California surveillance for pesticide-related illness and injury: coverage, bias, and limitations

Public Health Surveillance for the Prevention of Pesticide-Related Illness in Illinois

OBJECTIVES

There is no pesticide related illness (PRI) surveillance program in Illinois. This study examines the quality of state-based data sources for their ability to inform public health surveillance on PRI.

METHODS

We estimated the counts of PRI by probabilistic data linkage of hospital discharge, emergency department, and poison center databases from 2010 to 2015. We characterized identified PRI cases.

RESULTS

We identified 3867 unique cases of PRI and 6269 asymptomatic pesticide exposures. Out of the 3867 PRI cases, there were 1319 emergency department visits and 321 hospitalizations. We identified 13 deaths and 1640 major or moderate effects from PRI. Over half of ingestion related exposures occurred in children aged 0 to 4 years. Workers' compensation and Emergency Medical Service data were unusable.

CONCLUSION

An effective public health surveillance on PRI requires reliable state data sources and cost-effective methods of assembling data from multiple sources.

Pesticide-Related Hospitalizations Among Children and Teenagers in Texas, 2004-2013

OBJECTIVE

Acute exposure to pesticides is associated with nausea, headaches, rashes, eye irritation, seizures, and, in severe cases, death. We characterized pesticide-related hospitalizations in Texas among children and teenagers for 2004-2013 to characterize exposures in this population, which is less well understood than pesticide exposure among adults.

METHODS

We abstracted information on pesticide-related hospitalizations from hospitalization data using pesticide-related International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes and E-codes. We calculated the prevalence of pesticide-related hospitalizations among children and teenagers aged #19 years for all hospitalizations, unintentional exposures, intentional exposures, pesticide classifications, and illness severity. We also calculated age- and sex-specific prevalence of pesticide-related hospitalizations among children.

RESULTS

The prevalence of pesticide-related hospitalizations among children and teenagers was 2.1 per 100,000 population. The prevalence of pesticide-related hospitalizations per 100,000 population was 2.7 for boys and 1.5 for girls. The age-specific prevalence per 100,000 population was 5.3 for children aged 0-4 years, 0.3 for children and teenagers aged 5-14 years, and 2.3 for teenagers aged 15-19 years. Children aged 0-4 years had the highest prevalence of unintentional exposures, whereas teenagers aged 15-19 years had the highest prevalence of intentional exposures. Commonly reported pesticide categories were organophosphates/carbamates, disinfectants, rodenticides, and other pesticides (e.g., pyrethrins, pyrethroids). Of the 158 pesticide-related hospitalizations, most were coded as having minor (n=86) or moderate (n=40) illness severity.

CONCLUSION

Characterizing the prevalence of pesticide-related hospitalizations among children and teenagers leads to a better understanding of the burden of pesticide exposures, including the type of pesticides used and the severity of potential health effects. This study found differences in the frequency of pesticide-related hospitalizations by sex, age, and intent (e.g., unintentional vs. intentional).

The characteristics of emergency department presentations related to acute herbicide or insecticide poisoning in South Korea between 2011 and 2014

The aim of this study was to examine epidemiologic data regarding acute herbicide or insecticide poisoning in adults from 2011 to 2014 at the national level in South Korea. Further, the association between governmental regulations involving pesticides and changes in pesticide poisoning occurrences over time was determined. Data were obtained from the emergency department (ED)-based Injury In-depth Surveillance system conducted by the Korea Center for Disease Control and Prevention (KCDC). Governmental regulations on pesticides were downloaded from the homepage of the Korea Rural Development Administration. Pesticides were classified according to guidelines provided by the World Health Organization (WHO) and by the respective Resistance Action Committee (RAC). Trends in the number of ED presentations and case fatality rate (CFR) due to pesticide poisoning were investigated. The overall CFR due to poisoning from herbicides or insecticides in adults in South Korea was 16.8% during 2011-2014. However, CFR significantly decreased over the 4-year period. The ED presentations of paraquat (PQ) poisoning fell significantly, whereas poisoning due to glyphosate, glufosinate, or combined herbicides increased markedly over the 4 years. Between 2011 and 2013, PQ was the most common pesticide poisoning, whereas glyphosate became the most frequent in 2014. PQ produced the highest rate of fatality followed by endosulfan. Although the frequency of PQ poisoning decreased, which may be attributed to governmental regulations, the CFR and incidence of pesticide poisoning in adults remain a public health concern that needs to be addressed.

Developing Surveillance Methodology for Agricultural and Logging Injury in New Hampshire Using Electronic Administrative Data Sets

OBJECTIVE

Agriculture and logging rank among industries with the highest rates of occupational fatality and injury. Establishing a nonfatal injury surveillance system is a top priority in the National Occupational Research Agenda. Sources of data such as patient care reports (PCRs) and hospitalization data have recently transitioned to electronic databases.

METHODS

Using narrative and location codes from PCRs, along with International Classification of Diseases, 9th Revision, external cause of injury codes (E-codes) in hospital data, researchers are designing a surveillance system to track farm and logging injury.

RESULTS

A total of 357 true agricultural or logging cases were identified.

CONCLUSIONS

These data indicate that it is possible to identify agricultural and logging injury events in PCR and hospital data. Multiple data sources increase catchment; nevertheless, limitations in methods of identification of agricultural and logging injury contribute to the likely undercount of injury events.

Mortalidade por intoxicação ocupacional relacionada a agrotóxicos, 2000-2009, Brasil

OBJETIVO: Estimar o coeficiente de mortalidade por intoxicações ocupacionais relacionadas aos agrotóxicos no Brasil.MÉTODOS: Utilizaram-se dados do Sistema de Informações sobre Mortalidade de 2000 a 2009 referentes aos diagnósticos de intoxicação por agrotóxicos, T60.0-T60.4, T60.8 e T60.9, X48, Y18, e Z578 da CID-10, para a causa básica ou associadas; a natureza ocupacional foi identificada pelo registro no campo <acidente de trabalho>, <circunstância do óbito> e se a <ocupação> era na agropecuária. Foram excluídos homicídios e suicídios. Para cálculo da mortalidade, o número de trabalhadores da agropecuária foi obtido do Instituto Brasileiro de Geografia e Estatística, projeções do Sistema de Contas Nacionais.RESULTADOS: Foram encontrados registros de 2.052 óbitos por intoxicação por agrotóxicos no Brasil, dos quais 36,2% (n = 743) não continham dados sobre a ocupação. Dentre os 1.309 restantes, 679 (51,9%) eram trabalhadores da agropecuária. A mortalidade por intoxicação ocupacional por agrotóxicos caiu de 0,56/100.000 (2000 a 2001) para 0,39/100.000 (2008 a 2009) entre trabalhadores no período, maior queda entre os homens que entre as mulheres. Os homens tiveram maiores estimativas de mortalidade por esse tipo de intoxicação em todos os anos. A maior parte dos óbitos foi causada por agrotóxicos do tipo organofosforados e carbamatos. O número de óbitos por esse tipo de intoxicação declinou em todas as regiões, exceto no Nordeste.CONCLUSÕES: É necessária a melhoria dos registros das declarações de óbito, em especial da ocupação e da relação dos diagnósticos com o trabalho, fundamentais para o controle e prevenção mais adequados para esses acidentes de trabalho. Atenção especial deve ser dirigida à região Nordeste do Brasil.

Pesticide poisonings in South Korea: findings from the National Hospital Discharge Survey 2004-2006

OBJECTIVES

Pesticide poisoning stands as a major public health issue worldwide. The objective of this study was to examine the epidemiologic characteristics of pesticide-related hospitalizations in South Korea.

METHODS

Data from the Korea National Hospital Discharge Survey were analyzed to describe the epidemiologic characteristics of pesticide poisoning among hospitalized patients from 2004 through 2006. Pesticide-related hospitalizations were identified using the International Classification of Diseases, Tenth Revision codes. National estimates of pesticide-related hospitalizations were calculated using sampling weights for number of hospitalizations.

RESULTS

A total of 25,982 pesticide-related hospitalizations were estimated during the years 2004-2006, yielding an average annual pesticide-related hospitalization rate of 17.8 per 100,000 population in South Korea. Age-specific rates for pesticide-related hospitalization increased with age, with the highest rate noted among those aged 70 or above. The majority of pesticide-related hospitalization was cases of intentional poisoning in rural areas. Seasonal variation in the rate was observed, with summer being the highest among both men and women.

CONCLUSIONS

Pesticide-related hospitalization is prevalent and demonstrates demographic and seasonal and regional variations. More effective strategies to reduce pesticide-related hospitalizations are required in South Korea.