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Title: Pesticide Exposure and Health Top Ten Reasons to Use PPE


1
Pesticide Exposure and Health Top Ten Reasons to
Use PPE
  • Julia F. Storm, MSPH
  • Dept. of Environmental Molecular Toxicology
  • College of Agriculture and Life Sciences
  • NC State University

2
Top Ten Reasons to Use PPE
3
Top Ten Reasons to Use PPE
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

4
Risk of Harmful Health Effects Toxicity x
Exposure
  • Toxicity
  • The measure of the ability of a substance to
    cause harmful effects.
  • Exposure The total amount of substance that gets
    in or on an organism route, frequency, and
    duration of exposure are important.

5
Relative Potential Pesticide Exposure
  • HIGH
  • Applicators (backpack sprayers, airblast)
  • Mixers/Loaders
  • Flaggers
  • Fumigators (confined spaces)
  • Animal dippers
  • MEDIUM
  • Applicators (open groundrig)
  • Fumigators (greenhouse, field, orchard, vineyard)
  • LOW
  • Mixer/loader (closed systems)
  • Applicators (aerial, closed cab groundrig)
  • Fieldworkers

6
Relative Toxicity, rat LD50, mg/kg
Caution Caution Warning
Danger-Poison
  • Sugar (sucrose)
  • Alcohol
  • Glyphosate (Roundup)
  • Salt (sodium chloride)
  • Malathion
  • Aspirin
  • Metalaxyl (Ridomil)
  • Ammonia
  • Arsenic (arsenic acid)
  • Nicotine
  • Aldicarb (Temik)
  • Dioxin (TCDD)
  • Botulinum toxin
  • 29700
  • 14000
  • 5600
  • 3000
  • 1375
  • 1000
  • 633
  • 350
  • 48
  • 1
  • 0.93
  • 0.001
  • 0.00001

7
Top Ten Reasons to Use PPE
  • 9. If you can remember anything about the
    sixties, you werent really there.
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

8
The Dose Makes the Poison
All substances are poisons, the right dose
differentiates a poison from a remedy. Paracelsu
s (1493 - 1541)
9
Relative Toxicity, rat LD50, mg/kg
Caution Caution Warning
Danger-Poison
  • Sugar (sucrose)
  • Alcohol
  • Glyphosate (Roundup)
  • Salt (sodium chloride)
  • Malathion
  • Aspirin
  • Metalaxyl (Ridomil)
  • Ammonia
  • Arsenic (arsenic acid)
  • Nicotine
  • Aldicarb (Temik)
  • Dioxin (TCDD)
  • Botulinum toxin
  • 29700
  • 14000
  • 5600
  • 3000
  • 1375
  • 1000
  • 633
  • 350
  • 48
  • 1
  • 0.93
  • 0.001
  • 0.00001

10
Top Ten Reasons to Use PPE
  • 8. Just because you can hold your liquor
    doesnt mean your liver loves you.
  • 9. If you can remember anything about the
    sixties, you werent really there.
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

11
As Dose Increases, Response Worsens
RESPONSE
Alcohol DOSE
12
Top Ten Reasons to Use PPE
  • 7. Shirts and skins are fine for basketball or
    soccer, but not for pesticide application.
  • 8. Just because you can hold your liquor
    doesnt mean your liver loves you.
  • 9. If you can remember anything about the
    sixties, you werent really there.
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

13
Exposure Routes
O R A L
D E R M A L
14
Means of Exposure to Pesticides
  • Oral
  • Unwashed Hands
  • eating
  • smoking
  • Unwashed Foods
  • Inhalation
  • Dusts
  • Vapors
  • Dermal (Skin eyes)
  • Spills and splashes
  • Open cuts
  • Inadequate protective clothing
  • Unwashed clothing
  • Unwashed hands

15
Top Ten Reasons to Use PPE
  • 6. Parts may be parts, but skin is not skin.
  • 7. Shirts and skins are fine for basketball or
    soccer, but not for pesticide application.
  • 8. Just because you can hold your liquor
    doesnt mean your liver loves you.
  • 9. If you can remember anything about the
    sixties, you werent really there.
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

16
Chemical Absorption by Human Skin
Foot arch 1 Palm 6 X Forearm 8 X Back 12
X Scalp 25 X
Armpit 26 X Forehead 43 X Jaw 93
X Scrotum 300X
17
Surface Area Exposed in a Casually Dressed
Individual
  • Unclothed Surface
  • Face
  • Hands
  • Forearms
  • Back of Neck
  • Front of Neck Vof Chest
  • Surface Percent Area (sq ft) of Total
  • 0.70 22.0
  • 0.87 27.6
  • 1.30 41.3
  • 0.12 3.8
  • 0.16 5.1


18
Exposure to Hands Without Gloves
19
Exposure to Hands With Gloves
20
Top Ten Reasons to Use PPE
  • 5. Youll live to watch the next Super Bowl or
    World Cup.
  • 6. Parts may be parts, but skin is not skin.
  • 7. Shirts and skins are fine for basketball or
    soccer, but not for pesticide application.
  • 8. Just because you can hold your liquor
    doesnt mean your liver loves you.
  • 9. If you can remember anything about the
    sixties, you werent really there.
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

21
Acute Effects
  • Adverse effects that may appear immediately after
    exposure to a pesticide (usually within 24 hours)

22
Poisoning Cases
  • 37 year old farmer
  • Spilled endosulfan on hands while mixing about
    noon
  • Experienced nausea and vomiting at 330 pm
  • Kept working till 430 pm
  • Found unresponsive at 6 pm
  • Pronounced dead at hospital 2 hrs later
  • 43 year old farmer
  • Mixed (no PPE or hand-washing) applied
    endosulfan with boom sprayer
  • Developed seizures and overturned tractor, but no
    traumatic injury found
  • Never regained full consciousness
  • 5 years later still impaired neurologically

23
Poisoning cases
  • 20 yr old Mexican male
  • Emptying 14 bags of aldicarb burning bags
  • No protective equipment
  • 2 hours later found crushed by tractor
  • Test results
  • No drugs low cholinesterase activity
  • Blood, tissue levels of aldicarb 3x gt cholinergic
    symptoms (body burden18.2mg)
  • Contaminated clothing
  • Conclusion physical incapacitation led to
    tractor roll-over

24
Incidence of Pesticide Illness Top 20 Pesticides
Implicated California, 1998-2000
  • Not determined
  • Adjuvant
  • Sulfur
  • Metam-sodium
  • Chlorpyrifos
  • Sodium hypochlorite
  • Petroleum oil
  • Glyphosate
  • Methomyl
  • 509
  • 251
  • 202
  • 194
  • 156
  • 110
  • 59
  • 55
  • 54

25
Incidence of Pesticide Illness Top 20 Pesticides
Implicated California, 1998-2000
  • Carbofuran
  • Diazinon
  • Myclobutanil
  • Naled
  • Copper hydroxide
  • Iprodione
  • Spinosad
  • Oxydemeton-methyl
  • Methyl bromide
  • Esfenvalerate
  • Mancozeb
  • 40
  • 38
  • 38
  • 36
  • 36
  • 35
  • 33
  • 32
  • 31
  • 28
  • 26

26
Acute Poisoning Cases Top 10 Crops California,
1997-2000
  • Grapes
  • Soil
  • Oranges
  • Cotton
  • Packing/processing
  • Almonds
  • Alfalfa
  • Ornamentals
  • Lettuce
  • Tomatoes
  • Broccoli
  • Strawberries
  • Subtotal
  • All other crops/sites
  • Unknown
  • Total
  • 331
  • 222
  • 124
  • 116
  • 99
  • 98
  • 58
  • 54
  • 44
  • 40
  • 38
  • 32
  • 1283
  • 488
  • 128
  • 1899

27
Pesticide Illness Circumstances California
  • 1998-2000
  • 51 due to drift
  • 55 involved violations
  • 25 dermal contact with residues
  • 43 involved violations
  • Conclusion apparent compliance failed to protect
    workers
  • 1997-2001
  • 572 pesticide-related field observations
  • 33 had 1 or more violations
  • Common violations
  • PPE (88 employer failure to provide, 12 worker
    failure to use)
  • Inadequate or no washing/decontamination
    facilities
  • Fieldworker access to pesticide information

28
Hospitalized Pesticide Poisoning in North
Carolina, 1990-1993
  • 61 Insecticides (OP, pyrethrins)
  • all groups
  • 19 Rodenticides
  • adult intentional
  • childhood
  • 10 Fungicides Herbicides
  • occupational

29
Incidence of Pesticide Poisoning
  • Occupational OP Incidents Reported
  • Poison Control Centers 1993-1996
  • 3205 exposures
  • 336 significant illnesses (23 of all pesticides)
  • 18 life-threatening
  • 38 of all pesticides
  • highest of 18 types of pesticides (2x average)
  • 1468 treated

30
Top Ten Reasons to Use PPE
  • 4. Just because you have 2 legs, not 6, doesnt
    mean an insecticide cant kill you.
  • 5. Youll live to watch the next Super Bowl or
    World Cup.
  • 6. Parts may be parts, but skin is not skin.
  • 7. Shirts and skins are fine for basketball or
    soccer, but not for pesticide application.
  • 8. Just because you can hold your liquor
    doesnt mean your liver loves you.
  • 9. If you can remember anything about the
    sixties, you werent really there.
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

31
Organophosphate (OPs) Carbamate Insecticides
  • OPs
  • acephate, Orthene
  • disulfoton, Di-Syston
  • chlorpyrifos, Lorsban
  • fonofos, Dyfonate
  • malathion, Malathion
  • diazinon, Spectracide

Carbamates carbaryl, Sevin aldicarb,
Temik oxamyl, Vydate L carbofuran,
Furadan methomyl, Lannate
32
Common Symptoms of OP Carbamate Exposure
  • excessive tears
  • excessive sweating
  • excessive salivation
  • pinpoint pupils (eyes)
  • dizziness
  • nausea
  • vomiting
  • diarrhea
  • excessive urination

33
Organophosphates
  • Mode of Action
  • Irreversible inhibition of acetylcholinesterase
    (AchE)
  • Treatment
  • Atropine
  • 2-PAM
  • Supportive therapy

34
Carbamates
  • Mode of Action
  • Reversible inhibition of acetylcholinesterase
    (AchE)
  • Treatment
  • Atropine
  • Supportive therapy

35
Monitoring OP/Carbamate Exposure
  • Blood cholinesterase analysis
  • Baseline determination is important
  • Depression of 25 or more is indicative of
    serious overexposure

36
Conditions Confused With Pesticide Poisoning
  • Heat stress fatigue, dizziness, severe thirst,
    heavy sweating, altered behavior, headache,
    nausea, chills
  • Green tobacco sickness stomach cramps, nausea,
    vomiting, difficulty breathing, dizziness

37
Emergency Response
  • Remove the person from exposure
  • Follow label first aid instructions or call
    Poison Control 1-800-222-1222
  • Call 911 or take victim to ER or MD
  • Give EMTs label, MSDS exposure information

38
Skin Conditions Associated with Pesticide Exposure
  • Irritation
  • Allergy

39
Pesticides Associated with Allergic Reactions
  • lindane, Drexol, Lindane
  • esfenvalerate, Asana XL
  • permethrin, Pounce, Ambush
  • rotenone, various
  • maneb, Maneb
  • dazomet, Basamid
  • benomyl, Benlate
  • captan, various
  • dichloropropene, Telone II


40
Importance of Allergic Reactions
  • Permanent
  • Worsen with recurrent exposures
  • Can be fatal
  • Allergy to similar substances

41
Top Ten Reasons to Use PPE
  • 3. Because somebody loves you and wants you to be
    healthy and be around a long time.
  • 4. Just because you have 2 legs, not 6, doesnt
    mean an insecticide cant kill you.
  • 5. Youll live to watch the next Super Bowl or
    World Cup.
  • 6. Parts may be parts, but skin is not skin.
  • 7. Shirts and skins are fine for basketball or
    soccer, but not for pesticide application.
  • 8. Just because you can hold your liquor
    doesnt mean your liver loves you.
  • 9. If you can remember anything about the
    sixties, you werent really there.
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

42
Delayed Effects
  • Adverse effects that do not appear immediately
    (within 24 hours) after exposure to a pesticide

43
Chronic Health Effects Associated with Certain
Pesticides
  • Developmental
  • Nervous System
  • Immune System
  • Cancer
  • Reproductive Effects

44
Evidence of Carcinogenicity of Pesticides from
Animal studies
  • National Toxicology Program
  • 107 pesticides tested in animals
  • 54 had some carcinogenicity
  • International Agency for Research on Cancer
  • 26 pesticides with sufficient evidence
  • 8 still registered for use in U.S.
  • 19 pesticides with limited evidence
  • 15 still registered for use in U.S.

45
Summary of Agricultural Health
  • Health Problems
  • Higher risk of injury
  • Risk of lung disease (not lung cancer)
  • Skin conditions
  • Higher rates of certain cancers
  • Other immune, nervous, reproductive system
  • Health Pluses
  • Live longer
  • Lower heart disease death rate
  • Lower death rate due to some cancers
  • Lung
  • Esophagus
  • Bladder
  • Colon

46
Agricultural Health Study First 12 years
  • Associated with Chemicals
  • Pesticides, solvents, diesel tractors
  • Fungicides
  • Methyl bromide
  • Alachlor
  • Pesticide use
  • Symptom or Disease
  • Wheeze (lung symptom)
  • Retinal degeneration (vision problem)
  • Prostate cancer
  • Multiple myeloma and leukemia (immune system
    cancers)
  • Abnormal menstrual cycles (female reproductive
    health)

47
Risk
  • Toxicity
  • Nature of the chemical (dose/response)
  • Interaction with other chemicals
  • Exposure
  • Dose
  • Route
  • Duration
  • Frequency

48
Top Ten Reasons to Use PPE
  • 2. The label says so, and its the law.
  • 3. Because somebody loves you and wants you to be
    healthy and be around a long time.
  • 4. Just because you have 2 legs, not 6, doesnt
    mean an insecticide cant kill you.
  • 5. Youll live to watch the next Super Bowl or
    World Cup.
  • 6. Parts may be parts, but skin is not skin.
  • 7. Shirts and skins are fine for basketball or
    soccer, but not for pesticide application.
  • 8. Just because you can hold your liquor
    doesnt mean your liver loves you.
  • 9. If you can remember anything about the
    sixties, you werent really there.
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

49
To Minimize Pesticide Exposure
  • Know the chemical and associated hazards
  • Read and follow the label instructions

50
Top Ten Reasons to Use PPE
  • 1. Because it just makes common sense.
  • 2. The label says so, and its the law.
  • 3. Because somebody loves you and wants you to be
    healthy and be around a long time.
  • 4. Just because you have 2 legs, not 6, doesnt
    mean an insecticide cant kill you.
  • 5. Youll live to watch the next Super Bowl or
    World Cup.
  • 6. Parts may be parts, but skin is not skin.
  • 7. Shirts and skins are fine for basketball or
    soccer, but not for pesticide application.
  • 8. Just because you can hold your liquor
    doesnt mean your liver loves you.
  • 9. If you can remember anything about the
    sixties, you werent really there.
  • 10. Bad habits are like a comfortable bed, easy
    to get into, but hard to get out of.

51
To Minimize Pesticide Exposure
  • Wear Personal Protective Equipment (PPE)
  • Mix and load pesticides in a spill containment
    area

52
To Minimize Pesticide Exposure
  • Use integrated pest management (IPM) techniques
    to minimize pesticide use

53
To Minimize Pesticide Exposure
  • Use techniques that minimize surface and ground
    water contamination and drift
  • Recycle pesticide containers

54
To Minimize Pesticide Exposure
  • Comply with intervals for re-entry harvest
  • Wash hands before eating, smoking, and using the
    bathroom

55
To Minimize Exposure to Others
  • Wash pesticide contaminated clothing separately
  • Store mix pesticides in original containers
    labeled mixing equipment -- never in food
    containers
  • Lock pesticides away from children

56
For More Information Contact
  • Greg Cope
  • 919-515-5296
  • greg_cope_at_ncsu.edu
  • Julia Storm
  • 919-515-7961
  • julia_storm_at_ncsu.edu

Wayne Buhler 919-515-5369 wayne_buhler_at_ncsu.edu
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