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Organophosphates

My Lords, I declare an interest. I was poisoned by organophosphate sheep dip in 1989. In fact, it is almost exactly 20 years since I was doused while helping to dip our sheep. Prior to that, I had been chronically exposed to a variety of OPs in common use on farms and in homes. At the time we were led to believe that OPs were safe if used as instructed. It was not until 1991, after a long process of elimination and observation after further exposures, that the cause of my illness became clear to me and to my GP. Contrary to received belief, the signs and symptoms of poisoning were not temporary and, for me, the effects are still evident today. I am extremely fortunate in that I have supportive medical practitioners whose main objective in life is not to poison me further. Sheep dipping once or twice yearly in the UK was compulsory from 1975 to 1992 as part of the regime to control sheep scab. OPs replaced organochlorines from the early 1980s after the latter were found to persist in the environment. It was in 1992 that the noble Lord, Lord Tyler, then Paul Tyler MP, and I independently started to ask questions about the safety of using OPs as veterinary medicines and as both agricultural and domestic pesticides. Indeed, I almost said, "Welcome to the ‘Mar and Tyler Show’" because we have been together on this for so long, but perhaps I should say the ‘Mar, Tyler and Rooker Show’ because the noble Lord, Lord Rooker, has also been involved for a long time. In 1992, the noble Lord, Lord Tyler, and I first met John Gummer, then the Minister of Agriculture, to ask him to apply a moratorium on OP sheep dips. By this time it was becoming clear that OPs were affecting a significant number of individuals who were using them or were inadvertently exposed to them. At first, the Government assured us that these products were safe and that they presented no risk to human health. Since then there has been progress and their acute effects are readily acknowledged. Many OPs have been removed from the market, while stringent instructions now apply to those that are still in use. But there is still no recognition of their chronic central and autonomic nervous system effects. Following close on the heels of the sheep farmers and other agricultural workers were some Gulf War veterans who reported very similar adverse health effects following medication with pyridostigmine bromide, a carbamate closely related to OPs, and exposure to OP nerve gas and pesticide sprays. Despite the fact that the US Research Advisory Committee on Gulf War Illnesses recently concluded that some 25 per cent of Gulf War veterans—25 per cent of more than 6,000 people—are suffering the effects of OP poisoning, the British Government persist in their denial that these same exposures have had any effect on our troops. More recently, airline pilots and crew have reported ill effects following exposure to cabin air contaminated by leaking engine oil that produces very toxic OPs when heated. In all these groups, scientific research has shown consistently that there may be a relationship between long-term, low-level exposure to organophosphates and the development of neurobehavioural problems. The first study of sheep farmers was in 1991, and the latest was published this year. As there have been very few reports of adverse reactions to OP sheep dips in recent years, it is fairly safe to assume that the problems are persistent. It is interesting that Dr Sarah Mackenzie Ross, who conducted the DEFRA-funded research entitled "Neuropsychological and Psychiatric Functioning in Sheep Farmers Exposed to Organophosphate Pesticides", had to eliminate 60 per cent of possible subjects, all of whom were sheep farmers exposed to OPs, because they had other conditions. Among those eliminated were people with a history of acute exposure; those with a neurological condition such as Parkinson’s disease or multiple sclerosis; heart conditions and lung disease, all of which are associated with possible toxic causation. This means that those in whom she did find neuropsychiatric problems were likely to have been those who had the lowest exposure to OPs. When the Labour Party came into Government in 1997, Ministers from all the departments involved agreed that an interdepartmental group of high-level officials should be formed to report to Ministers on the continuing public debate over whether OPs damage human health. This was the Official Group on Organophosphates, also known as the Carden Committee, although I understand that Mr Carden has since retired. The group reported in 1998 and a number of its recommendations, including a research programme, were implemented, for which I am grateful. I understand that the group has met occasionally since then, the last time being 26 June 2007. As the minutes of its meetings are not published, we have no means of knowing the detail of their discussions. What is clear is that the science has moved on considerably since 1998. The Carden report gives at paragraph 2.2 a simple explanation of the manner in which inhibitors of acetylcholinesterase function, stating that: ""In the case of most OPs and all medicinal and pesticidal anticholinesterase OP products the effect is either reversible or recoverable"." It also reminds us that some non-OPs are anticholinesterases and that they have similar toxicity to anticholinesterase OPs, to which I shall come later. There appears to be a genetic susceptibility to OP poisoning. It is recognised that cytochrome P450 enzymes, paraoxonase-1 and butyrylcholinesterase play important parts in the detoxification of anticholinesterases. It has also been recognised for some time that there are flaws in the traditional methods of assessing exposure to OPs by measuring metabolites for specific OPs in the urine or measuring levels of red blood cell acetylcholinesterase. The scientific paper Identification and Characterisation of Biomarkers of Organophosphorus (OP) Exposure in Humans by Kim et al, 2009, details, ""the development of rapid protocols for extraction of the target biomarker protein from a sample, digesting the enzyme and identifying the OP modified peptide by mass spectrometry"." The authors go on to state: ""We feel these methods are optimal for filling the void of diagnosing and treating long-term exposures to several ubiquitous OPs"." In the UK, the Government have funded a few neuropsychological function studies and epidemiological studies of shepherds exposed to OPs. None of these has gone into the detail of the US research on sick Gulf veterans. The US neurocognitive studies found similar significantly poorer performance results on veterans who had been exposed to anticholinesterase chemicals to those conducted in the UK on shepherds. Six out of seven projects that evaluated brain structure and function using highly specialised equipment found significant differences between veterans with Gulf War illnesses and healthy controls, although they qualify their results by stating that additional research is needed. I could go on, and those interested in the detail will find it in the US RAC report of last November. In view of the fact that providing scientific proof has been a virtual impossibility for those who are suffering the effects of OPs, may I ask the Minister how many of the most recent developments have been accepted in the UK? I cannot express adequately the effect that the somewhat apathetic attitude of those who are responsible for ensuring our health and safety over the past 20 years has had. By failing to study individuals who report symptoms after more than a minute exposure to OPs in the initial stages and by failing to conduct longitudinal studies, they may well have exposed many sick people to at least a poor quality of life or at worst an early death. My own experience has taught me that there is an almost total lack of understanding of the life-threatening heart and lung function damage and of the effects of administering drugs that act on the acetylcholine system. The Health and Safety Executive’s leaflet MS17, Medical aspects of work-related exposures to organophosphates, warns of the effects of repeated absorption of small doses of OPs. However, I can find no warning to the medical profession of the effects of administering any of a wide range of drugs that may have a similar action. First-line drugs for bladder incontinence, asthmatic symptoms and glaucoma are all in this group and the first two are, to my knowledge, also caused by OP damage to the autonomic system. Is the Minister able to say how much research has been conducted into the effects that drugs which act on the acetylcholine system have on patients who have reported illness following exposure to organophosphate pesticides? If he knows of none, does he agree that this is an important consideration for a large number of agricultural workers, Gulf War veterans and aircrew? Should this not be an urgent consideration? I have made a brief outline of some of the reasons why I believe that the Official Group on Organophosphates should reconvene. I have barely touched on recent developments in this field. I have asked that it should give the matter priority. I also ask that on this occasion it produces a report on the lines of its 1998 report.