Pesticides are used in agriculture and in public health programmes as important elements in an integrated approach to vector control. However, they are frequently misused, and pose a serious health problem to the whole population. The risks are higher for infants, children and adolescents, as they may be exposed during periods of special vulnerability.
Unsafe use, storage and disposal of pesticides are the main causes of acute poisoning. Pesticides such as insecticides, herbicides and rodenticides are accessible to children in rural areas, but may also be found by toddlers exploring their home, garden sheds or garages. A study in Canada showed that almost 60% of poisoning cases registered at a paediatric hospital were due to pesticides and that the effects of most pesticides were acute and severe. In developing countries, the real incidence of pesticide poisoning is difficult to assess, but is assumed to be high. A large number of child and adolescent workers are exposed to pesticides through agricultural work, as they are commonly involved informally in the preparation and application of pesticides. Children are also exposed as bystanders during spraying for agricultural pest control.
Chronic, low-level exposure to pesticides is linked with neurological, developmental, reproductive and other effects in children. Persistent pesticides considered persistent organic pollutants (POPs) that are present in the diets of small children (including breast milk) raise particular concern. They accumulate in fatty tissue, and remain stored in the fatty tissue of the body over long periods.
More child-specific research, as well as activities to strengthen surveillance mechanisms and promotion of regulatory measures and risk-reduction interventions, are required. In addition, the provision of information and technical advice to countries, harmonized collection of case data on children’s chemical exposure and poisoning, classification of pesticides by hazard, and recommendations on the public health use of pesticides should be strengthened.
Policy actions and regulatory measures should be put in place to reduce or eliminate exposure to priority chemical pollutants affecting child health and development, such as persistent organic pollutants (POPs) and heavy metals. As a first step in reducing children’s exposure to lead, governments should be urged to phase out the use of leaded gasoline. Mechanisms should be put in place to provide logistical, financial and technical support for such efforts. Regulatory measures should be encouraged to promote safe use of chemicals and substitution by safer alternatives. Integrated agricultural practices should be promoted to reduce reliance on the use of toxic pesticides.
At the local level, action should be taken to promote the safe use of chemicals through the provision of evidence-based information on health risks from exposure to chemicals and on cost-effective interventions to decision-makers. Aspects of chemical safety and health should be incorporated into school curricula, and health personnel should be trained to recognize and prevent toxic exposures. The commitment and active involvement of communities in such efforts should be solicited.