Division of Disease Control and Health Protection

1. What is the purpose of the surveillance program?
2. What type of cases is investigated?
3. Who must report?
4. How are investigations conducted?
5. How are cases classified?
6. How is the surveillance data managed?
7. What are the limitations of the surveillance data?
8. How is the surveillance data used?

1. What is the purpose of the surveillance program?

The primary purpose of the surveillance program is to identify the magnitude and distribution of acute pesticide-related illness and injury and to implement prevention and intervention activities aimed at reducing the occurrence of pesticide poisonings.

2. What type of cases is investigated?

The Florida Department of Health/Pesticide Exposure Surveillance Program (DOH/PESP) investigates reports of acute adverse health effects resulting from exposure to pesticides. The types of reports that are investigated include:

• Exposures to insecticides, herbicides, fungicides, rodenticides, and any other pesticides defined under federal law (FIFRA-Federal Insecticide, Fungicide, and Rodenticide Act)
• Workplace and residential exposures
• Exposures in public places (e.g. roadways, parks etc.)
• Workplace exposures to antimicrobials (e.g. detergents)
• Exposures to general-use (over-the-counter pesticides) and restricted-use pesticides
• Exposures involving emergency response
• Reports of pesticide-related symptoms such as skin and eye injuries, and allergic reactions

3. Who must report?

The Florida reporting rule 64D-3 is typically aimed at licensed health care providers, physicians and laboratory personnel, http://www./www.doh.state.fl.us/environment/community/pesticide/pdfs/rep_dis_list (353K PDF). The program however accepts reports from other entities such as the exposed person(s)/witnesses, legal services, farmworkers advocacy groups, other state agencies, media, etc. Report can be made to the Department of Health at (850) 245-4277/1-800-606-5810 or the county health department, CHD Directory.
 

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 4. How are investigations conducted?

The typical case investigation involves:

A.  Interviews with symptomatic persons and/or witnesses to get information on:

• When the exposure occurred
• Type of symptoms experienced
• The activity of the exposed person(s)
• Where the exposure occurred (e.g. work, home, school, roadway, etc.)
• If medical care was sought and what type (e.g. skin decontamination, airway protection, etc.)
•  If other persons were exposed

B. Review of the exposed person(s) medical records and clinical or laboratory test results:

• Determine type of test done
• Interpretation of test results
• Determine medical diagnosis and treatment
• Determine other possible cause if not pesticide poisoning

C. Review of pesticide field investigation or environmental laboratory analysis records from regulatory agent to:

• Determine if an pesticide application did occur and the possibility of exposure
• Determine how the exposure actually occurred
• Confirm the pesticide product involved in the exposure

Interviews may be conducted by phone or in person. DOH/PESP does not have a laboratory for processing environmental and biological samples, but will review the results of tests conducted by approved laboratories operating within the state. Case investigation may be done in collaboration with the regulatory agency (e.g. Department of Agriculture and Consumer Services) especially when there is a suspected pesticide use violation.

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5. How are cases classified?

DOH/PESP uses a standard protocol for classifying cases as to the likelihood that the symptoms reported are related to a pesticide exposure. This protocol was developed by the National Institutes of Occupational Safety and Health/Sentinel Event Notification System for Occupational Risk (NIOSH/SENSOR) program and is used by most states that conduct pesticide illness/injury surveillance. The full protocol is available at the NIOSH website.
 

All cases investigated by DOH/PESP are subjected to internal and NIOSH review to assure accuracy in coding and case classification. The case classification criteria for acute pesticide-related illness and injury are based on evidence of exposure, presence of adverse health effects and casual relationship between the symptoms and the pesticide toxicology. Cases are classified as definite, probable, possible, suspicious, unlikely, insufficient information, and not a case. For a detailed description of the classification categories refer to the Classification of Acute Pesticide Illness and Injury (9K PDF).

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6. How is the surveillance data managed?

Information collected during case investigations is entered into the Pesticide Incident Monitoring System (PIMS) database. The information in PIMS database can be queried by variables such as demographic information of the exposed, county of exposure, site of exposure, pesticide type, pesticide active ingredient, signs/symptoms, case classification and severity type. Analysis of the PIMS data is conducted and published annually on the program’s website.

The database contains personal identifiers and medical information, and is therefore not open to public. The information on the database can only be access by the program staff. Under Florida law, email addresses are public record. If you do not want your email address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone in writing. You may contact the program coordinator,Rosanna Barrett for additional data information on a documented pesticide exposure.