Man Vs chemical misuses and consequences

Dr. Inoka SuraweeraMBBS,MSc, MD (Community Medicine)

Consultant Community PhysicianEnvironmental and Occupational Health Directorate

Ministry of Health

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CHEMICALS ARE USED IN EVERYDAY LIFE

Benefits Promote hygiene Protect crops Control vectors

Risks Adverse health effects Unwanted pollutants in the environment Persistence

WHO

So Many Chemicals so Little Data

78.2% no data

21.4% some data

12 or 0.4% good data

2863 above 1 Million pounds

www.preventingharm.org

• Approximately 80,000 chemicals listed by EPA• Most of these chemicals have not been tested

for developmental toxicity• For example, High Production Volume (HPV)

Chemicals• Chemicals produced at >1 million lbs/year

• Approximately 3,000 chemicals identified internationally

• Few tested for both reproductive and developmental toxicity

Current Chemical Facts

399 BC Death of Socrates by HemlockSocrates was charged with religious heresy and corrupting the morals of local youth.

The active chemical used was the alkaloid coniine which, when ingested causes paralysis, convulsions and potentially death.

Ancient Awareness

From Romeo and Juliet - act 5Come bitter pilot, now at once run onThe dashing rocks thy seasick weary bark!Here’s to my love! O true apothecary!Thy drugs are quick. Thus with a kiss I die.

Shakespeare (1564-1616)

Historical Awareness

“All substances are poisons; there is none which is not a

poison. The right dose differentiates a

poison from a remedy.”

Paracelsus (1493-1541)

Paracelsus

“As crude a weapon as a cave man’s club, the chemical barrage has been hurled against the fabric of life.”

Rachel Carson – Silent Spring (1962)

Silent Spring

Chemical Misuse

Improper transportation

Too little

Improper disposal

Improper storage

Too much

Improper handling

Chemical weapons

Improper manufacturing

practices

Who will be affected?

• Individuals

• Populations•Especially children

• Workers

Individuals

• Deliberate self harm with chemicals– A public health problem– Though the rate of suicide has declined to 16 per 100,000 in

2011, it remains among the worst globally. – Around 60% suicides are due to pesticide poisonings– Mostly due to ingestion of

• highly toxic pesticides• Paracetamol• Kaneru / niyagala• Washing powder

– Decline is due to many interventions and especially due to banning some of the highly toxic pesticides.

Workers and misuse of chemicals

Characteristics of Sri Lankan workforce (Sri Lanka LabourForce Survey Annual Report – 2013) Employed population in Sri Lanka 8,417,674 Males 5,498,815 (65.5%)Females 2,918,859 (34.5%)Formal sector 39.2%

Informal sector 60.8 %Agriculture 86.8 %Non agriculture 49.8 %

Selected occupational carcinogens and health outcomes

Occupational carcinogen Health out come

Benzene Leukaemia

Ethylene oxide Leukaemia

Silica Cancer of the trachea, bronchus, or lung

Asbestos Malignant mesothelioma, Lung cancers

Diesel exhaust Cancer of the trachea, bronchus, or lung

Available data on chemicals in occupationsWHO: Chemicals burden of disease | 20 May 2011

Chemicals/Chemical groups

Disease outcomes Attributable fraction

DeathsPer year

DALYsPer year

Chemicals in occupational exposures (longer term effects)

581,000 (sub-total)

6,763,000 (sub-total)

Asbestos Mesothelioma; lung cancer

107,000 1,523,000

Occupational lung carcinogens (8 selected carcinogens)

Lung cancer (8 6%) 111000 1 011 000

Occupational leukaemogens(benzene ethylene oxide ionizing rad )

Leukaemia (2.3%) 7400 113,000

Occupational particulates – causing COPD (dusts, fumes/gas)

COPD (13%) 375,000 3,804,000

Occupational particulates - other respiratory diseases than COPD (silica, asbestos and coal mine dust)

Asbestosis; silicosispneumoconiosis

29000 1,062,000

• More than 8% of all cancer deaths in men are due to occupational exposures, and for lung cancer, the most important occupational cancer, the estimate for men is above 20%Estimating the burden of occupational cancer as a strategic step to prevention Kurt Straif1,* British Journal of Cancer. 2012 Jun 19; 107(Suppl 1): S1–S2

• 2.0% of global deaths (1.7% of DALYs) are from industrial and agricultural chemicals, and accidental poisonings

Pesticide Definition - Simple

The function of a pesticide is to kill or

harm some form of life

Concerns about Pesticide-Use

Pest Resistance

Health Outcomes

Immediate• Flu-like symptoms• Skin Rash• Breathing problems

Long-Term• Asthma• Cancer• Damage to brain and nervous system• Immune system damage• Endocrine disruption

Vulnerable Populations

Environmental Damage

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www.toxicsoy.org/toxicsoy/news/Artikelen/2009/7/1_Girl_suffering_from_pesticide_poisoning.html

E A Guillette, M M Meza, M G Aquilar, A D Soto, and I E Garcia, (1998), An anthropological approach to the evaluation of preschool children exposed to pesticides in Mexico. Environ Health Perspect.,106(6)

Long-Term Exposure to Pesticides

Cancer

Develop-mental

Others?

Behavioral

Allergies Brain Damage

Infertility

Asthma

Birth Defects

Chronic Exposure:AsthmaCancerNeurological damageImmune system damagePermanent chemical sensitivityEndocrine disruption

Chemical accidents

Event

• Sudden leakage of a gas (??Ammonia)

• Around midnight • Only the security guard was available

at the time of the accident

Immediate effects

• Around 70 hospitalized to Piliyandala Divisional Hospital

• Some had been transferred to Kalubowila Teaching Hospital

• Majority had – difficulty in breathing– Severe eye irritation– Burning sensation of the skin

Other effects

• Mental health problems

• Public Health issues such as• Water safety• Food safety

• (Veterinary health issues)