OP Information Network (OPIN) wishes to draw to the attention of the ETRA Select Committee the disturbing situation concerning the limited circulation of an extremely important document published by the Health and Safety Executive, Biological monitoring of workers exposed to organophosphorus pesticides, Medical Series 17. This was written by a group of HSE doctors, published in 1981 and revised and republished in 1987. Its existence was never made known to doctors, farmers or indeed to many HSE officers. When the Countess of Mar asked for whom this document was intended she never got an answer.

  An HSE officer in Plymouth gave a copy of MS 17 to OPIN in 1992, asking that we should not disclose his name, since when we have been sending copies to the 780 OP sufferers on our database, as well as to the many health professionals who contact us asking for information. This document contains the type of information which should be made available to doctors, as recommended by Sir S Zuckerman in his committee report to MAFF in 1951, Toxic Chemicals in Agriculture (HMSO).

  MS 17 states that "subacute exposure to OP pesticides can produce harmful effects in man", and that "repeated exposure at lower doses may cause insidious cumulative toxicity". It lists the type of occupational sources of exposure as manufacture and packaging, transport, storage and distribution, application and use and handling used containers. It says that the most common routes of exposure are via skin, eyes and the respiratory tract, and that solvents used in certain formulations (such as sheep dips) can penetrate protective clothing. Most importantly it lists symptoms of OP poisoning, such as headache, giddiness, loss of appetite, nausea and diarrhoea, impaired co-ordination, blurred vision, excessive salivation and sweating, increased bronchial secretions, bradycardia with decreased cardiac output, and hypotension. It continues: urinary incontinence, abdominal pain, vomiting and broncho-contriction and various non-specific psycho-motor effects, such as apprehension, anxiety, restlessness, irritability, depression, sleep problems, expressive language defects and changes of mood, lack of concentration, memory impairment and slowed reaction time.

  MS 17 contained all this information in 1981, but it was not until a variety of consultants had laboriously perfected neurological testing apparatus and ways of detecting neuropsychological cognitive impairment that the medical profession had any idea that such damage could be caused by OP exposure (much of which has been criticised or ignored even now).

  The deliberate suppression of this document, which should have been made available to all rural GPs as well as users of OPs, undoubtedly exacerbated, if not caused, much of the suffering experienced by farmers, who had no idea what was wrong with them. What was worse was then being confronted by the ignorance among the health professionals encountered by sick and frightened farmers. There must be an explanation as to how this came about, and why.

  Dr Rawbone, the author of the new, updated MS 17 has told OPIN that he was determined that this new revision will be made very widely available. I hope that such a guarantee can be given.

Elizabeth Sigmund

October 1999