Sri Lanka: Agrochemicals linked to chronic kidney disease

A team of Sri Lankan and WHO scientists has linked the high prevalence of chronic kidney disease of uncertain aetiology (CKDu) on the island to indiscriminate use of agrochemicals including fertilisers and pesticides. In its final report released on February 28, the team, led by WHO researcher Shanthi Mendis, identified districts in the North, center, and east of the island and the rice-growing areas as “most vulnerable.”

While uncertainty prevailed over the exact cause of CKDu, the number of affected people in the country had grown to 450,000, according to estimates by the health ministry, which commissioned the WHO study.

WHO representative in Sri Lanka, Firdosi Rastam Mehta, told SciDev.Net that a new form of chronic kidney disease unlinked to diabetes mellitus, hypertension, kidney damage or other known causes, has emerged in the identified areas.

The new disease has been characterized as “slowly progressive, probably starting in the second decade of life, and asymptomatic (without apparent symptoms) until very advanced,” said health secretary Nihal Jayatillake.

The researchers found one or more pesticide residues above reference levels in 31.6 percent of people living with CKDu.

These residues, according to government epidemiologist Paba Palihawardene, are demonstrative of the extent of the environmental distribution of pesticides, which may be contributing to the prevalence of the disease.

Cadmium, lead, and arsenic values in phosphate fertilizers from the endemic areas are higher than the levels reported in agricultural soils in many other countries, according to the study. It detected pesticide residues in urine, hair, and nail samples taken from people in the worst-affected North Central Province.

“There is strong evidence available of chronic exposure to low levels of arsenic, and in susceptible individuals, co-exposure to low levels of cadmium and arsenic giving rise to more pronounced renal (kidney) damage than exposure to each element alone,” said Priyani Paranagama, head of the chemistry department, University of Kelaniya.

The World Health Organisation has appreciated the action taken by the government to ban the import of three agro-chemicals based on its recommendation. WHO said that these three agro-chemicals had caused health problems especially for people in the North-Central province.

WHO Country Director Dr. F. R. Mehta said that the Sri Lankan government had fulfilled its commitment by taking necessary steps to prevent more people from falling prey to the deadly kidney disease by banning the import of harmful agro-chemicals.

Source: thehindu.com