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SENSOR-Pesticides

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Logo for SENSOR-Pesticides

Sentinel Event Notification System for Occupational Risks (SENSOR)-Pesticides is a surveillance program that monitors pesticide-related illness and injury. It is administered by the National Institute for Occupational Safety and Health (NIOSH) and run by several U.S. state health agencies. NIOSH supports these surveillance activities by providing funding and technical support to state health departments. The SENSOR-pesticides program is also partially funded by the US Environmental Protection Agency.

Background

Pesticides are used extensively in several industries. They are particularly useful for agriculture, because they increase crop yields and decrease the need for manual labor.[1] They are used to control pests in other industries and non-agricultural areas as well.[2][3][4][5] However, this extensive use of pesticides puts workers in these industries at risk for pesticide exposure and illness.[2][3][4][5][6][7][8] Additionally, the toxicity of pesticides continues to raise public concern,[9][10] and some feel that regulatory authorities have an ethical obligation to track the health effects of such chemicals.[10] Surveillance of pesticide-related injuries and illnesses is recommended by several national agencies, including the American Medical Association,[11] the Council of State and Territorial Epidemiologists (CSTE),[12] the Pew Environmental Health Commission,[13] and the Government Accountability Office.[14][15][16]

History

Map of SENSOR-Pesticides participating states with blue indicating states receiving federal funding for participation and red indicating unfunded program partners.

Beginning in 1987, NIOSH supported the implementation of the Sentinel Event Notification System for Occupational Risks (SENSOR) program in ten state health departments.[17] The objectives of the program were to assist state health departments in developing and/or refining reporting systems for selected occupational disorders so that they could direct appropriate intervention and prevention efforts and evaluate the effectiveness of such efforts. The primary areas of focus were silicosis, occupational asthma, carpal tunnel syndrome, lead poisoning, and pesticide poisoning. While each of the participating state health departments had previously performed surveillance and/or interventions for occupational illnesses, SENSOR clearly assisted the states to develop and refine reporting systems and to direct effective intervention and prevention efforts.

The original SENSOR model was based on physician reporting, with several states using a system of sentinel health care professionals who were contacted on a regular basis.[10] However, this system was labor-intensive and did not yield many cases.[18] Additionally, the individual state pesticide-poisoning surveillance systems used different methods for collecting and categorizing data, which did not allow for routine pooling and analysis.[10] In response to this issue, NIOSH, along with other federal agencies (EPA, National Center for Environmental Health), non-federal agencies (CSTE, Association of Occupational and Environmental Clinics), and state health departments, developed a standard case definition and a set of standardized variables, which were finalized in 1998.[10] Three states (California, Oregon, and Texas) joined the program that year, and more states joined the program in the years that followed. As of 2008, SENSOR-Pesticides has 12 participating states that contribute occupational pesticide-related injury and illness data. California, Iowa, Michigan, New York, North Carolina, Texas, and Washington receive federal funding to support surveillance activities, while Arizona, Louisiana, Florida, New Mexico, and Oregon are unfunded SENSOR-Pesticides program partners.[19]

Case definition

A case of pesticide-related illness or injury is characterized by an acute onset of symptoms that are temporally related to a pesticide exposure.[10] Cases are classified as occupational if exposure occurs while the patient is at work, with the exception of suicides and attempted suicides.

Cases are reportable to the national surveillance system when:

  • there is documentation of new adverse health effects temporally related to a documented pesticide exposure AND
  • consistent evidence of a causal relationship between the pesticide and the health effects based on known toxicology of the pesticide OR
  • insufficient information is available to determine whether a causal relationship exists between the exposure and the health effects.[10]

Cases investigated by state programs are rated and reported as definite, probable, possible or suspicious. Illness severity is assigned to all cases as either low, moderate, severe, or fatal.

Data collection

All states currently participating in the program require physician reporting of pesticide-related injuries and illnesses; however, the principal sources of reporting for most states come from workers’ compensation claims, poison control centers, and/or state agencies with jurisdiction over pesticide use, such as state departments of agriculture.[10][19] When a report is received, the information is reviewed to determine whether it was pesticide-related. If so, medical records are requested (if available) and attempts are made to interview the patient (or a proxy) and anyone else involved in the incident (e.g. supervisors, applicators, and/or witnesses). The data each year is aggregated to produce a national database consisting of acute pesticide-related illness and injury cases.

In addition to identifying, classifying, and tabulating pesticide poisoning cases, the states periodically perform in-depth investigations of pesticide-related events and develop interventions aimed at particular industries or pesticide hazards.[19]

Impact

Florida Medfly Eradication Program

The Mediterranean fruit fly or Medfly

In response to an outbreak of Mediterranean fruit fly (also known as “Medfly”), officials from the Florida Department of Agriculture sprayed pesticides (primarily malathion) and bait over five counties in Florida during the spring and summer of 1998.[20] Scientists from the University of Florida’s Institute of Food and Agricultural Sciences stated that malathion was being sprayed in a safe manner and did not pose a risk to residents in treated areas.[21] However, 230 cases of illness attributed to the pesticide were reported to and investigated by the Florida Department of Health.[20] Officials from the Florida Department of Health and the SENSOR-Pesticides program published an article in Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) that described these case reports and recommended alternative methods for Medfly control, including exclusion activities at ports of entry to prevent importation, more rapid detection through increased sentinel trapping densities, and the release of sterile male flies to interrupt the reproductive cycle.[20] The United States Department of Agriculture (USDA) incorporated these suggestions into their 2001 Environmental Impact Statement on the Fruit Fly Cooperative Control Program.[22]

Pesticide use in schools

Researchers from the SENSOR-Pesticides program published an article in 2005 in the Journal of the American Medical Association (JAMA) on pesticide poisoning in schools. The article, which included data collected by SENSOR, described illnesses in both students and school employees associated with pesticide exposures.[23] The article generated media coverage and drew attention to the issue of pesticide safety in schools and the use of safer alternatives through integrated pest management, or IPM.[24][25][26][27][28] Officials in organizations supporting the pesticide industry, such as CropLife America and RISE (Responsibile Industry for a Sound Environment, a trade association representing pesticide manufacturers and suppliers), reacted strongly to the report, calling it “alarmist” and “incomplete” in its health reporting.[26][28] CropLife America president Jay Vroom claimed that the report was “written without context about the proper use of pesticides in schools and [did] not mention the positive public health protections they provide to [children]"[26] and stated that pesticide use in schools is "well regulated" and can be managed so that the risk is low.[28] RISE president Allen James faulted the article for relying on unverified reports and said that evidence suggested that such incidents were extremely rare.[28] The increased awareness of pesticide use in schools resulting from the article influenced parents and other stakeholders in numerous states to call for the adoption of integrated pest management programs.[29]

Birth defects in Florida and North Carolina

In February 2005, three infants were born with congenital abnormalities within eight weeks of each other in Collier County, Florida.[19][30] Because one case had worked in North Carolina and the other two worked in Florida, neither state initially recognized the cluster. However, upon presenting their findings at the annual SENSOR-Pesticides workshop in 2006, scientists in the program realized that all three mothers worked for the same tomato grower, Ag-Mart, and that the cases were related.[19] Ag-Mart’s farms in Florida and North Carolina were inspected by the respective state health departments, and the grower was fined $111,200 for violations discovered during the inspections.[31] Following the investigation, North Carolina Governor Mike Easley assembled the “Governor’s Task Force on Preventing Agricultural Pesticide Exposure.” The task force presented its findings in April 2008,[32] which led to the passage of anti-retaliation and recordkeeping laws, training mandates to protect the health of agricultural workers, and funding for improved surveillance.[19] In Florida, the state legislature added ten new pesticide inspectors to the Florida Department of Agriculture and Consumer Services.[19][33]

Total release foggers

An article published in the CDC MMWR with SENSOR-Pesticides state partner co-authors, in conjunction with the California Department of Pesticide Regulation (CDPR), called attention to the high number of injuries and illnesses resulting from consumer and employee use of total release foggers, also known as “bug bombs.”[34] In response to this report, the New York State Department of Environmental Conservation (DEC) published a press release stating that the state would restrict the use of total release foggers.[35] DEC Commissioner Pete Granis announced that the department would move to classify foggers as a restricted-use product in New York State, meaning that only certified pesticide applicators would be able to obtain them.

References

  1. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 16499408, please use {{cite journal}} with |pmid=16499408 instead.
  2. ^ a b Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 17357366, please use {{cite journal}} with |pmid=17357366 instead.
  3. ^ a b Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1002/ajim.20286, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1002/ajim.20286 instead.
  4. ^ a b Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1002/ajim.20452, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1002/ajim.20452 instead.
  5. ^ a b Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 12660205, please use {{cite journal}} with |pmid=12660205 instead.
  6. ^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1002/ajim.20623, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1002/ajim.20623 instead.
  7. ^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1289/ehp.6157, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1289/ehp.6157 instead.
  8. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 11783860, please use {{cite journal}} with |pmid=11783860 instead.
  9. ^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1002/ajim.10309, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1002/ajim.10309 instead.
  10. ^ a b c d e f g h Calvert GM et al. 2009. Surveillance of pesticide-related illness and injury in humans. In: Krieger, Robert (2009), Hayes' Handbook of Pesticide Toxicology (3rd ed.), San Diego, CA: Academic Press, ISBN 978-0123743671
  11. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 9085387, please use {{cite journal}} with |pmid=9085387 instead.
  12. ^ Council of State and Territorial Epidemiologists. 1996. CSTE position statement 1996-15: adding acute pesticide poisoning/injuries (APP/I) as a condition reportable to the National Public Health Surveillance System (NPHSS). Atlanta, GA: Council of State and Territorial Epidemiologists.
  13. ^ Pew Environmental Health Commission. 2001. “Strengthening our public health defense against environmental threats: transition report to the new administration.” Baltimore, Maryland: Johns Hopkins School of Public Health, Pew Environmental Research Commission.
  14. ^ Government Accountability Office. 1994. Pesticides on farms. Limited capability exists to monitor occupational illnesses and injuries. Washington, DC: U.S. General Accounting Office, GAO/PEMD–94–6.
  15. ^ Government Accountability Office. 1999. Pesticides. Use, effects, and alternatives to pesticides in schools. Washington, DC: U.S. General Accounting Office, GAO/RCED–00–17.
  16. ^ Government Accountability Office. 2000. Pesticides: improvements needed to ensure the safety of farmworkers and their children. Washington, DC: U.S. General Accounting Office, GAO/RCED–00–40.
  17. ^ Levy B, Johnson A, Rest K. 1992 September 28. Evaluation of the Sentinel Event Notification System for Occupational Risks (SENSOR). Final Report.
  18. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 10476993, please use {{cite journal}} with |pmid=10476993 instead.
  19. ^ a b c d e f g Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1002/ajim.20707, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1002/ajim.20707 instead.
  20. ^ a b c Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 10577491, please use {{cite journal}} with |pmid=10577491 instead.
  21. ^ Spence, Cindy (1997-06-27). "UF Experts Say Fear Unwarranted But Treat Malathion With Respect". University of Florida News. Retrieved 2009-10-01.
  22. ^ United States Department of Agriculture. 2001. Fruit Fly Cooperative Control Program: Environmental Impact Statement. United States Department of Agriculture: Washington, DC.
  23. ^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1001.2Fjama.294.4.455, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1001.2Fjama.294.4.455 instead.
  24. ^ Osterweil, Neil (2005-07-27). "School Kids and Teachers Bugged by Pesticide Exposure". MedPage Today. Retrieved 2009-09-29.
  25. ^ Staff (2005-09-15). "JAMA Study of Pesticide Risks in Schools". Pesticide Action Network Updates Service. Pesticide Action Network North America. Retrieved 2009-09-29.
  26. ^ a b c Staff (2005-07-26). "Industry Responds to JAMA Report on Incidence of Pesticide Exposure at Schools". U.S. Newswire. Retrieved 2009-09-29.
  27. ^ BBC news. July 26, 2005. "School study sparks pesticide row."
  28. ^ a b c d USA Today. July 26, 2005. "Pesticides may be sickening school kids."
  29. ^ PR Newswire. September 7, 2005. "Parents Urge Schools to Start Year Without Toxic Pesticides; U.S. Senator Introduces Bill To Protect Children from School Pesticide Poisoning." Accessed October 1, 2009.
  30. ^ Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1289/ehp.9647, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1289/ehp.9647 instead.
  31. ^ Rural Migration News. October 2005. “Florida, Southeast.” Rural Migration News 11:4.
  32. ^ Devlin L, Beauregard K, Borre K, Buhler WG, Engel J, Melton TA, Parks J, Price J, Troxler S. 2008. Report to the Honorable Michael F. Easley, Governor of the State of North Carolina from the Governor’s Task Force on Preventing Agricultural Pesticide Exposure. Tallahassee, Florida: Office of the Governor.
  33. ^ Gomez A. “Proposals benefiting migrants quietly having successes.” Palm Beach Post: May 1, 2006.
  34. ^ Attention: This template ({{cite pmid}}) is deprecated. To cite the publication identified by PMID 18923383, please use {{cite journal}} with |pmid=18923383 instead.
  35. ^ New York Department of Environmental Conservation. October 17, 2008. State to Restict Use of “Bug Bombs”. Accessed September 29, 2009.
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