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PUBLIC HEALTH: ACUTE ILLNESS AND PESTICIDES IN SCHOOLS

The following points are made by W.A. Alarcon et al (J. Am. Med. Assoc. 2005 294:455):

1) Exposure to pesticides in the school environment is a health risk facing children and school employees. Despite efforts of several organizations and laws in several states to reduce pesticide use at and around schools,[1] pesticides continue to be used in schools.[2] Another source of pesticide exposure at schools is from pesticides used on farmland contiguous to school facilities. However, as a result of the work of the US Environmental Protection Agency (EPA), advocacy groups, universities, state regulators, the pest control industry, and others, and laws or strong voluntary programs in several states, pesticide use has been reduced in some school districts.[3]

2) Currently, there are no specific federal requirements on limiting pesticide exposures at schools. Under the Federal Insecticide, Fungicide, and Rodenticide Act, pesticides must be registered with the EPA before they are sold or distributed.[4] The Food Quality Protection Act[5] of 1996 amended the Federal Insecticide, Fungicide, and Rodenticide Act, bolstering the protection of children through requiring that pesticides used on foods produce no harm. However, there are no specific provisions in these laws about the use of pesticides at schools.[1]

3) The Federal Insecticide, Fungicide, and Rodenticide Act is often supplemented by more stringent state pesticide laws to protect children from pesticides at schools. For example, 18 states recommend (n = 6) or require (n = 12) schools to use integrated pest management strategies and 7 states restrict pesticide applications in areas neighboring a school. However, there are still large gaps throughout the country where children may not be afforded adequate protection.[1]

4) Pesticide poisoning is a commonly underdiagnosed illness in the United States today. The clinical findings of acute pesticide poisoning are rarely pathognomonic but instead can resemble acute upper respiratory tract illness, conjunctivitis, or gastrointestinal illness, among other conditions.

5) The authors conducted a study to estimate the magnitude of and associated risk factors for pesticide-related illnesses at schools. The authors analyzed surveillance data from 1998 to 2002 of 2593 persons with acute pesticide-related illnesses associated with exposure at schools. Nationwide information on pesticide-related illnesses is routinely collected by 3 national pesticide surveillance systems: the National Institute for Occupational Safety and Health's Sentinel Event Notification System for Occupational Risks pesticides program, the California Department of Pesticide Regulation, and the Toxic Exposure Surveillance System.

6) The authors concluded: Pesticide exposure at schools produces acute illnesses among school employees and students. To prevent pesticide-related illnesses at schools, implementation of integrated pest management programs in schools, practices to reduce pesticide drift, and adoption of pesticide spray buffer zones around schools are recommended.

References (abridged):

1. US General Accounting Office. Pesticides: use, effects, and alternatives to pesticides in schools. Washington, DC: US General Accounting Office; 1999. Available at: http://www.gao.gov/archive/2000/rc00017.pdf. Accessibility verified June 16, 2005.

2. Ohio Schools Pest Management Survey. Available at: http://ipm.osu.edu/school/survey.htm. Accessibility verified June 16, 2005.

3. US Environmental Protection Agency. Integrated pest management (IPM) in schools. Available at: http://www.epa.gov/pesticides/ipm/. Accessibility verified June 16, 2005.

4. US Environmental Protection Agency. The Federal Insecticide, Fungicide, and Rodenticide Act. Available at: http://www.epa.gov/opp00001/regulating/fifra.pdf. Accessibility verified June 16, 2005.

5. US Environmental Protection Agency. The Food Quality Protection Act (FQPA) background. Available at: http://www.epa.gov/oppfead1/fqpa/backgrnd.htm. Accessibility verified June 16, 2005.

J. Am. Med. Assoc. http://www.jama.com

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Related Material:

LINK BETWEEN HOME PESTICIDE EXPOSURE AND PARKINSON'S DISEASE

The following points are made by Joan Stephenson (J. Am. Med. Assoc. 2000 283:3055):

1) The author discusses a study reported at a conference, a study that involved 496 patients diagnosed with Parkinson's disease within the Kaiser Permanente Medical Care Program of Northern California during the years 1994-1995, and 541 age- and sex-matched controls from the same population. Using in-person structured interviews, a research team collected information about lifetime history of exposure to home pesticides (herbicides, insecticides, and fungicides) prior to diagnosis.

2) After controlling for known risk factors such as family history of the disorder, occupational exposure to pesticides and herbicides, and cigarette smoking, the investigators found that home exposure to insecticides and herbicides were associated with an increased risk of Parkinson's disease. Fungicide exposure was not linked with an increased risk of the disorder.

3) Individuals with high-level herbicide exposure had a 70 percent increased risk compared with those who were not exposed. People who used insecticides in the garden showed a 50 percent increased risk compared to those who had never been exposed to home pesticides of any type. In-home use of insect-killing chemicals was associated with a 70 percent increased risk of Parkinson's disease compared with no use of pesticide.

4) In her report to the American Academy of Neurology, Lorene Nelson, a neuroepidemiologist, pointed out that the idea that pesticides might be linked with Parkinson's disease is biologically plausible, since many pesticides are neurotoxic and may affect various aspects of central nervous system function, possibly even resulting in the death of specific nerve cells. Previous studies have found a substantially increased rate of Parkinson's disease among city dwellers who gardened for a hobby.

J. Am. Med. Assoc. http://www.jama.com

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