How to Identify the Products Your Patients Are Exposed To Name That Pesticide How to Identify the Products Your Patients Are Exposed To

The nomenclature of pesticides is similar to medications in that they have…. A brand/trade or product name: e.g. Motrin A generic name (common name or active ingredient): ibuprofen A chemical family: e.g. NSAID Likewise one needs to know the chemical family and more specifically the common name to understand the health effect of an exposure and how to treatment a poisoning.

What the Patient Will Know ? NOT the common or chemical family name. More likely they can identify: BRAND name TYPE of pesticide (insecticide, herbicide, fungicide, fumigant) CROP to which the pesticide was being applied.

Pesticide Product Label The label is the agriculture world = the package insert for the medical world The label is the LAW and dictates: Use Required personal protective equipment The label on the bottle or package provides basic information

Information Sources on Pesticides Label MSDS Ingredient statement EPA registration number Establishment number Formulation Signal word Statement of practical treatment (first aid) Personal protective equipment (PPE) handlers Environmental hazards Directions for use Hazards to humans Storage and disposal directions Chemical product identification Physical and chemical properties Fire and explosion hazards Toxicological information / Human health data Regulatory levels and classifications Personal protection recommendations (concentrate only) Emergency and first aid procedures Ecological or environmental hazards Spills, fires, and accident procedures Storage and disposal directions Ingredient statement – Name and percentage of each active ingredient and total percentage of inert ingredients. An inert ingredient is one for which no toxic activity against the pest is claimed, while the active ingredient is that component that actually controls the pest. (Although they are not toxic, inerts can cause health and environmental concerns.) EPA registration number – Indicates that the pesticide label has been registered by EPA. Establishment number – Identifies that facility where the product was made. Formulation – Certain formulations are more likely to be absorbed through the skin or inhaled. Signal word – Indicates level of acute toxicity. DANGER = extremely toxic (high potential for skin and eye irritation); DANGER/POISON = extremely toxic by ingestion;WARNING = moderately toxic; CAUTION = slightly toxic to relatively nontoxic. Statement of practical treatment (first aid) – Indicates initial first aid practices to mitigate exposure. Indicates whether inducement of vomiting is recommended or contraindicated. Personal protective equipment (PPE) – Clothing and/or equipment required to be worn when handling the pesticide. Environmental hazards – Potential concerns regarding hazards to environment, including fish, avian, and bee toxicities. Directions for use – Identifies crops/sites for application, pests controlled, method of application, rate of application, mixing directions, preharvest intervals, restricted entry intervals, etc. Hazards to humans – Indicates which route of entry (mouth skin, eyes, lungs) must particularly be protected and what specific actions should be taken to avoid acute effects from exposure. Storage and disposal directions – Usually fairly general information such as "Store out of reach of children" and "Do not re-use container."

Sample Package Labels Type of pesticide Company name Brand/trade/product name Common/generic name (sometimes the same as the active ingredients) Chemical family Signal word (hazard level)

Brand Name “SUPRACIDE” Type “Insecticide” Hazard Level “Danger/poison” Poison Icon Common Name “Methadithion” Chemical Family “Organophosphate” Antidote “Atropine” Manufacturer Gowan

Class Exercise Distribute Sample Pesticide Product Labels Temik Sevin Thiodan Guthion Dursban Gramoxone Weed Rhap Asana Captan Roundup Dithane Ziram

Class Exercise Find the following items on the label Company/Manufacturer’s name Brand/Product/Trade name Common name (generic – active ingredient) Type: use in agriculture Chemical family Signal word (hazard level) Fill in the pesticide classification table (hand out)

Pesticide Classification Table # Company Name Brand Common Type Chemical Family Signal Class 1. Gowen Supracide methidathion insecticide OP organophosphate Danger-Poison (Ib)

Exercise: Classifying Pesticides Pesticide Labels * COMPANY BRAND COMMON TYPE FAMILY SIGNAL WHO 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Bayer Temik Aldicarb Insecticide Carbamate Danger-poison la Verdicon Sevin Carbaryl Insecticide Carbamate Caution ll UCP Alliance Thiodan Endosulfan Insecticide Organochlorine Warning ll Bayer Guthion Azinophos methyl Insecticide Organophospate Danger-poison lb Dow Dursban Chlorpyrifos Insecticide Organophospate Warning ll Syngenta Gramoxone Paraquat Herbicide Paraquat Danger-poison ll Helena Weed Rhap 2, 4-D Herbicide Chlorophenoxy Danger-poison ll DuPont Asana Esfenverlate Insecticide Pyrethroid Warning lV Bayer Captan Captan Fungicide Danger-poison II Max Roundup Glyphosate Herbicide Caution U-IV Mancozeb Fungicide Dow Dithane Caution U-IV Cerexagri-Nisso Ziram Ziram Fungicide III Danger * WHO – World Health Organization International Classification

Company Name May be useful in looking up a product Workers may confuse this name with the brand, product or trade name. Some companies also produce pharmaceuticals.

Brand/Trade/Product Name Agricultural workers know pesticides primarily through the brand name Companies will keep brand names but CHANGE the active ingredients (e.g. Raid) Can use brand name as a search term

Common Name Critical identifier of the chemical Some databases only allow you to search by common name. Basis of treatment!

Types of Pesticides Fumigants Kill rodents with anticoagulants Disinfectants Fumigants Kill rodents with anticoagulants Control pests by attacking their nervous system Antibiotics for plants Corrosive weed killers

Pesticide Chemical Families -grouping based on similarities- Similar chemically (similar structure) Attacks pests in a similar way (toxicity) Common treatment + antidote Pyrethroid insecticides Organophosphate insecticides Carbamate insecticides Paraquat Diquat herbicides Organochlorine insecticides Chlorophenoxy Herbicides

How Toxic Is It? Source: Richards, Kerry Penn State University Extension Service

Source: Richards, Kerry Penn State University Extension Service

LD50 Lethal dose = Amount of chemical it takes to kill 50% of an experimental population

Source: Richards, Kerry Penn State University Extension Service

WHO International Standard US Standard * DANGER/POISON = extremely toxic by ingestion DANGER = extremely toxic high potential for skin and eye irritation * Adapted from Richards, Kerry Penn State University Extension Service

Source: Richards, Kerry Penn State University Extension Service

Sample Case A patient comes into your office after spilling the weed killer – Direx - on himself. He is having some vague non specific problems. How will you identify what kind of adverse heath effects he may experience?

Pesticide Identification Resources Poison Control (800) 222-1222 (TDD) 1(800) 572-0638 Google “Direx” Pesticide Websites: PAN http://www.pesticideinfo.org/ CDMS http://www.cdms.net/LabelsMsds/LMDefault.aspx NPIC http://npic.orst.edu/npicfact.htm

Practice: Using these resources for Diurex ™find The common name The chemical family Health effects Recommended decontamination Recommended PPE Describe the attributes of each resource used including advantages and disadvantages