EPA's Report on the Environment: External Review Draft
Reported Pesticide Incidents
Note to reviewers of this draft revised ROE: This indicator reflects data through 2010. EPA anticipates updating this indicator in 2014.
Although pesticides play a role in protecting human health, food, and crops, they pose a risk of poisoning when not used and/or stored properly. The American Association of Poison Control Centers (AAPCC) collects statistics on poisonings and represents the single largest source of information on acute health effects of pesticides resulting in symptoms and requiring health care (Calvert et al., 2001). The data include incidents related to individual pesticides and to mixtures of products (about 8 percent of reports). The data also include intentional exposures such as suicide attempts and malicious use. The AAPCC uses the National Poison Data System (NPDS), formerly Toxic Exposure Surveillance System, to collect information on all reported incidents.
This indicator is based on data from NPDS-published reports for the years 1998 through 2010. During this period, more than 80 percent of the U.S. population was covered by Poison Control Centers (PCCs) reporting to the national database. Annual reports of incidents were divided by the percent of U.S. population served to estimate the total incidents nationwide, and divided by the total U.S. population to develop the incidence rate.
What the Data Show
Between 1998 and 2010, there was an overall 41 percent decline in reported pesticide incidents in the U.S. (Exhibit 1). Incidents of cases involving fungicides and rodenticides decreased by more than half. The single largest decline occurred for the category of organophosphate (OP) insecticides, which saw an 83 percent drop in the rate of reported incidents between 1998 and 2010. Part of the decline in reported OP-related incidents may be due to the substitution of other, less toxic insecticides for some of the OPs over time. Reported incidents involving other categories of pesticides also decreased during this time period, including disinfectants by 43 percent and herbicides by 38 percent.
- Misclassification of incidents may occur when incidents reported over the phone are not verified by laboratory tests. For example, a child found holding a pesticide container may not have actually been exposed, but if a call is received by a PCC poison specialist who determines that the reported symptoms were consistent with the toxicology, dose, and timing of the incident, the call will be registered as an incident. About 16 percent of calls to PCCs arise from health care professionals, but the majority are calls made by victims or their relatives or caretakers. Although some misclassification can be expected to occur, it is assumed to be non-differential among the different types of pesticides.
- Only calls with known outcomes are reported in this indicator. This may introduce some bias, because the proportion of all reported pesticide incidents with known outcomes declined from 48 percent in 1998 to 40 percent in 2010.
- The data collection process is standardized for PCCs, but it is a passive system. Under-reporting of incidents is a serious shortcoming. Studies show that medical facilities generally report between 24 and 33 percent of incidents from all substances to PCCs (Chafee-Bahamon et al., 1983; Harchelroad et al., 1990; Veltri et al., 1987).
- In 2006, the methodology for identifying exposures and outcomes changed, potentially making comparison of these data with the data in previous AAPCC Annual Reports problematic. The extent to which the changes affect the numbers of exposures and reported outcomes is unclear from the published report, and generally the data do not significantly fluctuate during the 2004-2006 reporting period.
- Data are collected by multiple poison centers, with follow-up likely performed in different ways.
This indicator is based on summary data from annual reports published by the NPDS, 1998-2010 (AAPCC, 2011) (available from http://www.aapcc.org/annual-reports/). Annual data from these reports are presented and incidence rates were calculated from the population served by participating PCCs; population figures can also be found in the annual reports. Only summary data are publicly available; raw data from individual cases are considered confidential.
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