Diagram8

__ ,,,_,_~--·-.J

I c----cc-c----:c~----c .• I i ----t'&- Under 5 years old i i

[--GJ-5to 14yearso!d i I [-ll-151o19yearsoldj i !

1

1

-a- 20 to 44 years old\ I -m- 45 to 64 years old j i !~-m-~ __ Ov_~r 64~y~e~~~~ [

Source of data: Ministry of Health

24

When compared with Jordanian data (12) for the period 1979 to 1985, the Mauritian mortality rates were 2 to 12 times higher. R.S. Levine and J.Doull reported poisonings mortality rates during the years 1978-1980 for 31 more developed and 24 less developed countries; Mauritius had the highest rate, while most of these deaths were related to pesticides poisonings (13). To be valid, these international comparisons assume a similar effectiveness in the case detection between the different countries, they suggest that pesticide poisonings is specially common in Mauritius.

No data on mortality according to sex were available. According to age, the adults (20 to 64 years old age group) are more at risk of dying from pesticides poisonings compared to other age groups, with an age specific mortality rate up to 40 times higher than the one in other classes of age. This is due to a combination of a high incidence rate of pesticides poisonings specially among the 20 to 44 years old and a quite high case fatality rate in this class of age ( cf diagram 9). Pesticides poisonings are then more severe among adults, what is likely related to the high proportion of "successful" suicides and possible severe occupational accidents in this class of age. Suicide attempts seem less fatal among the teenagers (cflower case-fatality rate). Over time, these specific mortality rates have declined in all classes of age, except the one of the elderly (26% increase of the specific mortality rate among them, related to an increase of the case fatality rate, cffurther).

Case fatality rate: it has fluctuated from 7 to 14% in the whole population during the 1981-1994 period, with a slight decreasing trend in the last five years ( cf diagram 5). According to age, it is shown in diagram 9, that the risk of dying when

25

poisoned, has been roughly conversely proportional to age. The adults (20 to 64 years old) have a high case fatality rate around 12%. Over time, case fatality rate has diminished in each class of age, except among the elderly, among whom it has increased by 20%.

50%

45%

~-- ----·······- .. ·--·-·--~----------------,

,

1

. PESTICIDES POISONINGS CASE FATALITY RATES ACCORDING TO AGE DURING THE! , PERIOD FROM 1981 TO 1994. !

'.1

1

! liil Under 5 Y~-ars old l ! -<i!l-5to 14 years old j

:-ll-15to 19 years old i [ 1--o-20 to 44 years old i I

I

-IlD- 45 to 64 years old I 1

-il- Over 64 years old \ ] 1980 1983 1986 1989 1992

Years

·------

Diagram 9 Source of data: Ministry of Health

To prevent fatal issues in attempted suicides, stronger and more effective restriction on the availability of highly toxic pesticides (potent organophosphates and carbamates, paraquat) needs to be implemented. Increased awareness of the hazards associated with these compounds' misuse has to be developed in the general public. On a curative side, medical management of poisoned people may be improved, specially the emergency care, as well as poison centers with hot line may be created.

I

SUMMARY TABLE ON HEALTH STATISTICS ABOUT PESTICIDES POISONINGS HOSPITALIZED IN MAURITIAN PUBLIC HOSPITALS

DURING THE 1981 TO 1994 PERIOD.

26

Age groups Average Relative risk Average annual Relative risk Average case annual of getting specific of dying of fatality. rate

incidence poisoned mortalit¥, rate pesticides : rate (/105

) (/1 0 ) poisonings

Under 5 years 20 1 0.12 1 0.8% old (baseline) (baseline)

5 to 14 years 10 0.5 0.24 2 2.8% old

15 to 19 years 61 3.05 3.27 27.2 5.3% old females: 75

20 to 44 years 45 2.1 4.82 40 10.6% old males:57

45 to 64 years 20 1 4.31 36 21.6% old males: 30

Over 64 years 10 0.5 2.24 19 22.3% old

Whole 32 3.05 9.5% population (decreasing (decreasing by (decreasing

by 27% over 42% over the by 11% over the period, period, but the period,

but increasing but increasing among the increasing among the elderly) among the underfive)

The rates are calculated per 100,000 persons-years in each population category.

When looking at these estimates, we have to keep in mind that only part of the cases of overexposure are taken into account: those having received medical assistance in public hospitals, for whom symptoms have been recognised as associated with pesticides overexposure. The true magnitude of the health effects related to pesticides exposure is thus largely unknown and underestimated by the available data.

In terms of public health, pesticides poisonings have represented during the last 14 years, around 0.2 to 0.3% of all the hospitalisations in the 8 public infrastructures. During the period 1990 to 1994, the four regional hospitals have admitted 90% of the cases of pesticides poisonings, with respectively 36% of them in SSR hospital, 30% in Victoria hospital, 14% in Nehru hospital and 10% in Jeetoo hospital. Over this time period, these types of intoxications have been the most hazardous, with a case fatality rate at least 5 times higher than the one for other causes of poisonings; pesticides have

elderly)

27

been responsible for 70% of the deaths by intoxications. These accidents, presumably mostly suicides, affect specially the young population, teenagers and the 20 to 44 years old among whom respectively 4% and 2% of the deaths are related to pesticides intoxications. In terms of mortality, the burden of pesticides poisonings among teenagers is as heavy as the one of infectious and parasitic diseases. So, although this health problem could be considered globally of decreasing intensity over time through the analysis of the available data, the frequency and severity of the poisonings is still alarming. Moreover, the true magnitude of pesticides intoxication needs to be better appreciated, with the support of other sources of information.

28

CONCLUSION

The large circulation of pesticides in Mauritius results mainly from their intensive utilisation in agriculture, as there is no local production and a limited use of them in vector control. The following factors increase the risk of human overexposure in Mauritius:

- lack oflocal quality control of products on sale, - easy access to highly toxic pesticides (some potent organophosphates, carbamates and paraquat) through the sale by numerous retailers and on markets, - large use of pesticides in agriculture and in households, - weak awareness of pesticides uses and hazards all the way down the substances distribution chain, in the small growers community as well as in the general public, - limited implementation of safety measures and standards, lack of comprehensive monitoring systems of the pesticides levels in the different media, - limited contribution of the Health Inspectorate, the Factory Inspectorate and . the Extension Service for pesticides management education of their respective subgroups targets, - poor medical surveillance among workers, specially among the small planters.

In terms of public health, deleterious effects to human health resulting from the wide spread of these toxics are already noticed, while their true magnitude is still underestimated, specially among the exposed workers.

From the existing data, two categories of pesticides intoxications should be deserved priority for future investigations:

- First, pesticides poisonings occurring in the general public: the data on hospitalised cases of pesticides poisonings reveal the severity of these accidents. Pesticides poisonings are the most hazardous intoxications,. with a case fatality rate five times higher than the one for other causes of poisonings; they represent 70% of the deaths by poisonings, although pesticides rank as the third cause of intoxication, with 14% of the incident cases of poisonings. Moreover, teenagers and young adults (20 to 44 years old) pay the largest tribute in terms of mortality, with 4% and 2% of their respective age group specific mortality being related to pesticides intoxications. Among the 15 to 19 years old, these lethal cases due to pesticides are as much numerous than the deaths associated with infectious and parasitic diseases.

Facing this alarming situation, preventive interventions as well as strategies of medical management to decrease the frequency and severity of these accidents need to be strengthened. The first step to review these measures is to gather additional data

29

on these acute poisonings. Their investigation through an hospitalised-based study will specifY the circumstances of exposure (intentional or not), the nature and origin of the compound(s), the sociodemographic characteristics of the subjects, their awareness of the compound's genuine toxicity and the effectiveness of the medical management.

- Secondly, intoxications resulting from occupational exposure: the level of pesticides exposure in the 19,000 exposed workers is likely high regarding to the hazardous pesticides use practices prevailing among the planters. Few health data are up to now available: acute occupational poisonings having required hospitalisations are not distinguished from the other accidental and the intentional pesticides poisonings. Mild signs of intoxications have been reported among 20% of a sample of small growers in 1988; the quite reassuring levels of blood acetyl cholinesterase detected in a non randomly chosen fraction of workers have a limited value in terms of detection of harmful effects. Data are then really scarce and we strongly recommend deeper research on biological and tnild clinical deleterious effects following the presumed large cumulative exposure of this risky group. A repeated cross-sectional survey conducted in a sample of these 19,000 occupationally exposed people will specifY the magnitude of pesticides related health problems in this cohort, in order to design a standardised medical follow-up according to the different job categories and to identity the compounds and practices associated with the most harmful effects.

At a second stage, additional research to quantity the exposure to presumably low levels of pesticides (residues in the environment, food specially) would assess the cumulative exposure in the general public.

BffiLIOGRAPHY

(1) Statistics from the External Trade Statistics Division.

(2) "Public Health Impact of Pesticides used in Agriculture." WHO -1990

(3) "Digest of Agricultural Statistics 1992." Central Statistical Office- July 1993 Ministry of Economic Planning and Development

(4) "State of the Environment in Mauritius." Ministry of environment and Quality ofLife- 1991

(5) "Feasibility report for the improvement of pesticides rules and regulation in Mauritius." Dr D.K.Paharia- Consultants for international Development Plc. September 1992.

(6) "Sugar Industry Statistics." The Mauritius Chamber of Agriculture- July 1995

(7) "Pertinent aspects of pesticide usage in Mauritius." l.Fagoonee, School of Agriculture, University of Mauritius in Insect. Sci. Applic. Vol.5, n°3, pp 203-212, 1984.

(8) "Pesticide practice among vegetable growers in Mauritius." I.Fagoonee, School of Agriculture, University of Mauritius in Management of pests and pesticides, Westview Press, USA, pp 175-181, 1987.

(9) "Improving trends in pesticide perception and management among vegetable growers in Mauritius: 1979-1990." S.Facknath, School of Agriculture, University of Mauritius, 1992.

(10) "Pesticides Control Act" in Mauritius Laws 1990, Vo1.3, pp 554-564.

( 11) "Pests, pesticides, pesticide legislation and management in Mauritius." l.Fagoonee, School of Agriculture, University of Mauritius in Insect. Sci. Applic. Vol.5, n°3, pp 175-182, 1984.

(12) "Pesticide mortality in Jordan." Samih Y.Abu Al-Ragheb, Abdulazim S.Salhab,

30

The American Journal ofForensic Medicine and Pathology Vol.10, n°3, pp 221-225, 1989.

(13) "Global estimates of acute pesticide morbidity and mortality" Robert S.Levine, John Dou11, Reviews of Environmental Contamination and Toxicology, Vol.129, pp 29-50, 1992.

ANNEX

ANNEX 1

MAIN IMPORTED HERBICIDES

DURING THE 1990-1992 AND 1993-1994 PERIODS BY CHEMICAL FAMILIES.

Classification by estimated imported quantities of active ingredient, ranked by decreasing order for tbe years 1993-94. Source of data: Pesticides Control Board. Average annual imported quantity of herbicides (technical and formulated products) during tbe 1990-1995 period: 845 tons.

CHEMICAL TYPE HAZARD AVERAGE ANNUAL IMPORTED CLASS QUANTITY IN KG

IN 1990-92 AND 1993-94

I. PHENOXY ACIDS II,III 85,697 116,990

2. SUBSTITUTED UREAS III,III+ 91,235 93,300

3. TRIAZINES lll,III+ 51,-90,000 51,-90,000

4. ANILIDES lii 58,600 44,660

5. AMINE ACIDS III+ 44,-48,300 32,-45,000

6. ORG. HALOG. ACIDS III+ 59,000 26,000

7. BIPYRIDYLS 11, !II+ 10,478 18,861

8. PICOLINIC DER. l!I,III+ 3,769 15,042

9.AMIDES II!,III+ 380-5,400 10,580

10. CARBAMATES III+ 10,654 10,126

11. BENZONITRILES !I 5,650 6,830

12. TRIAZINONES Ill 3,643 6,767

13. OXADIAZOLE DER. 111+ 1,040 1,560 -"

14. TOLUIDINES III,III+ 200-400 350-800

15. PHENOLIC DER. Ill+ 760 456

16. DIAZINES III,III+ 1,100 60-500

17. AMMONIUM GLUFOSINATE Ill 33 165

18. SULFONUREASES Ill+ 21 40

19.1NORGANIC Ill <22,500

TOTAL (Estimation) 462,920 kg 462,282 kg

MISCELLANEOUS IMPORTED PESTICIDE PRODUCTS

DURING THE 1990-92 AND 1993-94 PERIODS BY CHEMICAL FAMILIES.

Classification by estimated imported quantities of active ingredient, ranked by decreasing order for the period· 1993-94. Source of data: Pesttcides Control Board. Average annual imported quantity of miscellaneous pesticide products (technical and formulated ones) during the 1990-1995 period: 50 tons.

1/ NEMATICIDES: ""'"·

CHEMICAL TYPE

1. ORGANOPHOSPHATES

2. DITHIOCARBAMATES

3. CARBAMATES

TOTAL (Estimation)

2/ RODENTICIDES:

CHEMICAL TYPE

1. COUMARINS

2. INDANEDIONES

TOTAL (Estimation)

HAZARD CLASS

la

!I

la

HAZARD CLASS

Ia,Ib

la

AVERAGE ANNUAL IMPORTED QUANTITY IN KG

IN 1990-92 AND 1993-94

44 166

54 82

40

138 kg 248 kg

AVERAGE ANNUAL IMPORTED QUANTITY IN KG

IN 1990-92 AND 1993-94

39

19

58 kg

55

18.5

73.5 kg

3/ MOLLUSCICIDES:

CHEMICAL TYPE

1. CARBAMATES

2. SODIUM FLUOSILICATE

TOTAL (Estimation)

HAZARD CLASS

Il,III

II

4/ PLANT GROWTH REGULATORS:

CHEMICAL TYPE

1. ETHYLENE GENERATORS

2.AUXINES

3. SERADIX

TOTAL (Estimation)

51 RIPENERS:

CHEMICAL TYPE

SODIUM SESQUI SALT OF GLYCERINE

61 WOOD PRESERVATIVE:

CHEMICAL TYPE

ARSENICAL COMPOUND

HAZARD CLASS

Ill+

Ill+

?

HAZARD CLASS

III+

HAZARD CLASS

?

AVERAGE ANNUAL IMPORTED QUANTITY IN KG

IN 1990-92 AND 1993-94

5,393 4,200

<llO

5,393 kg 4,255 kg

AVERAGE ANNUAL IMPORTED QUANTITY IN KG

IN 1990-92 AND 1993-94

>263 240

37 225

69 19

238 kg 484 kg

AVERAGE ANNUAL IMPORTED QUANTITY IN KG

IN 1990-92 AND 1993-94

46.5 kg

AVERAGE ANNUAL IMPORTED QUANTITY IN KG

IN 1990-92 AND 1993-94

9,731 4,378

7/ AIR FRESHENER:

CHEMICAL TYPE

P ARADICHLOROBENZENE

'

HAZARD CLASS

WHO CLASSIFICATION OF HAZARD CLASSES:

la: extremelyhazardous Ib: highly hazardous II: moderatly hazardous Ill: slightly hazardous Ill+: compound unlikely to present hazard in normal use.

AVERAGE ANNUAL IMPORTED QUANTITY IN KG

IN 1990-92 AND 1993-94

12,667 16,667

ANNEX 2

COHMON NAME

Aldrin

Amitrole

Arsenic

Binapacryl

Bitertanol

Campheclor

captafol

Carbozulf'an

Choline

Chlordane

Chlorthiophos

Chlordcconc

Chlorclimeform

l'HNI.STRY OF HEALTH

Pf.o:'•TICTDI':S CONTROL BOAf·\D

Cr. Suffren/I"lgr. Gonin St::;. P/Loui::;

LIST OF BANNED Pl~S'riCIDES

CLASS H,\ZARD

' IB

V

IA

II

II

If\

lB

Chlorobcnzilote

II

III

Chloropic:rin

Cyhcxatin

DDT

191/27.7.95

REMAHKS

Banned in Agricul­ture except as wood pr·cscrvativc

Fumigant

Banned except for mnlari<l control

DBCP

D1· rfll··,l~"'J. ··. .._ .. >. 1... ,. V '¥

\ Dict'otupho;:i

Di.cldri.n

e.LtnethoatG

1.}:i.no:-JE11:l

DLnoJ.foton

I r)'' \1'1"\ ). \L L· '.C .

F;thyl D:i.bf'Cllll i.d e

FC>nc>ul:C o tb :i.on

fk.ptachlor-

:·~·elcv::.l.n

lA

J..B

J.;\

11

lH

'] ' ... n

1/!.

JB

11

11

Banne(i as household ~)·2r.:; t:icidc

Du:;t formulation banned

--------· .. -·---·------............... --.......... _ ...... ----·-·· __ .,..,_,__, _____ • ...,,,.~u-.,.. .. .,._, _____ _.,.,.,~--- ,,_, _______ ,. __ ..,_

Ln:'d ,·\rsenate

i·kv:! npho:;

f·1ercu:C'y Compound.~:;

f•lonur·~)n

Parat!Linn 11ethy1

Pent<'IGhloJ.'o phc:n o:t

Phornte

Po!-,._;.<"'v""'..: :;-;;,J;u"" S"{·h r') tlc:J£.\c lJro Lho~·l te I

t·cllr·:::~d:-J.n

~;od 1um FluoroaGetc.t te

'Ttl;JlJ :Lum

]))

1J\

Ul

1: L

11

111

ll.!.

l.i3

Jil

i-\<ro ~- ,. 7~-J.z. . 1{\

li\

},\

1 '-3

...... -------···~-·--· ....... - ... ~~·· ··-·' .... ·------.. ·---.. ·-

----·---... ·-·----.... ~.--.---·- .. -·--·-· .. ---·~· _,.. __

'COlvJMON NArftE CL!1SS HAZJ\RD l'tEM!IfUZS

Vinylchlorode

Warfarin

Zineb lll

2-4-5T

PESTICIDES CONTf\OL BOA_ftD

Cr. Suffren/t1!gr. Gonj.n Sts. , Port Louis

- --·-COMMON NAMJ;

Aldica;;>b

Ah:min!•um Phcsphide

Aminoc&i:'~

Benom:/•

Benfuwcarb

CaptaM,

Carboluran

Chlc.J'thiqphof• ..

Coumachlor

Dioofol

Ethrophos

Fenthion

Formetan~t~

Fenofos

Gusatr.~on ( /\zin)jflos-ethyl)

!1cthnmidophos

r·rcthomyl

f<Jethy1 Bromide

LIST OF RESTRICTED PESTICIDES

!•1/\ IN U<"r,• 0.W

1-S

1\C

I

F

I

Ii'

I

I

R

AC

l,L

AC

1 (:• .. ..,

1

1

l

CHEMICAL 'l'YPE

c

c

'l'C

c

c

OP

oc

OP

c

OP

OP

c

CLASS HAZARP

lA(E.H)

lll(S.H)

lb(H.H)

lll(UN)

lb(H.H)

lll(UN)

lb (l-LH)

1n(E.H)

lb (H.H)

lll(S.H)

lA

1b (H.H)

lb (H.H)

la(E.H)

lA(E.H)

1h (II.H)

113 (H.H)

LD '!0 j,Jg/;g

0.93

800

50

RE!VfARKS

For soil treatment only. Not t6 be used to close. spaces

Fumignnt - not for sale to public

Not to be used on ct.:.nij . .r~::d spa.ccc.

+10000 Dry flowab1e for­mulation bnnned

138

9000

B

9.1

33

690

330 ·-"

21

8

16.5

30

17

For seeds dr.essj_ng and drenching

Used (5-10% granu late form) for potatoes and m<.~ize at planting stage

Granular formulation re:c>tricted

Raticide

Hestrictcd - used by Min. of ,\r;ricul turc

Alloded under restricted condition::

Restricted - used on citrus and ornamen­tal::;

RaJ.c to authorised permit holder:; only

90% S. P & 25% EC: allowed

Fumir;ant used by of.ficir.tl services only

C011MON NM1E

Monocroptophos

Ornethoatc

Para quat

Ph os phawid'on

Te:fluthrin·

Thir<un

Zinc Phosphide

MAIN USE

1

1

H

1

F

'I'YPE

OP

OP

p

OP

- 2 -

CLf,SS IiAZMm

lB(H.H)

lB(H.H)

1 (H.H)

la (E.H)

lll(S.l!)

lb(H.H)

LD 50 (mg/kg)

50

150

7

560

HEM/\HKS

To contain <m emetic, stench and coloured blue

Restricted ac; a rodenticide ~.sed by 1'1( /\gricul ture and lhnistry of H~alth

All pestic1dcs clnssificd by \'lorld Henlth Organis::rt.ion as class la and lb are restricted.

Restricted pesticides \'fill be

1. imported by holder of special permit

2. m;ed by <Juthorised personnel under supervision

3. used for specific crop

'+. a register o:f restricted pesticides to be ]{ept by importer

5. a register of users to be kept by retnilers

6. sale by authorised reta.ilers only

7. import and sale in original cont.J:Lners

8. L~bellinc; - restricted pesticides,