ÐÓ°ÉÔ­´´

No one knows how many Britons are harmed by pesticides each year. There
are no reliable figures because of the failure of a bureaucratic system
of reporting exposure that operates through two vastly underfunded government
services, the National Health Service and the Health and Safety Executive.
As a result, almost 30 years after Rachel Carson prophesied pesticide disaster
in her book Silent Spring, the silence of the human victims of pesticide
poisoning is still profound. Over the past year I have contacted 46 victims
and begun to listen to their stories.

Organophosphates have been in use since the Second World War. The chemicals
were first developed as insecticides in 1937, then used in military research
on chemical weapons. After the war, organophosphates were once again directed
towards the control of insect pests as well as fungi and weeds. The agrochemical
industry turned to the organophosphates, preferring them to organochlorines,
such as the discredited DDT, because most degrade rapidly into other compounds
in plants and in the soil.

The early organophosphates were very toxic to both insects and people,
but chemists modified the compounds to make them much safer. There are important
differences in the way that insects and humans handle these chemicals physio-logically,
which makes them more toxic to insects and much less so to people. Yet human
nerve cells are not immune to their effects.

These insecticides work by interfering with the function of nerve cells.
In a healthy nervous system, insect or human, an activated nerve cell stimulates
the next in line by releasing the enzyme acetylcholine, which flows across
the tiny gaps or synapses that separate nerve cells. Once the nerve impulse
has passed across the synapse another enzyme, cholinesterase, acts to stop
the message reverberating endlessly across the synapse.

Without the dampening effect of cholinesterase, which is unavailable
because it is locked up in combination with the organophosphate, the nervous
system goes ‘berserk’. Alistair Hay, a chemical pathologist at the University
of Leeds, likens the effect to being continuously ‘switched on’. The voluntary
muscles that we can move at will are affected. So too are the involuntary
muscles that surround our vital organs such as the heart, lungs, stomach
and uterus. Both voluntary and involuntary muscles can go into spasm in
response to the absence of cholinesterase.

For those who survive exposure to organophosphates the impact on their
lives and bodies is enormous. The unchecked nerve messages to the voluntary
muscles result in tremors in all the muscles a person can think of moving.
Hands tremble, feet shake, eyelids twitch or refuse to open, eyes roll,
facial muscles twitch. Muscle pain and muscle wastage are common. The unchecked
signals to the involuntary muscles can result in heart attacks, stomach
cramps and vomiting, excessive menstruation and spontaneous abortion in
women, impotence and sterility in men, loss of sphincter control, increasing
excitement and fearfulness.

Many survivors are unable to work because they are permanently disabled.
Muscle pain and muscle weakness mean most movements cannot be sustained
for more than a few minutes. People who have been exposed to these pesticides,
either through their work or simply by chance, include agricultural and
horticultural workers, smallholders, caretakers, florists, secretaries,
social workers, salespeople, translators and senior citizens. Those doing
heavy agricultural work usually lose their livelihood and their homes. For
anyone whose work requires fine manipulative skills, exposure spells the
end of employment.

While not all organophosphates are equally toxic, everyone seems equally
vulnerable to those that are. The poisoning effect, whether acute or chronic,
is related simply to dose and duration. Those with prolonged, heavy exposure
may be unable to leave the uncontaminated atmosphere of their homes. Others
with a lower exposure may experience what seems rather like a common cold
or a ‘stomach bug’: the chronic symptoms of organophosphate poisoning are
sore throat, runny nose, tremor, aches and pains in the limbs, headaches
and stomach upsets. People who assume that they have a ‘summer cold’ or
‘stomach bug’ are unlikely to connect their symptoms with organophosphate
poisoning unless they notice that their recurrent complaints coincide with
repeated spraying. Yet exposure at this level may eventually result in serious
illness.

In 1987, the House of Commons Agriculture Select Committee, chaired
by Sir Richard Body, attempted to investigate the effects of pesticides
on human health. The committee concluded that under-reporting is a serious
problem, and pointed out that epidemiological studies would be unlikely
to identify an increase in symptoms which mimic ailments as common as colds
or flu.

Sufferers feel isolated because they have to avoid recontamination,
with attendant convulsions, vomiting and breathing difficulties, by staying
in their homes. They feel ill and tired most of the time. Some are barely
able to regain their strength between attacks brought on by recontamination.
Some suffer constant pain and restricted movement. Some are paralysed for
years. Some lose their speech for a time, or retain only the vestiges of
their sight and hearing. Some cannot keep their eyes still; others cannot
keep them open. Skin ulcers, a common symptom of the poisoning, can make
sufferers feel anxious about their appearance. And people exposed to the
most toxic organophosphates rarely feel confident about the behaviour of
their stomachs.

Poisoning events are under-reported, partly because many victims are
just too ill to report to a baffling system. The reporting system has four
disparate channels. Members of the public are supposed to report suspected
poisonings and deaths to the Health and Safety Executive. Only doctors can
report cases to the National Poisons Unit, based in Guy’s Hospital, London.
The Department of Trade and Industry operates the Home Accident Surveillance
System; this draws its figures from 20 hospitals in England and Wales with
a 24-hour emergency status. Hospital Inpatient Enquiry uses coroners’ returns
of deaths from a 10 per cent sample of hospitals.

The system is terribly unwieldy in operation. The various reporting
agencies use different definitions of poisoning so their figures disagree.
GPs are not trained to recognise poisoning, so make few referrals to the
National Poisons Unit. Members of the public are unlikely to know that they
should inform the Health and Safety Executive about a poisoning. Few victims
in agricultural areas live close enough to be treated by one of the big
hospitals offering round-the-clock emergency services.

In 1987, Body’s report called for urgent changes to the system. In response,
new regulations known as COSHH (Control of Substances Hazardous to Health)
were introduced towards the end of 1989. The new regulations shift responsibility
for assessment, monitoring and reporting of risk from the government to
the employer, but so far have made little impact on the poison reporting
scene. There is still no mechanism to ensure the reporting of cases of poisoning
that happen anywhere other than at work.

My research with organophosphate victims in England and Wales is an
attempt to reach people who have been overlooked by this inadequate reporting
system. A feature in Woman magazine last March invited victims to contact
me. I interviewed people in their own homes in confidence, so that they
could tell their stories despite disability and without fear of reprisals.

Most organophosphate victims have had no success in reporting to the
official agencies. Respondents found it very difficult to pass on information
about their exposure. Mr N, a horticultural labourer badly affected by working
with pesticides, first tried the Citizens’ Advice Bureau. Workers there
said ‘they didn’t know where to go with it’. He then contacted the environmental
health officers: ‘They didn’t want to know. They said it was not their field.’
Mrs O, whose home and garden were drenched by a helicopter spraying pesticides,
told of similar struggles to inform an appropriate service. ‘We were taken
ill straight away but we don’t call in our doctor very often. (So what I
did was) I tried very hard to look in the telephone directory that evening,
and my eyes had been so badly affected I could not read.’

The next day Mrs O. tried again: ‘I managed to get someone from the
council because I did not know what else to do. I reported it to him and
he made very few local investigations. He did not give me any advice and
I did not realise that the Health and Safety Executive should be involved.
Maybe I was very naive.’

Social and economic constraints can also block true reporting of what
has happened. Mr N’s wife explained how awkward it had been for them to
make any complaint about Mr N’s exposure because of the family’s dependence
on his employer: ‘He had to stop work because he kept collapsing. Mrs R.
(the employer’s wife) was asking what was wrong because he was so slow.
Me and the kids were trying to do his work with the chickens and such. We
didn’t want to say anything until we’d got out of the tied cottage into
the council house.’

Mr J, a skilled agricultural labourer, changed doctors because the first
one he consulted refused to entertain pesticide poisoning as a possible
cause of his excruciating stomach pains. His wife told how awkward changing
doctors had been in a small community where she met the doctor’s family
daily at school and their children played together at home. She said, ‘When
we changed doctors his wife asked me what the problem was. The doctor felt
he had worked very hard, going to the library and things like that. He was
³ó³Ü°ù³Ù.’

People also found it difficult to pursue their own investigations into
spraying accidents. Mrs M. contacted the Environmental Health Office about
pesticide spray in her pond. An official came to take her dead fish for
testing-two weeks later. The Environmental Health Office reported back to
Mrs M. that lime was spread on the field at the same time as the pesticides
and would affect the water so there was no proof that pesticides had killed
the fish. No reference was made to the fact that the fish had been dead
two weeks before they were analysed.

In contrast, Mrs E, a smallholder, called in the local water board so
that they could take her dead fish for analysis and prove the presence of
the pesticide in her pond water. Two hours later officials from the board
arrived, told her the fish had been ‘dead too long’ and refused to take
them away for examination. Neither woman knew what steps to take next.

Mr D, a sheep farmer, now distrusts the official government laboratories
where he sent animals for postmortem examinations: ‘We don’t get to hear
of it if the results are odd. Only the company hears.’

Lay people were aware, too, that although the pesticides may be safe
when used in controlled ‘laboratory’ conditions, these conditions do not
prevail in real life. At work, the risks involved in handling the pesticides
increase enormously. Mr J, who was college-trained in the use of pesticides
for his work as an agricultural labourer, said: ‘The ruling is as long as
you’re wearing all the safety equipment when it’s a concentrate then it’s
all right. But these are paper boiler suits. They are so torn there’s nothing
as protection.’

Mr N, a professional gardener, was also distrustful of chemicals used
in workplace conditions: ‘We used agricultural chemicals, not horticultural
ones, because they’re cheaper. There was a storage shed for the chemicals.
They were locked up. But the glass front in the storage cupboard was broken
anyway. When we found bottles with no labels the boss told us: ‘Burn the
stuff and dispose of it as best you can’.’

The victims also questioned the use of scientific concepts such as ‘sensitivity’
outside laboratory conditions, where livelihoods are at stake. Mrs D, whose
husband became ill as a result of handling his sheep after they had had
an organophosphate dip, said her husband’s supposed oversensitivity was
being blamed instead of the chemical. ‘MAFF (the Ministry of Agriculture,
Fisheries and Food) said, ‘If you can’t use OPs then you’re not fit people
to keep sheep’,’ she said.

Some said they felt they had been experimented upon by an intellectual
elite. Mrs D, exposed to sheep-dip as a farmer’s wife, spoke angrily about
professionals such as chemists, university professors and scientists: ‘The
so-called ‘brains’ of this country have been poisoning the rest of us.’
Seventy-year-old Mrs H, protested against her involuntary exposure to pesticide
sprays: ‘ÐÓ°ÉÔ­´´s have been permitted to indulge in too many experiments.
Guinea pigs, we are! Some of us object.’

Not many exposure victims have the resources to fight their way into
the reporting system. Enfys Chapman is one notable exception. Following
the drenching of herself, her sons and employees, her home, her farm and
her animals with the organophosphates triazophos and dimethoate from a helicopter
on 14 July 1977, Mrs Chapman was admitted five days later to Addenbrooke’s
Hospital in Cambridge suffering muscular spasms so violent that they threw
her from her bed. She experienced stroke-like paralysis of the left side
of her body, suffered convulsions and agonising cramps, lost her memory
and with that the use of her second language, English, and she was partially
blind for four years. Fourteen years later, she has the use of only 20 per
cent of the left side of her body, sees with only one eye, walks with the
aid of a stick or must use a wheelchair to reduce the strain on her heart.
Re-exposure is liable to bring about involuntary muscle spasms which could
be fatal.

Trained as a botanist and nutritionist, Mrs Chapman guessed when the
helicopter flew over the farm that the spray might threaten her health.
She sent her sons to get the helicopter’s number and made the operators
tell her the names of the chemicals they had used. The Civil Aviation Authority
(CAA) was informed of the helicopter’s number. Advised by the Health and
Safety Executive to keep everyone else away from the cattle because organophosphates
could cause sterility in men and abortion in women, Mrs Chapman tended her
sick cows herself, fearing she might be sued over the health threat to her
employees.

A past president of the British Veterinary Association living opposite
Mrs Chapman contacted Hoechst, the manufacturers of the pesticides, to find
out how to help Mrs Chapman’s pain-crazed cows. Although Hoechst’s chemist
rang the next day to tell her to wear protective gear and to get her eyes
treated, five days later, when she was admitted to hospital, the Hoechst
chemist could not be contacted by the hospital doctors.

Although very ill, Mrs Chapman had immediately contacted the CAA, the
DHSS, the HSE, solicitors, MPs, the Minister of Agriculture, veterinary
services, Hoechst Chemicals, Lloyds Insurance, the hospital and her GP.
Her comprehensive and well-informed alerting of diverse authorities contrasts
with most victims’ muddle of indecision and ignorance.

Mrs Chapman’s experience also contrasts with people who are exposed
on a daily basis. Then there is no pinpointing of a single ‘poisoning event’
which they suspect could cause problems later and which ought to be safeguarded
against by informing the authorities. Mrs Chapman was paid £12 000
compensation in an out-of-court settlement with Hoechst. Despite all the
people she had alerted, her solicitors advised her that she could not win
and that she risked having to pay the agrochemicals company’s legal costs.

In 1988 Mrs Chapman and two others set up the Pesticide Exposure Group
of Sufferers (PEGS). She counsels other victims and campaigns for effective
regulation. In 1989 she enlisted the help of the Centre for Science Studies
and Science Policy at Lancaster University to survey pesticide victims.
On 15 March 1990 Mrs Chapman organised a Parliamentary lobby and the signing
of an Early Day Motion by hundreds of supportive MPs.

Why, despite such valiant campaign efforts, do the victims of pesticide
poisoning continue to be ignored? And why do these incidents, recounted
to me in such detail, fail to swell the numbers of registered poisonings
in the official records? The victims’ comments on their experiences reveal
part of the answer. These show how social and official obstacles prevent
the reporting of such incidents and how lay awareness of hazard is routinely
undervalued.

The effects of the poison also help to mask the size of the problem.
Death, illness, loss of fine motor skills, lack of concentration, inability
to communicate, fatigue and depression all conspire against the reporting
of organophosphate poisoning.

But the failure to register a poisoning may stem from factors other
than illness. Some victims feel that, as lay people, they can do nothing
when faced with technological failure. Residents near Three Mile Island
in the US showed this re-sponse after the nuclear accident in 1979. The
closer they were to the damaged reactor, the more powerless they felt. Psychologists
have produced what may be analogous responses in laboratory animals given
electric shocks or some other stress from which they are unable to escape.
The animals become withdrawn and inactive, and seem to ‘give up’. This so-called
‘learned helplessness’ may explain some of the under-reporting and inactivity
that surrounds organophosphate poisoning.

Some organophosphate exposure victims, however, are finding ways to
achieve more of a sense of taking control. They feel that by recounting
their experiences they can contribute to society’s store of knowledge. Mrs
Chapman had sufficient information, training and social contacts to avoid
‘learned helplessness’.

The pesticide exposure victims’ feeling that they were the unwitting
subjects of large-scale experimentation ties in with an idea elaborated
by Wolfgang Krohn and Johannes Weyer of Bielefeld University in Germany.
Drawing largely on evidence from the nuclear industry, they suggest that
research is unavoidably moving out of the laboratory and into society, taking
research risks with it. Like the victims of poisoning, the researchers seek
a redistribution of responsibility for the ‘scientific errors’ which science
used to ‘contain’ within its own laboratories.

Organophosphate pesticides meet Krohn and Weyer’s criteria for technologies
involved in implicit large-scale trials. The impact of pesticides is not
just confined to the laboratory; people in society have been affected. Nor
is the discussion confined to scientists. It continues in every farming
magazine, every advertisement for flea spray, every comment that feeding
the world’s population depends on killing agricultural pests with chemicals.

That people exposed to pesticides often see themselves as guinea pigs
does not mean, of course, that they believe that the agrochemical industry
has planned experiments. But they feel the effects are the same-except that
their experiences, their ‘data’, are not being used.

Having found what seem to be research risks in their everyday lives,
victims expect the experiment to be completed. Many are frustrated and angry
when they realise that they cannot communicate their ‘results’. The broken
cycle of information appears to result from the failure of the reporting
system. In a study carried out in 1983, for instance, only 1 in 25 poisoned
farmers knew they should report such incidents to the Health and Safety
Executive. The victims’ comments demonstrate the social, official and physical
difficulties which prevent victims’ access to the agencies. So the agrochemicals
industry remains deaf to the outpourings of the people exposed to pesticides.

But the information is not inevitably lost. Victims’ data have been
dispersed into several areas: veterinary science, medicine, sociology, neuropsychology,
nutrition, the sufferers’ group PEGS, alternative medicine institutions
and farming magazines. People working in these fields are understandably
unsure what to do with the seemingly anecdotal evidence about these poisons,
because the data are so scattered. In 1962, Rachel Carson foresaw the communication
problems inherent in increasing specialisations. She pictured an awful future:
‘an era of specialists, each of whom sees his own problem and is unaware
of or intolerant of the larger frame into which it fits’. Which field will
collect the information from the people exposed to organophosphates, in
order to construct Carson’s ‘larger frame’?

We need to determine the relationship between the victims’ information
and the data reported to the agrochemicals industry. Would companies welcome
improved feedback from victims? Do they want to hear the voice of the victims
of pesticide poisoning who have suffered in silence for so long? Research
with the agrochemicals industry and the reporting agencies is the next item
on the agenda for investigation.

Hazel Bartle is a postgraduate student at the Centre for Science Studies
and Science Policy at the University of Lancaster. Anyone who believes themselves
to have been affected by pesticides can write either to Hazel Bartle at
Lancaster or to PEGS, 10 Parker Street, Cambridge CB1 1JL.