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In the News: How to report a pesticide exposure incident
From HEAL: Special: Pesticide exposures--avoidance and cleanup. Dozens of tips!
At a Glance: Pesticide safety-- Resources on the Web
by Louise Kosta
Chief writer, The Human Ecologist
The Environmental Protection Agency is in the process of re-registering pesticides. A current focus is on organophosphate insecticides, including chlorpyrifos and others that are in wide agricultural and non-agricultural use. Pyrethroid pesticides are also of current interest.
As part of this effort, EPA reviews reports of incidents in which pesticides have harmed human health. Such incidents can indicate changes that need to be made, such as new directions for safer handling and use, restrictions on how and where a pesticide may be used-- or in extreme cases, banning a pesticide altogether.
EPA receives information about pesticide exposures and health effects from a variety of sources. Some come directly to the agency from the public. But most come from Poison Control Centers, the National Pesticide Telecommunication Network (NPTN), state surveillance programs and pesticide-producing companies. Poison Control Centers get their information from the public and from physicians and hospitals. NPTN gets information primarily from the public. Industry gets its information from the public and from some medical sources, as well as from companies that distribute, use and apply pesticides, and from agricultural pesticide users. Federal law requires pesticide manufacturers to collect and report to EPA incidents involving the products they manufacture.
The quality and completeness of this information vary widely. Poison Control Centers collect information about pesticide incidents, but they do not determine the circumstances that caused the exposure. Incidents reported by the public and even by some medical vpersonnel may lack important information as well. Industry reports must be categorized so that 'minor' and 'moderate' incidents are reported in summary form, while only 'major' incidents are reported in full. Thus reports can vary so much in their contents that it can be difficult to identify pesticide products that are causing health problems.
It is important to understand that, under the current system used for pesticide incident reports, only acute effects are routinely reported. Long-term health problems arising from acute pesticide exposure are seldom reported. EPA is less interested in such reports because typically it is not possible to properly document the original exposure or tie it to the health effects as causally related. Reports of chronic effects of long-term, apparently uneventful exposure are more rare. However, the exacerbation of an existing health problem (like asthma) during or shortly after a pesticide exposure, or the onset of a new health problem in conjunction with pesticide exposure, are definitely of interest to EPA.
Dr. Jerome Blondell, an EPA epidemiologist who works with pesticide incident reports in conjunction with the agency's ongoing pesticide re-registration process, acknowledged that the pesticide incident reporting process is far from perfect. Improvements are in the works, however. The joint EPA and NIOSH project SENSOR (Sentinel Event Notification Systems for Occupational Risk) is expanding from three states to five this year (California, Texas, Florida, New York and Oregon).
Blondell said that California has long had the best occupational agricultural use pesticide incident reporting and surveillance system in the country. Physicians are required to report and, for workers compensation cases, physicians do not get paid unless they report. This system will soon expand to include residential use pesticide incidents, too. And on the international front, the World Health Organization has begun a multi-country pesticide incident surveillance project in which physician reports of pesticide incidents will be reported on standard forms, and collated and studied by WHO.
Blondell explained how to report adverse effects from pesticide exposure. There are certain things that EPA is particularly interested in. For instance, health effects arising from proper use of a pesticide can indicate a need to change the directions for its proper use. But a widespread pattern of product misuse can also result in changes in rules governing use of that pesticide. Pesticide incident reports are often the only source of such information.
Blondell told us that a useful pesticide incident report contains information documenting both the exposure and the health effects.. The following list of items shows what EPA requires industry to report starting in June 1998. If you are unable to supply all the information suggested, you can file a report anyhow-- but the more information the report includes, the more useful it will be.
The informational items below are grouped by sections for ease in reporting pesticide incidents. Include the following:
(A) Administrative.
(1) Name of reporter, address, and telephone number.
(2) Name, address, and telephone number of contact person (if
different than reporter).
(3) Incident report status (e.g., new or update); if update, include
the date of original submission.
(4) Date of incident (if appropriate, list start and end dates).
(5) Location of incident (city, county and state).
(B) Pesticide.
(1) Product name.
(2) Formulation, if known (e.g., ready-to-use solution, emulsifiable
concentrate, not needed if EPA registration number is provided).
(3) EPA Registration Number.
(4) Active Ingredients (not needed if you have the EPA Registration
Number).
(5) Was exposure to a concentrate prior to dilution for use.
v (6) List the same information above for other pesticides that may
have contributed to this incident.
(C) Circumstance.
(1) Evidence the label directions were not followed (e.g., yes, no,
unknown).
(2) How exposed (e.g., spill, drift, equipment failure, container
failure, ingestion, etc.).
(3) Situation (e.g., household use, mixing/loading, application,
reentry, disposal, transportation, other (describe)).
(4) Use site (e.g., home, yard, commercial turf, agricultural
(specify crop), industrial, building/office, school, other.
(5) Applicator certified (yes, no, unknown).
(6) A brief description of the circumstances that led to the exposure.
(D) Human health effects and medical information.
(1) Route of exposure (skin, eye, respiratory, oral).
(2) List signs/symptoms/adverse effects. For each effect note time of onset, how long
it lasted, and whether or not medical help was sought.
*Rash: indicate where it first appeared, whether or not it spread, and how long
it lasted. If it was a blistering rash, be sure to mention it.
*Unusual type or amount of nasal or oral secretions.
*Watering or reddened eyes.
*Gastrointestinal upset including pain, nausea, vomiting, diarrhea, bleeding.
*Respiratory symptoms including cough, difficulty breathing, wheezing or chest
tightness, attack of chronic asthma condition.
*Nervous system symptoms including headache, especially if
new, severe, or an attack of a chronic headache condition; fainting,
seizure, sensory changes (changes in hearing, vision; numbness,
tingling, pain), behavioral changes (extreme fatigue, lethargy,
depression, irritability, violence, loss of memory, confusion, panic state).
(3) If laboratory tests were performed, list name of test(s) and
results.
(4) If available, submit laboratory report(s).
(5) Time between exposure and onset of symptoms.
(6) Was adverse effect the result of suicide/homicide or attempted
suicide/homicide.
(7) Type of medical care sought, (e.g., none, Poison Control Center,
hospital emergency department, hospital inpatient, private physician,
clinic, other).
(8) Demographics (sex, age, occupation).
(9) If female, pregnant?
(10) Exposure data: amount of pesticide; duration of exposure;
weight of victim.
(11) Was exposure occupational; days lost due to illness.
(12) Was protective clothing worn (specify).
Send written pesticide incident reports to Jerome Blondell Ph.D., Health Effects Division, Office of Pesticide Programs 7509C, US EPA, 1200 Pennsylvania Ave NW, Washington DC 20460. You do not have to report pesticide incidents in writing: You can call the National Pesticide Telecommunication Network at 800/858-7378, 6:30 AM - 4:30 PM (Pacific Time, 7 days a week) and they will take your report. NPTN will then notify EPA of your report. For chlorpyrifos incidents only: call 800/369-4532.
Source: Personal communications, EPA.
Important: About this document
Cleanup after pesticide exposure-- people and pets
Yard cleanup after pesticide contamination
Laundering pesticide-contaminated textiles
The ability of individuals to withstand pesticide exposure without ill effects varies considerably. We believe that it is both reasonable and prudent to take steps to avoid pesticide exposures and to minimize the impact of exposures that occur.
The suggestions offered in this document are just that -- suggestions. No guarantee is made that following the steps outlined will afford complete protection from pesticide exposure, nor is it claimed that it is necessary to follow all the suggestions outlined in order to avoid exposure.
However, we believe that these suggestions will help readers understand how pesticide exposures can occur, what kinds of materials can become contaminated, what can be easily cleaned and what cannot--all things that most people never think about. We believe that a better understanding of these issues can lead to better protection from pesticide exposure, and reduced impact from exposures and contaminations that do occur.
The suggestions are offered on a "take what you can use, and leave what you can't" basis. HEAL offers them in a helpful spirit, and with the hope that simply reading the suggestions will help raise awareness about how they may become exposed to pesticides, and how they may avoid such exposures. HEAL believes that raising awareness of pesticide exposures is an important first step in learning about their potential to do harm , and taking steps to minimize exposures and thus risk.
The overall approach taken has been to suggest how pesticide exposures may occur, and to offer suggestions about how to either avoid such exposures, or to minimize exposures when direct contact with pesticides in unavoidable. The suggestions offered come from a variety of sources, including practical experience. HEAL welcomes suggestions for additions to these suggestions--please leave a message for us at the HEAL homepage.Click here.
The best way to avoid contact with pesticides is not to use them. However, many people choose to use these products, or feel they must use them in order to protect their property. The following suggestions are offered as ways to minimize potential risks from pesticides.
Clothing shields the body from direct contact with pesticides. Swimwear, exercise clothing , and other garments that offer minimal coverage also offer minimal protection. When handling, applying, cleaning up or disposing of pesticides, always wear garments that cover the body, in addition to whatever protective wear is required for safe application by pesticide product labels.
Items used outdoors that may become contaminated by pesticides should be kept under cover during pest control activities. Heavy items should be covered in place if possible; if this is impractical, such items should not be used until they have been cleaned of pesticide residues (scrub with detergent and water and rinse thoroughly). Portable items should be brought indoors before they are contaminated. Items suspected of being contaminated should be cleaned thoroughly before bringing them indoors.
Items to keep under cover include:
NOTE: If the above items have already been contaminated with pesticides, or if they are left in the open during pesticide applications, do not bring them indoors or store with uncontaminated items until they have been cleaned. Some items--such as books and paper, and play-sand-- cannot be cleaned and should be discarded after contamination.
Pesticides applied outdoors can infiltrate indoor air as particles or vapors. Once indoors, they may persist much longer than the same pesticide outdoors. Because they do persist, each additional indoor contamination adds to those that have gone before--thus posing the possibility of higher indoor levels of pesticides than those found outdoors. Since the indoor environment provides the first line of defense against outdoor pesticide application, it is important to protect indoor air from pesticides.
Outdoor pest control may result in lawn, drive-, and walk-way contamination. Pesticides on these surfaces can cling to shoes and be tracked indoors. Once indoors, they can become mixed with house-dust and become airborne; they can also vaporize under certain conditions. Mixed with dust particles or as vapors, they can then be inhaled or ingested. Thus it is important to minimize as much as possible the chance of transporting pesticides from contaminated surfaces outdoors into the indoor environment.
If you must step indoors while wearing shoes worn outdoors, wipe shoes thoroughly before entering. You may want to purchase and use a large "welcome" mat at the outside of each home entry. Mats that can be easily hosed off are preferable to a natural-fiber mat that can retain pesticide residues.
During pest control season:
In the event that the interior of your car becomes contaminated with pesticides, or you or your passengers have become contaminated with pesticides, it is helpful to have the car upholstery covered with washable removable covers. These are available from car detailing outlets. In a pinch, old blankets can be used to protect the car interior from pesticide contamination. (This is not a frivolous or cosmetic concern. Pesticides in small confined spaces like cars can be sources of ongoing exposure, with intimate contact, and over prolonged periods. This type of exposure is to be avoided if at all possible.)
For the same reasons, it is wise to use disposable--or at least washable-- floor mats in the car: It is likely that you will track pesticides into your car from contaminated surfaces. Change the mats often, or launder them frequently.
No matter how careful you are, and how well you plan, there is a chance that you or a family member will have contact with freshly applied pesticides.
*ABOVE ALL, NOTE:* A severe exposure warrants an immediate visit to the emergency room. Do not take the time to mitigate a severe exposure--get medical help at once! This is a true emergency, and time is precious.
In addition: *All* adults who have experienced pesticide contamination should write down the date of the exposure, where it occurred, and any other circumstances surrounding the exposure that may have influenced its severity. Not all pesticide-related health effects are immediately apparent. Even if the exposure seemed minor at the time, any unusual or new physical symptoms that arise after an exposure incident should be reported to a physician as soon as they occur, together with an account of the exposure incident. Parents should record their children's' exposures and monitor exposed children carefully for physical or behavioral symptoms. Pet exposures should be should be monitored by the primary human companion as well as by the principle caretaker
See 'How to report pesticide exposure incidents.
Purchase plain soap to use for washing skin and hair contaminated with pesticides. Plain soap will rinse off the without leaving behind a film to which pesticides might adhere.
Kid clean-up
Small children who have been exposed to pesticides need to be
washed the same way as adults-- but in the tub, with the drain
open. Infants should be washed with water from one basin , and
the soapy used water should be collected in another and discarded.
The object here is to prevent the infant or child from having
contact with the pesticide that is removed by washing. If you
don't have a hand-held shower head, you may want to get one if
you have small children. Follow the same procedure as for adults,
taking care not to let the child ingest or inhale the water or
soap as you go.
Pets that have been exposed to pesticides may become quite ill if their coats are not cleaned before they lick them off. They can also carry surprising quantities of pesticides indoors on their feet and coats. Shampoo pets carefully (wear gloves if the coat is very contaminated) , especially around the eyes, nose and mouth areas. Don't let the pet stand or soak in the wash water-- let it drain away. For everyone's sake, it may be best just to keep the family cat indoors for the duration. If the family dog normally lives outdoors, it may be wise to place the kennel close to an enclosed area to which you can easily move him--such as a garage or enclosed porch-- in case of direct pesticide exposure.
During pest control season, plan to do more laundry-- and more separate loads of laundry-- than usual, and purchase supplies accordingly. Pesticides wash from clothing most readily when a heavy-duty liquid detergent is used at double the amount recommended on the product label, according to a textile expert at the University of Nebraska Cooperative Extension. You may need to purchase triple the amount of detergent you would normally use during the same interval.
Here are a few links to the many sources of information about pesticides available on the Web.
National Pesticide Telecommunication Network
From EPA: Healthy lawn, healthy environment (pdf file)
From EPA: Citizen's Guide to Pest Control and Pesticide Safety
From EPA: Pesticides and Child Safety
From EPA: Using insect repellants safely
Many other links to related sources are available at the HEAL homepage. See HEALinks: Environmental Science and Health.
HEAL has many resources in print on least-toxic pest control . Recent topics covered in The Human Ecologist include head lice control and flea control. The HEAL Service List also contains many items related to least-toxic pest control, including resources for home integrated pest management. Contact HEAL for more information.
#77 Spring 1998
Major concerns of the allergic and sensitive: Three feature articles cover:
*Siting and building a low toxicity home. An Australian author tells how she chose a pristine site on which to build her innovative, award-winning -and virtually chemical-free-home. The article also contains resources for researching US locales- everything from weather, to land use, to toxic releases, to state and local government programs.
* Sensitive people and their tough choices. A chemically sensitive writer tells how she and her husband have dealt with the funerals of family members.
* Information options for the print and paper sensitive. Our professional librarian has lots of good ideas for the chemically sensitive and others who find it difficult to deal with printed materials. Many of these options are free!
-The Spring 1998 issue of The Human Ecologist also contains the conclusion of the ground-breaking series on Gulf War veterans' illnesses that began in September 1997. Find out if research on "Gulf War Syndrome" will yield answers-and treatments- for the veterans (and others who suffer from similar conditions). Learn about how the military health care system is treating our Gulf War vets. This is the story no one else is covering- it's only available in The Human Ecologist!
Each issue of The Human Ecologist contains information on the latest environment and health research and medical news, pesticides and health, public policies that can affect health, book reviews- and much, much more!
Interested in getting a copy? Click here for the HEAL homepage
Other recent issues of The Human Ecologist had the following cover stories:
#76 Winter 1997 Gulf War Syndrome: Exposures in the Line of Duty Part 2: The eye of the beholder.
#75 Fall 1997 Gulf War Syndrome: Exposures in the Line of Duty Part 1. [Overview]
#74 Summer 1997 Pesticides Indoors: Methyl Parathion. "The worst case of pesticide misuse in U.S. history."
#73 Spring 1997 Dioxin and Health: An interview with Arnold Schecter MD
e-mail: HEALNatnl@aol.com ---voice: 404.248.1898.--- fax 404.248.0162.
1977--HEAL marks 21 years of service--1998
The Human Ecology Action League, Inc. (HEAL) is a national nonprofit education and information organization, founded in 1977 by physicians and citizens concerned about the health effects of environmental exposures. HEAL is a member-service organization funded solely by memberships and donations; over 85% of all revenues are dedicated to member services. Annual HEAL membership (US funds only): US $24, Canada $30, other international $36. Annual membership includes 4 issues of THE HUMAN ECOLOGIST, HEAL's flagship publication-plus discounts on other HEAL publications, referrals to local and regional HEAL chapters and support services. Donations are tax-deductible. Write HEAL, PO Box 29629, Atlanta GA 30359. Visa and Mastercard accepted. Call 404/248-1898.
THE Supplement is intended to supplement information available from HEAL in written form. Information provided in THE Supplement is assembled with care, but users are responsible for use made of the information provided. HEAL does not endorse any form of medical treatment, nor does it encourage the public to undertake any such treatment on their own. If medical advice or assistance is needed, the advice of a competent professional should be sought. THE Supplement is prepared by staff of The Human Ecologist and HEAL's Public Information Committee.