Pesticide-related diseases going undiagnosed in rural India: Research

A new study warns that India's healthcare system is failing to identify pesticide-related illnesses in farming communities. Gaps in medical education, limited toxicology training, and inadequate patient questioning mean chronic diseases linked to pesticide exposure often go undiagnosed and unreported.

Hyderabad: While the literature highlighting the adverse effects of pesticides is well documented, the public health system in Telangana and across the Country remains ill-equipped to diagnose pesticide-related diseases.

A recent paper, ‘The Silent Epidemic: Why Indian Doctors Fail to Connect Pesticides with Rising Rural Health Crisis’, authored by Dr Donthi Narasimha Reddy, highlights how the present healthcare model blinds physicians to the primary cause of many chronic diseases now devastating farming communities

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“Rural India is experiencing a silent epidemic of pesticide-related disease including cancers, chronic kidney failure, haematological disorders, reproductive harm, and neurodevelopmental damage, that the Indian medical system has systematically failed to recognise, diagnose, or report,” Dr Narasimha Reddy said in the paper.

The researcher noted that even if the evidence is presented, caregivers usually maintain that there is no documented proof or established linkage between agricultural chemicals and the disease patterns they witness daily.

In the paper, Dr Reddy, who is also an advisor for Climate Action Program for Centre for Earth Leadership and Sustainability (CELS), points out that the structure of medical education in India ensures that doctors struggle to diagnose pesticide-based diseases among the rural community.

“Toxicology is housed within Forensic Medicine and Toxicology, which focuses overwhelmingly on medicolegal aspects like injury documentation, sexual offence examination, and criminal matters. Pesticide poisoning beyond acute organophosphate ingestion receives a few pages at best within this framework,” he said.

Continuing Medical Education (CME) in India, which practising doctors are required to accumulate under NMC regulations, has never systematically addressed pesticide toxicology, environmental health, or occupational medicine in agricultural contexts.

As a result, a doctor who graduated in 1995 knowing only organophosphate toxicology is still, in 2026, treating patients from farming families without any updated knowledge of the neonicotinoids, pyrethroids, herbicides, and fungicide combinations that now dominate crop protection in India, he said.

Doctors fail to correlate acute poisoning cases because they do not ask the patients the right questions. A farmer arriving at a hospital with neurological symptoms, respiratory distress, or severe gastrointestinal problems is rarely queried about recent pesticide application, the chemicals used, protective equipment worn, or exposure duration, he said.

Pesticide exposure

* Medical education curriculum must be revised to include pesticide toxicology, environmental health, and structured occupational history-taking as mandatory, assessable competencies.

* Continuing Medical Education (CME) must focus on pesticide toxicology and environmental medicine to maintain their licenses.

* Reporting pesticide-related illness must be made mandatory

* Strengthening testing capabilities is mandatory

* NMC and ICMR should issue updated clinical guidelines to report pesticide and environmental exposure

* Specific symptoms like renal dysfunction, haematological abnormalities, or developmental delays must be included

* Need for more studies on relation between chronic pesticide exposure and persistent anaemia in agricultural populations

*Central Insecticides Board and Registration Committee should have clinicians as permanent members