actually reveal how well the environment is doing, or how well the regulated commu-
nity is obeying environmental laws. To the extent that these data measure enforce-
ment or other governmental performance, they are much more likely to be misleading
than useful.
The data on which the EPA and state agencies currently rely relate almost exclu-
sively to activities: the number of permits issued, inspections conducted, enforcement
actions initiated, and penalty dollars collected. For many years, these data have served
as the basis for management decisions and oversight of agency performance. When
the EPA delegated responsibility for implementing national environmental programs
to the states and provided them with funding to do so, it created data systems to
track these activities, and it used activities data to hold states accountable for proper
use of federal funds and implementation of federal laws, including timely and appro-
priate enforcement.
Using these same data, the EPA’s inspector general and an environmental advocacy
group have recently concluded that state enforcement activities have declined, raising
concerns that states have de-emphasized enforcement to the detriment of the environ-
ment. However, the Environmental Council of the States (ECOS), a national non-
profit, non-partisan association of state environmental agency leaders, challenged
these conclusions. It argued that state data in the EPA systems were often incomplete
and inaccurate, did not reflect the full range of state compliance activities, and
revealed little about whether environmental conditions are improving.^32
Complications Stemming from Misdiagnoses
Farmers and farmworkers suffer from pesticide exposure and other ailments that
often are misdiagnosed or improperly treated because doctors never have faced the
malady or the patients don’t think to pass along relevant information. Physicians, for
instance, commonly misdiagnose as pneumonia lung irritations or infections that
actually result from pesticides or other toxic substances. Or they see the farmworker
before symptoms begin and send him or her home before fluid buildup and breath-
ing difficulties start. Primary care professionals who can recognize a potential pesti-
cide exposure are more likely to make the correct diagnoses. They need to be familiar
with the settings that predispose patients to pesticide exposure, the symptoms associ-
ated with these exposures, and appropriate diagnostic methods. Yet many health pro-
fessionals receive little training in pesticide health issues. The following cases illustrate
that further illnesses could have been avoided with properly educated and trained
health care providers.
The EPA regulates an organophosphate insecticide called methyl parathion for use
on specific crops. During the 1980s and 1990s, methyl parathion was used widely by
unlicensed applicators. One published report describes methyl parathion–related illness
among several siblings, two of whom died. Approximately two days before these chil-
dren were correctly diagnosed, five of them were seen by their local physician and sent
back to their contaminated homes with a mistaken diagnosis of viral gastroenteritis.^33
Pesticides in Agriculture | 41