Insecticide use and increased mortality in rural Central Luzon, Philippines.

In a major rice-growing area of the Philippines, widespread adoption of insecticides by farmers on smallholdings was followed by a 27% increase in mortality from causes other than trauma among economically active men. Several factors suggest a causal link: highly toxic chemicals have been used unsafely; mortality has increased only in the age and sex class occupationally exposed; mortality has decreased among unexposed urban men; specific mortality rates have increased for those conditions likely to be confused with insecticide poisoning and have decreased for others; and, both within and between years, the pattern of mortality among men has reflected that of insecticide use. The results suggest that the currently accepted figure of 10,000 deaths annually worldwide due to accidental intoxication with insecticides is a substantial underestimate.