Pesticide-Related Illness or Injury

Pesticide-Related Illness or Injury reporting code 09894 case reporting form DACS 130320 (9/96)

(Adopted June 1999) Pesticide Incident Monitoring Report

Clinical case definition

Any acute adverse health effect resulting from exposure to a pesticide product (defined under the Federal Insecticide Fungicide and Rodenticide Act [FIFRA] with the exception that disinfectants are excluded*) including health effects due to an unpleasant odor, injury from explosion of the product, and allergic reaction. Symptoms typically involve one or more of the following

· Systemic signs or symptoms (including respiratory, gastrointestinal, allergic and neurological signs/symptoms)

· Dermatologic lesions

· Ocular lesions

Laboratory criteria for diagnosis

· Biological tests for the presence of, or toxic response to the pesticide and/or its metabolite (in blood, urine, etc.), which may include:

· Measurement of the pesticide and/or metabolite(s) in the biological specimen

· Measurement of a biochemical response to pesticide in a biological specimen (e.g., cholinesterase levels)

· Environmental tests for the pesticide (e.g., foliage residue, analysis of suspect liquid)

· Pesticide detection on clothing or equipment used by the case subject

Case classification

Reports are scored according to the following three criteria (a) documentation of pesticide exposure,

(b) documentation of adverse health effect, and(c) evidence supporting a causal relationship. Refer to the classification matrix which follows this criteria section – the matrix provides the case classification categories and the scores needed to place the case into a specific category.

A. Documentation of Pesticide Exposure:

1. Laboratory, clinical, or environmental evidence corroborate exposure

· analytical results from foliage residue, clothing residue, air, soil, water, or biologic samples

· observation of residue and/or contamination (including damage to plant material from herbicides) by a trained professional**

· biologic evidence of exposure (e.g., response to administration of an antidote such as 2-PAM, Vitamin K, or repeated doses of atropine

· documentation of a characteristic eye injury or dermatological effects at the site of direct exposure by a licensed health care provider

· clinical description of two or more post-exposure health effects characteristic for the pesticide by a licensed health care provider

2. Evidence of exposure based solely upon written or verbal report

· report by case

· report by witness

· written records of application

· observation of residue and/or contamination (including damage to plant material from herbicides) by other than a trained professional

· other evidence suggesting that exposure occurred

3. Strong evidence that no pesticide exposure occurred

4. Insufficient data

B. Documentation of Adverse Health Effect

Two or more new post-exposure abnormal signs and/or test/laboratory findings reported by a licensed health care provider

Two or more new post-exposure abnormal signs reported (when new post-exposure signs and test/laboratory findings are insufficient to satisfy a B1 score, they can be used in lieu of symptoms towards satisfying a B2 score)

3. One post-exposure abnormal sign or symptom or insufficient data

C. Evidence Supporting a Causal Relationship Between Pesticide Exposure and Health Effects

1. Where the signs and symptoms documented under the criteria B. Health Effects are:

· characteristic for the pesticide and the temporal relationship between exposure and health effects is plausible

· consistent with an exposure-health effect relationship based upon the known toxicology (i.e., exposure dose, symptoms, and temporal relationship) of the putative agent from commonly available toxicology texts, government publications, information supplied by the manufacturer, or two or more case series or positive epidemiologic studies published in the peer-review literature

2. Evidence of exposure–health effect relationship is not present because

· the exposure dose was insufficient to produce the observed health effects or

· a temporal relationship does not exist (i.e., health effects preceded the exposure or occurred too long after exposure) or

· the constellation of health effects are not consistent based upon the known toxicology of the putative agent from information in commonly toxicology texts, government publications, information supplied by the manufacturer, or the peer-reviewed literature

Definite evidence of non-pesticide causal agent

Insufficient toxicological information is available to determine causal relationship between exposure and health effects including

· circumstances where minimal human health effects data are available or

· where there are less than two published case series or positive epidemiologic studies linking health effects to exposure to the particular pesticide product/ingredient or class of pesticides

CASE CLASSIFICATION MATRIX

CLASSIFICATION CATEGORIES
CLASSIFICATION CRITERIA	Confirmed Case	Probable Case		Possible Case	Suspicious Case	Unlikely Case	Insufficient Information		Not a Case
									Asymptomatic	Unrelated
A. Exposure	1	1	2	2	1 or 2	1 or 2	4	-	-	3	-
B. Health Effects	1	2	1	2	1 or 2	1 or 2	-	4	3	-	-
C. Causal Relationship	1	1	1	1	4	2		-	-	-	3

Comment

The Florida Poison Information Network (800-282-3171) can provide emergency information to physicians and the public. For information regarding Florida pesticide laws and regulations, contact the Florida Department of Agriculture and Consumer Services, Bureau of Compliance Monitoring at 850-488-3314. For information regarding this case definition, contact the Florida Department of Health, Bureau of Environmental Epidemiology, Pesticide Poisoning Surveillance Program at (850)-488-8921.

* PESTICIDES: are defined under FIFRA as any substance or mixture of substances intended to prevent, destroy, repel or mitigate insects, rodents, nematodes, fungi, weeds, microorganisms, or any other form of life declared to be a pest by the Administrator of the USEPA and any substance or mixture of substance intended for use as a plant regulator, defoliant, or desiccant. Pesticides include herbicides, insecticides, rodenticides, fungicides, disinfectants, wood treatment products, growth regulators, insect repellents, etc.

** TRAINED PROFESSIONAL: may be a plant pathologist, agricultural inspector, agricultural extension agent, industrial hygienist or any other licensed or academically trained specialist with expertise in plant pathology and/or environmental effects of pesticides. A licensed pesticide applicator may also be considered a trained professional.