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Recent legislation by the states of Florida (Ref. House Bill 3188 1970) and New York (Ref. Assembly Bill 5881-B 1970) give further evidence of things being done to control the use of pesticides. Legislation designates certain pesticides as restricted-use substances if they persist in the environment, accumulate as a pesticide or metabolic degradation product in plant or animal tissues or their products, and are not excreted or eliminated within a reasonable length of time. In addition these laws go on to state that if such a compound creates or presents a future risk or harmful effect on any organism other than the target organism the restriction of its sale, purchase, possession, or use is in the public interest. Indiscriminate use of pesticidal chemicals has been largely responsible for many of the problems that people do not attribute to pesticides. People must somehow be made to realize that pesticides are poisons and should be used in response to a specific problem and not for convenience.

Our present technologically oriented society is responsible for many of the problems such as those associated with the use of pesticides. First of all, our colleges and universities have produced narrowly educated scientists and technicians who have produced a highly sophisticated technology without considering the means of controlling it.

Industrial giants have developed highly sophisticated products and machines that are tremendously efficient in carrying out their specific purposes. These products are released to the public, and unfortunately the public lacks sufficient knowledge to understand what constitutes abuse or misuse of a product. The orientation of an industrial world toward obtaining a quick and dirty dollar has resulted in the provision of only the information required by law in the labeling of products. Therefore, if a given use is not contraindicated on the label, the public is apt to use pesticides for almost any purpose.

An informed public would help, but the most feasible solution seems to be legislation. This entails drawing up rules and regulations which control the misuse, indiscriminate use, and identification of restricted use of pesticide chemicals.

REFERENCES

1. Conley, B. E. Morbidity and mortality from economic poisons in the United States. Arch. Industr. Health 18:126-133, Aug. 1958.

2. Berry, C. M. Health hazards from agricultural chemicals. J. Iowa Med. Soc. 49:387-389, July 1959.

3. Long, K. R., and Walden, J. Preliminary Studies on Economic Poisons (Bulletin No. 4) Des Moines, Institute of Agricultural Medicine, University of Iowa, 1958.

4. Durham, W. F., and others, Organophosphorus insecticides and mental alertness. Arch. Environ. Health 10:55-66, Jan. 1965.

5. Grob, D., and Harvey, A. M. Effects and treatment of nerve gas poisoning. Am. J. Med. 14:52, Jan. 1953

6. Metcalf, D. R., and Holmes, J. H. Toxicology and physiology; EEG, psychological. and neurological alterations in humans with organophosphorus exposure. Ann. N.Y. Acad. Sci. 160:357-365. 1969.

7. Spencer, M. C. Herbicide dermatitis. JAMA 198:1307-1308, Dec. 19, 1966. 8. Boguisky, E. Occupational Disease in California Attributed to Pesticides and other Agricultural Chemicals. Sacramento, Calif., Bureau of Occupational Health and Environmental Epidemiology, Department of Public Health, 1967.

9. Long, K. R. Iowa Community Pesticides Study. (Progress Report No. 16) 1969. (Unpublished)

10. Tocci, P. M. and others. Biochemical differences found in persons chronically exposed to high levels of pesticides. Industr. Med. 38:188-195, June 1969. 11. Long, K. R., and others. Epidemiology of pesticides in a rural area. Am. Ind. Hya. Assoc. J. 30:298–304, May-June 1969.

12. Long, K. R., and Bonderman, R. P. Lactic and Glucose-6-Phosphate Dehydrogenase Values in Subjects Occupationally Exposed to Pesticides. (To be published)

13. West, Irma, and Milby, T. H. Public health problems arising from the use of pesticides. Residue Rev. 11:141-159, 1965.

Thimet® is the registered trademark of the American Cyanamid Company. SevinR is the registered trademark of the Union Carbide Company, and DiSyston is the registered trademark of the Chemagro Corporation. Dr. Long says, "Commercial sources and trade names are provided for identification only. Their mention does not constitute endorsement by the Environmental Protection Agency or by the University of Iowa."

[Reprinted from The Journal of The Medical Society of New Jersey, May 1971, Vol. 68, No. 5, pp. 375-77]

PHYSICIAN'S PESTICIDES PRIMER*

(By Donald S. Kwalick, M.D./Trenton)

In suspected pesticide poisoning your State Department of Health offers services essential for confirmatory diagnosis. These services include:

1. Determinations of serum and RBC cholinesterase in suspected organophosphate or carbamate intoxications;

2. Analyses of serum, urine, and gastric contents for identification of various pesticides or their metabolites; and ;

3. Identification of whether unknown substances suspected of poisoning a patient contain pesticides.

In suspected pesticide poisoning, collect the following specimens as soon as possible during treatment: (1) Blood-heparinized and clotted; (2) Urine; and (3) Gastric Contents-if ingestion is suspected.

Refrigerate all specimens but don't freeze them. Telephone the Pesticide Projject-Area Code 609-292-7608, Monday through Friday, 9 a.m. to 5 p.m. After hours, call-Area Code 609-392-2020.

The New Jersey Community Study on Pesticides (hereafter referred to as the Pesticide Project) is sponsored jointly by the Office of Pesticides and Product Safety of the Federal Food and Drug Administration and the New Jersey Department of Health, and is part of a nationally coordinated study in fifteen states. The acute effects of pesticide poisonings are well understood, but the effects of long-term, low-level exposure are unknown. To determine whether chronic effects exist, the Project has selected 200 individuals (farmers, pest control applicators, aerial applicators, and formulators) who are occupationally-exposed to high levels of pesticides. If these persons do not demonstrate any effects from prolonged exposure, then the general population whose exposure is far less should show no effects. These persons are compared with a group of 50 minimally-exposed "controls" for any differences in blood and urine biochemistry, renal and liver function tests, complete blood counts, urinalyses, pesticide residues, and physical signs or symptoms. Each subject is given an annual physical examination, an electrocardiogram, and a chest X-ray.

The Pesticide Project has found, as would be expected, that persons exposed to pesticides in their occupation have higher serum residues of pesticides than general population or control individuals. For example, the mean residue for DDT in our exposed industrial population is 28.8. ppb†, while in the minimallyexposed and general population it is 4.4 ppbt. Thus far, no abnormal biochemical chronic changes have been found in the exposed individuals compared with our minimally-exposed control group. However, comparing 40 controls with 52 exposed (farmers and pest control operators) disclosed a statistically significant difference in the number of individuals with hearing and eye problems, chronic cough and sinusitis, dizziness and headaches, and hypertension.

TABLE 1.-GENERAL GUIDE FOR ESTIMATING LETHAL DOSE OF POISONOUS SUBSTANCES !

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1 This table has been adapted from "Clinical Handbook on Economic Poisons," Hayes, W. J., Jr., U.S. Public Health Service Publication No. 476, reprinted January 1967, p. 4.

Kwalick is Director of our State Health Department's Community Study on Pestl cides. This comes from material presented as a scientific exhibit at the Annual Meeting of The Medical Society of New Jersey, Atlantic City, New Jersey, May 16-19. The work was supported by the U.S. Department of Health, Education, and Welfare; the Public Health Service; and the Food and Drug Administration.

Parts per billion

The acute toxicity of pesticides varies from very mild to extremely high. The relative differences are seen in Table I, which presents a general guide of lethal dose for any poisonous material. Many compounds are best classified by generic and/or chemical type. The most commonly used pesticides in New Jersey and their relative toxicity are presented alphabetically in Table II.

TABLE II.-COMMONLY USED PESTICIDES IN NEW JERSEY-TYPE AND RELATIVE TOXICITY

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Cube, Derris; pyrethrum, rotenone_

Carbaryl (Sevin), Ferbam Maneb, Furan Zectan; Nabam,
Zineb.

Aldrin, Dieldrin, Endrin, Benzene hexachloride (BHC),
Chlordane; DDT, toxaphene, heptachlor, Lindane,
methoxychlor.

Acute toxicity rating

Mild-depends upon
dosage.
Extremely high.

Mild.

Mild to moderate.

Very mild to high.

Herbicides (chlorphenoxy)... 2,4-dichlorophenoxyacetic acid (2,4-D); 2,4,5-trichloro- Very mild to mild. phenoxyacetic acid (2,4,5-T); (MCPA) 2-methyl-4chlorophenoxyacetic acid.

Organophosphates....

Chlorthion, Decapthon, DDVP (Vapona), Diazinon; Malathion,
Parathion, Phosdrin, TEPP.

Moderate to extremely high.

Organophosphates have caused over 60 percent (52 of 82) of the reported pesticide poisonings. Since 1967 the number of organophosphate poisonings has greatly exceeded poisoning from other pesticides. With the decreased use of persistent pesticides (such as DDT) there will be a corresponding increase in the use of less persistent compounds such as carbamate and organophosphates. Although less persistent, the organophosphates include some of the most dangerous chemicals known to man. An increased number of poisonings with possible the use of less persistent compounds such as carbamates and organophosphates. usage unless there is stringent control on the purchase and use of these substances, and unless there is intensive education of the public and many occupationally-exposed individuals.

The pharmacology, onset, signs and symptoms, and treatment of the more common pesticide poisonings are summarized in Table III.

Many clinical effects of pesticide poisonings are similar but treatment varies. In any poisoning where ingestion is suspected, gastric lavage with several liters of water is indicated. If the patient is conscious, an emetic may be administered or sodium sulfate catharsis may be useful. Therapy should not await laboratory confirmation, but begun at the earliest suspicion.

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TABLE III.-ONSET, PHARMACOLOGY, SIGNS AND SYMPTOMS, AND TREATMENT OF COMMON ACUTE PESTICIDE POISONINGS

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Maintain patent airway, suction excessive secretions, artificial respiration if necessary, oxygnation to overcome cyanosis, gastric lavage as indicated, decontamination of skin, hair and nails with soap and water followed by alcohol sponging.

Atropine sulfate p.o. or i.m. 1-4 mg depending Severe cases: atropine sulfate parenterally 2-4 mg. upon severity of symptoms.

Pralidoxime (2-PAM) is NOT recommended, tranquilizers, aminophylline, morphine contraindicated.

q. 5-15 minutes until atropinized (dry, warm skin and tachycardia) Child dose .015-.05 mg/kg; pralidoxime (2-PAM) 1-1.5 gram deep i.m. or i.v., Child dose 25-50 mg/kg, May double doses if necessary, milder cases: atropine 1-2 mg p.o. or i.m.qlh; pralidoxime (2-PAM) 1-2 gram p.o. Observe closely 24-48 hours after symptoms subside; handle contaminated materials carefully; discard contaminated clothing carefully; phenothiazines, aminophylline, morphine, theophylline contraindicated.

SELECTED BIBLIOGRAPHY

For those interested in more extensive reading on pesticides, a selected reference list is included below.

1. Biological Effects on Pesticides in Mammalian Systems, Annals N.Y. Acad. Sci., Vol. 160. Art. 1 (June 23, 1969), Price $23.

2. Cleaning Our Environment, The Chemical Basis for Action, pp. 195–244, Sept. '69, Price $2.75.††

3. Clinical Handbook on Economic Poisons, Emergency Information for Treating Poisonings, Hayes, W. J., Jr., PHS Publ. No. 476, Reprinted Jan. '67, Price 55 cents. ***

4. Health Aspects of Pesticides, monthly abstract bulletin from Pesticides Program of FDA, Price $6.50 per year.***

5. Organic Pesticides in the Environment, Advances in Chemistry Series, 1966, Price $8.50.††

6. Pesticides Monitoring Journal, monthly journal from Pesticides Program of FDA, Price $1.75 per year.***

7. Report of the Secretary's Commission on Pesticides and Their Relationship to Environmental Health, Dec. '69, Price $3.***

8. Safe Use of Pesticides, a manual for public health personnel, 1967, APHA, 1740 Broadway, New York 10019, Price $3.

[Reprinted by the U.S. Department of Health, Education. and Welfare, Public Health Service from Pesticides Monitoring Journal, vol. 5, No. 1, June 1971]

CRITERIA FOR DEFINING PESTICIDES LEVELS TO BE CONSIDERED AN ALERT TO POTENTIAL PROBLEMS

(Panel on Pesticide Monitoring Working Group on Pesticides1 (W. S. Murray, Executive Secretary))

The objective of the National Pesticide Monitoring Program is to determine levels and trends of pesticides in the various substrates sampled. The establishment of mean levels of specific pesticides through the NPMP provides baselines necessary for determining whether levels of specific pesticides are high or low. We have not yet determined, however, just what would be considered the levels of concern for each pesticide in certain environmental components. For example, we know what the actionable level of DDT is in human food, but there has been no level established for DDT in human tissues that would result in action to reduce exposure. On the other hand, for some elements of the environment, there have been maximum allowable levels set based on known adverse effects, although these levels may include a built-in margin of safety.

The following criteria may be used to define pesticide levels to be considered an alert to potential problems: Environmental component

Wildlife..

Fish__.

Soil__

Water--

Food and Feed__

Humans

Criteria for identifying potential problems

(1) Any concentration of a pesticide known to be potentially harmful (based on research demonstrating harm).

(2) Increasing trends.

(1) Any concentration of a pesticide known to be
potentially harmful (based on research demon-
strating harm).

(2) Evidence of exceeding established levels.
(3) Increasing trends.

(1) Evidence of exceeding established levels in soil-
associated items.

(2) Increasing trends.

(1) Evidence of exceeding established water quality

standards.

(2) Increasing trends.

(1) Evidence of exceeding established levels and standards.

(2) Increasing trends.

(1) Increasing trends.

(2) Recognition of adverse effects.

Available from American Chemical Society, 1155 Sixteenth Street, N.W., Washington, D.C. 20036. ***For Sale by Superintendent of Documents, U.S. Government Printing Office, P.0. Box 1540, Washington, D.C. 20402.

1 Responsible to the Council on Environmental Quality.

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