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===History===
===History===
Beginning in 1987, NIOSH supported the implementation of the Sentinel Event Notification System for Occupational Risks program in ten state health departments.<ref name=1992rpt>Levy B, Johnson A, Rest K. 1992 September 28. Evaluation of the Sentinel Event Notification System for Occupational Risks (SENSOR). Final Report.</ref> The objectives of the program were to assist state health departments in developing and/or refining reporting systems for selected occupational disorders so that they could direct appropriate intervention and prevention efforts and evaluate the effectiveness of such efforts. The primary areas of focus were silicosis, occupational asthma, carpal tunnel syndrome, lead poisoning, and pesticide poisoning. While each of the participating state health departments had previously performed surveillance and/or interventions for occupational illnesses, SENSOR clearly assisted the states to develop and refine reporting systems and to direct effective intervention and prevention efforts.<br>
Beginning in 1987, NIOSH supported the implementation of the Sentinel Event Notification System for Occupational Risks program in ten state health departments.<ref name=1992rpt>Levy B, Johnson A, Rest K. 1992 September 28. Evaluation of the Sentinel Event Notification System for Occupational Risks (SENSOR). Final Report.</ref> The objectives of the program were to assist state health departments in developing and/or refining reporting systems for selected occupational disorders so that they could direct appropriate intervention and prevention efforts and evaluate the effectiveness of such efforts. The primary areas of focus were silicosis, occupational asthma, carpal tunnel syndrome, lead poisoning, and pesticide poisoning. While each of the participating state health departments had previously performed surveillance and/or interventions for occupational illnesses, SENSOR clearly assisted the states to develop and refine reporting systems and to direct effective intervention and prevention efforts.<br>
Before 1998, the individual state pesticide-poisoning surveillance systems used different methods for collecting and categorizing data, which did not allow for routine pooling and analysis.<ref name=bookch>Calvert GM et al. 2009. Surveillance of pesticide-related illness and injury in humans. In: Krieger R, editor. Handbook of pesticide toxicology 3rd edition. San Diego, CA: Academic Press (in press).</ref> In response to this issue, NIOSH, along with other federal agencies (EPA, National Center for Environmental Health), non-federal agencies (CSTE, Association of Occupational and Environmental Clinics), and state health departments, developed a standard case definition<ref>Centers for Disease Control and Prevention. 2005. [http://www.cdc.gov/niosh/topics/pesticides/pdfs/casedef2003_revAPR2005.pdf Case Definition for Acute Pesticide-Related Illness and Injury Cases Reportable to the National Public Health Surveillance System]. Cincinnati, OH: Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health.</ref> and a set of standardized variables,<ref> Centers for Disease Control and Prevention. 2009. [http://www.cdc.gov/niosh/topics/pesticides/pdfs/standardized_variable_document_0909.pdf Standardized Variables for State Surveillance of Pesticide-Related Illness and Injury]. Cincinnati, OH: Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health.</ref> which were finalized in 1998. Three states (California, Oregon, and Texas) joined the program that year, and more states joined the program in the years that followed. As of 2008, SENSOR-Pesticides has 12 participating states that contribute occupational pesticide-related injury and illness data. [[California]], [[Iowa]], [[Michigan]], [[New York]], [[North Carolina]], [[Texas]], and [[Washington]] receive federal funding to support surveillance activities, while [[Arizona]], [[Louisiana]], [[Florida]], [[New Mexico]], and [[Oregon]] are unfunded SENSOR-Pesticides program partners. <ref name=SensorPPT>Calvert, GM. 2008. "[http://www.doh.wa.gov/ehp/PIRT/08calvertppt.pdf An Overview of SENSOR-Pesticides]". Retrieved on [[March 10]], [[2009]]</ref>
Before 1998, the individual state pesticide-poisoning surveillance systems used different methods for collecting and categorizing data, which did not allow for routine pooling and analysis.<ref name=bookch>Calvert GM et al. 2009. Surveillance of pesticide-related illness and injury in humans. In: Krieger R, editor. Handbook of pesticide toxicology 3rd edition. San Diego, CA: Academic Press (in press).</ref> In response to this issue, NIOSH, along with other federal agencies (EPA, National Center for Environmental Health), non-federal agencies (CSTE, Association of Occupational and Environmental Clinics), and state health departments, developed a standard case definition<ref>Centers for Disease Control and Prevention. 2005. [http://www.cdc.gov/niosh/topics/pesticides/pdfs/casedef2003_revAPR2005.pdf Case Definition for Acute Pesticide-Related Illness and Injury Cases Reportable to the National Public Health Surveillance System]. Cincinnati, OH: Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health.</ref> and a set of standardized variables,<ref> Centers for Disease Control and Prevention. 2009. [http://www.cdc.gov/niosh/topics/pesticides/pdfs/standardized_variable_document_0909.pdf Standardized Variables for State Surveillance of Pesticide-Related Illness and Injury]. Cincinnati, OH: Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health.</ref> which were finalized in 1998. Three states (California, Oregon, and Texas) joined the program that year, and more states joined the program in the years that followed. As of 2008, SENSOR-Pesticides has 12 participating states that contribute occupational pesticide-related injury and illness data. [[California]], [[Iowa]], [[Michigan]], [[New York]], [[North Carolina]], [[Texas]], and [[Washington]] receive federal funding to support surveillance activities, while [[Arizona]], [[Louisiana]], [[Florida]], [[New Mexico]], and [[Oregon]] are unfunded SENSOR-Pesticides program partners.<ref name=SensorPPT>Calvert, GM. 2008. "[http://www.doh.wa.gov/ehp/PIRT/08calvertppt.pdf An Overview of SENSOR-Pesticides]". Retrieved on [[March 10]], [[2009]]</ref>


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<ref> "[http://www.doh.wa.gov/ehp/Pest// Pesticide Program. Washington State Department of Health]" Retrieved on [[March 10]], [[2009]] </ref>
<ref> "[http://www.doh.wa.gov/ehp/Pest// Pesticide Program. Washington State Department of Health]" Retrieved on [[March 10]], [[2009]] </ref>
==Impact==
==Impact==
===Florida Medfly Eradication Program===
In response to an outbreak of Mediterranean fruit fly (colloquially known as “Medfly”) in 1997-1998, the Florida Department of Agriculture launched an aggressive eradication campaign that involved the aerial spraying of malathion.<ref name=MalathionMMWR>Shafey O et al. 1999. [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4844a3.htm Surveillance for Acute Pesticide-Related Illness During the Medfly Eradication Program -- Florida, 1998]. MMWR 48(44);1015-1018,1027.</ref>
<ref name=UFLarticle>Spence, C. June 27, 1997. “[http://news.ufl.edu/1997/06/27/spray/ UF Experts Say Fear Unwarranted But Treat Malathion With Respect].” University of Florida News. Accessed [[October 1]],[[2009]].</ref>
<ref>Charman, Karen. November 16, 2001. “[http://www.mindfully.org/Pesticide/Fired-Forcibly-Removed.htm Florida Health Official Does Job So Well He's Fired and Forcibly Removed].” Accessed [[October 1]],[[2009]].</ref> During the spring and summer of 1998, federal and state agricultural authorities sprayed pesticides (primarily malathion) over infested areas of five counties in Florida.<ref name=MalathionMMWR/> Despite assurances from scientists and officials that malathion was a “safe pesticide” and did not pose a risk to residents in treated areas,<ref name=UFLarticle/> 230 cases of illness attributed to the pesticide were reported to and investigated by the Florida Department of Public Health.<ref name=MalathionMMWR/> Officials from the Florida Department of Public Health and the SENSOR-Pesticides program published an article in [[Centers for Disease Control and Prevention]] (CDC) Morbidity and Mortality Weekly Report (MMWR) that described these case reports and recommended alternative methods for Medfly control, including exclusion activities at ports of entry to prevent importation, more rapid detection through increased sentinel trapping densities, and the release of sterile male flies to interrupt the reproductive cycle.<ref name=MalathionMMWR/> The United States Department of Agriculture (USDA) incorporated these suggestions into their 2001 Environmental Impact Statement on the Fruit Fly Cooperative Control Program.<ref>United States Department of Agriculture. 2001. [http://www.aphis.usda.gov/plant_health/ea/downloads/fffeis.pdf Fruit Fly Cooperative Control Program: Environmental Impact Statement]. United States Department of Agriculture: Washington, DC.</ref>

===Pesticide use in schools===
===Pesticide use in schools===
Researchers from the SENSOR-Pesticides program published an article in 2005 in the [[Journal of the American Medical Association]] (JAMA) on pesticide poisoning in schools. The article, which included data collected by SENSOR, described illnesses in both students and school employees associated with pesticide exposures.<ref>Alarcon et al. Acute Illnesses Associated With Pesticide Exposure at Schools. JAMA 294:455-465.</ref> The article generated media coverage and drew attention to the issue pesticide safety in schools and the use of safer alternatives through integrated pest management, or IPM.<ref>Osterweil, Neil. July 27, 2005. [http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/1430 School Kids and Teachers Bugged by Pesticide Exposure]. Accessed [[September 29]],[[2009]].</ref>
Researchers from the SENSOR-Pesticides program published an article in 2005 in the [[Journal of the American Medical Association]] (JAMA) on pesticide poisoning in schools. The article, which included data collected by SENSOR, described illnesses in both students and school employees associated with pesticide exposures.<ref>Alarcon et al. Acute Illnesses Associated With Pesticide Exposure at Schools. JAMA 294:455-465.</ref> The article generated media coverage and drew attention to the issue pesticide safety in schools and the use of safer alternatives through integrated pest management, or IPM.<ref>Osterweil, Neil. July 27, 2005. [http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/1430 School Kids and Teachers Bugged by Pesticide Exposure]. Accessed [[September 29]],[[2009]].</ref>

Revision as of 15:59, 1 October 2009

Sentinel Event Notification System for Occupational Risks (SENSOR)-Pesticides is a state-based surveillance program that monitors pesticide-related illness and injury. It is administered by the National Institute for Occupational Safety and Health (NIOSH), which collaborates with several state health agencies. NIOSH supports these surveillance activities by providing funding and technical support to state health departments. The SENSOR-pesticides program is also partially funded by the US Environmental Protection Agency.

Importance

Pesticides are used extensively in several industries. They are particularly useful for agriculture, because they increase crop yields and decrease the need for manual labor.[1] They are used to control pests in other areas as well.[2] [3] However, this extensive use of pesticides puts workers in many different occupations at risk for pesticide exposure and illness, and so surveillance is needed to assess the magnitude and severity of occupational pesticide poisonings. Surveillance of pesticide-related injuries and illnesses is critical and is recommended by several national agencies,[4] including the American Medical Association,[5] the Council of State and Territorial Epidemiologists (CSTE),[6] and the Government Accountability Office.[7] [8] [9]

Overview

History

Beginning in 1987, NIOSH supported the implementation of the Sentinel Event Notification System for Occupational Risks program in ten state health departments.[10] The objectives of the program were to assist state health departments in developing and/or refining reporting systems for selected occupational disorders so that they could direct appropriate intervention and prevention efforts and evaluate the effectiveness of such efforts. The primary areas of focus were silicosis, occupational asthma, carpal tunnel syndrome, lead poisoning, and pesticide poisoning. While each of the participating state health departments had previously performed surveillance and/or interventions for occupational illnesses, SENSOR clearly assisted the states to develop and refine reporting systems and to direct effective intervention and prevention efforts.
Before 1998, the individual state pesticide-poisoning surveillance systems used different methods for collecting and categorizing data, which did not allow for routine pooling and analysis.[11] In response to this issue, NIOSH, along with other federal agencies (EPA, National Center for Environmental Health), non-federal agencies (CSTE, Association of Occupational and Environmental Clinics), and state health departments, developed a standard case definition[12] and a set of standardized variables,[13] which were finalized in 1998. Three states (California, Oregon, and Texas) joined the program that year, and more states joined the program in the years that followed. As of 2008, SENSOR-Pesticides has 12 participating states that contribute occupational pesticide-related injury and illness data. California, Iowa, Michigan, New York, North Carolina, Texas, and Washington receive federal funding to support surveillance activities, while Arizona, Louisiana, Florida, New Mexico, and Oregon are unfunded SENSOR-Pesticides program partners.[14]


Data collection

The original SENSOR model was based on physician reporting, with several states using a system of sentinel health care professionals who were contacted on a regular basis.[11] However, this system was labor-intensive and did not yield many cases, and was thus discontinued.[15] All states currently participating in the program require physician reporting of pesticide-related injuries and illnesses; however, the principal sources of reporting for most states come from workers’ compensation claims, poison control centers, and/or state agencies with jurisdiction over pesticide use, such as state departments of agriculture.[11] In addition to identifying, classifying, and tabulating pesticide poisoning cases, the states periodically perform in-depth investigations of pesticide-related events and develop interventions aimed at particular industries or pesticide hazards.[16] [17] [18] [19]

Impact

Florida Medfly Eradication Program

In response to an outbreak of Mediterranean fruit fly (colloquially known as “Medfly”) in 1997-1998, the Florida Department of Agriculture launched an aggressive eradication campaign that involved the aerial spraying of malathion.[20] [21] [22] During the spring and summer of 1998, federal and state agricultural authorities sprayed pesticides (primarily malathion) over infested areas of five counties in Florida.[20] Despite assurances from scientists and officials that malathion was a “safe pesticide” and did not pose a risk to residents in treated areas,[21] 230 cases of illness attributed to the pesticide were reported to and investigated by the Florida Department of Public Health.[20] Officials from the Florida Department of Public Health and the SENSOR-Pesticides program published an article in Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) that described these case reports and recommended alternative methods for Medfly control, including exclusion activities at ports of entry to prevent importation, more rapid detection through increased sentinel trapping densities, and the release of sterile male flies to interrupt the reproductive cycle.[20] The United States Department of Agriculture (USDA) incorporated these suggestions into their 2001 Environmental Impact Statement on the Fruit Fly Cooperative Control Program.[23]

Pesticide use in schools

Researchers from the SENSOR-Pesticides program published an article in 2005 in the Journal of the American Medical Association (JAMA) on pesticide poisoning in schools. The article, which included data collected by SENSOR, described illnesses in both students and school employees associated with pesticide exposures.[24] The article generated media coverage and drew attention to the issue pesticide safety in schools and the use of safer alternatives through integrated pest management, or IPM.[25] [26] [27] Officials in the pesticide industry reacted strongly to the report, calling it “alarmist” and “incomplete” in its health reporting.[27] Critics claimed that the report was “written without context about the proper use of pesticides in schools and [did] not mention the positive public health protections they provide to [children].” The increased awareness of pesticide use in schools resulting from the article influenced several school districts to adopt integrated pest management programs.

Total release foggers

An article published in the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report by SENSOR-Pesticides state partners, in conjunction with CDPR, called attention to the high number of injuries and illnesses resulting from consumer use of total release foggers, also known as “bug bombs.”[28] In response to this report, the New York State Department of Environmental Conservation (DEC) published a press release stating that the state would restrict the use of total release foggers.[29] DEC Commissioner Pete Granis announced that the department would move to classify foggers as a restricted-use product in New York State, meaning that only certified pesticide applicators would be able to obtain them.

References

  1. ^ Litchfield MH. 2005. Estimates of acute pesticide poisoning in agricultural workers in less developed countries. Toxicol Rev 24(4): 271-278.
  2. ^ Calvert GM et al. Acute pesticide poisoning in the US retail industry, 1998-2004. Public Health Rep 2007; 122:232-244.
  3. ^ Calvert GM et al. Acute pesticide-related illness among emergency responders, 1993-2002. Am J Ind Med 2006; 49:383-393.
  4. ^ Centers for Disease Control and Prevention. 2006. Pesticide-Related Illness and Injury Surveillance (DHHS Publication No. 2006-102). Cincinnati, OH: National Institute for Occupational Safety and Health.
  5. ^ American Medical Association. 1997. Educational and information strategies to reduce pesticide risks. Prev Med 26:191-200.
  6. ^ Council of State and Territorial Epidemiologists. 1996. CSTE position statement 1996-15: adding acute pesticide poisoning/injuries (APP/I) as a condition reportable to the National Public Health Surveillance System (NPHSS). Atlanta, GA: Council of State and Territorial Epidemiologists.
  7. ^ Government Accountability Office. 1994. Pesticides on farms. Limited capability exists to monitor occupational illnesses and injuries. Washington, DC: U.S. General Accounting Office, GAO/PEMD–94–6.
  8. ^ Government Accountability Office. 1999. Pesticides. Use, effects, and alternatives to pesticides in schools. Washington, DC: U.S. General Accounting Office, GAO/RCED–00–17.
  9. ^ Government Accountability Office. 2000. Pesticides: improvements needed to ensure the safety of farmworkers and their children. Washington, DC: U.S. General Accounting Office, GAO/RCED–00–40.
  10. ^ Levy B, Johnson A, Rest K. 1992 September 28. Evaluation of the Sentinel Event Notification System for Occupational Risks (SENSOR). Final Report.
  11. ^ a b c Calvert GM et al. 2009. Surveillance of pesticide-related illness and injury in humans. In: Krieger R, editor. Handbook of pesticide toxicology 3rd edition. San Diego, CA: Academic Press (in press).
  12. ^ Centers for Disease Control and Prevention. 2005. Case Definition for Acute Pesticide-Related Illness and Injury Cases Reportable to the National Public Health Surveillance System. Cincinnati, OH: Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health.
  13. ^ Centers for Disease Control and Prevention. 2009. Standardized Variables for State Surveillance of Pesticide-Related Illness and Injury. Cincinnati, OH: Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health.
  14. ^ Calvert, GM. 2008. "An Overview of SENSOR-Pesticides". Retrieved on March 10, 2009
  15. ^ Schnitzer PG, Shannon J. 1999. Development of a surveillance program for occupational pesticide poisoning: lessons learned and future directions. Public Health Reports 114:242-248.
  16. ^ "California Occupational Health Surveillance and Evaluation Program (OHSEP)." Retrieved on March 10, 2009.
  17. ^ "Program Q&A ." Florida Department of Health/Pesticide Exposure Surveillance Program (DOH/PESP). Retrieved on March 10, 2009.
  18. ^ "Pesticide Surveillance Program". Louisiana Center for Environmental Health. Retrieved on March 10, 2009.
  19. ^ "Pesticide Program. Washington State Department of Health" Retrieved on March 10, 2009
  20. ^ a b c d Shafey O et al. 1999. Surveillance for Acute Pesticide-Related Illness During the Medfly Eradication Program -- Florida, 1998. MMWR 48(44);1015-1018,1027.
  21. ^ a b Spence, C. June 27, 1997. “UF Experts Say Fear Unwarranted But Treat Malathion With Respect.” University of Florida News. Accessed October 1,2009.
  22. ^ Charman, Karen. November 16, 2001. “Florida Health Official Does Job So Well He's Fired and Forcibly Removed.” Accessed October 1,2009.
  23. ^ United States Department of Agriculture. 2001. Fruit Fly Cooperative Control Program: Environmental Impact Statement. United States Department of Agriculture: Washington, DC.
  24. ^ Alarcon et al. Acute Illnesses Associated With Pesticide Exposure at Schools. JAMA 294:455-465.
  25. ^ Osterweil, Neil. July 27, 2005. School Kids and Teachers Bugged by Pesticide Exposure. Accessed September 29,2009.
  26. ^ PANNA. September 15, 2005. PANNA: JAMA Study of Pesticide Risks in Schools. Accessed September 29,2009.
  27. ^ a b U.S. Newswire. July 26, 2005. Industry Responds to JAMA Report on Incidence of Pesticide Exposure at Schools. Accessed September 29,2009.
  28. ^ Wheeler K et al. 2008. Illnesses and Injuries Related to Total Release Foggers – Eight States, 2001-2006. MMWR 57(41):1125-1129.
  29. ^ New York Department of Environmental Conservation. October 17, 2008. State to Restict Use of “Bug Bombs”. Accessed September 29,2009.