How to report pesticide exposure incidents

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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.
  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).
    1. If laboratory tests were performed, list name of test(s) and results.
    2. If available, submit laboratory report(s).
    3. Time between exposure and onset of symptoms.
    4. Was adverse effect the result of suicide/homicide or attempted suicide/homicide.
    5. Type of medical care sought, (e.g., none, Poison Control Center, hospital emergency department, hospital inpatient, private physician, clinic, other).
    6. Demographics (sex, age, occupation).
    7. If female, pregnant?
    8. Exposure data: amount of pesticide; duration of exposure; weight of victim
    9. Was exposure occupational; days lost due to illness.
    10. 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.

if you or a family member has had a severe or prolonged exposure to pesticides, do not stop to read this document. Get medical help at once.

 

Pesticide Exposures: Avoidance and clean-up

Important: About this document

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.

 

Avoiding personal contact with pesticides.

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.

  • Make sure you actually have a problem that is best solved by pesticide use. There are many pest control methods available that do not involve the use of pesticides. Contact HEAL for more information.
  • Select the least-toxic product that is effective against the pest you seek to control.
  • Purchase the smallest quantity of pesticide product that will accomplish your purpose. Read the product label before you purchase the product. You may also need to purchase protective equipment for use when handling the pesticide product.
  • Before using the pesticide, READ THE PACKAGE DIRECTIONS AND FOLLOW THEM TO THE LETTER..
  • Do not handle pesticides with uncovered cuts, or sunburned or abraded skin, rashes or inflamed skin. Intact skin offers protection against many pesticides, but broken, raw or sunburned skin may be more likely to allow pesticides that get on the skin to get through.
  • Avoid storing leftover pesticide products. If you must store pesticides, store them only in their original containers. (If you have leftover pesticide solution made from concentrate, do not store it. Dispose of it safely-- never pour such solutions down the drain or into a sewer. Do not pour it onto the ground. If you do not know how or where to dispose of pesticide solutions, contact your local government's waste management facility for instructions.)
  • Keep stored pesticides away from children, pets, heat, moisture, open flames, and water supplies. Store them away from living, storage and recreation areas.
  • IMPORTANT: Always wash hands thoroughly after any pesticide-related activity. Get into the habit of washing hands before taking medication, eating, doing your hair or face, feeding the baby, feeding pets, handling food, having contact with sick people-- any activity that may involve transferring pesticides from your hands to a surface or person that needs to be protected from contamination.

 

Dress for success

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.

  • Wear washable clothing rather than dry-clean only garments. Pesticides can be laundered out of washables, but may not be removed by dry-cleaning chemicals.
  • Handle and launder pesticide-contaminated clothing as directed in the "Laundry" section of this document.
  • Always wear full-coverage shoes (not sandals, sling-back or open-toed shoes) outdoors during pest control activities.
  • Do not wear shoes worn for pest control activities indoors. Change them before entering the home to avoid tracking pesticides indoors. NOTE: It is not known how to remove pesticides from leather or natural rubber.
  • Important: If you normally wear contact lenses, you may want to switch back to eyeglasses in situations that may involve exposure to pesticides or their vapors. If you opt to keep your lenses in, always carry a case and your prescription glasses with you, in case you need to remove your lenses quickly. But be aware that it may be very difficult to remove lenses safely after a pesticide exposure has occurred. If you believe your eyes may have been affected by pesticide exposure, go to a hospital emergency room at once.

 

In the yard -- protecting property from pesticide contamination

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:

  • Telephones
  • Clothing, including laundry drying on the clothesline
  • Clotheslines and drying racks, as well as clothes-pins and poles
  • Cooking and eating apparatus (dishes, glasses and flatware; grills, serving carts; table linens, tables and chairs, etc.)
  • Water fountains or bubblers used for drinking
  • Swimming pools (use pool covers--make sure they are free of holes, hose them off before removing them prior to pool use, and replace them each evening to guard against night-time pesticide applications
  • Hot-tubs (see swimming pools)
  • Children's wading pools
  • Pool toys and accessories
  • Children's toys
  • Play-sand boxes
  • Play-houses
  • Swing-sets and other play equipment
  • Sports and exercise apparatus and equipment
  • Lawn furniture, covers and cushions, umbrellas and awnings
  • Tents and other camping equipment
  • Pet dishes and bedding
  • Lawn and garden maintenance equipment
  • Flags and banners
  • Books and papers
  • Plants that normally live indoors

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.

 

The inside story-- Avoid bringing pesticides indoors

Protecting indoor air from pesticide 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.

  • Shut the windows and doors during pesticide applications and whenever responsible adults leave the home. Tightly caulked and sealed windows and doors provide better protection against pesticide infiltration than "leaky" ones.
  • Turn off the ventilation system during pesticide applications, and leave it off for at least an hour or two afterwards. [NOTE: Pesticides applied outdoors dry on surfaces long before they dissipate; some pesticides continue to vaporize for hours-- or even days -- after the application has dried. Waiting until the pesticide has dried limits the possibility of contact with wet pesticide, but does not protect against pesticide vapors.]
  • People with breathing or heart conditions may wish to consult their physicians about appropriate respiratory protection against pesticide fumes or mists. Others may wish to purchase and carry with them disposable commercial mist or fume masks available at drug, hardware and other outlets. (Note: Dust and nuisance-odor masks do not offer protection against pesticide mists and vapors.)
  • During the time the ventilation system is off, do not run exhaust fans, heat-pumps or other energy-recovery units, or clothes dryers. If there is an exhaust fan in the roof that runs on a thermostat, you may wish to turn it off manually, or tightly seal the living area of the building from the area ventilated by the roof fan.
  • [Comfort tip: In hot weather, keep blinds and curtains closed while the ventilation system is off, and don't do activities that generate heat and humidity, such as cooking, dishwashing, laundering or bathing. ]
  • Don't turn the ventilation system back on until you've hosed off the area around the system air intake (see below-- What to do after a pesticide application).

 

Don't track pesticides indoors.

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:

  • Hose off mats and porch floors frequently.
  • Indoors, use an inexpensive washable rug right in front of the door. The rug should be at least 6 feet long, and should cover the carpet on the main traffic pattern used by the residents. Wash this rug frequently-- daily during pest-control activities in the immediate vicinity of the home.
  • Vacuum rugs and carpets frequently during pest-control season. Use bags with HEPA filtration to capture contaminated dust that can be released from vacuum cleaner operation..
  • If your indoor entry is uncarpeted, damp-mop it daily and wash the mop head after each use. Damp mop bare floors several times a week to capture stray pesticide contaminants.

 

In the car

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.

 

Clean-up after exposure

People and pets

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.

  • If you have direct contact with a pesticide, don't panic, but take steps to get pesticides off your skin and hair as soon as possible:
  • Remove contaminated clothing as soon as possible after exposure. Take care not to rub pesticide-contaminated clothing on you nose or mouth, or around your eyes. Lift off pullovers from the neck up over your face, rather than from the hem up with the outer side of the garment turned toward your face.
  • Put contaminated clothes in a secure place until you can launder them. Away from home, bag them if possible, or at least turn them inside out and roll them up. Don't leave contaminated clothing where curious children or pets can get at them.
  • Keep pesticide-contaminated hair off your face and keep your hands away from your eyes, nose and mouth until you can wash them in running water with lots of soap..
  • Wet a face cloth or towel and gently but thoroughly wipe your face --away from eyes, nose and mouth. Be especially careful to wash your lips. Wash the cloth with soap and water, and repeat. Don't scrub! Apply soap to your face with a wrung-out cloth, and rinse it off in running water.
  • As soon as possible after you have contact with pesticides, shower rather than bathe in the tub.( Wash your face as above before you shower, to prevent pesticides from washing off your face and into your eyes, nose or mouth.) Keep the drain in the shower running freely, so that water does not accumulate. Using warm water and a strong spray, wash yourself with soap and water from the crown of your head to the soles of your feet--- in that order. Use lots of soap, and lots of running water. Soap and rinse yourself so that the water doesn't run into your eyes, nose or mouth. Rinse very thoroughly. Towel dry and use whatever moisturizer you normally use.

 

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.

 

Pet clean-up

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.

 

Clean up: In the yard

  • Wait for an hour or two to allow the pesticide to dry. Remember that dry pesticide is still emitting vapors, and may continue do so for many hours unless it is washed away by rain or clear water sprayed with a hose. You may wish to use a vapor or fume mask while doing clean-up soon after a pesticide application.
  • When outdoors, avoid coming into contact with surfaces and vegetation that may have been affected by pesticide applications. Avoid getting splashed while you hose off contaminated surfaces. Wear waterproof shoes or boots. Change clothing and take a shower immediately after outdoor pesticide-related work is complete.
  • You may wish to leave the garden hose attached to the outdoor faucet and keep the nozzle and the part of the hose you handle during use under cover between uses.
  • If this isn't feasible, wear household rubber gloves when handling the hose, and wash the gloves in soap and water before removing. Don't use these gloves for any purpose other than pesticide contamination-related activities.
  • After each outdoor pesticide application around the outside perimeter of your home, first hose down a path to the ventilation system air intake, and then thoroughly hose off surfaces and vegetation around the air intake.
  • Then hose down the driveway, walkways and frequently used paths across the yard..
  • Follow these steps for each window or door that is ordinarily opened in the course of a day.
  • If you must wash down vehicles or other large items after a pesticide application, avoid getting the wash water on your skin and clothing, and be sure to rinse the wash water off both the item and the surrounding surfaces (drive, lawn etc.).

 

Laundering pesticide contaminated textiles

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.

  • Keep washables contaminated with pesticides separate from the rest of the household wash. Don't launder pesticide-contaminated clothing with uncontaminated clothing-- residues can transfer from garment to garment in the wash.
  • Wash contaminated items as soon as possible after contamination--the longer the pesticide sits on the textile, the more thoroughly it may bond with it.
  • Pretreat contaminated items before laundering. Use one of the following methods: Hose off the items on an outdoor clothesline; soak in a standing tub in a large volume of water; soak the items in the washing machine using the presoak cycle. Let the pre-treatment water drain thoroughly out of the items before laundering. Don't use the presoak cycle water for the first wash cycle--drain it out of the machine and refill. Don't use the presoak water for garden "gray-water" purposes either.
  • Don't use the suds-saver feature on the washing machine when laundering pesticide-contaminated items. Use very hot water when laundering pesticide contaminated items. (Warm or cool rinses are acceptable, but hot water in combination with the heavy-duty detergent is what is needed to remove residues.) Wash few contaminated garments per load, using ample water. Run each batch of contaminated items through two complete cycles, using double "doses" of detergent each time.
  • Line-drying, preferably in the sun, is the preferred way to dry laundered items that have been contaminated with pesticides, according to the Nebraska Cooperative Extension. However, community pest-control methods that involve aerial spraying or ground misting may re-contaminate items on outdoor lines. Indoor line-drying in a dehumidified basement or other enclosed space may work well, although this method of drying does not hasten the breakdown of pesticide residues (sunlight does hasten this breakdown).
  • Don't use the family clothes-drier to dry laundered clothing that had been contaminated--remaining residues can transfer onto the interior of the drier and in turn transfer onto other loads of clean laundry.
  • After laundering pesticide-contaminated items, don't use the washing machine for the rest of the family wash without cleaning the tub first: Using hot soapy water, thoroughly sponge down the tub and agitator, then run the washer empty on with hot water for a full wash cycle. As an added measure of protection, you may want to rinse down the tub with a vinegar and water solution to remove mineral film to which pesticide may have adhered.
  • Starching clean clothing adds a thin layer of water-soluble protection to fabrics: pesticide that adheres to starched clothing can wash out more easily as the dissolved starch carries it away.

 

At a Glance: Pesticide safety on the Web

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.