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Learn more about
the Division of Environmental Health
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Pesticide Illness Investigations
About our investigations
Examples of reported cases
What DOH collects during case
investigation
How DOH
classifies cases
Data analysis
Limitations of
DOH pesticide illness surveillance data
About our investigations
The Washington State Department of Health
(DOH) investigates reports of
acute adverse health effects resulting from exposure to pesticides.
The types of reports that we investigate include:
-
Exposures to insecticides, herbicides,
fungicides, rodenticides, and any other pesticides defined under
federal law (FIFRA-Federal
Insecticide, Fungicide, and Rodenticide Act). DOH does
not investigate exposures to disinfectants.
-
Workplace and home
exposures.
-
Exposures to over-the-counter
pesticides and restricted-use pesticides used by professional
pesticide applicators.
-
Case reports of systemic
symptoms, irritant symptoms, skin and eye injuries, and allergic
symptoms.
Examples
of reported cases
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What DOH
collects during case investigation
The typical case investigation involves:
-
interviews with
symptomatic persons and/or witnesses.
-
review of relevant medical records and
clinical laboratory results.
-
review of pesticide spray records or
interview with the applicator to confirm the pesticide product
involved.
Interviews may be conducted by phone or at the
patients home or work site. DOH does not have a laboratory for
processing environmental samples, but will review the results of sampling
conducted by other agencies such as WSDA or L&I, who may also be involved
in the case. Suspected violations may be referred to Washington State
Department of Agriculture or Washington State Department of Labor
and Industries.
How DOH classifies cases
DOH 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 (NIOSH and is used by
most other states that conduct illness prevention. The full
protocol is available at the
NIOSH website.
All cases investigated by DOH are
submitted to internal review to assure high quality and standard
coding of pesticide illness cases.
The chart below provides a basic description of
the case classification criteria for acute pesticide-related
illness and injury.
|
Classification of Acute Pesticide-Related Illness and Injury |
|
Category |
Description |
|
Definite |
Objective evidence confirms both the exposure
and the health effects. Objective evidence of the exposure include
residues detected in the environment or positive results from
biological testing for human exposure to a pesticide. Objective
evidence of health effects includes documented observation by a
health care provider of clinical signs or symptoms.
The
symptoms and pattern of symptom onset are consistent with what is
known from human health and toxicology studies on the pesticide. |
|
Probable |
Objective evidence of either the pesticide
exposure or the health effects is available.
The symptoms and pattern of symptom onset are consistent with what
is known from human health and toxicology studies on the
pesticide. |
|
Possible |
Only subjective evidence of exposure and
health effects is available. The exposure may be reported by the case
and/or a witness, and supported by pesticide spray records. The
case may have been seen by an health care provider. However, all
symptoms were self-reported and were not documented by a health
care provider.
The
symptoms and pattern of symptom onset are consistent with what is
known from human health and toxicology studies on the pesticide. |
|
Suspicious |
Subjective or objective evidence of both the
pesticide exposure and the health effects are available.
However,
there is insufficient toxicological or exposure information
available to determine whether the symptoms and pattern of symptom
onset are consistent with what is known from human health and
toxicology studies on the pesticide. |
|
Unlikely |
The
relationship between the reported exposure and health effects is not
consistent with the known toxicology of the pesticide. Symptoms
may be atypical but cannot be ruled out as unrelated. |
|
Insufficient Information |
Insufficient documentation on the exposure or the health effects
was available to determine whether the health effects were related to the pesticide exposure.
|
|
Not a case |
An
individual may have been reported to a state surveillance system
due to an alleged exposure, but was asymptomatic; or it was
determined that health effects were due to a condition other than
a pesticide exposure. |
Top of Page
Data
analysis
Information collected during case investigations is entered into
the Pesticide Illness Monitoring System (PIMS) database. PIMS is searchable by a number of variables including
county, target crop, site of exposure, pesticide type, pesticide
active ingredient, and demographic information. Analysis on PIMS
data is conducted and published annually in the PIRT report.
Because the database contains personal identifiers and medical
information, it is not open to public viewing at this time. Contact
Pesticide Program staff for additional
data inquiries.
Limitations
of DOH pesticide illness surveillance data
The data collected by DOH have limitations
because:
- The surveillance program investigates acute illnesses and
injuries only. DOH does not investigate chronic or latent
effects of pesticides.
These types of effects include cancer, birth defects, developmental
abnormalities, and neurological disease. Chronic and latent effects of
low-level pesticide exposure require investigative tools and resources
that are different than
the passive surveillance tools and resources that are available to DOH
at this time. There are several
regional research institutions
that are actively
studying these types of
effects.
-
Not all cases of pesticide illness are
reported
to DOH. The case may not
be reported if the sick person does not seek health care, if the person
seeks health care but the health care provider fails to recognize it as
pesticide-related illness, or if the health care provider does not
report the case as required. Under-reporting is a common problem
among all states that monitor pesticide-related illnesses
and among passive surveillance systems in general.
WA State recently undertook a 3-year study to identify barriers to
reporting and possible remedies for under-reporting. The study used focus groups
to gather information from agricultural workers to assess their health seeking behaviors. The
majority of participating farm workers said that they have not and/or
would not seek health care for mild or moderate severity illnesses if
they thought the illness was pesticide-related. The primary reason cited was cost
resulting from time off work and cost of medical care.
The study also included a review of medical records for Yakima area
clinics and hospitals. For cases of Yakima County agricultural workers
who did seek health care and were assigned a pesticide-related
diagnosis, the DOH Pesticide Program received the case reports 60% of
the time. DOH is currently taking steps to improve reporting rates
for cases of pesticide illness.
The full report on this study,
Improving Data Quality in Pesticide Illness Surveillance, is available on the
Pesticide Illness Publications Web page.
- Information on reported cases may be insufficient
to document the case. We may not be able to locate a
seasonal worker for our interview. We may not be able to determine where
pesticide spray drift originated. We may not be able to identify a
pesticide product. Such cases are entered into the PIMS database but are not included in most analyses of DOH data.
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For more information about the Pesticides Program, please contact
Cynthia Lσpez
or 360-236-3340.
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