We, Toxicologists and Health Professionals, call for a global elimination of Highly Hazardous Pesticides

Open letter to Mr Achim Steiner, Executive Director of UNEP, Dr José Graziano da Silva, FAO Director-General of FAO, and Dr Margaret Chan, Director-General of WHO on the occasion of the fourth session of the International Conference on Chemicals Management

Many pesticides pose a threat to human health and the environment and result in heavy costs to societies. Due to their extensive use over a long period of time, highly hazardous pesticides (HHPs)[1] are now widely dispersed throughout ecosystems globally. Pesticides are found in human bodies and other living organisms, food and water, soil, and in the air.

Early statistics from the World Health Organisation (WHO) indicated that about 200,000 people were being killed worldwide and as many as 25 million agricultural workers in the developing world were suffering from occupational pesticide poisoning, every year.[2] In the decades since that estimate, surveys have indicated that occupational poisoning is increasing.[3] Official studies grossly underestimate these numbers. It is known that many children are poisoned by pesticides but there is no estimate of numbers.[4] UNEP’s Global Chemical Outlook report points out that “Acute chemical poisoning data are highly variable and depend on the surveillance infrastructure in place in individual countries or regions”.[5] WHO acknowledges that there are no reliable estimates of pesticide poisonings and that existing estimates likely significantly underestimate the global burden.[6][7]

A recent meta-analysis of worldwide literature on pesticide self-poisoning resulted in a conservative estimate of suicides by pesticides accounting for approximately 33% of suicides globally.[8] According to this WHO study restricting access to the means of suicide such as pesticides is a key element of suicide prevention efforts as pesticides are among the most common methods of suicide globally.

Further, Maximum Residue Limits, Acceptable Daily Intakes and Maximum Allowable Concentrations support a belief in “safe” levels of exposure that do not exist. Because of their inherent toxicity to humans and/or biological systems, the risks associated with HHPs cannot be managed safely, and thus ‘risk management’ approaches do not effectively prevent their disastrous effects on the health of humans and the environment, including the widespread disappearance of honeybees.[9]

Current risk assessment is largely based on the idea that “the dose makes the poison.” However, recent advances in science have demonstrated that chronic exposure to low, so-called “non-toxic” doses and to mixtures means there is unacceptable uncertainty in identifying safe levels to exposure to carcinogens, reproductive toxins, neurodevelopmental toxins and endocrine disruptors.

Existing regulatory guidelines are insufficient for hazardous effects such as immunotoxicity, endocrine disruption and postnatal reproductive toxicity effects.

There is growing evidence that the health of future generations may be severely jeopardized by HHPs. The foetus and the newborn child are sensitive to the harmful effects of many pesticides and other environmental contaminants, which may irreversibly influence their developmental processes.

Our understanding of the many ways in which chemicals can affect humans and the environment is still unfolding. For instance, our understanding of the fact that environmental chemicals can interfere with hormone action has developed slowly over the past half-century,[10] but is still insufficiently defined for regulatory systems to take appropriate action on them.

For the above reasons, it is ethically important for us, as concerned toxicologists and health professionals, to call for the immediate global elimination of HHPs. Their production, distribution and use must be stopped to protect our children and the succeeding generations from an impending toxic tragedy.

Signatories:

1. Dr. George Ackerman, MD
Physicians for Social Responsibility
USA
2. Dr. Omar Arellano Aguilar, Ph D (Ecotoxicology)
Expert in Environmental and Health Risk Evaluation
Professor and Researcher Universidad Nacional Autónoma de México (National Autonomous University of Mexico), Vice-President Union of Concerned Scientists
Mexico
3. Jorge Enrique Alaniz
Hospital toxicologist
Aldo Cantoni-Calingasta
Argentina
4. Dr. Lilia A. Albert, Ph.D (Chemistry)
Sociedad Mexicana de Toxicología (Mexican Society of Toxicology)
Latin American Toxicology Association
Mexico
5. Dr. Nelson Francisco Albiano
Medical toxicologist
Former Head of Toxicology Unit at Children’s Hospital “A. Gutiérrez”, Buenos Aires
Current Counsel at National Superintendence of Occupational Risks, Ministry of Labor, Employment and Social Security
Argentina
6. Maryse Arendt
Lactation consultant IBCLC
Initiativ Liewensufank
Luxemburg
7. Dr. Mohammed Asheel, MD
District Programme Manager, Kasaragode District
National Rural Health Mission
India
8. Dr. Mohammad Ali Barzegar, MD, MPH
People’s Health Movement
USA
9. Dr. Giovanni Beghini, MD
Neurology, Acupuncture and Homeopathy Specialist
President, International Society of Doctors for the Environment, Verona
Italy
10. Dr. Trude Bennett, DrPH
Associate Professor Emerita
Gillings School of Global Public Health
The University of North Carolina at Chapel Hill
USA
11. Julia Blanco, MPH
Researcher and Professor in Medical Sciences
National Public Health Institute/ Instituto Nacional de Salud Pública
Mexico
12. Dr. Alison Bleaney
National Toxics Network
Tasmanian Public and Environmental Health Network
Doctors for the Environment Australia
Australian College of Rural and Remote Medicine
Royal Australian College of General Practitioners
Australia
13. Dr. Mirta Borrás
Pediatrician and Toxicologist
Coordinator of the committee on environment and health of the Argentina Society of Pediatrics
Argentina
14. Dr. Paul Butler, MD
Physicians and Scientists for Global Responsibility
Fellow, Royal New Zealand College of General Practitioners
New Zealand
15. Dr. Salvador Eugenio C. Caoili, MD, PhD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
16. Dr. Elda Cargnel
Head of Toxicology Unit
Ricardo Gutierrez Children’s Hospital
Argentina
17. Dr. Carlo G. Catabijan, MD, MSc
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
18. Dr. Peter Clausing
Toxicologist (retired)
Member of the German Society for Experimental and Clinical Pharmacology and Toxicology
Germany
19. Dr. James Dahlgren, MD
Physicians for Social Responsibility
USA
20. Dr. Leslie Michelle M. Dalmacio, MSc, PhD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology), and National Institute of Health
Philippines
21. Dr. Javier Alejandro Belmont Díaz, PhD
Laboratory of Biochemistry National Institute of Cardiology “Ignacio Chávez”
México
22. Dr. Jake Donaldson, MD
Santa Paula Hospital Clinic
USA
23. Dr. Marsha Epstein, MD
Physicians for Social Responsibility
USA
24. Dr. Guadalupe Barrera Escorcia, PhD (Biological Sciences)
Ecotoxicology Laboratory
Universidad Autónoma Metropolitana (UAM)-Iztapalapa
México
25. Dr. Rhodora C. Estacio, MSc, PhD
Professor, Chair, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
26. Dr. Leticia Yañez Estrada, PhD
Laboratory of Gender, Health and Environment
Medicine Faculty, Universidad Autónoma San Luis Potosi,  University (UASLP)
Mexico
27. Dr. Jane E Ferrie
Academic Editor, International Journal of Epidemiology
UK
28. Dr. Mia J. Fojas, MD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
29. Dr. Lawrence Freedman, MD
Physicians for Social Responsibility
USA
30. Dr. Marisa Gaioli, Pediatrician
Health and environment committee of the Argentina Society of Pediatrics
Faith Hospital Garrahan
Argentina
31. Dr. Aurora Elizabeth Rojas García, PhD
Researcher and Professor, Coordinator of Academics (Environmental Toxicology and Pollution)
Universidad Autónoma de Nayarit (UAN)
Mexico
32. Dr. Patrizia Gentilini, MD
Oncology and Haematology Specialist
Member of International Society of Doctors for the Environment, Italy
Italy
33. Dr. Steven G. Gilbert, PhD, DABT
Institute of Neurotoxicology & Neurological Disorders
USA
34. Dr. Michael Godfrey, MBBS, FACNEM
Physicians and Scientists for Global Responsibility
New Zealand
35. Dr. Charles Goldsmid, PhD
Physicians for Social Responsibility
USA
36. Dr. Paula Goldsmid, PhD
Physicians for Social Responsibility
USA
37. Dr Elizabeth Harris
Physicians and Scientists for Global Responsibility
Fellow Royal New Zealand College of General Practitioners
New Zealand
38. Dr. Catalina Eibenschutz Hartman
Physician, University professor and researcher
ALAMES, PHM
Mexico
39. Dr. Francisco M. Heralde III, MSc, PhD
University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
40. Dr. Jaqueline Garcia Hernández, PhD (Environmental Science)
Centro de Investigación en Alimentación y Desarrollo (CIAD) / Research Center on Food and Development
Mexico
41. Dr. Hans-Ulrich Hill
Biologist, specialisation in toxicology
European Academy of Environmental Medicine
Germany
42. Dr. Cleotilde H. How, MD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
43. Dr. C. Vyvyan Howard, MB. ChB. PhD. FRCPath
Professor of Bioimaging and Leader of the Nano Systems Research Group
School of Biomedical Sciences, University of Ulster
UK
44. Dr. Quinton James, MD
Physicians for Social Responsibility
USA
45. Dr. Henk Jans  MD, MPH
Chair, Dutch Association for Environmental Health (NVMM);
The Netherlands
46. Dr. Helen Jaskoski, PhD
Physicians for Social Responsibility
USA
47. Dr. Mohamed Jeebhay, MBChB, DOH, MPhil, MPH, PhD
Professor and Director of School of Public Health and Family Medicine
University of Cape Town
South Africa
48. Dr. Sandra Joos, PhD
Physicians for Social Responsibility
USA
49. Dr. Arvind Kasthuri
Professor, Department of Community Health
St John’s Medical College,
India
50. Dr Sévilor Kekeunou
Senior Lecturer toxicology specialist
Faculty of Science, University of Yaoundé I
Collaborator of the International Institute of Tropical Agriculture
Cameroon
51. Dr. Leslie Klein, DO
Physicians for Social Responsibility
USA
52. Dr. Bruce Lanphear, MD
Professor, Faculty of Health Sciences, Simon Fraser University
Canada
53. Marie Leven, RN
Physicians for Social Responsibility
USA
54. Dr. Jean Suzanne Lindo, MD
Department of  Community Medicine
Davao  Medical  School Foundation
Philippines
55. Dr. Jennifer A. Lowry, MD
USA
56. Horacio Lucero
Biochemist, Researcher at the Laboratory of Molecular Biology
Institute of Regional Medicine Northeastern University
Integrante de Los médicos de los pueblos fumigados (Member of Doctors of Peoples Fumigated)
Argentina
57. Dr. Antonio Lupo
Hematologist
International Society of Doctors for the Environment Italia
Italy
58. Dr. Marcela Galar Martínez, PhD (biochemistry)
Aquatic Toxicology Laboratory
National School of Biological Sciences / National Polytechnic Institute (IPN)
Mexico
59. Dr. Gustavo Mazzi
Specialist in Nephrology, Digestive System Diseases and Clinical Pathology (immunohematology) President International Society of Doctors for the Environment,
Italy
60. Dr. Geralyn McCarron, RACGP, AMA, DEA, NTN
Castle Hill Medical Centre
Australia
61. Dr. Rob McConnell, MD
Professor of Preventive Medicine
Keck School of Medicine
University of Southern California
USA
62. Dr. Paul Medina, MSc, PhD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
63. Dr. Kathleen Mirante, MD
Physicians for Social Responsibility
USA
64. Carlo Modonesi
Zoologist, University of Parma
International Society of Doctors for the Environment, Italy
Italy
65. Dr. Mercedes Meza Montenegro, PhD (Toxicology)
Sonora Technological Institute /Instituto Tecnológico de Sonora
Head of Environmental Toxicology and Public Health  Laboratory
Mexico
66. Dr. Hanns Moshammer
Senior Researcher, Institute of Environmental Health, The Medical University of Vienna
co-chair, International Society of Doctors for the Environment, Austria
Austria
67. Dr. Henning Mothes, MD
Consultant, University Hospital Jena, Dpt. of General, Visceral and Vascular Surgery
Head of Working Group Developing Countries of the German Society of Surgery
General Secretary of the German Society of Tropical Surgery
Germany
68. Dr. Lothar Müller
Department of Pediatrics, Immanuel Clinics Bernau
Germany
69. Dr. Prashanth N S
Faculty, Institute of Public Health,
India
70. Dr. Ravi Narayan
Community Health Advisor, Society for Community Health Awareness, Research and Action (SOCHARA)
India
71. Dr. Thelma Narayan
Director, Society for Community Health Awareness, Research and Action (SOCHARA)
India
72. Dr. Jose B. Nevado Jr., MD, PhD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
73. Nemencio A. Nicodemus Jr., MD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
74. Dr. Jaime Rendón von Osten, PhD (Biology- Ecotoxicology)
Program of Ecology, Fisheries and Oceanography for the Gulf of Mexico (EPOMEX) Center,
Universidad Autónoma de Campeche (UC)
Mexico
75. Dr. Lynn Crisanta Panganiban, MD
Professor, Chair, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
76. Dr. Rodolfo Edgardo Páramo
Neonatologist Pediatrician, José María Cullen Hospital
Department of Pediatrics Samco Malabrigo Hospital
Integrante de Los médicos de los pueblos fumigados (Member of Doctors of Peoples Fumigated)
Argentina
77. Dr. Edelina P. Dela Paz
Executive Director, Health Action Information Network
Associate professor, College of Medicine
University of the Philippines Manila
Philippines
78. Dr. David R. Pepper, MD, MS
USA
79. Dr. Adithya Pradyumna
Research and Training Assistant
Society for Community Health Awareness, Research and Action (SOCHARA)
India
80. Andrea Pucci, RN
Physicians for Social Responsibility
USA
81. Dr. Jaime Purificacion, MD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
82. Dr. Romeo F. Quijano, MD
Physician, President of Pesticide Action Network Philippines
Professor, Department of Pharmacology and Toxicology
University of the Philippines Manila
Member, Philippine Society of Clinical and Occupational Toxicology (PSCOT)
Philippines
83. Dr. King Reilly, MD
Physicians for Social Responsibility
USA
84. Wolfgang Reuter
Toxicologist, Biologist
Adviser on pesticide and chemical assessments ForCare
Germany
85. Dr. Graham Roberts
Irish Doctors Environmental Association
Ireland
86. Dr. Roberto Romizi
President the International Society of Doctors for the Environment
Italy
87.Dr. Tammy Dela Rosa, MD, MSc
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
88. Dr. Bob Rosenberg, DDS
Physicians for Social Responsibility
USA
89. Dr. Carolyn Rosenstein, MD
Physicians for Social Responsibility
USA
90. Dr. Richard Rosenstein, MD
Physicians for Social Responsibility
USA
91. Dr. Jesus Manuel Sevilleja, MD, MPhil (Epidemiology)
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
92. Dr. Ted Schettler MD, MPH
Science Director, Science and Environmental Health Network
USA
93. Dr. Margret Schlumpf, PD Dr.sc. nat.
ETH, Leader, Group for Reproductive Endocrine and Environmental Toxicology (GREEN Tox)
University of Zürich
Switzerland
94. Dr. Claudio Schuftan MD
People’s Health Movement in Vietnam
Vietnam
95. Dr. Mira Shiva MBBS, MD
Coordinator Initiative for Health & Equity in Society
India
96. Dr. Anne Siegrist, DDS
Physicians for Social Responsibility
USA
97. Dr. Jamie Solow, PhD
Physicians for Social Responsibility
USA
98. Dr. Susana Somoza, PhD
Professor, Biochemistry and Public Health, National University of Formosa
Argentina
99. Mosudi Babatunde Sosan, (Pesticide Toxicologist)
Department of Crop Production and Protection
Faculty of Agriculture
Obafemi Awolowo University
Nigeria
100. Dr. Marcelo Firpo de Souza Porto, PhD
Senior Researcher, National School of Public Health
Oswaldo Cruz Foundation
Brazil
101. Dr. Arthur Strauss, MD
Physicians for Social Responsibility
USA
102. Dr. Jaime Z. Galvez Tan
Health Futures Foundation Inc Philippines
Philippines
103. Dr. Joven Q. Tanchuco, MD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
104. Dr. Andrei N. Tchernitchin, PhD
Physician-surgeon, President of the Environmental Dept of the Medical College of Chile
Head of Experimental Endocrinology and Environmental Patology Laboratory,
ICBM Faculty of Medicine, University of Chile
Science Director of the Executive Secretariat of the Sustainable Development Council in Chile
Chile
105. Dr. Claudia Thomas, MD
USA
106. Dr. Ricardo Tiongco, MD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
107. Dr. Emilse Tirapegui
Médica del Hospital Durand
Argentina
108. Dr. Sharon Torrisi, DVM
Physicians for Social Responsibility
USA
109. Katherine Towers, RN, CNM, WHNP, IBCLC
USA
110. Dr. Carmen Martínez Valenzuela, Ph D (Genetics and toxicology)
Instituto de Instituto de Investigación en Ambiente y Salud (Research Institute of Environment and Health) Universidad de Occidente, Sinaloa
Mexico
111. Dr. Oscar Lanza Van den Berghe, MD, MSc, MPH
Professor of Public Health
Justicia, Salud & Desarrollo (Justice, Health and Development)
Bolivia
112. Dr. Medardo Avila Vazquez
Chair of Pediatric Clinic, Faculty of Medical Sciences, National University of Cordoba
Member of Doctors of peoples fumigated
Argentina
113. Dr. Minako Watabe, MD
Obstetrics and Gynecology
Santa Paula Hospital Clinic/Ventura County Medical Center
USA
114. David Werner, biologist and health educator
Director, HealthWrights
USA
115. Dr. Paul Winchester MD
Director Neonatology, St. Francis Hospital
Clinical Professor, Pediatrics, Indiana University School of Medicine
USA
116. Prof. Dr. rer. nat. Irene Witte
University Oldenburg
Germany
117. Dr. Gracia Fe B. Yu, MSc, PhD
Professor, University of the Philippines Manila
College of Medicine (Department of Pharmacology and Toxicology, Department of Biochemistry and Molecular Biology) and National Institute of Health
Philippines
118. Dr. Ed Zuroweste, MD
Assistant Professor of Medicine, Johns Hopkins School of Medicine
Chief Medical Officer, Migrant Clinicians Network
USA

__________________

[1] For more on the definition and history of HHPs, please refer to the PAN International List of HHPs, available at http://pan-international.org/. The FAO/WHO Joint Meeting on Pesticide Management first used the term “HHPs”, and identified criteria for HHPs, which PAN since expanded to include important criteria missing from the JMPM definition, such as endocrine disrupting properties and inhalation toxicity.

[2] Jeyaratnam, J. (1990): Acute Pesticide Poisoning: A Major Global Health Problem. World Health Statistics Quarterly 43, no. 3 (1990): 139-44.

[3] The figure of 25 million was based on an average of 3 percent of agricultural workers in low-income countries suffering one episode of pesticide poisoning per year. However recent surveys show that figure may be very much higher now, with, for example, acute occupational pesticide poisoning amongst young male Korean farmers reported to be 24.7%. [Lee WJ, Cha ES, Park J, Ko Y, Kim HJ, Kim J. (2012): Incidence of acute occupational pesticide poisoning among male farmers in South Korea. Am J Ind Med 55(9):799-807.]

[4] Watts M. (2013): Poisoning Our Furure: Children and Pesticides. Pesticide Action Network Asia and the Pacific, Penang.

[5] Prüss-Ustün et al. (2011): Knowns and unknowns on burden of disease due to chemicals: a systematic review. Environmental Health 2011, 10:9. See also: United Nations Environment Programme (2015): Global Chemicals Outlook Towards Sound Management of Chemicals, p. 57. United Nations Pubns, 2015.

[6] Thundiyil, J.G., Stober, J., Besbelli, N., Pronczuk, J. (2008). Acute Pesticide Poisoning: A Proposed Classification Tool. Bulletin of the World Health Organization. Available from http://www.who.int/bulletin/volumes/86/3/07-041814/en/.

[7] Goldman. L. (2004). Childhood Pesticide Poisoning: Information for Advocacy and Action. United Nations Environment Programme and the World Health Organization. Available from http://www.who.int/ceh/publications/pestpoisoning.pdf

[8] WHO (2014): Preventing Suicide: A Global Imperative. World Health Organization, Geneva.

[9] Some of the target sites of pesticides (proteins and enzymes) have been conserved throughout the evolution of species and can be found in very different organisms, for example humans, fruit flies, yeast and bacteria. Thus it is not surprising that some pesticides are toxic for non-target species.

[10] Endocrine Society (2015): Position Statement: Endocrine-Disrupting Chemicals in the European Union. http://www.endocrine.org/~/media/endosociety/Files/Advocacy%20and%20Outreach/Position%20Statements/2015/Position_Statement_EDC_EU.pdf