1. How to Identify the Products Your Patients Are Exposed To Name That Pesticide Helen Murphy, RN, FNP, MHS Director of Outreach Pacific Northwest Agricultural Safety and Health University of Washington, Seattle WA

2. The nomenclature of pesticides is similar to medications in that they have…. A brand/trade or product name: e.g. Motrin A brand/trade or product name: e.g. Motrin A generic name (common name or active ingredient): ibuprofen A generic name (common name or active ingredient): ibuprofen A chemical family: e.g. NSAID 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.

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

4. Pesticide Product Label The label in the agricultural world = the package insert for the medical world The label in the agricultural world = the package insert for the medical world The label is the LAW and dictates: The label is the LAW and dictates: use use required personal protective equipment required personal protective equipment The label on the bottle or package provides basic information The label on the bottle or package provides basic information

5. Information Sources on Pesticides Ingredient statement Ingredient statement EPA registration number EPA registration number Establishment number Establishment number Formulation Formulation Signal word Signal word Statement of practical treatment (first aid) Statement of practical treatment (first aid) Personal protective equipment (PPE) handlers Personal protective equipment (PPE) handlers Environmental hazards Environmental hazards Directions for use Directions for use Hazards to humans Hazards to humans Storage and disposal directions – Storage and disposal directions – Chemical product identification Chemical product identification Physical and chemical properties Physical and chemical properties Fire and explosion hazards Fire and explosion hazards Toxicological information / Human health data Toxicological information / Human health data Regulatory levels and classifications Regulatory levels and classifications Personal protection recommendations (concentrate only) Personal protection recommendations (concentrate only) Emergency and first aid procedures Emergency and first aid procedures Ecological or environmental hazards Ecological or environmental hazards Spills, fires, and accident procedures Spills, fires, and accident procedures Storage and disposal directions - Storage and disposal directions - Label MSDS

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

7. Brand Name “SUPRACIDE” Type“Insecticide” Hazard Level “Danger/poison” Poison Icon Common Name “methadithion” ManufacturerGowan Chemical Family ‘organophosphate’ Antidote“atropine”

8. Class Exercise Distribute Sample Pesticide Product Labels Pesticide Product LabelsPesticide Product Labels 1. Temik 2. Sevin 3. Thiodan 4. Guthion 5. Dursban 6. Gramoxone 7. Weed Rhap 8. Asana 9. Captan 10. Roundup 11. Dithane 12. Ziram

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

10. Pesticide Classification Table #CompanyNameBrandNameCommonNameType Chemical Family SignalClass 1.GowenSupracidemethidathioninsecticideOPorganophosphate Danger- Poison (Ib)

11. COMPANYBRANDCOMMONTYPEFAMILYSIGNALWHO 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Pesticide Labels BayerTemikAldicarbInsecticideCarbamateDanger-poisonla VerdiconSevinCarbarylInsecticideCarbamateCautionll UCP AllianceThiodanEndosulfanInsecticideOrganochlorineWarningll BayerGuthionAzinophos methylInsecticideOrganophospateDanger-poisonlb DowDursbanChlorpyrifosInsecticideWarningll SyngentaGramoxoneParaquatHerbicideParaquatDanger-poisonll HelenaWeed Rhap2, 4-DHerbicideChlorophenoxyDanger-poisonll DuPontAsanaEsfenverlateInsecticidePyrethroidWarninglV BayerCaptan FungicideDanger-poison MaxRoundupGlyphosateHerbicideCautionU-IV II Dow Dithane Mancozeb Fungicide Caution U-IV Cerexagri-Nisso Ziram Fungicide Danger III Exercise: Classifying Pesticides Organophospate * * WHO – World Health Organization International Classification

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

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

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

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

16. Pesticide Chemical Families - grouping based on similarities- 1. Similar chemically (similar structure) 2. Attacks pests in a similar way (toxicity) 3. Common treatment + antidote Organophosphate insecticides Carbamate insecticides Pyrethroid insecticides Organochlorine insecticides Chlorophenoxy Herbicides Paraquat Diquat herbicides

17. How toxic is it? Source: Richards, Kerry Penn State University Extension Service

19. LD 50 Lethal dose = Amount of chemical it takes to kill 50% of an experimental population

20. Source: Richards, Kerry Penn State University Extension Service

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

22. Source: Richards, Kerry Penn State University Extension Service

23. 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?

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

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