Cholinesterase Monitoring ~ What Washington is Learning Margaret Tucker WA State Department of Agriculture

What Will Be Covered Program overview ChE results to date Findings of workplace investigations Training focus

Program overview Began in 2004 Lawsuit brought by labor advocates WA Supreme Court required Labor & Industries to institute rulemaking for cholinesterase (ChE) monitoring program Agricultural employers only

Program overview Who must comply? – Growers with employees who handle Category 1 or 2 organophosphate or N-methyl carbamate pesticides

Program overview What must they do? – Document hours of handling of covered pesticides – Offer testing to employees who handle covered pesticides

Program overview ChE Testing – Baseline before handling covered pesticides – Follow-up testing when exposure threshold met 2004 – 50 hours in consecutive 30 days 2005 – 30 hours in consecutive 30 days

Program Overview If ChE depression > 20%, employer must: – Perform an investigation of: work practices clothes respiratory protection sanitation – Keep a record of the investigation – Record actions taken to correct problems

Program Overview If > 30% decrease in red blood cell ChE or > 40% decrease in plasma ChE: – Work practice investigation by L&I – Employee temporarily removed from exposure Covered by medical removal protection benefits May return to handling tasks when ChE levels within 20% of baseline

Program Overview With ChE depressions, symptoms are generally reversed when – Exposure is stopped – ChE levels increase No pesticide illness cases in WA as a result of ChE depressions

Year Employees receiving baseline test Employees receiving follow-up test Number of periodic or follow-up tests Employees with depressions > 20% Employees with depressions >30% RBC ChE or >40% plasma ChE , (16.7% of those receiving follow-up test) 22 (3.8% of those receiving follow-up test) 119 (20.5% of those receiving follow-up test) 2005 (as of 7/11/2005) 2, (8.1% of those receiving follow-up test) 9 (1.6% of those receiving follow-up test) 56 (9.7% of those receiving follow-up test) Summary of ChE Monitoring Data Total

Preliminary Data from 2005 Research Investigations* BACKGROUND INFORMATION 27 Employers - all pome fruit growers About 75% of the farms > 500 acres About 1/3 had more than 10 handlers * NOTE: ADDITIONAL INVESTIGATIONS ONGOING

Preliminary Data from 2005 Research Investigations ChE-inhibiting pesticides handled by workers with significant ChE depressions – Lorsban – Sevin – Guthion – Carzol

Preliminary Data from 2005 Research Investigations Respiratory Protection No respirator cartridge change out schedule or overuse of cartridges13 Using half-face respirator 17 Improper fit-tests 3 Wrong prefilters for oil2

Preliminary Data from 2005 Research Investigations General Personal Protective Equipment (PPE) Spray glasses not chemical proof1 Cotton caps (7 wearing sweatshirt hoods also) 9 Wearing bump cap 1 Cotton gloves under nitrile2

Preliminary Data from 2005 Research Investigations Decontamination PPE decontamination inadequate 11 Application equipment decon inadequate 3 PPE removed & placed on contaminated surface (e.g. tractor) 3

Preliminary Data from 2005 Research Investigations Decontamination Adjust respirator without glove decon. 1 Smoking without washing/decon. 1 Equipment used for other activities w/o decontamination (e.g. tractor used w/o cleaning) 2

Preliminary Data from 2005 Research Investigations Handling Activities Eye flush supplies missing3 Eyewash supplies missing or not working4 Drift exposure (spray on face reported)3 WPS training cited inadequate4

Preliminary Data from 2005 Research Investigations Change of clothes not provided2 Improper respirator storage 1 No respiratory protection program 1 Improper respirator maintenance 1

Preliminary Data from 2005 Research Investigations Preliminary data highlights many factors making simple conclusions difficult Only evaluating employees with depressions – How do their practices differ from those without depressions?

Preliminary Data from 2005 Research Investigations AREAS OF CONCERN: Wearing absorbent caps and/or half-face respirators when applying Lorsban/oil tank mix with airblast sprayers Required PPE not available Improper use of PPE PPE decontamination inadequate or not performed at necessary times

Preliminary Data from 2005 Research Investigations AREAS OF CONCERN: Personal hygiene practices Equipment decontamination – none or insufficient. Multiple users w/varying practices Safety standards/best practices not being carried “down the line”

Training Focus At all levels: Growers Safety officers Foremen and crew bosses Handlers Coordinated, partnership effort: Industry, WSDA, WSU, DOH, L&I, PNASH

Training Focus How? Train the Trainer Hands-On Handler Training Spanish/English Recertification Programs  Washington State Horticultural Association  Governor’s Ag Safety Day  WSDA/WSU sponsored courses WSU Decontamination Video WSDA focused newsletter to ag employers

Training Focus Growers & Handlers Emphasize personal, equipment and PPE decontamination every time Eliminate use of absorbent caps, etc. Convert to full face respirators where appropriate Follow farm safety policies

Training Focus Growers, Safety Officers, Foreman Communicate results of L&I investigations Encourage them to: Create and nurture a safety culture Develop, implement and actively enforce pesticide safety policies  Ensure adequate availability, use and decontamination of protective equipment

More Information Go to Click on the Topics Index at the top of the page Find “Cholinesterase” Click on “Cholinesterase monitoring” Call BE-SAFE ( ) and select “pesticide blood testing” – – Spanish

Thank You! Margaret Tucker WA State Dept. of Agriculture (360) agr.wa.gov/PestFert/