Walter A. Alarcon, MD MSc, NIOSH/CDC
Purpose/Objectives
To identify potential risk factors for acute occupational pesticide poisonings and potential prevention factors.
Background
Pesticides are substances or mixtures of substances intended to prevent, destroy, repel, or mitigate pests. Pests include insects, rodents, fungi, and weeds. The benefits of using pesticides to control pests are well recognized and include protecting the food supply and controlling disease vectors. However, using pesticides is not perfectly safe and can result in pesticide-related poisonings. Therefore, there is need to conduct public health surveillance of acute pesticide-related illness and injury. The Sentinel Event Notification System for Occupational Risks (SENSOR)-Pesticides program conducts surveillance of acute pesticide-related illnesses and injuries in the United States. The SENSOR-Pesticides program is a partnership of CDC?s National Institute for Occupational Safety and Health (NIOSH) with state SENSOR-Pesticide programs and the US Environmental Protection Agency (EPA).
Methods
Thirteen State SENSOR-Pesticides programs investigated and reported acute pesticide poisonings using standardized methods. A case was defined as a person reporting acute onset of two or more new adverse health effects, that are temporally related to a documented pesticide exposure, combined with consistent evidence of a causal relationship between the pesticide and the health effects, based on the known toxicology of the pesticide product. Data sources used by the state programs include poison control centers, specific government agencies (e.g., Department of Agriculture), workers? compensation systems, and physician reports. Data analyses is ongoing.
Findings
From 1998 to 2018, 13 state programs reported that more than 33,000 persons had acute pesticide poisonings. Severity of cases was low in about 79% of cases, moderate in 19%, high in 2%, and there were 52 deaths. Overall, insecticides (43%), disinfectants (19%), and herbicides (11%) were associated with 73% of cases. Most cases were associated with exposure to multiple pesticide products (27%), pyrethroids (19%), inorganic compounds (15%), and organophosphates (8%). About 32% of persons were exposed while applying pesticides, 22% while performing routine work activities not involving pesticide application, and 16% while performing routine indoor activities not involving pesticide application.
Discussion
These data provide critical information for occupational and public health by identifying potential risk factors for acute occupational pesticide poisonings and potential prevention factors. These findings can be used to inform policy with the ultimate goal to improve worker health by reducing exposure to harmful pesticides. For multiple reasons, these data likely underestimate the actual magnitude of acute occupational pesticide-related illness and injury.
Conclusions
Acute pesticide poisonings in the United States are still of concern as these are preventable. Prevention efforts need to be targeted at persons who apply pesticides, those who conduct routine work activities not involving pesticide application, and those persons who were exposed while performing routine indoor activities not involving pesticide application.