What
to Do if You Suspect Pesticide Poisoning
- As reported by the
Arizona Structural Pest Control Commission, 50 to 90% of
the cases involving sickness from pesticides occurs with
children and the elderly. Guess what that means?
Concerning the Chemically Injured or MCS/EIs, illness
from pesticide exposure does not necessarily
mean that the chemicals have been misused. The following
list, prepares you for only
those instances when
the symptoms and/or contamination is so extreme that you
suspect there has been a misuse.
- 1. Design
a plan. Ask your physician what he or
she would recommend to do in case of pesticide poisoning.
- A. Does
your doctor have a preferred emergency room or lab? etc.
If your hospital or lab does not have cholinesterase
(blood) or alkylphosphates
(urine) testing available, contact Pacific Toxicology, in
item #5, for the lab nearest to you. See
comparison of these 2 tests listed in #5. Please remember
that you need a doctor's order to run these tests.
- B. Before
your doctor's visit, read online or order the booklet, Recognition
and Management of Pesticide Poisoning,
listed in #4 of this list.
- C. Check
with physician about your tolerance or the safety of
antidotes in the preceding EPA publication.
- D. Important:
It is recommended
that you have a cholinesterase inhibitor
pesticide test or alkylphosphates test done beforehand
to record baseline levels of pesticide in your system.
This is most practical test because there are many
pesticides that cannot be specifically identified. The
cholinesterase inhibitor test will not
identify the specific name of pesticides in your system.
Later, these levels can be compared when the same test is
run in the event of a suspected poisoning.
2. Find
and investigative agency. Inquire as to whether or not
your State Department of Agriculture or other government agency
will investigate suspected pesticide poisoning
or misuse especially in places with public access.
Please research this in advance. Each State has it's own system
and it has been reported that some do not handle
pesticide misuse investigation. If they do, record phone
number(s) and contact person(s). For Arizona and
Nevada investigation, see #7.
3. Post all emergency
information: contact persons, medical facilities and
government department phone numbers. Place by the phone and keep
info in your wallet.
- 4. Let
the patient be aware! The following book was
recommended by Dr. Linda Aston, from Pacific Toxicology,
for the patient and physician. It lists symptoms and
offers treatment guidelines for pesticide poisoning. Bring
the book or the EPA link to the emergency room to
show your doctor if you suspect a poisoning. Many
physicians have been trained in toxicology, but the
standard training is brief.
- Order this booklet free
from the EPA:
- Recognition
and Management of Pesticide Poisoning - 540988001
(208 pgs.)
- Call 703-305-7666
or 1-800-490-9198 to order from the Certification
and Worker Protection Branch of the EPA, Office of
Pesticide Programs.
- or view the publication directly on
the EPA site: http://www.epa.gov/pesticides/safety/healthcare/handbook/handbook.htm
-
- 5. Warning:
Concerning cholinesterase tests and treatment
for poisoning. Cholinesterase
tests may be helpful for litigation purposes only. "Cholinesterase has no
Prognostic Value." Our Toxic Times," Issue
142. Volume 13, Number 5, page 28. "Misdiagnosis
from relying on serum cholinesterase readings could have
injurious or life threatening consequences for patients
with OP(pesticide) poisoning." Chemical Injury
Information Network Newsletter. http://www.ciin.org
-
- Editor's note:
As someone with MCS/EI, you may not have all the typical
symptoms and the poisoning may bring on other unusual
symptoms.
-
- 5. Choose an
experienced lab for the pesticide testing.
-
- Pacific Toxicology accepts
work from all over the USA.
- Lab work
cannot be done without a physician's order.
- Dr. Linda Aston,
Bioanalytical Chemist, is available during
regular business hours to answer questions. This
lab also tests for hazardous chemicals- solvents
and heavy metals to monitor employee exposure in
industry.
- When in doubt,
request that the attending physician check with
her for the proper test to fit the suspected
class of pesticide.
- Pacific
Toxicology, 1545 Pontius Avenue, Los Angeles, CA
90025
- Call: 1-800-328-6942
- http://www.pactox.com/
- Types of
tests:
- Cholinesterase
Inhibitor: This record of baseline levels of
pesticide in your system can be compared to suspected
exposure levels. (This test should also be available
through your local doctor or ER.) Pacific Toxicology
billing: Will not bill insurance. This is problematic for
Medicare patients. Patient pays in advance. $43.50.
- Alkykphosphates -
Organophosphate (OP) Screen: Tests for
types of pesticides. Billing: Patient pays in advance.
Will not bill insurance. $93.25
Comparison of
Pesticide Tests*
- Cholinesterase
(blood)
- Pros
- Relatively simple,
inexpensive
- Longer period of detection
- Physiological parameter
measured
- Cons
- Invasive sample collection
- Reqires baseline
measurement
- Difficulty determining
degree of exposure
- Difficulty in laboratory
standardization
- Non-specific factors
affect activity
-
- Alkylphosphates
(urine)
- Pros
- More sensitive (10-50x's)
- Greater specificity
- Easier sample collection
- Direct chemical
measurement
- Cons
- Shorter period of
detection (3-6 days)
- More expensive test
- Expensive instrumentation
required
-
- *Source: Coye,
M.J., Lowe, J.A., Maddy, K.J. Biological monitoring
of agricultural workers exposed to pesticides. II
Monitoring of intact pesticides and their metabolites.
J. Occ. Med. 28:628-635. 1986.
- Malathion:
If you are reasonably sure this is the source of the
poisoning, this test can identify this OP pesticide.
Billing: Patient pays in advance. Will not bill
insurance. $130.00
- Clorpyrifos
(Dursban): If you are reasonably sure this is
the source of the poisoning, this test can identify this
OP pesticide. Billing: Patient pays in advance. Will not
bill insurance. $108.00
-
- 6. Within
24 hours of exposure or ASAP, visit your doctor
or emergency room. Make sure to bring EPA publication
listed in #4 of this list or link to EPA site with title
of book. Please note EPA instructions about how
to handle contaminated clothing and cleanup of patient,
if that is necessary to do before visiting emergency
room.
If you suspect the exposure was
to an organophosphate type of pesticide, (the majority of
pesticides used at present), a urine sample is required. These
pesticides are undetectable after 72 hours. Rare, organochloride
pesticides are present in the blood for much longer, but most of
these are outlawed in this country. Head lice shampoo may have
the ingredient, Lindane, which is an organochloride pesticide.
Testing for the carbamate class of pesticides is forwarded to
another lab for analysis.
7. Report to the investigative
agency within 24 hours or ASAP. Report the suspected
misuse to your State Department of Agriculture or governmental
investigative agency. Ask someone to do this for you, if you
cannot.
- Arizona
- Arizona Structural
Pest Control Commission. 602-255-3664.
Ask to speak to an investigator. If it occurs on a
weekend, just leave a message so that it can be handled
ASAP.
- Nevada
- Las Vegas- Nevada
Department of Agriculture. 702-486-4690. Ask to
speak to the investigator. They can fax the report form
to you. The incident must be in writing to process the
investigation. The law requires that all reports are
investigated. Numbers of individuals involved in
suspected poisoning incident help determine priority
along with workload.
- All other areas-
Reno office can dispatch. 775-688-1180.
-
- To understand the
investigative process, call 775-688-1180 ext. 251
to order the Nevada Department of Agriculture free
brochure "Pesticide and Investigative
Procedures."
- Or write: Nevada
Department of Agriculture, 350 Capitol Hill Ave., Reno,
NV 89502, Attn: Charles Moses.
8. Make your own record. Make
a list of your symptoms and their duration. Record the location,
date and time of their onset. If you can't do it, ask someone to
help you. This information
will be needed for the report.
9. Report to the EPA.
Use the HEAL homepage to print out form, fill it out, and mail to
EPA Locate form on site in HEAL On-Line, The Supplement
Vol.2, # 1 April 1998. http://members.aol.com/HEALNatnl/hs0201.html
- 9 A. Report to
ECHO. ECHO Tracking Adverse Health Effects
of Pesticides
- As you know many cases of
pesticide injury are never documented or reported. As
part of ECHO's "Lady Bug Project" we have
developed a Pesticide Incident form to collect data on
injuries caused by pesticides. We hope to use this
information to help educate our legislators and the
public about the serious health risks of pesticide use.
The Pesticide Incident form is available on the ECHO
website. If you have been injured by a pesticide or have
had any bad reactions to a pesticide application, please
print out and complete a Pesticide Incident form and mail
to: ECHO - Pesticide Registry, PO BOX 8232,
Berlin, CT 06037. Your name is optional and will be kept
confidential. We are also interested in documenting any
pets that have been sickened and any plants that may have
been injured by drift from a neighbor's pesticide
application This is an ongoing project and there is no
deadline for submitting the forms. E-mail: ECHOMCSCT@aol.com Phone/Fax: 860-228-2693 http://www.ECHOMCSCT.Homestead.com
10. Share the information! Please
e-mail me and I will post the information you have gathered for
your area. It can help many others!
Editor's Note:
This is a lot of work, but you can also help prevent pesticide
misuse that could harm others. This is based on my personal
experience.
Litigation or Proof
of Disability
If you are
collecting this evidence to prove injury for litigation or
disability, you will need other testing. Information
provided by Cynthia Wilson, Chemical Injury Information Network.
(5-23-01)
- To show damage or proof of
injury you will also need:
- A lawyer
- Spect Brain
Scan to show tissue injury
- Neurotoxicity
Screening Exam
- Contact Raymond
Singer, PhD., Neuropsychology and Neurotoxicology
- Phone: 505-466-1100
- http://members.aol.com/neurosite/ or http://www.neurotox.com
For more information on
pesticide testing, see CIIN "Our Toxic Times" Medical
and Legal Briefs- Vol.4, No. 3. Nov./Dec. 1998. "Cholinesterase
Not a Reliable Indicator of OP Pesticide Poisoning" $5.00.
This article explains why cholinesterase inhibitor tests do not
singlehandedly prove chemical injury.
- Contents
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