THIRUVANANTHAPURAM: The state government has redefined the guidelines for identifying endosulfan victims in the state. According to the new guidelines issued by the Health and Family Welfare Department, ‘persons who lived in endosulfan-affected places or had intrauterine exposure from January 1980 till October 2011’ are defined as ‘exposed’ to endosulfan’. The department also issued an order in this regard on October 18.
The government decision came after considering the report submitted by the expert committee for identifying endosulfan victims. The committee was constituted on September 2023. It submitted the report in November, containing draft guidelines for identifying endosulfan victims based on available scientific evidence the government order said.
The expert committee came to the conclusion that, though the environmental persistence of endosulfan varied in various studies, the maximum possible duration for persistence was given as six years. Endosulfan spraying was banned in the state in 2005 after many cases of victims with deformities emerged. “Considering the ban imposed through a Gazette notification on October 25, 2005, the maximum environmental persistence will be up to October 25, 2011. So, anyone who lived in these places or had intrauterine exposure from January 1980 till October 2011 is defined as ‘exposed’, “ the draft guidelines said.
The government also approved the committee’s recommendation to form a two-tier system for identifying endosulfan victims. There will be an initial baseline screening at the lower level and an examination by a multi-speciality expert panel at the district level to identify the victims.
In the initial baseline screening, a medical officer of a primary health care centre, community health care centre or family health centre will assess the victim at the primary level. Then a multi-specialty expert panel constituted at the district level in line with the disability board will conduct a detailed examination of the subject. For this, a step-wise algorithm consisting of five items would also be used. The first two items in the algorithm are related to endosulfan exposure, while the other three are based on the decrease in review.
Most of the acquired diseases and non-communicable diseases do not come under the disease identified as due to endosulfan and those identified are included in the algorithm.
The committee has recommended that the multi-speciality expert panel should include a physician, paediatrician, neurologist, and psychiatrist (physical medicine specialist). Other members could be co-opted as required if the expert panel identifies a special need to assess a particular clinical condition. It is the duty of the multi-speciality expert panel constituted by the district medical officer to review and quantify the disability and issue the disability certificate. The committee also recommended problem-based follow-up care for the identified endosulfan victims.