If you have a poisoning emergency, call the poison help hotline: 800-222-1222
With respect to label information that can help you recognize and respond to a pesticide exposure:
Specify the types of information that appears on labels.
Locate the information on a pesticide label.
In relation to using a pesticide, tell when you should become familiar with label statements regarding pesticide exposure.
Indicate when you should assume that a pesticide poisoning has occurred and what your immediate response should be.
Identify situations in which you should seek medical attention for possible pesticide poisoning or injury.
Describe the actions you should take if you decide medical attention is necessary following a suspected pesticide exposure.
Describe the basic first-aid procedures for oral, dermal, inhalation, and eye exposure to pesticides.
Give examples of situations in which it is and isn't safe to induce vomiting after someone has swallowed pesticide.
List the symptoms of shock.
Tell how to respond when someone goes into shock.
Tell who can administer antidotes to a person who has been exposed to pesticides.
Tell where you should keep a first-aid kit.
List items that should be in a first-aid kit.
If you or someone else is exposed to a pesticide, you can reduce the risk of poisoning or injury if you
quickly recognize that an exposure may have occurred and properly tend to the victim. This requires that you become familiar with symptoms of exposure to pesticides you handle and with the proper procedures to help whoever was exposed. As usual, the pesticide label is a vital resource for you.
A "First Aid" or "Statement of Practical Treatment" section on a pesticide label provides instructions in case of poisoning or accidental exposure. Contained in these instructions for some pesticides, including all products bearing the signal word "Danger" or "Danger - Poison," is a note to physicians describing appropriate medical procedures and antidotes for poisoning emergencies.
Sample label directions for response to a pesticide exposure
Read the "First Aid" or "Statement of Practical Treatment" section before you use a pesticide so you can react quickly to an exposure. Acting fast will reduce exposure and lower the risk. If you wait until after an exposure occurs to read the label, you will lose valuable time and will increase the risk of harm to the victim. And if you are the victim, you may not even be able to read the label.
Reprinted with permission from Northeast Pesticide Applicator Training Core Manual (3rd ed.), 2012, produced by the Cornell University Pesticide Management Education Program; and
National Pesticide Applicator Certification Core Manual, published by the National Association of State Departments of Agriculture Research Foundation (NASDARF) for the U.S. Environmetal Protection Agency Office of Pesticide Programs.
Become familiar with symptoms of exposure to the pesticides you handle so you know what to watch for. The National Pesticide Information Center (800-858-7378 or npic.orst.edu) is a good source of information on symptoms of pesticide exposure.
Pesticides with a common mode of action tend to induce a common set of symptoms in exposure victims. For example, organophosphate and carbamate insecticides are both cholinesterase inhibitors and cause similar symptoms of exposure.
Common symptoms associated with organophosphate/carbamate insecticide poisoning.
-Nausea and vomiting
-Stomach cramps and diarrhea
-Inability to walk
-Constriction of pupils
-Mild symptoms become more severe
-Severe constrict-tion of pupils
-Running nose and drooling
-Coma and death
You can see from the list of symptoms of mild organophosphate or carbamate poisoning in the above table that it's not always easy to tell whether a person has been poisoned or is just plain sick. Symptoms of pesticide poisoning often mimic symptoms of other ailments including colds, the flu, or even a hangover. If you get a headache or begin to feel nauseated at work, you won't know right away whether or not you are just coming down with something.
Play it safe. Always assume that any symptoms that arise while or soon after working with a pesticide are due to the pesticide. If you or any of your fellow workers feel sick or unusually tired or notice a skin rash or irritated eyes, do not try to finish the job. Leave the treated area and seek help immediately. Responding quickly is vital to preventing or minimizing poisoning.
Obviously, there will be times you want to act even before symptoms develop. Examples include splashing yourself with pesticide or getting any pesticide in your eyes. If you know or suspect that exposure has occurred, immediately separate the victim from the source of exposure, apply appropriate first aid, and seek medical attention (if warranted).
Even as you are applying first aid, seek medical attention whenever someone:
Becomes ill while or soon after working with pesticides or in a pesticide-treated area,
Gets pesticide in their eyes,
Exhibits symptoms of injury following dermal or inhalation exposure to a pesticide, or
Experiences enough dermal or inhalation exposure that common sense tells you to get help even if there are no symptoms yet.
Call for medical help as soon as possible. If you are alone with the victim, you may have to get the person out of the exposure situation and begin first aid before you can call for help. If you are the victim and no one is around to help you, don't panic; follow the same guidelines as you would if someone else had been exposed.
Keep phone numbers for each of the following with you, such as in the contacts list on your cell phone or in your work vehicle:
Your local doctor or medical facility,
The emergency contact phone number (if any) provided on the pesticide label, and
The Poison Center (1-800-222-1222 nationwide)
When you call the Poison Center number provided, you will be automatically routed to your nearest Poison Center, which is staffed 24 hours a day with people who are trained to deal with poisonings. You can call the Poison Center yourself, though it is best to get the victim to a medical facility and let them make the call.
When you call any of these resources listed above, have a copy of the pesticide label with you, provide as much detail as you can about the exposure (e.g., duration, diluent and adjuvants used, weather conditions), and describe the victim's condition. If you are calling a doctor, also provide any emergency contact numbers and/or notes to physicians that may be on the pesticide label.
Have someone take the victim to the doctor; someone who needs medical attention should go alone only if no one is near to help them. Be sure to bring a copy of the pesticide label so the medical personnel know what they are dealing with and can check the label for helpful information.
Always bring a copy of the pesticide label when seeking medical advice for exposure symptoms.
Bring a copy of the label rather than the labeled pesticide container. There is no need to bring pesticide to a medical facility, and doing so presents unnecessary risks. This is one reason it is good practice (and may be state law) to carry a copy of the label of each pesticide you have with you at a job site.
First aid is the initial effort to help a victim before you can get them to medical personnel. It is not a substitute for medical attention, but can be critical in avoiding serious poisoning or injury. Become familiar with label statements regarding first aid and the procedures we'll discuss here before you use a pesticide; you likely won't have the time or opportunity to look up the information if there is an emergency.
Regardless of the route or extent of exposure:
The first step is to separate the victim from the source of the exposure (e.g., take them out of the treated area, remove contaminated clothing). However, be sure to protect yourself (and first responders) from exposure when doing so, such as by putting on appropriate PPE. You may be of little help to the victim if you get exposed yourself.
Always have a source of clean water readily available when you work with pesticides, as water is necessary in responding to most exposures. In an emergency, any source of reasonably clean water will suffice, including a nearby surface water.
Never give anything by mouth to an unconscious person.
If a victim is convulsing, protect the person's head and watch that breathing continues.
Learn how to give artificial resuscitation in case you ever have to help a victim whose breathing stops or becomes impaired.
If pesticide gets on a person's skin:
Remove all contaminated clothing immediately. If you think the clothing can be reused, wash it according to directions provided in the previous chapter. If not, properly dispose of the clothing (see Chapter 27, "Managing Pesticide Wastes").
Drench the exposed skin with water.
Wash the exposed skin with soap and water and rinse well. A shower is best. Avoid harsh scrubbing because it may cause abrasions, which enhances pesticide absorption through the skin.
Gently dry the exposed skin and wrap it loosely in a cloth or blanket, if necessary.
Loosely cover chemical burns with a soft, dry cloth. Do not apply ointments, powders, or other medications to the burns unless instructed to by medical personnel.
If pesticide gets in a person's eyes:
Act very quickly. Eyes are especially sensitive to injury and readily absorb pesticide.
Hold the eyelids open and immediately begin washing the eyes with a gentle stream of clean water. If only one eye is involved, take care not to contaminate the other eye.
Do not use chemicals or drugs in the water unless instructed to do so by medical personnel.
Direct the water across the eyes rather than directly into them to aid in flushing.
Continuously rinse the eyes with large amounts of water for at least 15 minutes.
Flush under the eyelids with water to remove debris.
After you are done rinsing the eyes, cover them with a clean piece of cloth and seek medical attention.
If someone is suffering from an inhalation exposure:
Carry the victim to fresh air immediately (do not make the person walk).
Have the victim lie down and loosen all tight clothing.
Keep the victim warm and quiet. Do not let the person become chilled or overheated.
Keep the victim's chin up to ensure that air passages are open for breathing.
If pesticide has gotten in the mouth but has not been swallowed, rinse the mouth out with plenty of water. After rinsing, have the victim drink at least 1 quart of water or milk to dilute small amounts of pesticide that may have been swallowed during rinsing.
If pesticide has been swallowed, one of the most crucial decisions to make is whether to induce vomiting. The decision must be made quickly and only by a medical professional because the victim's life could depend on it. Call a medical facility or the Poison Center immediately and relay label directions about inducing vomiting.
Induce vomiting only if the pesticide label and medical professional tell you to and only as a first-aid measure until the victim can get medical attention. Do not spend a lot of time inducing vomiting if it delays getting the victim to a hospital.
Ipecac syrup is no longer recommended for routine use in most poisonings. Clinical studies have demonstrated no benefit from its use. Ipecac works too slowly in inducing vomiting and results in only about one-third of stomach contents being voided.
To induce vomiting:
Give the victim at least 2 glasses of water to dilute the product. Do not use carbonated beverages.
Make sure the victim is kneeling forward or lying on their side to prevent vomitus from entering the lungs and causing additional damage.
Put your finger or the blunt end of a spoon at the back of the victim's throat. Do not use anything sharp. Also, do not use salt water to induce vomiting.
Collect some vomitus for the doctor, who may need it for chemical analysis.
Never induce vomiting if the label warns against it or if the victim:
Is unconscious or having convulsions, because the victim could choke to death on the vomitus.
Swallowed a corrosive pesticide. These materials, such as a strong acid or alkali, will burn the throat and mouth. A person who has swallowed a corrosive pesticide will complain of severe pain. If you induce vomiting, the pesticide will just cause more burns as it comes back up. Also, it could be aspirated into the lungs and burn the lung tissue.
Swallowed an emulsifiable concentrate or oil solution; these may kill the person if aspirated into the lungs during vomiting.
If instructed to do so by medical personnel, you can give the victim activated charcoal either as an alternative to inducing vomiting or to help with any pesticide left in the stomach after vomiting. Activated charcoal acts like a sponge to absorb many different chemicals. Give the victim 2 to 4 tablespoons of activated charcoal in at least 8 ounces of water. You can get pharmaceutical-grade activated charcoal at drug stores or, in an emergency, you can use activated charcoal that is prepared for cleaning up pesticide spills.
Sometimes poisoning victims go into shock. If untreated or ignored, the victim can die from shock even if the poisoning itself would not be fatal.
Symptoms of Shock
The victim's skin will be pale, moist, cold and clammy. The eyes are vacant and lackluster with dilated pupils. The breathing will be shallow and irregular. The pulse is very weak, rapid, and irregular. The victim may be unconscious or may have fainted.
If a person is in shock, keep the victim:
Flat on his/her back (unless the victim is vomiting) with legs up 1 to 1 1/2 feet above the head.
Warm enough to prevent shivering, but do not overheat.
Quiet and reassure the person often.
Antidotes are available only for anticoagulant rodenticides and organophosphate and carbamate insecticides. Antidotes can be extremely dangerous if misused, so they should be prescribed and administered only by a qualified physician. Never use antidotes before handling pesticides in an effort to prevent pesticide poisoning.
A well-equipped first-aid kit which is always readily available can be important in a pesticide emergency. It should have a tight fitting cover with a latch and seal so that it won't come open or allow pesticides to leak inside. Label it clearly with a permanent marker. Keep a first-aid kit wherever you keep or work with pesticides, such as in your work vehicle, near your pesticide storage area, and where you mix and load pesticides into application equipment.
Some items to consider including in a first-aid kit include:
At least one quart of water,
An eyewash bottle,
Bandages to cover cuts and scrapes to help prevent pesticide from being absorbed through the skin,
Chemical-resistant gloves for use when removing and handling contaminated clothing,
Clean pieces of cloth,
A small plastic jar with a tight-fitting lid that can be used for drinking water or for collecting vomitus,
A small package of activated charcoal,
A shaped plastic airway for mouth-to-mouth resuscitation, and
The emergency phone numbers listed earlier in this chapter.
Although not technically a part of a first-aid kit, it's a good idea to have a change of clothes available in case a person's work clothes become contaminated. Note that the Worker Protection Standard (WPS; discussed in more detail in Chapter 14, "Federal Pesticide Laws and Regulations") has specific requirements for decontamination kits for covered employees of agricultural establishments.