AGRICULTURAL PESTICIDE USE IN DEVELOPING-COUNTRIES - HEALTH-EFFECTS AND RESEARCH NEEDS

Large worker populations in the Third World are exposed to increasing amounts of pesticides, including pesticides severely restricted and ba nned in industrialized countries. Studies on knowledge, attitudes, and practices indicate that unsafe use of pesticides is the rule in Third World countries. Surveys of acute poisonings show high rates in these countries, despite underregistration. The scarce studies on chronic h ealth outcomes demonstrate neurotoxic, reproductive, and dermatologic effects. Exposure assessment consists mainly of cholinesterase testing , and few studies have quantified dermal and respiratory exposure. The few intervention studies demonstrate the need for evaluation of the i mpact of preventive measures and policies. There is no evidence that w idespread ''safe-use'' programs have greatly affected exposure and mor bidity. It was concluded that research should focus on simple methods for surveillance of exposure and on surveillance of acute illness and its causes in order to develop and evaluate rapid local interventions. Studies on chronic effects should be carried out in selected countrie s, aiming at long-term and broader interventions. Policies that promot e the use of pesticides should be critically evaluated. North-South an d South-South research collaborations must be encouraged to address th is global health problem.