Acute Illnesses Associated With Pesticide Exposure at Schools - increase from 1998 to 2002

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A survey of national surveillance data finds that pesticide exposures at

schools produce acute illnesses among school employees and students.

Incidence rates for 1998-2002 were 7.4 cases per million children and

27.3 cases per million school employee full-time equivalents. The

incidence rates among children increased significantly from 1998 to

2002. JAMA.

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http://jama.ama-assn.org/cgi/content/short/294/4/455

Acute Illnesses Associated With Pesticide Exposure at Schools

Walter A. Alarcon, MD; Geoffrey M. Calvert, MD; Jerome M. Blondell, PhD;

Louise N. Mehler, MD; Sievert, BS; Propeck, BS; Dorothy

S. Tibbetts, MPH, MS; Alan Becker, MPH; Lackovic, MPH;

B. Soileau, MS; Rupali Das, MD; Beckman, BS; Dorilee P. Male, BS;

L. Thomsen, MPH; Martha Stanbury, MSPH

JAMA. 2005;294:455-465.

Context Pesticides continue to be used on school property, and some

schools are at risk of pesticide drift exposure from neighboring farms,

which leads to pesticide exposure among students and school employees.

However, information on the magnitude of illnesses and risk factors

associated with these pesticide exposures is not available.

Objective To estimate the magnitude of and associated risk factors for

pesticide-related illnesses at schools.

Design, Setting, and Participants Analysis of surveillance data from

1998 to 2002 of 2593 persons with acute pesticide-related illnesses

associated with exposure at schools. Nationwide information on

pesticide-related illnesses is routinely collected by 3 national

pesticide surveillance systems: the National Institute for Occupational

Safety and Health's Sentinel Event Notification System for Occupational

Risks pesticides program, the California Department of Pesticide

Regulation, and the Toxic Exposure Surveillance System.

Main Outcome Measures Incidence rates and severity of acute

pesticide-related illnesses.

Results Incidence rates for 1998-2002 were 7.4 cases per million

children and 27.3 cases per million school employee full-time

equivalents. The incidence rates among children increased significantly

from 1998 to 2002. Illness of high severity was found in 3 cases (0.1%),

moderate severity in 275 cases (11%), and low severity in 2315 cases

(89%). Most illnesses were associated with insecticides (n = 895, 35%),

disinfectants (n = 830, 32%), repellents (n = 335, 13%), or herbicides

(n = 279, 11%). Among 406 cases with detailed information on the source

of pesticide exposure, 281 (69%) were associated with pesticides used at

schools and 125 (31%) were associated with pesticide drift exposure from

farmland.

Conclusions Pesticide exposure at schools produces acute illnesses

among school employees and students. To prevent pesticide-related

illnesses at schools, implementation of integrated pest management

programs in schools, practices to reduce pesticide drift, and adoption

of pesticide spray buffer zones around schools are recommended.

Author Affiliations: National Institute for Occupational Safety and

Health, US Centers for Disease Control and Prevention, Cincinnati, Ohio

(Drs Alarcon and Calvert); Office of Pesticide Programs, US

Environmental Protection Agency, Washington, DC (Dr Blondell);

Department of Pesticide Regulation, California Environmental Protection

Agency, Sacramento (Dr Mehler); Environmental and Injury Epidemiology

and Toxicology Branch, Texas Department of State Health Services, Austin

(Mss Sievert and Propeck); Pesticides and Surveillance Section,

Washington Department of Health, Olympia (Ms Tibbetts); Bureau of

Community Environmental Health, Florida Department of Health,

Tallahassee (Mr Becker); Section of Environmental Epidemiology and

Toxicology, Louisiana Department of Health and Hospitals, New Orleans

(Mss Lackovic and Soileau); Occupational Health Branch, California

Department of Health Services, Oakland (Dr Das); Public Health

Institute, Oakland, Calif (Mr Beckman); Bureau of Occupational Health,

New York State Department of Health, Troy (Ms Male); Environmental and

Occupational Epidemiology, Oregon Department of Human Services-Health

Services, Portland (Ms Thomsen); and Division of Environmental and

Occupational Epidemiology, Michigan Department of Community Health,

Lansing (Ms Stanbury).