TABLE III. Cases of specified notifiable diseases, United States, weeks ending
May 28, 1988 and May 30, 1987 (21st Week)

TABLE III. (Cont'd.) Cases of specified notifiable diseases, United States, weeks ending May 28, 1988 and May 30, 1987 (21st Week)

*For measles only, imported cases includes both out-of-state and international importations. N: Not notifiable U: Unavailable *International $Out-of-state

Syphilis (Civilian)

(Primary & Secondary)

TABLE III. (Cont'd.) Cases of specified notifiable diseases, United States, weeks ending May 28, 1988 and May 30, 1987 (21st Week)

Reporting Area

Syndrome

(RMSF)

*Mortality data in this table are voluntarily reported from 121 cities in the United states, most of which have populations of 100,000 or more. A death is reported by the place of its occurrence and by the week that the death certificate was filed. Fetal deaths are not included. **Pneumonia and influenza.

†Because of changes in reporting methods in these 3 Pennsylvania cities, these numbers are partial counts for the current week. Complete counts will be available in 4 to 6 weeks.

++Total includes unknown ages.

§Data not available. Figures are estimates based on average of past available 4 weeks.

One of the persons interviewed was a 43-year-old female dog groomer who had been treating 8-12 dogs each day for 3 years. She sponged a concentrated solution of flea-dip product directly onto flea-infested areas on the dogs. For a year, she had had periodic dizziness, fatigue, blackouts, blurred vision, chest pain, sweating, coldness, and chills. During these episodes, she had pinpoint-sized pupils. Because of the blackouts, her physician referred her to a neurologist, who observed that she had unequal pupils during one of these episodes. Diagnostic tests-including an electroencephalogram and a brain scan-did not reveal the cause of her symptoms. Pesticide poisoning was not suspected until HESIS referred her to a physician specializing in occupational medicine. Three months later, after she had completely avoided all exposure to the products, her red blood cell cholinesterase levels had gradually increased by more than 30%. The majority of her symptoms also resolved during this period. On the basis of this finding, her illness was diagnosed as organophosphate pesticide poisoning (2).

Further Investigations

CDHS is now conducting a statewide investigation of pet groomers and other animal handlers. The California Department of Food and Agriculture is evaluating the hazards, use, and labeling of all flea-control products containing phosmet. Reported by: J Rosenberg, MD, SG Quenon, RN, Hazard Evaluation System and Information Svcs, California Dept of Health Svcs/Dept of Industrial Relations. Surveillance and Programs Br, Div of Environmental Hazards and Health Effects, Center for Environmental Health and Injury Control, CDC.

Editorial Note: HESIS, which was established in 1977 and is jointly supported by CDHS and CDIR, provides an "early warning system" for identifying occupational diseases and hazards. Since 1980, HESIS has assessed occupational hazards, provided health information to the public, and maintained surveillance for occupational illness and exposure. In 1986, HESIS responded to 2,429 inquiries.

EPA has assigned phosmet to Toxicity Class II because of acute oral toxicity (LD50=147 mg/kg) (1). In a recent review of registration data on pesticides, investigators found a lack of information on acute inhalation toxicity, subchronic dermal toxicity, mutagenicity, oncogenicity, and the general metabolism of phosmet (3). The low-level, acute dermal toxicity (LD50 = 3,160 mg/kg) suggests a low rate of dermal absorption, but quantitative data on dermal absorption-particularly of flea-dip formulations-are lacking.

EPA requires that products used as flea dips for dogs and cats must have labels cautioning the users to wear long-sleeved shirts, long pants, elbow-length waterproof gloves, waterproof aprons, and unlined waterproof boots. Because animals that have been dipped or sprayed with pesticides have become ill or have died, EPA now requires that the product label state that a dog or cat may be poisoned if the product is not properly diluted before use.

The extent to which animal handlers in the United States are exposed to or become ill from flea-control pesticides is unknown. Animal groomers and handlers should follow label directions precisely and should wear gloves and protective clothing as recommended.

References

1. Sine C. Farm chemicals handbook '87. Willoughby, Ohio: Meister Publishing, 1987.

2. Coye MJ, Lowe JA, Maddy KT. Biological monitoring of agricultural workers exposed to pesticides: I. Cholinesterase activity determinations. J Occup Med 1986;28:619-27.