Use of Pesticide Surveillance Data for Training of Targeted Groups. Sheila Higgins NC Pesticide Incident Surveillance Program 12/4/12

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Use of Pesticide Surveillance Data for Training of Targeted Groups Sheila Higgins NC Pesticide Incident Surveillance Program 12/4/12

Outline Why do pesticide surveillance in NC? Surveillance findings highlights Targeted groups for intervention

Large ag-worker population NC ranks 5 th in the nation for number of farms with migrant farm labor NC ranks 7 th in the nation for number of hired labor on farms NC pesticide applicators: 15,652 private pesticide applicators (rank #13 in U.S.) 20,247 commercial applicators (rank #2 in U.S.) Source: Census of Agriculture, 2007

Pesticide Use N.C. Top 15 highest pesticide using states: 1. CA 2. FL 3. WA 4. IL 5. IA 6. ID 7. TX 8. NE 9. MN 10. IN 11. KS 12. GA 13. NC 14. MO 15. ND Source: Keily, EPA, 2009

Pesticide Use - N.C. Pesticide use in North Carolina: lbs. per year Pesticide class Field crops 7,901,015 Herbicides (69%) Fruit/Vegetables 726,065 Fumigants (40%) Tobacco 14,398,078 Fumigants (77%) Lawn and Garden 1,383,000 Herbicides (75%) Ind/Commercial/Govt. 1,964,000 Herbicides (66%) Source: 2009,Dr. Bob Bruss, NCDACS

Applicators and Handlers Mixing, loading Application Equipment repair

Field Worker Exposure NC crops requiring hand labor: apples blueberries cabbage Christmas trees cucumbers grapes greens ornamentals peaches peppers strawberries sweet potatoes tobacco tomatoes water melons

Field Worker Exposure:

Community Exposure Use in schools, apartments Lawn, garden, pools, pet use Indoor home use Household cleaning Recreational facilities Drift from fields to homes

NC Pesticide Incident Surveillance Program 5 year grant; EPA 2011 2015 Collect case data on acute pesticide illness and injury, focus on work-related cases Carolinas Poison Center primary source Use data for prevention activities

N.C. Data Reported Cases, 2007-2009 (N=2480) Number Percent Occupational 210 8.5 Non-Occupational 2270 91.5 Total 2480 100 Reported Cases by Severity, 2007-2009 (N=2480) Severity Number Percent Death 2 0.1 High 8 0.3 Moderate 38 1.5 Low 1076 43.4 Evaluated; Not Applicable 1356 54.7 Total 2480 100

N.C. Data Occupational Cases by Classification 2007-2009 Classification Number Percent Confirmed Definite 5 2.4 Probable 13 6.2 Possible 95 45.2 Suspicious 9 4.3 Total confirmed 122 58.1 Not confirmed Unlikely 23 11 Insufficient Information 49 23.3 Asymptomatic 11 5.2 Unrelated 5 2.4 Total not confirmed 88 41.9 Total 210 100

N.C. Data Activity of Confirmed Occupational Cases, 2007-2009 (N=117*) Activity Number Percent Applying pesticides 62 53.0 Routine work activities 47 40.2 Mixing or loading 4 3.4 Manufacturing or formulation 2 1.7 Transport or disposal 2 1.7 Total 117 100.0 * Activity was unknown for five confirmed cases

N.C. Data Product Type of Confirmed Occupational Cases, 2007-2009 (N=122) Product Type Number Percent Insecticide 68 55.7 Herbicide 30 24.6 Multiple 9 7.4 Disinfectant 7 5.7 Fumigant 4 3.3 Fungicide 3 2.4 Insect Repellent 1 0.8 Total 122 100

Occupation of Confirmed Occupational Cases, 2007-2009 (N=118*) Type of Occupation Number Percent Building and Grounds Cleaning and Maintainance Occupations 38 32.2 Farming, Fishing, and Forestry Occupations 38 32.2 Office and Administrative Support Occupations 8 6.8 Construction and Extraction Occupations 7 5.9 Transportation and Material Moving Occupations 5 4.2 Sales and Related Occupations 5 4.2 Healthcare Practitioners and Technical Occupations 4 3.4 Healthcare Support Occupations 2 1.7 Architecture and Engineering Occupations 2 1.7 Life, Physical, and Social Science Occupations 2 1.7 Management Occupations 1 0.85 Business and Financial Operations 1 0.85 Community and Social Services Occupations 1 0.85 Arts, Design, Entertainment, Sports and Media Occupations 1 0.85 Protective Services Occupations 1 0.85 Food Preparation and Serving Related Occupations 1 0.85 Installatioin, Maintenance and Repair Occupations 1 0.85 Total 118 100.0 * Occupation w as unknow n for four confirmed cases Categorized based on US Bureau of Labor Statistics, 2002 Census of Occupation Codes

Intervention Priorities Education of affected persons Educate advisory group members Partner with agencies that reach targeted groups Integrate information in public health or other community educational efforts

High Severity Case Report Applicator was preparing soil for cantaloupe planting, using a tractor and fumigating rig. Rig was stopped and he got off to try and unclog a line. Face was 10 inches away. Lines were stopped up, and while trying to unstop them, the lines broke loose and what was left in them came out and went into his eyes. Eyes were burned right away, vision went blank. No PPE worn, had left safety glasses in the tractor. Went to emergency department then specialty eye center. Had two surgeries on left eye to include grafting. NCDACS investigated case. NOW issued.

Target Groups & Partner Farmers and Families: NC Cooperative Extension East Carolina University, Agromedicine Institute Network

Target Groups & Partner Migrant Farmworkers: NC Community Health Care Association NC Farmworker Health Program Network

Target Groups & Partner Applicators: Network NC Department of Agriculture NC State University

Target Groups & Partner Health Care Providers: NC Medical Society NC Agromedicine Institute Network