If you were toask a group of medical professionals to name the most significant public healthachievements of the past century, antibiotics and widespread vaccinationagainst infectious diseases would almost certainly top the list. The US Centers for Disease Control andPrevention2 (CDC) would add motor vehicle safety,fluoridated water, workplace safety, and a decrease in cigarette smoking.
If you were to saypesticides not only belonged on the list, but well toward the top of it, youwould likely be greeted with skepticism, if not incredulity. On this topic,highly educated professionals are little different from general consumers, whoget most of their information from media stories that overwhelmingly portraypesticides as a health threat or even a menace. At best, some open-minded interlocutorsmight concede that pesticides are a necessary evil that regulators should seekto limit and wherever possible, eliminate from our environment.
Yet by any ofthe standard measures of public health reductions in mortality, impairment,and infectious diseases, as well as improved quality of life the contributionof modern pesticides has been profound. An adequate supply of food is absolutelyfoundational to human health. Denied sufficient calories, vitamins, and othermicronutrients, the bodys systems break down. Fat stores are depleted and thebody begins to metabolize muscles and other organs to maintain the energynecessary for life. Cardiorespiratory and gastrointestinal functions falter andthe immune system is seriously compromised.
A 2019 report3 from the United Nations Childrens Fund (UNICEF) found thatone-third of children under age five are malnourished stunted, wasted oroverweight while two-thirds are at risk of malnutrition and hidden hungerbecause of the poor quality of their diets. And according to the World HealthOrganization1, undernutrition is currently an underlying cause in nearlyhalf of deaths in children under five years of age. Inadequately nourishednewborns who survive early childhood can suffer permanently stunted growth andlifelong cognitive impairment. Death results more often from undernutritionthan insect-borne killers like malaria, Lyme disease, Zika virus, dengue andyellow fever combined. In addition, it makes people more susceptible to suchinfectious diseases. Pesticides help to address all of these problems byincreasing the food supply, controlling the growth of harmful mycotoxins, andpreventing bites from mosquitoes, ticks, other disease-transferring insects,and rodents.
Food Securityis a Recent Phenomenon
The medicalcommunity knows all of the broad strokes above, at least in the abstract. Butliving in a time of unprecedented agricultural abundance, we often take forgranted the provision of adequate diets. We shouldnt.
As the economistRobert Fogel noted in a 2004 book,4 even in advanced, industrializednations, widespread food security is a relatively recent phenomenon. According toProfessor Fogel, per capita calorie consumption in mid-nineteenth century Britainbarely equaled what the World Bank would designate today as that in low incomenations. The availability of calories in early nineteenth century France would placeit today among the worlds most food insecure. It wasnt until well into the twentiethcentury that even the wealthiest nations reached the level of per capita calorieconsumption necessary to escape chronic undernutrition.
What made thatpossible was a rapid increase in farm productivity following World War II. Cropyields had been improving during the previous two centuries, to be sure, but ascan be seen in charts of historical yield trends,5 progress was slow and uneven. Thatchanged dramatically in the mid-1940s, when the gradually ascending yieldcurves suddenly turned sharply upward, climbing almost vertically to where theystand today.
Average wheat yieldsin Great Britain in 1942, which stood a mere thirty percent above their level acentury earlier, doubled by 1974. By the late 1990s, they had tripled comparedto 1942. Crops throughout Western Europe and the United States followed asimilar trajectory: slow growth or stagnation in the pre-WWII era, followed by rapidacceleration starting in the late 1940s. US corn yields per acre, which hadincreased only eighteen percent between 1900 and 1945, tripled in the next forty-fiveyears, and by 2014, had increased more than 460 percent.5
The EssentialRole of Pesticides
So, whatchanged to produce such dramatic improvements? The two factors most often citedare cheaper nitrogen fertilizers produced by the Haber-Bosch method of fixing nitrogen6 directly from the air, which came on line after 1910, and newhybrid crops created by Henry Wallace, which were first marketed in 1926 by hisseed company, Pioneer Hi-Bred Corn Company (later Dupont Pioneer and now Corteva Agriscience). Both innovations were rapidly adoptedby farmers in the first half of the nineteenth century the use of artificialnitrogen fertilizer by US farmers increased ten-fold7 between 1900 and 1944, and sixty-fivepercent8 were planting hybrid crops by 1945 buttheir use and development increased enormously in the post-war years.
Often ignored,however, was the post-WWII introduction of new, synthetic chemical pesticides thatdramatically reduced crop losses and made possible much of the yield growthstimulated by new fertilizers and seeds. Farmers had been using chemicalpesticides since the earliest days of agriculture, but up until the mid-1940s,these were largely simple chemical compounds containing sulfur and heavy metals.An example was copper sulfate, which organic farmers still rely on today due,ironically, to its high toxicity, indiscriminate pesticidal activity, andlong-lasting effects (i.e., persistence in the environment). Advances9 in organic (i.e., carbon-based) chemistry, however,provided farmers in the post-WWII era with a broad array of highly effectiveand increasingly targeted pesticides that have revolutionized agriculture.
According toone of the worlds leading experts in plant diseases, E.-C. Oerke of theUniversity of Bonn, these pesticides were responsible10 for nearly doubling crop harvests, from forty-two percentof the theoretical worldwide yield in 1965 to seventy percent by 1990. It hasbeen estimated11 by others that herbicides (which are a subset ofpesticides) alone boosted rice production in the United States by 160 percentand are responsible for a full sixty-two percent of the increase in US soybeanyield. Modern fungicides contributed11 somewhere between fifty and one hundred percent of theyield increases in most fruits and vegetables.
Yet even thesenumbers vastly understate the contribution of modern pesticides. As Professor Oerkeand others8 have pointed out, many of the critical attributes of moderncrop varieties that enable higher yields make modern crops more attractive topests; these include shorter stalks (which prevent damage from the elements butincrease competition from weeds), increased resistance to cold (which enablesearlier spring planting and double-cropping), higher crop density and increasedproduction of nutrients stimulated by synthetic fertilizers. Without theinnovation of new pesticides, much of the benefit of enhanced fertilizer useand even the survivability of new plant varieties that define agriculture todaywould be severely curtailed or even blocked.
The GreenRevolution
In the 1960s,rapid population growth worldwide raised alarms of mass starvation. Many of thefears were exaggerated, but the urgency was real. Over the next half century,world population doubled, with much of the increase taking place in poornations already chronically unable to feed their populations. That the worldaverted widespread famine is largely credited to one man: Norman Borlaug. Knownas the Father of the Green Revolution and the man who saved a billion lives,he received the Nobel Peace Prize in 1970 for his tireless efforts to exportthe benefits of agricultural technology to struggling farmers around the world.The effects were dramatic: New high-yielding, disease-resistant wheat hybridsBorlaug introduced in Mexico, Pakistan and India doubled yields within a matterof years and helped turn those nations into net exporters.
Borlaug was adamant12 throughout his life that the success of the GreenRevolution was only possible because of modern pesticides. In a speech hedelivered a year after receiving the Nobel Prize, he forcefully condemned12 the environmental movements vicious, hystericalpropaganda campaign against agricultural chemicals.4 Insisting thatchemical inputs were absolutely necessary to cope with,12he expressed alarm that legislation then being pushed in the US Congress to banpesticides would doom the world to starvation.
Starting in the1960s, led by dramatic gains in developing nations, global crop productionbegan an impressive13 ascent. Tufts University Professor Patrick Webb13 has calculated, In developing countries from 1965 to 1990,there was a 106 percent rise in grain output, which represented an increasefrom roughly 560 kilograms per capita to over 660 kilograms per capita. And accordingto the United Nations Food and Agriculture Organization, the rapid rise infood production caused a reduction in world hunger which is defined as nothaving adequate caloric intake to meet minimum energy requirements by more than half14 between 1970 and 2014. Behind that single statistic arebillions of premature deaths averted, billions of lives rescued from chronicdisease and suffering, and whole communities and even nations saved from anendless cycle of underdevelopment and grinding poverty.
From a publichealth perspective, those achievements can hardly be overstated. Unfortunately,they are rarely stated at all these days.
Fear, Not Facts,Prevail
The discussionof pesticides today largely ignores the challenges inherent in producing foodat the necessary scale and focuses instead on inflated fears surrounding them, althoughthey are among the most rigorously tested and tightly regulated of any class ofproducts. The result is a growing political and public backlash that retardsthe innovation of new products, restricts, and even bans from the market perfectlysafe, effective, and established products.
The increasingmomentum toward expanding bans on pesticides in Europe has called into question the very viabilityof agriculture15 on that continent. An avalanche of lawsuits16 in the United States against pesticides (such as theherbicide glyphosate17) universally deemed safe by regulators could put ourcountry on a similar path. Meanwhile, international development agencies suchas the UNs Food and Agriculture Organization which once championed the GreenRevolution are pushing the worlds poorest farmers to adopt agroecological approachesthat prohibit modern pesticides (and other technologies and products) and areas much as fifty percent less productive.18 That is a prescriptionfor potentially deadly challenges to food security.
It would be onething if this broad-based attack on modern pesticides approved by regulators hadscientific merit, but the obsessive focus by politicians, activists, and media onthe perceived risks to consumers collapses under scientific scrutiny. In this, itclosely parallels the public health challenge presented by the anti-vaccinationmovement, which is led by many of the same environmental groups. A criticaldifference is that the anti-pesticide movement is supported by billions ofdollars of annual funding from wealthy non-profits, governments (largely in theEU), and a burgeoning organic agriculture/food industry that seeks to increase its market share19 by spreading false and misleading claims20 about conventional farming.
And unlikeanti-vaccination propaganda, the media reflexively repeats and amplifies theanti-pesticide message with little qualification. (If it bleeds, it leads.) Evenseemingly authoritative voices in the health community, such as the American Pediatrics Association,21 advise the public to eatorganic food, mistakenly assuming that organic farmers dont use pesticides (they do,22 lotsof them23) or perhaps believing that naturalpesticides made with heavy metals are somehow less toxic than synthetic ones.(The EU has considered banning copper sulfate24 due to its human and environmental risks, but has continuedto reauthorize it because organic farmers have no viable alternatives.)Ironically, many organicpesticides are considerably more damaging to the environment.25
One of the mostsuccessful examples of anti-pesticide propaganda is the annual Dirty Dozen list26produced by the US activistEnvironmental Working Group (which also spreads vaccine fears),27 highlighting fruits andvegetables that have the highest detectable pesticide residues. The ability ofmodern technology to detect substances measured in parts per billion or evenper trillion is extraordinary, but the infinitesimal residues found on food arealmost certainly too small to have any physiological effect and by anyreasonable measure, represent a negligible risk to consumers.
Pesticideregulatory tolerances (safety levels) are calculated28 by dividing the highest dose of a pesticide found to have nodetectable effect in laboratory animals by a safety margin of one hundred to onethousand,28 which sets a maximum exposure limit on the cumulative amount of residue fromall approved products meaning regulators consider the sum of currenttolerances while determining the tolerance level for a new product. For tradingpurposes, maximum residue limits (MRLs) are set based on safety levelsmultiplied by an additional safety margin. So even if MRLs are exceeded, thereis very low risk of any health effect.
For example,the European Food Safety Authority29 noted in its most recent annual monitoring report onpesticide residues (2017), that more than half (fifty-four percent) of 88,000 samplesin the European Union were free of detectable residues. In another forty-twopercent, residues found were within the legal limits (MRLs). Only about fourpercent exceeded these limits, which still were unlikely to pose a safety issuedue to their trace amounts and built-in safety margins.
Paradoxically, regulatorsdont apply such large, conservative safety factors to other, more toxicsubstances we consume safely in much larger quantities every day. Consider, forexample, the difference between drinking one or two cups of coffee and drinkingone hundred to one thousand cups all at once. Given that a lethal dose ofcaffeine is about ten grams30 and a cup can easily contain 150 milligrams, sixty-six cupsmight well be fatal. Similarly, the absurdist nature of the EnvironmentalWorking Groups claims is seen in the calculations31 of the impossible quantities one would have to consume in asingle day e.g., 1,190 servings of apples, 18,519 servings of blueberries,25,339 servings of carrots per the Alliance for Food and Farming justto reach the no effect level.
Similarly,discussions of cancer risks commonly fail to acknowledge that most of thefruits and vegetables that are part of a healthy diet naturally contain32 chemicals that are potential carcinogens at high enoughdoses. Many, such as caffeine and the alkaloids in tomatoes and potatoes, arenatural pesticides produced by the plants themselves for protection againstpredators. Dr. Bruce Ames, who invented the test still used today to identifypotential carcinogens, and his colleagues estimate33 that 99.99 percent of the pesticidal substances we consumeare such natural pesticides which, of course, we consume routinely andsafely.
DiseasePrevention
The role ofpesticides in protecting public health is broad, varied, and sometimesunobvious. For example, the addition of the pesticide chlorine to publicdrinking water kills harmful bacteria. Hospitals rely on pesticides calleddisinfectants to prevent the spread of bacteria and viruses, and fungicides inpaints and caulks prevent harmful molds, while herbicides control allergen-producingweeds such as ragweed and poison ivy. Rodenticides are used to control rodentsthat spread diseases such as bubonic plague and hantavirus, and there are over 100,00034 known diseases spread by mosquitoes, ticks and fleas, whichinfect more than a billion people35 and kill more than a million of them every year; thosediseases include malaria, Lyme disease, dengue fever, West Nile Virus, andZika.
Even as thenumbers of tick- and mosquito-borne infections in the United States have surged,34 the CDC warns34 that we are dangerously unprepared in large part becauseof opposition36 to state-of-the-art pesticides by well-funded environmentalorganizations and the organic food and natural products industries, and the public fears37 they arouse.
Finally,naturally occurring toxins called mycotoxins,38 produced by certain molds (fungi), can grow on avariety of different food crops, including cereals, nuts, spices, dried fruits,apples and coffee beans. The most concerning of them are genotoxic aflatoxins,which can cause acute poisoning in large doses. Crops frequently affected by aflatoxins38 include cereals (corn, sorghum, wheat and rice), oilseeds(soybean, peanut, sunflower and cottonseed), spices (chili peppers, blackpepper, coriander, turmeric and ginger) and tree nuts (pistachio, almond,walnut, coconut and Brazil nut). Pesticides are effective in controlling thegrowth of these and other mycotoxins.
Epilogue
Certainly, justas with pharmaceuticals and medical devices, pesticides need to be well-regulatedand monitored, especially for potential effects on certain segments of thepopulation, such as farmers, who have the most direct contact (but have lowerrates of cancer than the general population). (See here,39 here,40 here,41and here.42)
The control ofpests has come a long way. The toxicity1of modern pesticides has already dropped ninety-eight percent and the applicationrate1 is down ninety-fivepercent since the 1960s. I grew up in the era of Better Thingsfor Better Living Through Chemistry (DuPonts advertising slogan from 1935 to1982) and lived through the worst of the backlash toward chemicals spawned inlarge part by the publication of Rachel Carsons compelling but often dishonestbook Silent Spring. Now, chemicals are being complemented, and sometimessupplanted, by biotechnology, but thats beside the point; the net benefit ofpesticides, whether chemical or biological, is irrefutable.
Our greatestpublic health challenge today isnt chemicals; rather, it is theinstitutionalized ignorance and fear-mongering that threatens to undo some ofthe twentieth centurys greatest technological and humanitarian uses of them.
Henry I. Miller, M.S., M.D., a physician and molecular biologist, is a seniorfellow in healthcare at the Pacific Research Institute. He was formerly a researchassociate at the National Institutes of Health and the founding director of theUS Food and Drug Administrations Office of Biotechnology. Please follow him onTwitter at @henryimiller.
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Is It Immoral To Oppose The Use Of Pesticides? - Science 2.0
