In the recent past, many Saudis and expatriate alike have sustained injuries and fatalities as a result of the ignorant use of pesticides, particularly those containing aluminum phosphate. Indeed it is shocking that in the past few months alone, up to 12 people – including a number of children – in the Kingdom have died as a result of the improper use of pesticides. Common pesticides form a necessary part of all households. We need them on a day-to-day basis in order to rid our homes of insects. In using them however, we often forget that pesticides are fundamentally, cocktails of poisonous substances that can adversely affect our health and the environment if not used with common sense and caution. Saudi Gazette met with a number of health professionals to discuss the hazardous nature of these pesticides and how to use them responsibly. The vital issue, of course, is why there is such an alarming number of poisonings – often fatal - and how people can protect themselves from the danger associated with regularly using toxic chemicals. Ahmad Nabil Abo-Khatwah is an adviser for the secretariat of pesticides and works at the King Abdul Aziz University in Jeddah and he identifies three kinds of pesticides: ‘general use', ‘restricted use', and ‘forbidden use'. “The problem lies with those consumers who are using ‘restricted use' pesticides to eliminate mice and cockroaches from their home, factories and farms, thereby ignoring the associated dangers,” he said. “In the Kingdom, a black market illegally deals in such pesticides and they cost as little as SR 10, without having an illustrative label urging cautious use – all for the purpose of financial gain.” “Aluminum phosphate is considered one of the riskiest substances in these pesticides because of the phosphate gas which gives off a distinctive ‘rotting fish' smell and can cause severe infections in a person's respiratory system. It causes congestion in the heart and can even halt the organ's function, consequently affecting the brain, kidneys and liver,” Abo-Khatwah added. He points out, moreover, that this is worldwide problem. There were 22,423 poisoning cases in the United States in 1996, for instance, where ten percent of those cases caused serious complications or death. Up to 250 active chemical substances exist in 2500 commercial pesticides within the agricultural, industrial and domestic sectors in the global market. Dr. Hussein Al-Gahtani is a Consultant Neurologist and professor at the King Khalid National Guard hospital in Jeddah, and he also stresses that pesticide-poisoning is a very large-scale problem, particularly in developing countries where there is less awareness about such issues, and strong pesticides are widely used for agriculture purposes for the control of insects and weeds. “On the basis of a survey of self-reported minor poisoning carried out in Asia, it is estimated that there could be as many as 25 million agricultural workers in the developing world suffering from an episode of poisoning each year,” he remarked. Most estimates calculating the extent of acute pesticide poisoning are based on data from hospital patient admissions, which obviously only include the more serious cases. The latest estimate by a World Health Organization (WHO) task group indicates that there may be a million serious, accidental poisonings each year in the world, with an additional two million people getting hospitalized for attempted suicide by consuming pesticides. These estimates are only the tip of the iceberg. Self-poisoning in the agricultural sector is considered to be on the rise, and represents a major hidden public health problem. The WHO estimates that approximately 300,000 people die from self-inflicted pesticide poisoning each year in the Asia-Pacific region alone, because many agriculture workers do not read the label and work without proper protection. Dr. Al-Gahtani indicates that organophosphorus insecticides are the most common form of pesticides, which are normally esters, amides, or thiol derivatives of phosphoric, phosphonic, phosphorthioic, or phosphonothioic acids. Most of these are recognizable for being only slightly soluble in water. “Organophosphorus affects insects and mammals both by inhibiting acetyle cholinesterase in the nervous system. It affects exposed persons as a result of disease-vector control programs, through contact with the skin and by inhalation (affecting the respiratory tract),” he explained. It is those pesticides that contain aluminum phosphates however, that are most harmful, and seem to affect women and children disproportionately to men. “A pesticide that contains strong chemicals will find it easier to deposit them inside an area of a woman's body – such as a breast, where they can induce a tumor – or rapidly affect the cells in a child's body to cause renal failure,” remarked Falah Al-Mazrua from the General Directorate of Preventative Health at the Ministry of Health. How do these toxic substances actually enter the body? Dr. Mohammed Garout, a Consultant in the Epidemiology Community Medicine department and director of the Infection Control department at the International Medical Center in Jeddah explained the process. “Any pesticide can enter the body through inhalation and ingestion. In the latter's case, the toxic substance will go straight to the stomach, where contact with water will produce stomach acid. This produces phosphate gas, which causes the person to experience stomach aches, vomiting, chest constrictions and a rise in body temperature,” he explained. He added that continued exposure to phosphate gas (and its by-products) will give the victim diarrhea and a bluish tinge to the skin. Moreover, shortness of breath, dizziness, a spike in the heart rate and slump in blood pressure will eventually be experienced, ultimately leading to death, if untreated. However, there are simple precautions one can take when using pesticides. “Hygiene, good ventilation and exposure to the sun are simple – but important – changes to lifestyle that one has to maintain,” remarked Abo-Khatwah. “The public should use safer alternative pesticides that contain Beta-cyfluthrin, Etofenprox, or Lambda-cyhalothrin.” He cautions against using products that are not in their original packaging and stresses the need to read labels thoroughly. It is extremely important – considering the spike in accidental pesticide poisonings the Kingdom has experienced in recent years – that residents are made aware of the dangers associated with using pesticides. Those working in the agricultural and industrial sectors, in particular, - including all workers and cleaners - should be made aware of the hazardous nature of aluminum phosphate, especially. “We have published approximately 2500 leaflets on this issue, but more awareness has to be created through campaigns at malls, hospitals, schools and the distribution of more booklets, especially in different languages, to cater to the Kingdom's diverse expatriate community,” remarked Dr. Garout. He added that the Kingdom's Ministries of Agriculture, Civil Defense and Commerce have tightened control for the sale of stronger pesticides. Moreover, a new policy is being implemented to measure the ratio of gas concentration in a certain area's atmosphere, so as to warn incoming people if the area shows a high percentage of toxic substances in the atmosphere. Let's hope that this unwelcome recent phenomenon dies down without a trace.
