Adolescent pesticide exposures

Numerous studies have targeted adolescents as a special population at risk for traumatic injury and infectious diseases, etc. Less attention has been paid to adolescents as subjects vulnerable to toxic chemical exposures – this despite the fact that more than 1.5 million U.S. youth live and/or work on farms. This population-based retrospective study highlights the extent to which adolescents in the lower Mississippi River Delta are exposed to pesticides and suggests targeted prevention strategies. Reports received from 1/1/2001 to 12/31/2002 by 9 poison centers serving 240 counties (8 states) were queried for cases implicating pesticides: 4,435 were abstracted (ages 4 months – 95 years). Reports involving adolescents ages 10-19 were selected for study inclusion (n=159, 60% male). Exposure routes included ingestion (46.5%), inhalation (31.4%), dermal (22.6%), and ocular (8.2%). Exposure substances were 71% insecticides; 31.9% pyrethins/pyrethroids; 17% organophosphates. The majority required no healthcare facility involvement (64.8%). Of 49 cases utilizing healthcare facilities, 13.8% were treated/released and 4.4% required non-critical care unit admissions. There was 1 critical-care unit admission. Medical outcome effects were: 21.4% no effect; 31.4% minor; 7.5% moderate. One case had major medical effects. The most severe medical outcomes resulted from organophosphates. Exposure circumstances included pesticide-contaminated food ingestion; pet product contact; malfunctioning equipment; non-standard or look-alike containers; and re-entry, confined space, or drift factors. Using the Haddon matrix, this study illuminates exposure-incident variables and identifies those educational/behavioral interventions, policies, and engineering controls that are most likely to be effective in decreasing the number and severity of adolescent pesticide exposures.