The Controlling Influence of the PIAP

The Pesticide Incidents Appraisal Panel is responsible for determining the likelihood of poisoning by pesticide incidents.
It is claimed that the panel receives as much information as possible about an incident, including the results of any medical examinations.
Specifically their responsibility concerns incidents which are alleged to have caused ill health with the supposed intention to identify any newly arising issues and trends.

The PIAP concerns itself with the circumstances of the incident, the health of the individuals involved (and strangely also their status), and the active ingredients of the pesticides.
The figures generated become part of an epidemiological data base and the national Statistics.
For this reason there is a need for accuracy in opinion but it is clear that the professed commitment to openness and transparency has been sadly lacking in the past.

Report summaries issued every year indicate only about a 100 incidents.
Figures estimate that thousands of individuals may be poisoned or may believe they have been poisoned by pesticides in any one year.

The PIAP can decide on several levels on any incident and this includes the phrases "Unrelated" and "Insufficient Information" which both indicate that pesticides were determined to be not involved in the causation of the illness.
There is therefore a problem with the figures since, even if all the other thousands of cases were determined as unrelated to pesticide exposures, those cases should appear in the PIAP statistics.

In 1993 the PIAP could determine that an incident was "Confirmed" as poisoning, "Likely" to be, "Unlikely" to be, "Not Confirmed", no evidence supported poisoning, or "Insufficient Data" so that no proper decision could be made.
This was changed in 1994 so that "Confirmed" cases had collaborating medical evidence, "Likely" was that exposure and symptoms were consistent with poisoning, Two levels of "Open Assessment" could be made where there might be an implied association between exposure and symptoms or that the evidence supported pesticide induced ill health but pre-existing disease complicated the issues, "Unrelated" with strong evidence against poisoning and "Insufficient Information" for cases which could not be classified.
Put simply there is little difference between the confirmed classifications or between those where incidents are not confirmed but the figures reported remain low.

What is perhaps more worrying is that the panel confirm so few cases which have medical supporting evidence.
One case went before the panel on two occasions in a single year because the panel denied even the possibility of poisoning despite supporting medical opinion from several different sources.
On the second occasion the reasons given for the refusal to recognise the case were based on false information regarding both the chemical and the symptoms but the panel refused to alter their decision.

Another more recent case involving the same chemical was also considered to be unrelated to poisoning despite positive blood test results and supporting medical opinion.

This begins to explain the reasons why the PIAP record so few cases and presents a worrying picture in respect to the accuracy of the statistics upon which pesticide safety policy is founded.

Once more we must ask why such things happen and it would seem that the answer is found once again in the make up of the committee.
Most of the members are drawn from the HSE themselves and from the Poisons Units and it has been admitted that the Poisons Units are closely linked to the Chemical Companies.
Information supplied suggests that the Poisons Units sub-contract toxicologists who are actually employed by the Chemical Companies and that some laboratories are also funded by them.
All questions to Ministers requesting confirmation or denial of these reports have been met with silence.
This refusal to answer can only mean that there is some substance in the claims made.

Both the above cases for example involved a chemical made by the very same company to whom the claims apply.
Is this simply a coincidence?

The PIAP is a very influential body.
Complaints to the Director General of the HSE may be responded to in letters drafted by the chairman of the PIAP, even if the substance of that complaint is the PIAP itself.

This is a problem commonly found in Government organisations and such activities have been criticised by the Parliamentary Ombudsman. The practice continues even so and is especially evident in the Offices of Cabinet Ministers who almost always pass complaints about Government departments to those departments for reply and the wrongs remain hidden.

Perhaps most importantly if the PIAP fail to confirm poisoning then the manufacturers are not notified and a false view of pesticide safety is ensured. National Statistics are corrupted by false data, and any use of those statistics by epidemiologists will produce grossly inaccurate predictions and observations on Public Health.

Despite this the Chairman wrote in 1995 that people set too great a store on the Panel's assessments and that such assessments should not be regarded as the "Gold Standard" because the panel can make its own decisions on individual cases regardless of the opinions of others. He claimed that the panel's purpose is not to decide once and for all on individual cases but to see if any lessons can be learned from the generality of them.
He explained that this can be done without having to be absolutely right in every case.

These problems must be addressed as a matter of urgency but this panel is very much part of the problem and it is likely that nothing will be done. If this remains the case then many thousands of lives will continue to be ruined by repeated exposures to pesticides.

The price to the National Health Service for this failure will be high.

Dated 16/9/2000

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