title: The Nicaraguan Pesticide Poisoning Register: constant underreporting.
abstract: This study estimated the level of underreporting of acute pesticide poisonings (APP) in the pesticide surveillance system in Nicaragua in 2000. Data on pesticide exposure and health effects were assessed in a nationally representative cross-sectional survey of 3,169 persons aged 15 years and older. The authors found 1,369 cases of APP in the official register for 2000. Responses to questionnaires revealed 22 cases of APP in which individuals sought medical attention. Most of these cases involved agricultural workers who spray organophosphate pesticides, mostly class I. In 68 percent of cases, the mean out-of-pocket cost for treatment of one APP episode was $41, almost equivalent to one month's salary. Only 1 of the 22 cases (< 5%) in which the individual sought medical attention was reported to the national register. The authors estimate that, nationally, about 30,000 pesticide poisoning cases receiving medical treatment were not reported. Characterization of APP based only on official figures, without considering the underreported cases, leads to a constant inability to interpret and report acute pesticide health effects in a manner useful to policymakers. The pesticide surveillance system must be strengthened to improve registration routines, analysis and interpretation of data, health personnel training, and participation of private providers.
authors.affiliation: OPS Nicaragua, Managua, Nicaragua. nelacorriols@yahoo.es
authors.forename: Marianela
authors.initials: M
authors.lastname: Corriols
authors.forename: Jesús
authors.initials: J
authors.lastname: Marín
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Berroteran
authors.forename: Luz Marina
authors.initials: LM
authors.lastname: Lozano
authors.forename: Ingvar
authors.initials: I
authors.lastname: Lundberg
authors.forename: Ake
authors.initials: A
authors.lastname: Thörn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000453:epidemiology; D003151:Community Health Centers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D017050:Episode of Care; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D019221:Mandatory Reporting; D008875:Middle Aged; D009527:Nicaragua / Q000453:epidemiology; D010575:Pesticides / Q000506:poisoning*; D011041:Poisoning / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D011635:Public Health Administration / Q000592:standards*; D040442:Public Health Informatics; D012042:Registries / Q000592:standards*; D012107:Research Design; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D010575:Pesticides