Toxicity - Continued Case 2 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 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. Toxicity - Continued 3. Environmental Protection Agency. Guidance for the reregistration of pesticide products containing phosmet as the active ingredient. Washington, DC: US Environmental Protection Agency, Office of Pesticide Programs, 1986; EPA report no. EPA-540-RS-87-107. Notices to Readers Announcement of the Third National Conference on Chronic Disease Prevention and Control CDC and the Association of State and Territorial Health Officials (ASTHO) will cosponsor the Third National Conference on Chronic Disease Prevention and Control, Putting Science Into Practice, October 19-21, 1988, at the Hyatt Regency Denver, in Denver, Colorado. The conference is open to the public; there will be no registration fee. The conference will build on the strategies identified by participants at the First and Second National Conferences on Chronic Disease Prevention and Control. Those two conferences placed particular emphasis on the interactions among federal, state, and local health departments; voluntary health agencies; professional organizations; and others. This year's conference will include the following plenary sessions: • Health Education/Mass Media Approaches for Changing Behaviors Preventive Health Services in Primary Care Settings (including the costeffectiveness of chronic disease prevention and control strategies) • Long-Term/Broad Strategic Issues for Public Health Chronic Disease Control Concurrent afternoon sessions will focus on breast cancer, cervical cancer, cholesterol/cardiovascular disease, diabetes, and smoking. Additional information may be obtained by contacting Martha S. Brocato, Division of Chronic Disease Control, Center for Environmental Health and Injury Control, Centers for Disease Control (F10), Atlanta, Georgia 30333; telephone: (404) 488-4251 or FTS 236-4251. Malaria Prevention Information System Information on prevention of malaria for travelers is now available 24 hours a day by calling (404) 639-1610. The information system, which is a CDC pilot project, gives general information about malaria and malaria prevention and detailed recommendations on malaria prevention in specific geographic areas (Africa, the Indian subcontinent, Mexico, Central America and the Caribbean, South America, China and Southeast Asia, and Oceania). Information on prevention of malaria in children and pregnant or breastfeeding women is also available. Callers can select any one or all of the informational messages and should be prepared to write down the names and dosages of drugs. The information will be updated as needed. p. 89-90 Erratum: Vol. 36, No. 6 In the article entitled "PCB Contamination of Ceiling Tiles in Public Buildings New Jersey," the second sentence of the third paragraph states: "In February 1986, a consultant hired by the college pursued the secretary's observation and evaluated ceiling tiles throughout the school." The sentence should read: "A consultant was hired by the college in January 1986, and the consultant's sampling and analysis of the ceiling tiles was under way at the time of the secretary's observation. The observations of both the secretary and the consultant occurred simultaneously and independently of each other." |