Richter E D, Safi J
Unit of Occupational and Environmental Medicine, Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel.
Environ Res. 1997;73(1-2):211-8. doi: 10.1006/enrs.1997.3717.
The major predictors of health risk from pesticide exposure are quantity and toxicity of pesticides reaching end-users, field workers, and persons (including children) with casual and indirect exposures to field and food residues, drift, and contaminated groundwater. Past work in Israel and the Palestinian National Authority has documented risks for acute poisoning, daily illness, transient neurotoxic effects, and potential cancer hazards in workers, populations exposed to pesticide drift, and the general population. Risk assessment predicts that reduction in use of agents with high toxicity and pesticide substitution are desired strategies for achieving the largest reductions in risk, but successful implementation and program sustainability depend on maintaining crop yield and increasing farmer earnings. A joint pilot Israeli-Palestinian-NGO program aims to determine whether crop yields and profits can be sustained while reducing pesticide use, promoting integrated pest management, and restricting ecosystem damage. The project involves six components: (1) assessments of health risk and crop yield in relation to pesticide use and exposure; (2) training health-agricultural teams to introduce and evaluate crop growth and managements with reduced pesticide use; (3) tracing and stopping import and trade in banned or restricted pesticides; (4) restricting child labor; (5) promoting information delivery and worker and community right-to-know and right-to-act; and (6) establishing a uniform regional standard for protection of workers and the general public. Preliminary evidence (organochlorines and breast cancer, organophosphates and illness in field workers) indicates that (1) a reduction of use is the foremost determinant of a reduction in health risk; (2) cotton yield can be increased despite a reduction in pesticide use (organophosphates); and (3) a reduction in pesticide use (organophosphates and organochlorines) has to be part of a crop rotation program for food crops timed to seasonal fluctuations in supply, demand, and crop price.
农药接触带来健康风险的主要预测因素是到达最终用户、田间工人以及偶然和间接接触田间及食物残留、漂移物和受污染地下水的人员（包括儿童）的农药数量和毒性。以色列和巴勒斯坦民族权力机构过去的研究记录了工人、接触农药漂移物的人群以及普通人群中急性中毒、日常疾病、短暂神经毒性效应和潜在癌症危害的风险。风险评估预测，减少高毒性药剂的使用和农药替代是实现最大风险降低的理想策略，但成功实施和项目可持续性取决于维持作物产量和增加农民收入。以色列-巴勒斯坦-非政府组织联合试点项目旨在确定在减少农药使用、推广综合虫害管理和限制生态系统破坏的同时，作物产量和利润能否得以维持。该项目包括六个部分：（1）评估与农药使用和接触相关的健康风险和作物产量；（2）培训健康-农业团队，以引入和评估减少农药使用情况下的作物生长和管理；（3）追踪并阻止违禁或受限农药的进口和贸易；（4）限制童工；（5）促进信息传播以及工人和社区的知情权和行动权；（6）建立保护工人和公众的统一区域标准。初步证据（有机氯与乳腺癌、有机磷与田间工人疾病）表明：（1）减少使用是降低健康风险的首要决定因素；（2）尽管减少了农药使用（有机磷），棉花产量仍可增加；（3）减少农药使用（有机磷和有机氯）必须成为粮食作物轮作计划的一部分，该计划要根据供应、需求和作物价格的季节性波动来安排。
