National Institute for Occupational Safety and Health/CDC Pesticide – Related Activities

NIOSH Pesticides Special thanks to Dr. Steve Olenchock and Dr. Geoff Calvert

Occupational Safety and Health Regulation/Enforcement Research, Training, and Prevention Recommendations Department of Labor Department of Health and Human Services Centers for Disease Control and Prevention Mine Safety And Health Administration Occupational Safety and Health Administration National Institute for Occupational Safety and Health

NIOSH Mission To provide leadership in research to prevent work-related illness, injury, disability, and death.

NIOSH Research – intramural and extramural Training Technical assistance Policy

NIOSH NIOSH Staff: 1,400 FY02 Budget: $276.1M

State Partnerships Adult Blood Lead Surveillance SENSOR National Occupational Mortality Surveillance Fatality Assessment and Control Evaluation (FACE) In-house FACE State FACE CDC/ NIOSH SAFER l HEALTHIER l PEOPLE

Sensor-pesticides State-based surveillance “Sentinel” case identification and follow-up Timely opportunities for prevention/intervention Develop state-based models for national implementation Standardized case definition, variables, and severity index

Sensor-pesticides Funding provided by NIOSH and EPA Funding began in 1987 NIOSH technical advisor: Geoff Calvert, (p) 513-841-4448, (f) 513-841-4489 ; gcalvert@cdc.gov

Sensor-pesticides Estimate of Magnitude First aggregated data set was developed Data provided by AZ, CA, FL, LA, NY, OR, TX From 1998-1999, 1004 cases identified Definite=96 Probable=258 Possible=540 Suspicious=110

Distribution of cases by industry, 1998-1999

Pesticide Functional Class, 1998-1999

Ten Most Common Active Ingredients Acute occupational pesticide-related illnesses, 1998-1999 Exposure Type Accounting for 40% or more of Cases Contact w/ treated surface Drift Indoor Air Spill or other direct contact Common Name Sulfur Cyfluthrin Chlorpyrifos Malathion Pyrethrins Mepiquat chloride Propetamphos Methyl bromide Diazinon Count* 89 74 64 61 52 50 49 Doesn’t include SURFACE or CONTACT and active ingredients in reported products

Outbreaks/emerging Problems Recently Identified Nosocomial pesticide poisoning-Georgia, 2000 Described 3 health care workers made ill by op-contaminated patient MMWR 2001;49:1156-1158 Poisoning associated with hydrogen cyanamide-Italy, 2001 23 cases; Label lacked adequate precautionary info MMWR 2001;50:845-847 Briefly discuss emerging problems recently identified (poisoning among working children, medfly, insecticide dispensers, WNV, etc.) Limited resources: For example the California Dept to Health and Human Services has established criteria for when a field investigation should be conducted (e.g. deaths, hospitalizations, events that involve 4 or more workers). Over a 21 month period (3/99-11/00), 187 events met these criteria but only had resources to investigate 19. Agenda of sister agencies is often different. In most instances, these investigations are conducted by the state agriculture department. However the ag depts may goal is to promote crop production and not to protect worker and community health. Therefore, their conclusions and recommendations may differ from those of the health dept

MMWR: Surveillance Related to West Nile Virus Control Efforts New York State 1999 and 2000 May pose risk of acute, temporary health effects; however, the risk appears to be low.

Outbreaks/emerging problems recently identified Acute pesticide poisoning among working youth, 1988-1999 Used data from SENSOR-pesticides, TESS, and California Dept of Pesticide Regulation 531 poisoned youth were identified Working youth found to have higher risk of pesticide poisoning compared to adults (incidence rate ratio=1.71 [95%CI=1.53, 1.91]) Accepted for publication in AJPH Briefly discuss emerging problems recently identified (poisoning among working children, medfly, insecticide dispensers, WNV, etc.) Limited resources: For example the California Dept to Health and Human Services has established criteria for when a field investigation should be conducted (e.g. deaths, hospitalizations, events that involve 4 or more workers). Over a 21 month period (3/99-11/00), 187 events met these criteria but only had resources to investigate 19. Agenda of sister agencies is often different. In most instances, these investigations are conducted by the state agriculture department. However the ag depts may goal is to promote crop production and not to protect worker and community health. Therefore, their conclusions and recommendations may differ from those of the health dept

Outbreaks - continued Acute disinfectant poisoning among working youth, 1993-1998 Identified 308 youth poisoned by disinfectants Working youth found to have higher risk of pesticide poisoning compared to adults (incidence rate ratio=4.14 [95%CI=3.66, 4.68]) Manuscript in preparation

Other Accomplishments Finalized the severity index Developed a webpage for sensor-pesticides http://www.cdc.gov/niosh/pestsurv/ How-to guide for pesticide poisoning surveillance Preparing responses to internal review comments on draft document First guide on developing a state-based surveillance program Guides for other conditions are now in development

NIOSH National Program in Agricultural Safety & Health Intramural Child Ag SENSOR Grants Community Partners International Ag Centers Est. 1990

Centers for Agricultural Disease & Injury Research, Education, and Prevention

Community Partners for Healthy Farming

Childhood Agricultural Injury Prevention Initiative Child Ag Center Grants Intramural

Reduction of Ergonomic Hazards in Harvesting Wine Grapes Reduce weight to below 50 pounds Outcome: < back, neck, shoulder and knee pain No decrease in productivity

Reducing Eye Injuries and Illnesses in Latino Farmworkers Trained 18 Promotores Culturally acceptable eye PPE Custom-fit 640 Farmworkers