Poison Center Surveillance of Agricultural Poisonings
Although all Americans are exposed to pesticides, agricultural workers and their families have the potential for additional exposures because of their work, place of residence, and recreation sites, which often adjoin one another or overlap (Arcury 2000, Arcury 2001, Kirkhorn 2002). Agriculture accounts for 75% of the 1.2 billion pounds of conventional pesticides applied annually in the United States (EPA 1998, Donaldson 2002, Calvert 2004). Thus, populations in agricultural regions need to be more thoroughly monitored for exposure (Ward 2000).
The Southeast Center is collaborating with poison control centers in four states to increase awareness of the links between hazardous chemical exposures and production agriculture. In a previous, retrospective study involving 240 counties in the lower Mississippi River Delta (McKnight, 2004; Bryden, 2005), researchers found that poison control center records contained limited information that could be used to identify chemical exposures related to production agriculture. However, few records included information on the circumstances of exposure – information needed to design and target effective prevention efforts.
In the current study, the Southeast Center is partnering with six poison control centers serving Kentucky, Alabama, Virginia, and West Virginia. All six centers use the Toxicall® data collection system to enter reports of exposures into the Toxic Exposure Surveillance System (TESS©) database maintained by the American Association of Poison Control Centers (AAPCC). This makes possible harmonized data collection and data sharing. The system as originally designed does not have a pre-formatted "variable" to distinguish production agriculture pesticide exposures from non-agricultural exposures; thus, for this six-site study, the Toxicall® data collection software has been modified to capture these facts.
Henry Spiller, MS, Director of the Kentucky Regional Poison Center, wrote the software modification being used in this study and trained poison control specialists on its application. During a 24-month period (2007-2008), three additional questions assessing an exposure’s link to production agriculture will be asked of an estimated 4,600 to 7,400 persons who report an exposure implicating at least one insecticide, herbicide, fungicide or fumigant from a list of 39 poison control center product codes. Of these reports we estimate that 10-15% of calls (450 to 1,000) implicating one or more of these product codes will be related to production agriculture.
The study has integrated the Toxicall® software modification in a voluntary, non-intrusive manner, keeping in mind the overall mission of poison control centers to eliminate or reduce morbidity and mortality from toxic exposures by providing information on poisoning and telephone consultations for emergencies (Simpson 2002). It is anticipated that the Toxicall© software modification will improve the ability to detect and monitor agriculture-related pesticide exposures and the circumstances under which they occur, in order that they might be more effectively prevented.
This project is supported by CDC/NIOSH Cooperative Agreement U50 OH007547.
For more information contact - Phyllis A. Bryden, DrPH, MSPH, RN Assistant Professor Department of Health Promotion & Administration Eastern Kentucky University Begley 428 521 Lancaster Ave. Richmond, KY 40475-3102 Phone: 859-622-1147