Abstract
BackgroundHuman poisoning by pesticides has long been seen as a severe public health problem. As early as 1990, a task force of the World Health Organization (WHO) estimated that about one million unintentional pesticide poisonings occur annually, leading to approximately 20,000 deaths. Thirty years on there is no up-to-date picture of global pesticide poisoning despite an increase in global pesticide use. Our aim was to systematically review the prevalence of unintentional, acute pesticide poisoning (UAPP), and to estimate the annual global number of UAPP.MethodsWe carried out a systematic review of the scientific literature published between 2006 and 2018, supplemented by mortality data from WHO. We extracted data from 157 publications and the WHO cause-of-death database, then performed country-wise synopses, and arrived at annual numbers of national UAPP. World-wide UAPP was estimated based on national figures and population data for regions defined by the Food and Agriculture Organization (FAO).ResultsIn total 141 countries were covered, including 58 by the 157 articles and an additional 83 by data from the WHO Mortality Database. Approximately 740,000 annual cases of UAPP were reported by the extracted publications resulting from 7446 fatalities and 733,921 non-fatal cases. On this basis, we estimate that about 385 million cases of UAPP occur annually world-wide including around 11,000 fatalities. Based on a worldwide farming population of approximately 860 million this means that about 44% of farmers are poisoned by pesticides every year. The greatest estimated number of UAPP cases is in southern Asia, followed by south-eastern Asia and east Africa with regards to non-fatal UAPP.ConclusionsOur study updates outdated figures on world-wide UAPP. Along with other estimates, robust evidence is presented that acute pesticide poisoning is an ongoing major global public health challenge. There is a need to recognize the high burden of non-fatal UAPP, particularly on farmers and farmworkers, and that the current focus solely on fatalities hampers international efforts in risk assessment and prevention of poisoning. Implementation of the international recommendations to phase out highly hazardous pesticides by the FAO Council could significantly reduce the burden of UAPP.
Highlights
Human poisoning by pesticides has long been seen as a severe public health problem
Our systematic review, which was carried out according to the international scientific PRISMA standards, updates outdated World Health Organization (WHO) figures on world-wide unintentional acute pesticide poisoning and complements a recent review on suicidal pesticide poisoning
Our results point to a heavy burden of non-fatal UAPP, for farmers and farmworkers, with about 385 million cases of UAPP and 11,000 deaths per year
Summary
As early as 1990, a task force of the World Health Organization (WHO) estimated that about one million unintentional pesticide poisonings occur annually, leading to approximately 20,000 deaths. As early as 1990, a task force of the World Health Organization (WHO) estimated that about one million unintentional pesticides poisonings with severe manifestations occur annually, leading to approximately 20,000 deaths [5]. During the last two decades, international bodies have taken up the issue and adopted a number of resolutions and programs to address the detrimental effects of pesticide use [7,8,9,10,11] Despite these efforts, global pesticide use has continued to grow steadily to 4.1 million tonnes per year in 2017, an increase of nearly 81% from 1990 [12]
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