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Organophosphates do cause long term damage

A High Court judge has made the first finding in a British court that exposure to organophosphates causes long term damage.

Mrs Justice Smith found that a Peterborough farm worker, John Hill, had experienced persistent neuropsychological and neurobehavioural effects from two exposures to the insecticide Actellic-D, whose active constituent is pirimiphos-methyl.

The judge also accepted the view of Peter Behan, professor of neurology at Glasgow University, that the exposures had caused Mr Hill to develop a condition similar to the chronic fatigue syndrome. But she dismissed claims by another of Mr Hill's experts, Goran Jamal, also of Glasgow University, that organophosphates cause long term peripheral neuropathy and abnormalities of the autonomic system.

Mr Hill's employer, the company William Tomkins, had admitted negligence but argued that exposure could not cause long term effects. Mrs Justice Smith said of Professor Behan's evidence: "Had [he] expressed himself with greater moderation and objectivity and had he not sought to misrepresent the effects of his research, my task would have been a great deal simpler." Lawyers for William Tomkins had accused Professor Behan of "cooking" the results in a research study that formed part of the evidence (2 August p 271). An investigation by the university cleared him.

The judge expressed disquiet about the role of expert witnesses in the case. She said that over nine months Mr Hill had been examined by 11 medicolegal experts, a process which had created anxiety and led him to believe that he was more ill than he was. She added: "It is remarkable to observe the extent to which some of the doctors have elicited a history which has enabled them to conclude that the plaintiff is suffering from a condition which is relevant to their own special research interest," she remarked.

She thought that Professor Behan, Dr Jamal, and another expert "to a large extent heard what they wished to hear." Dr Jamal twice carried out sets of tests which showed peripheral neuropathy. The same tests carried out by the defendant's experts showed no such signs. Dr Jamal repeated his studies, this time with closely similar results to those of the defendant's experts. The judge commented: "I am driven to the conclusion that, for some reason, Dr Jamal reported test results which appeared to demonstrate phenomena and abnormalities which I am satisfied were not present." The judge said that this might have been due to a fault of technique or to lack of objectivity.

Mrs Justice Smith accepted that Mr Hill had genuine symptoms of tiredness, muscular weakness, loss of concentration, irritability, and mood swings. But she said that before long his neurobehavioural symptoms had become overlaid by a psycho-logical reaction to the physical illness and loss of employment. While being subjected to so many medicolegal examinations, he became convinced that his health was permanently ruined and took to a wheelchair. Once the litigation was over, she thought the residual effects of exposure would be "of a low order."

Lawyers for the plaintiff and the defendant are now expected to reach an out of court settlement on damages. Courts in Australia and Hong Kong have awarded damages for long term effects of organophosphate poisoning this year; in two cases Dr Jamal was an expert witness. Hundreds of claims by Gulf war veterans and by farm workers alleging damage by sheep dip and pesticides are pending in Britain.

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