Pesticide research, particularly in low- and middle-income countries (LMICs) continues to identify exposure risks and why pesticide poisonings continue (e.g., poor surveillance, weak legislation, use of highly hazardous pesticides, high-risk use and application practices). Focus often is on highlighting specific pesticide products, exposure risk contexts and vulnerable populations, as well as behaviours of farmers, workers and consumers. What is, however, less often assessed in pesticide research is the impact of commercial determinants on health (CDoH), which is referred to as "strategies and approaches used by the private sector to promote products and choices that are detrimental to health”, and the role of corporate capture. In this review, the aim was to identify the key components of CDoH impacting on health outcomes for populations, particularly in Southern Africa, exposed to pesticides. Five strategies of the pesticide industry were identified that result in exposure risks and negative health outcomes. These strategies and concepts include: the social responsibility approach (e.g., responsible and safe use), mis- and lack of information (e.g., confidential business information), corporate capture (e.g., revolving staff door with regulators), apportioning blame (e.g., "misuse”), and uncertainty science (e.g., products are innocent until proven guilty, corporate research funding). The findings and complexity of each of these strategies will be presented. The impact of epidemiological research for evidence policy making will continue to be undermined as long as the CDoH are not addressed along side research. It is recommended that researchers include an analysis of pesticide commercial determinants as part of epidemiological research and that environmental health curricula include training on commercial determinants of environmental health. Young pesticide researchers need guidance on navigating corporate research funding, conflicts of interest and the long-term impact on their careers. To reduce pesticide poisonings in LMICs, CDoH need to be identified and addressed by researchers.
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