Sunday, July 8, 2007

Environmental Health Crisis in Punjab
By Umendra Dutt
Notwithstanding the severity of cancer prevalence in various parts of Punjab, the state health department is conveniently hiding behind its own inadequacies. The official misinformation regarding severity of cancer and traces of pesticides found in blood samples of people is an act of offence as it undermines the issue of state? environmental health. It is indeed a deliberate attempt to downplay a serious situation which potentially threatens all future generations.
Persistent negation of data which establishes that the state and its people are in the face of a grave ecological disaster show that Punjab Government is more interested in protecting the pesticide lobby than getting its act together in the face of astounding discoveries regarding cause of cancers in the region. But for some strange reason, the government is deliberately opposing findings of the scientifically designed Punjab Pollution Control Board- PGIEMR study as also the findings of CSE?
When Health department and some of agriculture experts are negating the PGIMER-PPCB study the environmental health experts are praising the study .Country's foremost environmental Health expert Dr.S.G.Kabra, Faculty, IIHMR, Jaipur and Advisor, SDM Hospital, Jaipur says " The well planned and executed PGI Chandigarh study brings out unequivocal evidence that the use of indiscriminate, indiscreet, excessive and unsafe use of pesticides in the study area is resulting into significantly higher number of pesticide related cancers and cancer deaths. Cancer figures from Rajasthan lend support to the carcinogenic and teratogenic effect of pesticides used in the state." blood testing report which found at least 6 to 13 pesticides in blood samples of people here.
Ironically, none of the past surveys by Health Department shows any trace of the cancer problem in Punjab. As per their study, no pesticide has been found in 235 blood samples that had been taken from 12 districts and got tested in State Forensic Laboratory, Patiala. These findings stand in stark contrast with those of the PPCB-PGIMER study and the CSE initiative. It is another matter that the Patiala laboratory has little expertise except Industrial Toxicology Research Centre, ITRC, Lucknow. Also hardly any blood samples were tested. It was also not explained as to wherefrom the samples were taken, if any were taken at all. In this regard the most vulnerable groups are farmers, their families and farm workers and also those with long term occupational exposure and that too from cotton belt.
It is topical to expose the state of affairs at the Patiala laboratory which has old outdated instruments and technologies. They have no gas chromatograph (GC) with electron capture detector which can detect pesticide residues in blood samples. Nor do they have nitrogen phosphorous detector for organ phosphorous. The lesser is said about their standards the better. In fact the lab is not accredited to conduct pesticide residual analysis. All the technology which chemical examiners of Patiala lab are working with is an old and far less sensitive technique of Thin Layer Chromatography. To detect pesticides in blood a scientific residual analysis is required and for that we have to detect pesticides to the extent of PPM or PPB. In the given situation it is doubtful if the lab is capable of undertaking this exercise.
The next big question pertains to the time the lab took to test 235 blood samples ? a meager 40 - 45 days. Also the method of selection of samples is doubtful.
The actual scenario in Punjab would never had been known had it not been for CSE Director Sunita Narayan releasing her report to the media on June 7 this year. It was only after she declared that there were 6 to 13 pesticides in the human blood and food people eat in this state that the Punjab Government got into action and ordered an enquiry after constituting a high power committee to review the issue. Strangely however the health department held a meeting on July 25 only to declare that it has tested samples and that the situation was not alarming. It is anybody? guess as to how the department got tested 235 blood samples for at least four groups of pesticides in just 45 days! Even if they carried out minimum four tests on every sample, it would take total number of tests to 940 and each test takes two-hour minimum time, taking the total testing time to 1880 working hours!
Also it is interesting to see how the state machinery back lashed following the release of CSE study. Within five days of CSE salvo, the officials of Patiala laboratory had gone to the press claiming no pesticides had been found in human blood, urine and vegetables. The CSE study was released on June 7 and on June 12 the chief Chemical examiner had made a claim based on his findings in 2500 cases of viscera examination. Media stated that a clinical study had been conducted at State Chemical Laboratory Patiala on the possibility of insecticides used over crops and no poison had been detected in the substance of any eatable or vegetable tested.
They added that samples of blood and urine of human beings obtained from different sources such as blood banks, clinical laboratories and volunteers had also been tested for traces of insecticides and pesticides. None of these samples, they claimed, tested positive for any poison. The activation of chemical examiner following CSE report is only understandable. Interestingly, the state health department did not even circulate the study methodology and results in the expert group meeting held at PGI Chandigarh on July 25. Also, conclusions given by Director Family Welfare (DFW) are similar to the arguments given by Chairman of Agro-Chemical Promotion Group. Both say pesticide residue in blood samples is not an issue Punjab should talk about. DFW had gone to the extent of claming that state average of cancer incidences of Punjab is very lower than the National average.
They said that prevalence of cancer is 120/100000 population which they claim is comparable to national prevalence. As the issue of high cancer prevalence in Punjab is related to rural areas of Bathinda and Giddarbaha, we actually have to compare it with rural areas mentioned in National Cancer Registry Programme of ICMR. That document states the incidence rate for male and female 46/100000 and 57/100000 respectively in rural areas. If health department compiled its information from the paramedical staff in the four Punjab districts which fell in the study group, the staff should have visited at least one lakh households in each of the four districts. If door to door survey was conducted then health staff should had been visited nearly three lakh house holds, but the fact that they could manage all this in three days is commendable.
And they should have filled up the same number of survey forms during the exercise. But little does Punjab know that every epidemiological study has a requisite protocol to be followed and a scientific methodology to be taken care of. The following factors have to be spelt -- systems followed in the study; study design, implementation mechanism, time frame, Principal Investigator. Director Health and Family Welfare however does not have any answer to any of these questions because the department didn't conduct a proper survey.
The Health and Family Welfare Department may swear by the authenticity of the survey and data produced but the circumstantial evidence indicates scientific fraud has been committed.Though newspapers mentioned health workers had gone to villages and made announcements from loudspeaker in village gurudwaras, calling for a cancer patients registered at health centers in the villages, ground survey shows no such announcement was made. The situation was better fudged in urban areas where a large number of cancer patient in towns still have no knowledge about any survey. In Faridkot, medical officers were told on July 5 evening to submit the report of cancer patients in their respective areas by 12 noon on July 6.
No scientific sampling can be done in such haste and if this is true, the health department is liable for scientific frauds. Incidentally this is the same department that set aside the cancer prevalence three years back. The same rotten system was adopted earlier too, and nothing alarming was found despite reports of high cancer cases in villages Jajjhal and Gyiana. Interestingly the Health department, experts from PAU, some high officials and Agro-Chemical promotion group are toeing the same line that there is no scientific evidence that pesticides can cause cancer. They are exactly in the same line as was for long time used by tobacco industry to controvert association between tobacco exposure and cancer. They used to submit extensively the so called 'scientifically valid' research studies to show that there was no correlation between tobacco exposure and cancer. It was debated in America's highest court. However, ultimately it was accepted world over that studies correlating tobacco with cancer were more reliable. The American tobacco companies were made to pay billions of dollars as compensation of cancer patients. It is now that world over tobacco related cancers is accepted to be an entity - including in India.
Pesticide related cancers are a new emerging entity based on scientific studies. There are several experimental, epidemiological and clinical studies published recently showing relationship between certain types of cancers and certain pesticides. It has no bearing or parallel to the present pesticide use in the India. In any case pesticides as a risk factor in specific types of cancers are cited in number of recent reports from USA and other parts of world The Pesticides are playing havoc with Ecology and Public health in Punjab. This is traumatized with the distressing fact that Cotton belt in Malwa region of Punjab is facing unprecedented crisis of environmental health from last few years. The abnormally high cases related to cancer, reproductive health, mental retardation, infertility and several other pesticide caused or related diseases were reported in surveys and general observations done in last three years.Study after study is pointing to words an devastating situation in making which ultimately leads to destruction, displacement, distress, debt and death.
Though banned about two decades back or even more the POPs are also found in blood samples too. According to PGIMER- PPCB study blood contains the residues of POPs like Heptachlor, DDT, Aldrin , Chlorpyriphos, Ethion and Endosulfan. Recently the study done by Centre for Science & Environment (CSE) also founds six to thirteen pesticides in virtually all blood samples. Some of are POPs as: HCH, Aldrin , DDT, Monocrotophos, Endosulfan, Phosphamidon, Chlorpyrifos , and Malathion After high cancer incidents in villages of Bathinda now a new area Muktsar – Giddarbaha is emerging as another toxic hotspot from where several cancer deaths have been reported in the recent times. Apart from this due to one or more reasons skeletal fluorosis is emerging in most of the villages depicting a sad and stark future picture of the Malwa.
The Punjab has only 1.5 % landmass of the country but it consumes about 18% of pesticides used in India and moreover the south-western districts of Malwa region are consuming near 75% of pesticides used in Punjab. In these circumstances only a participatory community action dedicated to environmental health crisis management and sustainable agriculture can save Punjab. Government and civil society must act together for this.

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