1. Man Vs chemical misuses and consequences
Dr. Inoka Suraweera
MBBS,MSc, MD (Community Medicine)
Consultant Community Physician
Environmental and Occupational Health Directorate
Ministry of Health

2. CHEMICALS ARE USED IN EVERYDAY LIFE
Benefits
Promote hygiene
Protect crops
Control vectors
Risks
Adverse health effects
Unwanted pollutants in the environment
Persistence
<<READ SLIDE>>
Chemicals are used in everyday life – they bring in numerous benefits, such as protecting human and animal health, promoting hygiene, protecting crops, controlling vectors of disease. However, chemicals may also pose risks to human and animal health. Exposures to chemicals in the micro- and macro-environments of children may cause functional and organic damage, especially during periods of vulnerability. Many become unwanted pollutants and some of these are persistent in the environment.
Ref:
Goldman L, Tran N. Toxics and poverty: the impact of toxic substances on the poor in developing countries. The World Bank, Washington DC, 2002.
WHO. Children's health and the environment: a global perspective. Pronczuk J, ed. WHO, Geneva, 2005
WHO/UNEP. Healthy environments for healthy children. Key messages for action. WHO, Geneva, Available at – accessed May 2011.
Image: WHO
WHO 2

3. So Many Chemicals so Little Data
2863 above 1 Million pounds
12 or 0.4%
good data
21.4% some
data
78.2% no data

4. Current Chemical Facts
April 23, 2017
Current Chemical Facts
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
ELSI - 2/10/04

5. Ancient Awareness 399 BC Death of Socrates by Hemlock
Socrates 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.

6. Historical Awareness From Romeo and Juliet - act 5
Come bitter pilot, now at once run on
The 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 ( )

7. Paracelsus “All substances are poisons;
there is none which is not a poison.
The right dose differentiates a poison from a remedy.”
Paracelsus ( )

8. April 23, 2017
Silent Spring
“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)
A Small Dose of Toxicology - Overview

9. Improper transportation Improper manufacturing practices
Too much
Too little
Chemical weapons
Improper disposal
Improper transportation
Chemical Misuse
Improper storage
Improper manufacturing practices
Improper handling

10. Who will be affected?
Individuals
Populations
Especially children
Workers

11. 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.

12. Workers and misuse of chemicals
Characteristics of Sri Lankan workforce (Sri Lanka Labour Force 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 %

13. Selected occupational carcinogens and health outcomes
Benzene
Leukaemia
Ethylene oxide
Silica
Cancer of the trachea, bronchus, or lung
Asbestos
Malignant mesothelioma, Lung cancers
Diesel exhaust

14. Available data on chemicals in occupations WHO: Chemicals burden of disease | 20 May 2011
Chemical groups
Disease outcomes
Attributable fraction
Deaths
Per year
DALYs
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
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; silicosis
pneumoconiosis
29000
1,062,000

15. 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 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

17. Pesticide Definition - Simple
April 23, 2017
Pesticide Definition - Simple
The function of a pesticide is to kill or harm some form of life
A Small Dose of Toxicology - Overview

18. Concerns about Pesticide-Use
Health Outcomes
Vulnerable Populations
Environmental Damage
Pest Resistance
Immediate
Flu-like symptoms
Skin Rash
Breathing problems
Long-Term
Asthma
Cancer
Damage to brain and nervous system
Immune system damage
Endocrine disruption
There are many concerns associated with pesticide-use. In fact, risk from exposure may outweigh the benefit of killing pests. One significant concern is health outcomes. Many studies have shown that exposure to pesticides can cause immediate reactions, and we know that there can also be long-term health problems.
Exposure to pesticides over a long time may also cause sickness or affect development. New studies show that children regularly exposed to low levels of pesticides may not be poisoned or get sick right away, but they may suffer from health problems that don’t show up for many years.
This image is from a study from Mexico on exposure to pesticides. Children ages 4-5 years old in two different communities were asked to draw a picture of a person. On the left are children’s drawings who lived in the foothills where pesticide were not used and on the right are children’s drawings who lived in the valley where pesticide use was used widely. You can see the difference in the drawings of the kids.
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)

19. Long-Term Exposure to Pesticides
Cancer
Develop-mental
Others?
Behavioral
Allergies
Brain Damage
Infertility
Asthma
Birth Defects
Chronic Exposure:
Asthma
Cancer
Neurological damage
Immune system damage
Permanent chemical sensitivity
Endocrine disruption

20. Chemical accidents

23. Event Sudden leakage of a gas (??Ammonia) Around midnight
Only the security guard was available at the time of the accident

24. 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

25. Other effects Mental health problems Public Health issues such as
Water safety
Food safety
(Veterinary health issues)