Advance Report of the Evaluation of Human Health Effects of Glyphosate and Other Pesticides in Zones
Intoxication caused by different toxic agents is a very frequent medical emergency that the great majority of health care service providers is not reporting to the Provincial Department Control Units. This has resulted in this information being enormously under-recorded in the National Public Health Control System (SIVIGILA). There is a demonstrated need to improve or implement a monitoring system for toxicological poisoning due to this underreporting and the low coverage afforded to monitoring intoxications throughout Colombia, the lack of data analysis in the provincial departments, the little training for those who intervene in the monitoring processes, and the scarce or nonexistent intervention of the territorial agencies regarding this matter.
The fact that health teams are not prepared to monitor intoxication caused by pesticides has contributed to the inadequate handling of the complaints that communities have filed regarding illness caused by aerial spraying with glyphosate and even, on several occasions, to unreliable or ill-interpreted information being disseminated. That is why the MINISTRY OF SOCIAL PROTECTION and the NATIONAL HEALTH INSTITUTE have begun to build a proposal to conduct such monitoring and to comply with the provisions set forth in Law 714 Article 43 Number 3.7 to control potentially toxic substances as well as those in 1991 Decree 1843 Article 170 regarding the epidemiological control of pesticides.
Simultaneously, for the purpose of monitoring the possible effects of glyphosate on human health, a short-term project has been planned called "Evaluation of the Effects of Glyphosate and Other Pesticides on Health in the Illicit Crop Eradication Program Target Influence Areas", to be carried out in eight (8) provincial departments (Antioquia, Guajira, Huila, Narico, Putumayo, Santander, Tolima, and the District of Santa Marta).
These activities are included in Technical Card No. 7 in the Illicit Crop Eradication Program through Glyphosate Spraying (PECIG) Environmental Management Plan - Public Health Program.
This enables the state to meet the responsibilities and requirements stipulated in National Defense Resolution No. 026 dated October 9, 2002 and through the Cundinamarca Administrative Court decision dated June 13, 2003.
To assist in developing the project, we count on the participation of Dr. Jorge Hernon Botero Tobin, United States Embassy, Bogota Narcotics Affairs Section (NAS) Human and Environmental Toxicology Advisor.
EVALUATION OF THE EFFECTS OF GLYPHOSATE AND OTHER PESTICIDES ON HEALTH IN THE AREAS OF INFLUENCE OF THE ILLICIT CROP ERADICATION PROGRAM
To detect possible cases of acute intoxication caused by pesticides that occur concomitantly with the aerial spraying of glyphosate.
To describe the health symptoms manifested by the population exposed to glyphosate in sprayed areas.
To characterize the population's exposure to other pesticides in the sprayed areas.
To explore some of the attitudes that the population has regarding the aerial spraying.
A descriptive study of cases experienced by the population of the sprayed areas in the departments of Narico, Putumayo, Huila, and Tolima.
The proposal is to research, gather and document epidemiological evidence, given the fact that until now the work done has been solely based on analyzing inconclusive complaints.
The project consists of detecting one hundred (100) patients from the spraying zone influence area, who, within a maximum of five (5) days after aerial spraying, consulted the IPS (health care provision companies) with health symptoms derived from contact or exposure to pesticides or where clinical exams showed a condition compatible with acute intoxication caused by pesticides, no matter what the degree of severity, diagnosed by the physician, and who, in addition, had previous contact or exposure to pesticides, for occupational or accidental reasons, excluding cases documented as suicide attempts.
Urine and blood samples will be taken from the persons selected for the study who voluntarily accept to participate in the study, in order to perform the below tests.
1. Determine the presence of glyphosate and amino methyl phosphonic acid (AMPA) in the urine: This will be done at the Quebec Toxicology Center in Canada upon remitting the collected urine samples.
2. Determine the presence of organochlorates (OC) in the blood: This will be done using fine-layer chromatography. The following pesticides will be included: heptachlorine, p-p, DDT, p-p, DDD, aldrin, chlordane-gama, oxichlordane, heptachlorine epoxide, and hexachlorine bencene. The samples will be processed in the National Health Institute Environmental Health Laboratory.
3. Determine the presence of acetyl cholinesterase (Ache) in the blood for organophosphorous (OF) and carbamate (C) pesticides: The test will be done using the Lamperos and Ranta method also in the National Health Institute Environmental Health Laboratory.
April 1 to May 30, 2003
Preparation of the protocol by the National Health Institute and the Ministry of Social Protection, discussion and consultation with the agencies participating in the project (National Directorate of Dangerous Drugs; Colombian National Police Anti-narcotics Division; Ministry of the Environment, Housing, and Territorial Development; United States Embassy; and the Narico, Putumayo, Huila, and Tolima Provincial Department Health Agencies.
June 1 to August 31, 2003
Designing the data gathering instruments, acquiring the equipment for sample taking, reagents for analyzing the biological samples, and acquiring material for the workshops, preparing the workshops, and preparing educational material.
Designing and developing informational material aimed at the community regarding pesticide exposure preventive measures. Posters and two types of pamphlets were made, one for the facilitators or tutors, and the other one for the agents who make community visits.
September 1, 2003 to January 16, 2004
Training for the health teams in the four territorial agencies, as follows:
Narico (September 1-5, 2003): 35 environmental health professionals and 53 environmental health were trained.
Putumayo (October 20- 24, 2003): 29 environmental health professionals, 2 environmental health technicians and 21 rural health promoters were trained.
Huila (December 1-5, 2003): 43 environmental health professionals and 34 environmental health technicians were trained.
Tolima (January 13-16, 2004): 26 environmental health professionals and 40 environmental health technicians were trained.
The training included diagnosing, handling, preventing, and monitoring intoxications caused by pesticides and the methodology for doing the project research.
During the month of January spraying has been done in the provincial department of Tolima, from which samples of a case in the municipality of Planadas have been received.
May 1, 2004 to July 15, 2004
An active search for cases in the provincial departments of Putumayo, Magdalena, and Guajira was made and thirty-nine (39) possible cases of intoxication caused by glyphosate were gathered. In addition, the Tolima and Huila Health Secretariats have detected four (4) more cases, which they spontaneously reported to the health units.
These samples are being processed in the National Health Institute Environmental Health Laboratory to determine the presence of organophosphorous, carbamate, and organochlorate pesticides. To detect glyphosate and its metabolite AMPA in the urine, the samples have been sent to the Quebec Toxicology Center (Canada) for analysis.
July 23- 27, 2004
Training will be given to health personnel and to municipal leaders in the provincial Departments of Guajira and Magdalena and in the District of Santa Marta.
August 23-27, 2004
Training will be given to health personnel and to municipal leaders in the provincial Department of Santander, and personnel from municipalities with illicit crops in the south of Bolivar department will be included in this training.
The impact of the project has been very favorable, reflected first of all in a 25% increase in reports of intoxication caused by toxic substances; therefore, we consider it a priority to extend the project to other provincial departments targeted by the PECIG.
We have done telephone follow-up and foresee fieldwork in each provincial department, in order to do an active search of cases during spraying; to do so we are coordinating with the Colombian National Police Anti-narcotics Division and with the Provincial Department Health Agencies. The Health Secretariats in the provincial departments of Narico, Putumayo, Huila, and Tolima have not reported any new cases.
For the remainder of this year, we foresee giving seven (7) training sessions in the provincial departments targeted by the PECIG.
The project work schedule is tied to the Colombian National Police Anti-narcotics Division's (DIRAN's) scheduling of spraying operations. DIRAN has changed the schedule several times due to weather conditions; thus the program is behind schedule in several departments.
During the follow-up done in the four (4) provincial departments, we found some inconveniences in carrying out the project. The main one was the fact that the trained health personnel are transferred or leave the agency due to administrative changes by the new mayors and governors.
The community is reluctant to participate in the study.
Little collaboration from the population, due to their dislike of central government agencies. They say that their legal crops (yucca, yam, and corn, to name a few) have been affected by the spraying activities.
The population is very dispersed and hard to access.
Extreme weather conditions (frequent rain and very high temperatures) hinder the research teams' mobility.