1. Pesticide Poisoning Symptoms and Other Health Issues Joanne Kick-Raack State Coordinator, Pesticide Education Programs The Ohio State University Extension

2. Objectives Briefly review acute and chronic effects Highlight some common pesticides and their effects on health Share early results of National Agricultural Health Study Answer your questions/concerns

3. Acute or Chronic? Acute Effects – Immediate “poisoning” or harm – Based on LD50 values – Most sensitive route determines Signal Word

10. Acute or Chronic Effects? Chronic Effects – Long-term effects from small doses over time – Not necessarily on label – Some information on MSDS

11. Chronic Effects Carcinogenicity-cancer Mutagenicity-genetic changes Teratogenicity- birth defects Oncogenicity-tumor growth (not necessarily cancers) Liver damage Reproductive disorders-sperm count, sterility, miscarriage Nerve damage Allergenic sensitization

12. Material Safety Data Sheets (MSDS) Provides information on chronic toxicity Refers to the concentrate rather than dilute product

13. Pesticides and Health Effects Insecticides Fungicides Herbicides

14. Organophosphates and Carbamates Examples: Lorsban, Diazinon, Sevin, Malathion, Furadan and many others Cause of most acute pesticide poisonings Inhibit cholinesterase, affect the nervous system Effect is reversible Monitor with blood tests

15. Signs and Sypmtoms of Cholinesterase Inhibition Affects the nervous system Can be confused with flu, or heat exhaustion Mild poisoning symptoms – Headache, fatigue, dizziness, loss of appetite, nausea, cramps, diarrhea – Blurred vision, excessive tearing, contracted pupils – Excessive sweating and salivation (this is not true for heat stress) – Slowed heartbeat

16. Cholinesterase cont’d Moderately severe – Unable to walk – Chest discomfort and tightness – Pinpoint pupils – Muscle twitching – Involuntary urination and bowel movement Severe – Seizures, incontinence, unconsciousness,

17. Aggregate and Cumulative Exposure Food Quality Protection Act –in reexamining pesticides EPA adds all exposures from all pesticides in a group (ex.organophosphates) together to estimate public health risks. Organophosphates will be reviewed together after reviewed individually

18. Natural Pyrethrum/Pyrethrins and Rotenone Crude pyrethrum is a dermal and respiratory irritant Asthma has occurred after exposures Refined pyrethrins less allergenic but some irritant and sensitizing properties Rotenone has little human hazard – Hazardous to fish, birds,

19. Synthetic Pyrethroids Examples: Baythroid, Pounce Synthetic mimics of natural pyrethrins Systemic toxicity by inhalation or skin absorption is low—few human poisonings Dermal and respiratory irritation – Stinging, itching, tingling progressing to numbness

21. Natural Inorganic Insecticides Boric Acid and Borates – Irritating to skin – Infants- “boiled lobster appearance” –redness, followed by peeling of skin Sulfur – Dermatitis-skin irritation – Irritation of eyes and respiratory tract

22. Fungicides Most are unlikely to cause severe or frequent poisonings Cause irritant injuries to skin and mucous membranes, dermal sensitization

23. Fungicides Chlorothalonil’s (Daconil) potential to cause cancer is unclear EBDC’s under FQPA review as group – Can degrade to ETU which can produce cancer in mice – However, do not appear to be carcinogenic

24. Herbicides Many can irritate skin, eyes and respiratory track Low systemic toxicity Ex. Some Round-up calls for eye protection

25. Diquat/Paraquat Paraquat more toxic (orally) – Large doses (6-8oz.) produces fatal lung changes. – Fluid accumulation in lungs can occur in 24 to 72 hrs. Respiratory failure. – Exposure may cause blackening and abnormal growth of nails Diquat affects eye lens and intestinal tract lining— vomiting. Both cause skin irritation and burning

26. 2,4-D and MCPA Moderately irritating to skin and mucous membranes May cause burning sensations in nose, sinuses and chest, dizziness Not “agent orange” Agent orange issue was from dioxin contaminant in the manufacture of 2,4,5-T

27. 2,4-D and Cancer There are no reports that indicate a direct link between 2,4-D exposure and cancer in humans. Some concern about higher rates of a type of cancer, non-Hodgkins lymphoma, among farmers, ag workers and pesticide applicators but different studies are not consistent.

28. 2,4-D and Cancer Most studies have not found a relationship between exposure to chlorophenoxy herbicides and soft sarcoma. Current evidence does not indicate that exposures to 2,4-D are linked with an increased incidence of breast cancer in humans or experimental animals.

29. Atrazine and Cancer Found in drinking water Under special review Based on scientific evidence presented, EPA reclassified atrazine as “not likely to be a human carcinogen” Will be evaluating endocrine disruption – Controversial “frog deformity” studies

30. Organochlorines and Cancer DDT/DDE, dieldrin, chlordane Accumulate in fatty tissues No conclusive evidence Infertile alligators and reduced sperm counts

31. Chronic Effects and Controversy Cancer Endocrine disruption – Infertility and sperm counts Multiple chemical sensitivity

32. Endocrine Disruption Hormones, alter bodily functions, development, and growth We are only starting to gather information on which chemicals are endocrine disruptors and at what level they have an effect. FQPA mandates testing of pesticides for endocrine disruption New screening tests must be developed—very difficult

33. Multiple Chemical Sensitivity More frequent in women Very controversial whether it is really a disease

34. Food Quality Protection Act All older pesticides must be reevaluated based on new standards Evaluating risk based on cumulative and aggregate exposure New testing for endocrine disruption Higher protection factor for children

35. A Landmark Study of Agricultural Workers and Their Families Agricultural Health Study

36. A large, prospective cohort study Goal: Establish a large group of people associated with pesticide application and follow them for many years to evaluate the relationship between agricultural exposures and disease

37. What is the Ag Health Study? Long-term study to investigate effects of several factors on the health of the agricultural population. These factors include Environmental Dietary Occupational Genetic factors

38. Exposures Experienced by Farmers PESTICIDES/ Fertilizers Fuels and oils Animal viruses Organic solvents Engine exhausts Paints Grain dusts Welding fumes

39. Who are they studying? Participants are commercial & private pesticide applicators (& spouses, if married) in Iowa & North Carolina 89,658 subjects in first 5 years (58,564 from IA & 31,094 from NC)

40. Questionnaires Occupational Factors Pesticides used Pesticide application methods used PPE use (current and 10 years ago) Other farm activities & exposures

41. Questionnaires Lifestyle & Dietary Factors Diet Cooking practices Physical activity Smoking Alcohol consumption Hair dye use

42. Mortality Followup (1994-1998) for Iowa Private Applicators Cause of DeathSMRObs/Exp All Causes0.4333/848 All Cancer0.4111/259 Colon0.7 16/23 Pancreas1.0 12/13 Lung0.2 21/95 Prostate0.3 6/19 Brain0.6 6/10 Lymphoma0.9 11/13 Leukemia0.7 7/10 Cardiovascular Disease0.4115/277 COPD0.2 7/43 Accidents1.0 46/48 Non-motor vehicle1.2 30/25 N = 31,877; person-years = 109,630

43. Early Findings Farmers are healthier and live longer than the general population Overall they have less cancer There are a few cancers that appear to be slightly higher in occurrence

44. Malignant Cancer Incidence Follow-up (1994-1998) for Iowa Members Cancer SiteSIRObs/Exp* All Sites0.81850/1050.3 Buccal cavity & pharynx0.56 18/32.2 Digestive system0.77143/186.8 Respiratory system0.27 49/184.1 Skin melanomas1.28 48/37.4 FEMALE BREAST1.19134/112.2 Female genital system0.68 35/51.4 PROSTATE1.25245/196.7 Urinary system0.58 28/48.4 Brain & CNS0.91 15/16.5 Lymphoma0.73 64/87.7 * Expected based on rates for entire state of Iowa, 1995-98

45. Retinal Degeneration Also called macular degeneration Leading cause of blindness in older adults Damage or breakdown of the retina of the eye, causing loss of central vision

46. Retinal degeneration & pesticide use Incidence related to fungicide use Fungicide applications to orchard fruits (apples or peaches), Christmas trees, or peanuts were involved Association was more pronounced with increasing lifetime days of fungicide use Association with prior organochlorine (aldrin, DDT) pesticide use was noted

47. Retinal degeneration & pesticide use Results similar in Iowa & North Carolina applicators Based on 154 applicators reporting doctor’s diagnosis of this condition & 17,804 applicators who did not More work needed to determine whether this relationship will be true for all data sets

48. How is the study funded? Primary funding provided by the National Cancer Institute Additional funding from the – National Institute of Environmental Health Sciences – U.S. Environmental Protection Agency – National Institute for Occupational Safety & Health

49. For more information… Visit the Ag Health Study’s Web site www.aghealth.org www.aghealth.orgwww.aghealth.org

50. Toxicity Information National Pesticide Telecommunication Network1-800-858-7378 Extoxnet ace.orst.edu/info/extoxnet/ Poison Control Centers 1-800-222-1222 Ohio State University Extension, Pesticide Education Program pested.osu.edu