Coby Jansen, Matthew Keifer, Helen Murphy-Robinson. University of Washington; WA Departments of Agriculture, Health and

1. PNASH Prevention Focus Using Data to Identify and Address Causes of Pesticide Over-Exposure in Washington State Agricultural Employees Little to no supervision No decon post-exposure PPE Missing/Problem Coby Jansen, Matthew Keifer, Helen Murphy-Robinson. University of Washington; WA Departments of Agriculture, Health and Labor and Industries. Label not explained to non-reader Assigned/ Allowed Unsafe Practice Unaware of hazard Introduction Personal Protective Equipment Workplace Practices • Background • The University of Washington and Washington State Departments of Agriculture, Health, and Labor and Industries are collaborating on a project to use agency data and scientific research to identify factors contributing to pesticide over-exposure among agricultural workers. The group plans to use these findings to create and implement recommendations for preventing these exposures. • Project Objectives • Use data to identify factors contributing to pesticide over-exposure • Craft prevention messages and identify solutions • Share data and prevention messages with handlers, agricultural community and policy-makers MAINTAINING & CLEANING SPRAY EQUIPMENT • Handlers who cleaned spray equipment were NINE TIMES more likely to have inhibited cholinesterase than handlers who did not2 18 handlers fell ill while maintaining & cleaning spray equipment. Most common practices: 1) unclogging nozzles or 2) washing sprayers1 The leading contributing factors of handler pesticide poisonings are lack of required personal protective equipment (PPE) and other PPE problems.1 Graph 1. Type of PPE missing by Ill handlers1 • 56% handlers with a • pesticide illness were • missing required PPE • (68) or had a • PPE problem (29)1 MIXING AND LOADING • 17 handlers poisoned by pesticides while M&L1 • Handlers who M&L were TWICE as likely to have inhibited ChE as handlers who did not2 Most common problem for mixer/loaders is eye injury from splash. In 73% of these cases, handler was missing eye protection1 Eye Protection1 42 (25%) of 167 handlers with pesticide poisoning were not wearing required eye protection. Many ill handlers wore the wrong type or poorly fitting PPE. • Why?1 • “Didn’t think I needed it” • Employer didn’t provide • Inadequate supervision • Poor fit (mist enters side of goggle) University of Washington ChE Risk Factors Study (154 participants) Caution! There were 48 WPS violations for not providing either: • Eyewash at M&L stations (24), or • Pint of water for emergencies (24)4= risk of more serious eye injury T R E N D S Dept. of Health Pesticide Illness Route Cause Interviews (351 cases) • Perceived task as low risk • Handler did not know PPE was required for task Why?1 Labor & Industries ChE Monitoring Consultations (60 handlers, 34 sites) • Why?1 • Employer did not provide • Wrong type • Not instructed to wear • Removed for dexterity • Not used when cleaning, fixing equipment (or other tasks besides mix/load, apply) Gloves 31 handlers (19%) who got sick from pesticide poisoning were not wearing required gloves1 Handlers became ill while unclogging spray nozzles1 PERSONAL DECONTAMINATION Poor decontamination practices may have contributed to: 1) Pesticide over-exposure among more than half of handlers with inhibited cholinesterase (31 cases); 2) 14 cases of handler illness WPS Inspections: L&I (31 sites, 79 violations) Training Messages Policy Changes Technical Solutions WPS Inspections: WSDA (~150 sites, 439 violations) Reduce pesticide over-exposures among agricultural employees Why? • Insufficient time to decontaminate3 • Decontamination not adequate or timely1,3 • Insufficient supplies (towels, soap, change of clothes)4 Handlers think gloves too thick? 6x more likely to use bare hands, disposable gloves for unclogging2 PROBLEM AREAS UNDERLYING FACTORS Personal Protective Equipment Protection by Labels • EYE PROTECTION Safety glasses not as effective in protecting against splashes or wind-blown spray mist1 Workplace Practices Respirators: Cartridge Change-out More than half of worksites with a ChE inhibited handler violated cartridge change-out regulations, affecting 27 workers.3 The most common technical PPE issue for ill handlers was over use of cartridges and use of incorrect cartridges.1 Ag Workers Over-Exposed to Pesticides Training Drift • RESPIRATORS: Handlers wearing full-face instead of half-face respirators were seven times less likely to have ChE inhibition2 • Dermal exposure at end of row? • Why? • Handlers with inhibited ChE often worked at sites not complying • with proper change-out schedules.3 • 9% No change-out schedule • 42% did not follow change-out schedule Restricted Entry Interval Handlers wearing well-sealed respirators and full PPE report feeling spray on face and neck when turning at the end of a row. May drive through spray mist when beginning next row.1 Protection by Labels Supervision Training and Supervision Respirators: Poor Fit One quarter of handlers with ChE inhibition had poorly fitting respirators and/or were not fit tested.3 Six handlers with pesticide poisoning had poorly fitting respirators that did not seal properly.1 • Why?1 • Facial hair • No regular on-the-job seal testing • No pre-season fit test Evidence of Poor Supervision1 Drift - Trainers not qualified - Training did not meet the WPS requirements (ex. No written materials; did not covered req’d pts) • Problem: Drift was the leading factor in pesticide overexposure of non-handler, agricultural workers.1 • 80 incidents involving 191 people (03-08) • More than half were drift to bystanders or non-agricultural workers • 34 events affected 103 agricultural workers • Why?1 • Neighbor farm or workers not notified • Workers unsure if okay to leave • Sprayer or worker thought they were at a safe distance Insufficient or poor training3 Chemical Resistant Boots Handlers who wore chemical resistant boots were SEVEN TIMES less likely to have inhibited ChE.2 Trainings too infrequent3 - Handlers and workers not trained at all - Handlers trained less than every 5 years Restricted Entry Interval Problem: Early entry contributed to pesticide illness in 19 workers1; 39% of WPS violations were related to central or field postings4; 4 handlers had ChE inhibition >20% after too early re-entry3 A collaborative effort by: • Data Sources: • WA Department of Health Pesticide Illness Investigations (2003-8) • Occupational determinants of serum cholinesterase inhibition among organophosphate- • exposed agricultural pesticide handlers in Washington State. JN Hofmann, MC Keifer, AJ • DeRoos, RA Fenske, CE Furlong, G vanBelle, H Checkoway. Occup Environ Med On-line • October 9, 2009. • 3. WA Labor & Industries – Cholinesterase Monitoring Program Consultations (2007-9) • 4. WA LNI & WS Dept. of Agriculture. WPS Investigations (2007-9) PNASH • Why?1 • Signs not seen • Workers follow verbal orders, not postings • No sign was posted • Wrong sign posted • Old signs not removed • Central Posting Issues3 • Incomplete spray records • REI not included in postings • Records not displayed for 30 days after REI expires • No spray records posted at all For more information contact: (800) 330-0827 pnash@u.washington.edu