Pesticide Poisoning Symptoms and Other Health Issues

1. Pesticide Poisoning Symptoms and Other Health Issues Joanne Kick-Raack State Coordinator, Pesticide Education Programs The Ohio State University Extension

2. Objectives • Briefly review acute and chronic effects • Highlight some common pesticides and their effects on health • Share early results of National Agricultural Health Study • Answer your questions/concerns

3. Acute or Chronic? • Acute Effects • Immediate “poisoning” or harm • Based on LD50 values • Most sensitive route determines Signal Word

10. Acute or Chronic Effects? • Chronic Effects • Long-term effects from small doses over time • Not necessarily on label • Some information on MSDS

11. Chronic Effects • Carcinogenicity-cancer • Mutagenicity-genetic changes • Teratogenicity- birth defects • Oncogenicity-tumor growth (not necessarily cancers) • Liver damage • Reproductive disorders-sperm count, sterility, miscarriage • Nerve damage • Allergenic sensitization

12. Material Safety Data Sheets (MSDS) • Provides information on chronic toxicity • Refers to the concentrate rather than dilute product

13. Pesticides and Health Effects • Insecticides • Fungicides • Herbicides

14. Organophosphates and Carbamates • Examples: Lorsban, Diazinon, Sevin, Malathion, Furadan and many others • Cause of most acute pesticide poisonings • Inhibit cholinesterase, affect the nervous system • Effect is reversible • Monitor with blood tests

15. Signs and Sypmtoms of Cholinesterase Inhibition • Affects the nervous system • Can be confused with flu, or heat exhaustion • Mild poisoning symptoms • Headache, fatigue, dizziness, loss of appetite, nausea, cramps, diarrhea • Blurred vision, excessive tearing, contracted pupils • Excessive sweating and salivation (this is not true for heat stress) • Slowed heartbeat

16. Cholinesterase cont’d • Moderately severe • Unable to walk • Chest discomfort and tightness • Pinpoint pupils • Muscle twitching • Involuntary urination and bowel movement • Severe • Seizures, incontinence, unconsciousness,

17. Aggregate and Cumulative Exposure • Food Quality Protection Act –in reexamining pesticides EPA adds all exposures from all pesticides in a group (ex.organophosphates) together to estimate public health risks. • Organophosphates will be reviewed together after reviewed individually

18. Natural Pyrethrum/Pyrethrins and Rotenone • Crude pyrethrum is a dermal and respiratory irritant • Asthma has occurred after exposures • Refined pyrethrins less allergenic but some irritant and sensitizing properties • Rotenone has little human hazard • Hazardous to fish, birds,

19. Synthetic Pyrethroids • Examples: Baythroid, Pounce • Synthetic mimics of natural pyrethrins • Systemic toxicity by inhalation or skin absorption is low—few human poisonings • Dermal and respiratory irritation • Stinging, itching, tingling progressing to numbness

21. Natural Inorganic Insecticides • Boric Acid and Borates • Irritating to skin • Infants- “boiled lobster appearance” –redness, followed by peeling of skin • Sulfur • Dermatitis-skin irritation • Irritation of eyes and respiratory tract

22. Fungicides • Most are unlikely to cause severe or frequent poisonings • Cause irritant injuries to skin and mucous membranes, dermal sensitization

23. Fungicides • Chlorothalonil’s (Daconil) potential to cause cancer is unclear • EBDC’s under FQPA review as group • Can degrade to ETU which can produce cancer in mice • However, do not appear to be carcinogenic

24. Herbicides • Many can irritate skin, eyes and respiratory track • Low systemic toxicity • Ex. Some Round-up calls for eye protection

25. Diquat/Paraquat • Paraquat more toxic (orally) • Large doses (6-8oz.) produces fatal lung changes. • Fluid accumulation in lungs can occur in 24 to 72 hrs. Respiratory failure. • Exposure may cause blackening and abnormal growth of nails • Diquat affects eye lens and intestinal tract lining—vomiting. • Both cause skin irritation and burning

26. 2,4-D and MCPA • Moderately irritating to skin and mucous membranes • May cause burning sensations in nose, sinuses and chest, dizziness • Not “agent orange” • Agent orange issue was from dioxin contaminant in the manufacture of 2,4,5-T

27. 2,4-D and Cancer • There are no reports that indicate a direct link between 2,4-D exposure and cancer in humans. • Some concern about higher rates of a type of cancer, non-Hodgkins lymphoma, among farmers, ag workers and pesticide applicators but different studies are not consistent.

28. 2,4-D and Cancer • Most studies have not found a relationship between exposure to chlorophenoxy herbicides and soft sarcoma. • Current evidence does not indicate that exposures to 2,4-D are linked with an increased incidence of breast cancer in humans or experimental animals.

29. Atrazine and Cancer • Found in drinking water • Under special review • Based on scientific evidence presented, EPA reclassified atrazine as “not likely to be a human carcinogen” • Will be evaluating endocrine disruption • Controversial “frog deformity” studies

30. Organochlorines and Cancer • DDT/DDE, dieldrin, chlordane • Accumulate in fatty tissues • No conclusive evidence • Infertile alligators and reduced sperm counts

31. Chronic Effects and Controversy • Cancer • Endocrine disruption • Infertility and sperm counts • Multiple chemical sensitivity

32. Endocrine Disruption • Hormones, alter bodily functions, development, and growth • We are only starting to gather information on which chemicals are endocrine disruptors and at what level they have an effect. • FQPA mandates testing of pesticides for endocrine disruption • New screening tests must be developed—very difficult

33. Multiple Chemical Sensitivity • More frequent in women • Very controversial whether it is really a disease

34. Food Quality Protection Act • All older pesticides must be reevaluated based on new standards • Evaluating risk based on cumulative and aggregate exposure • New testing for endocrine disruption • Higher protection factor for children

35. Agricultural Health Study A Landmark Study of Agricultural Workers and Their Families

36. Agricultural Health Study A large, prospective cohort study Goal: Establish a large group of people associated with pesticide application and follow them for many years to evaluate the relationship between agricultural exposures and disease

37. What is the Ag Health Study? • Long-term study to investigate effects of several factors on the health of the agricultural population. These factors include • Environmental  Dietary • Occupational  Genetic factors

38. PESTICIDES/ Fertilizers Fuels and oils Animal viruses Organic solvents Engine exhausts Paints Grain dusts Welding fumes Exposures Experienced by Farmers

39. Who are they studying? • Participants are commercial & private pesticide applicators (& spouses, if married) in Iowa & North Carolina • 89,658 subjects in first 5 years (58,564 from IA & 31,094 from NC)

40. QuestionnairesOccupational Factors • Pesticides used • Pesticide application methods used • PPE use (current and 10 years ago) • Other farm activities & exposures

41. QuestionnairesLifestyle & Dietary Factors • Diet • Cooking practices • Physical activity • Smoking • Alcohol consumption • Hair dye use

42. Mortality Followup (1994-1998) for Iowa Private Applicators Cause of DeathSMRObs/Exp All Causes 0.4 333/848 All Cancer 0.4 111/259 Colon 0.7 16/23 Pancreas 1.0 12/13 Lung 0.2 21/95 Prostate 0.3 6/19 Brain 0.6 6/10 Lymphoma 0.9 11/13 Leukemia 0.7 7/10 Cardiovascular Disease 0.4 115/277 COPD 0.2 7/43 Accidents 1.0 46/48 Non-motor vehicle 1.2 30/25 N = 31,877; person-years = 109,630

43. Early Findings • Farmers are healthier and live longer than the general population • Overall they have less cancer • There are a few cancers that appear to be slightly higher in occurrence

44. Malignant Cancer Incidence Follow-up(1994-1998) for Iowa Members Cancer SiteSIRObs/Exp* All Sites 0.81 850/1050.3 Buccal cavity & pharynx 0.56 18/32.2 Digestive system 0.77 143/186.8 Respiratory system 0.27 49/184.1 Skin melanomas 1.28 48/37.4 FEMALE BREAST 1.19 134/112.2 Female genital system 0.68 35/51.4 PROSTATE 1.25 245/196.7 Urinary system 0.58 28/48.4 Brain & CNS 0.91 15/16.5 Lymphoma 0.73 64/87.7 * Expected based on rates for entire state of Iowa, 1995-98

45. Retinal Degeneration • Also called macular degeneration • Leading cause of blindness in older adults • Damage or breakdown of the retina of the eye, causing loss of central vision

46. Retinal degeneration & pesticide use • Incidence related to fungicide use • Fungicide applications to orchard fruits (apples or peaches), Christmas trees, or peanuts were involved • Association was more pronounced with increasing lifetime days of fungicide use • Association with prior organochlorine (aldrin, DDT) pesticide use was noted

47. Retinal degeneration & pesticide use • Results similar in Iowa & North Carolina applicators • Based on 154 applicators reporting doctor’s diagnosis of this condition & 17,804 applicators who did not • More work needed to determine whether this relationship will be true for all data sets

48. How is the study funded? • Primary funding provided by the National Cancer Institute • Additional funding from the • National Institute of Environmental Health Sciences • U.S. Environmental Protection Agency • National Institute for Occupational Safety & Health

49. For more information… Visit the Ag Health Study’s Web site www.aghealth.org

50. Toxicity Information • National Pesticide Telecommunication Network 1-800-858-7378 • Extoxnet ace.orst.edu/info/extoxnet/ • Poison Control Centers 1-800-222-1222 Ohio State University Extension, Pesticide Education Program pested.osu.edu