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 2009

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 is the agriculture world = the package insert for the medical world The label is the agriculture 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. 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)

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

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

8. 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)

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

10. 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

11. 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.

12. 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

13. 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!

14. 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

15. 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

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

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

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

20. 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

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

22. 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?

23. 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

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. http://creativecommons.org/licenses/by-nc-sa/3.0/ This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported License.