Coby Jansen, Matthew Keifer, Helen Murphy-Robinson. University of Washington; WA Departments of Agriculture, Health and Labor and Industries.

Coby Jansen, Matthew Keifer, Helen Murphy-Robinson. University of Washington; WA Departments of Agriculture, Health and Labor and Industries.

PNASHPNASH

Data Sources:1.WA Department of Health Pesticide Illness Investigations (2003-8)2.Occupational determinants of serum cholinesterase inhibition among organophosphate-exposed agricultural pesticide handlers in Washington State. JN Hofmann, MC Keifer, AJ DeRoos, RA Fenske, CE Furlong, G vanBelle, H Checkoway. Occup Environ Med On-line October 9, 2009.3. WA Labor & Industries – Cholinesterase Monitoring Program Consultations (2007-9)4. WA LNI & WS Dept. of Agriculture. WPS Investigations (2007-9)

Data Sources:1.WA Department of Health Pesticide Illness Investigations (2003-8)2.Occupational determinants of serum cholinesterase inhibition among organophosphate-exposed agricultural pesticide handlers in Washington State. JN Hofmann, MC Keifer, AJ DeRoos, RA Fenske, CE Furlong, G vanBelle, H Checkoway. Occup Environ Med On-line October 9, 2009.3. WA Labor & Industries – Cholinesterase Monitoring Program Consultations (2007-9)4. WA LNI & WS Dept. of Agriculture. WPS Investigations (2007-9) For more information contact: (800) 330-0827 pnash@u.washington.edu

A collaborative effort by:

Prevention Prevention FocusFocus

TRENDS Training Messages

Policy Changes Technical SolutionsWPS Inspections: WSDA

(~150 sites, 439 violations)WPS Inspections: WSDA(~150 sites, 439 violations)

Labor & Industries ChE Monitoring Consultations (60 handlers, 34 sites)

Labor & Industries ChE Monitoring Consultations (60 handlers, 34 sites)

Dept. of Health Pesticide IllnessRoute Cause Interviews (351 cases)

Dept. of Health Pesticide IllnessRoute Cause Interviews (351 cases)

University of Washington ChE Risk Factors Study

(154 participants)

University of Washington ChE Risk Factors Study

(154 participants)

WPS Inspections: L&I(31 sites, 79 violations)

WPS Inspections: L&I(31 sites, 79 violations)

BackgroundThe University of Washington and Washington State Departments of Agriculture, Health, and Labor and Industries are collaborating on a project to use agency data and scientific research to identify factors contributing to pesticide over-exposure among agricultural workers. The group plans to use these findings to create and implement recommendations for preventing these exposures.

Project Objectives Use data to identify factors contributing to pesticide over-exposure Craft prevention messages and identify solutions Share data and prevention messages with handlers, agricultural community and policy-makers

The leading contributing factors of handler pesticide poisonings are lack of required personal protective equipment (PPE) and other PPE problems.1

Personal Protective Equipment

Eye Protection1 42 (25%) of 167 handlers with pesticide poisoning were not wearing required eye protection. Many ill handlers wore the wrong type or poorly fitting PPE.

Problem: Early entry contributed to pesticide illness in 19 workers1; 39% of WPS violations were related to central or field postings4; 4 handlers had ChE inhibition >20% after too early re-entry3

Central Posting IssuesCentral Posting Issues33

Incomplete spray records Incomplete spray records REI not included in postingsREI not included in postings Records not displayed for 30 Records not displayed for 30

days after REI expiresdays after REI expires No spray records posted at allNo spray records posted at all

Drift

Restricted Entry Interval

Reduce pesticide Reduce pesticide over-exposures among over-exposures among agricultural employeesagricultural employees

56% handlers with a

pesticide illness were missing required PPE

(68) or had a PPE problem (29)1

Graph 1. Type of PPE missing by Ill handlers1

Personal Protective Equipment

Workplace Practices

Drift

Restricted Entry Interval

Protection by Labels

Training

Supervision

UNDERLYING FACTORS

PROBLEM AREAS

Why?1

“Didn’t think I needed it” Employer didn’t provide Inadequate supervision Poor fit (mist enters side of goggle)

Why?1

Employer did not provide Wrong type Not instructed to wear Removed for dexterity Not used when cleaning, fixing equipment (or other tasks besides mix/load, apply)

Chemical Resistant Boots Handlers who wore chemical resistant boots were SEVEN TIMES less likely to have inhibited ChE.2

Respirators: Poor Fit One quarter of handlers with ChE inhibition had poorly fitting respirators and/or were not fit tested.3

Six handlers with pesticide poisoning had poorly fitting respirators that did not seal properly.1

Respirators: Cartridge Change-out More than half of worksites with a ChE inhibited handler violated cartridge change-out regulations, affecting 27 workers.3

The most common technical PPE issue for ill handlers was over use of cartridges and use of incorrect cartridges.1

Why?Handlers with inhibited ChE often worked at sites not complying with proper change-out schedules.3

9% No change-out schedule 42% did not follow change-out schedule

Gloves 31 handlers (19%) who got sick from pesticide poisoning were not wearing required gloves1

Handlers became ill while unclogging spray nozzles1

MAINTAINING & CLEANING SPRAY EQUIPMENT

• Handlers who cleaned spray equipment were NINE TIMES more likely to have inhibited cholinesterase than handlers who did not2

18 handlers fell ill while maintaining & cleaning spray equipment. Most common practices: 1) unclogging nozzles or 2) washing sprayers1

Most common problem for mixer/loaders is eye injury from splash. In 73% of these cases, handler was missing eye protection1

There were 48 WPS violations for not providing either: There were 48 WPS violations for not providing either: • • Eyewash at M&L stations (24), orEyewash at M&L stations (24), or •  • Pint of water for emergencies (24)Pint of water for emergencies (24)44 = = risk of more serious eye injuryrisk of more serious eye injury

Caution!

Caution!

Caution!

Caution!

Why?1

Signs not seen Workers follow verbal orders, not postings No sign was posted Wrong sign posted Old signs not removed

Problem: Drift was the leading factor in pesticide overexposure of non-handler, agricultural workers.1

80 incidents involving 191 people (03-08) More than half were drift to bystanders or non-agricultural workers 34 events affected 103 agricultural workers

Why?1

Neighbor farm or workers not notified Workers unsure if okay to leave Sprayer or worker thought they were at a safe distance 

RESPIRATORS: Handlers wearing full-face instead of half-face respirators were seven times less likely to have ChE inhibition2

Dermal exposure at end of row?

PERSONAL DECONTAMINATION Poor decontamination practices may have contributed to: 1) Pesticide over-exposure among more than half of handlers with inhibited cholinesterase (31 cases); 2) 14 cases of handler illness

Why? • Insufficient time to decontaminate3

• Decontamination not adequate or timely1,3

• Insufficient supplies (towels, soap, change of clothes)4

Handlers wearing well-sealed respirators and full PPE report feeling spray on face and neck when turning at the end of a row. May drive through spray mist when beginning next row.1

EYE PROTECTION Safety glasses not as effective in protecting against splashes or wind-blown spray mist1

PPE Missing/Problem

Little to no supervision

No decon post-exposure

Unaware of hazard

Label not explained to non-reader

Assigned/ Allowed Unsafe

Practice

Insufficient or poor training3

Trainings too infrequent3

- Trainers not qualified- Training did not meet the WPS requirements (ex. No written materials; did not covered req’d pts)

- Trainers not qualified- Training did not meet the WPS requirements (ex. No written materials; did not covered req’d pts)

Evidence of Poor Supervision1

- Handlers and workers not trained at all- Handlers trained less than every 5 years

PNASH

Ag Workers Over-

Exposed to

Pesticides

Using Data to Identify and Address Causes of Pesticide

Over-Exposure in Washington State Agricultural Employees

Using Data to Identify and Address Causes of Pesticide

Over-Exposure in Washington State Agricultural Employees

Why?1

Facial hair No regular on-the-job seal testing No pre-season fit test

Handlers think gloves too thick? 6x more likely to use bare hands, disposable gloves for unclogging2

Handlers think gloves too thick? 6x more likely to use bare hands, disposable gloves for unclogging2

Workplace Practices

MIXING AND LOADING

• 17 handlers poisoned by pesticides while M&L1 • Handlers who M&L were TWICE as likely to have inhibited ChE as handlers who did not2

Why?1

Protection by Labels

Training and Supervision

Introduction

• Perceived task as low risk• Handler did not know PPE was required for task