Cholinesterase Monitoring ~ What Washington is Learning

Cholinesterase Monitoring ~ What Washington is Learning

Margaret Tucker

WA State Department of Agriculture

What Will Be Covered

Program overviewChE results to dateFindings of workplace investigationsTraining focus

Program overview

Began in 2004

Lawsuit brought by labor advocates

WA Supreme Court required Labor & Industries to institute rulemaking for cholinesterase (ChE) monitoring program

Agricultural employers only

Program overview

Who must comply?

– Growers with employees who handle Category 1 or 2 organophosphate or N-methyl carbamate pesticides

Program overview

What must they do?

– Document hours of handling of covered pesticides

– Offer testing to employees who handle covered pesticides

Program overview

ChE Testing

– Baseline before handling covered pesticides

– Follow-up testing when exposure threshold met

2004 – 50 hours in consecutive 30 days

2005 – 30 hours in consecutive 30 days

Program Overview

If ChE depression > 20%, employer must:– Perform an investigation of:

work practicesclothesrespiratory protectionsanitation

– Keep a record of the investigation

– Record actions taken to correct problems

Program Overview

If > 30% decrease in red blood cell ChE or > 40% decrease in plasma ChE:– Work practice investigation by L&I

– Employee temporarily removed from exposureCovered by medical removal protection

benefitsMay return to handling tasks when ChE

levels within 20% of baseline

Program Overview

With ChE depressions, symptoms are generally reversed when– Exposure is stopped

– ChE levels increase

No pesticide illness cases in WA as a result of ChE depressions

Year

Employees receiving baseline test

Employees receiving follow-up test

Number of periodic or follow-up tests

Employees with depressions > 20%

Employees with depressions >30% RBC ChE or >40% plasma ChE

2004

2,630 580 1048 97(16.7% of those receiving follow-up test)

22 (3.8% of those receiving follow-up test)

119(20.5% of those receiving follow-up test)

2005(as of 7/11/2005)

2,211 577 799 47(8.1% of those receiving follow-up test)



Summary of ChE Monitoring Data

Total

Preliminary Data from 2005 Research Investigations*

BACKGROUND INFORMATION

27 Employers - all pome fruit growers

About 75% of the farms > 500 acres

About 1/3 had more than 10 handlers

*NOTE: ADDITIONAL INVESTIGATIONS ONGOING

Preliminary Data from 2005 Research Investigations

ChE-inhibiting pesticides handled by workers with significant ChE depressions– Lorsban– Sevin– Guthion– Carzol


Respiratory Protection

No respirator cartridge change out schedule or overuse of cartridges 13

Using half-face respirator 17

Improper fit-tests 3

Wrong prefilters for oil 2


General Personal Protective Equipment (PPE)

Spray glasses not chemical proof 1

Cotton caps (7 wearing sweatshirt hoods also) 9

Wearing bump cap 1

Cotton gloves under nitrile 2


Decontamination

PPE decontamination inadequate 11

Application equipment decon inadequate 3

PPE removed & placed on contaminated surface (e.g. tractor) 3


Decontamination

Adjust respirator without glove decon. 1

Smoking without washing/decon. 1

Equipment used for other activities w/o decontamination (e.g. tractor used w/o cleaning) 2


Handling Activities

Eye flush supplies missing 3

Eyewash supplies missing or not working 4

Drift exposure (spray on face reported) 3

WPS training cited inadequate 4


Change of clothes not provided 2

Improper respirator storage 1

No respiratory protection program 1

Improper respirator maintenance 1


Preliminary data highlights many factors making simple conclusions difficult

Only evaluating employees with depressions– How do their practices differ from those

without depressions?


AREAS OF CONCERN: Wearing absorbent caps and/or half-face

respirators when applying Lorsban/oil tank mix with airblast sprayers

Required PPE not available Improper use of PPE PPE decontamination inadequate or not

performed at necessary times


AREAS OF CONCERN:

Personal hygiene practices

Equipment decontamination – none or insufficient. Multiple users w/varying practices

Safety standards/best practices not being carried “down the line”

Training Focus

At all levels: Growers Safety officers Foremen and crew bosses Handlers

Coordinated, partnership effort: Industry, WSDA, WSU, DOH, L&I, PNASH

Training Focus

How? Train the Trainer Hands-On Handler Training Spanish/English Recertification Programs

Washington State Horticultural Association Governor’s Ag Safety Day WSDA/WSU sponsored courses

WSU Decontamination Video WSDA focused newsletter to ag employers

Training Focus

Growers & Handlers Emphasize personal, equipment and PPE

decontamination every time Eliminate use of absorbent caps, etc. Convert to full face respirators where

appropriate Follow farm safety policies

Training Focus

Growers, Safety Officers, Foreman Communicate results of L&I investigations Encourage them to:

Create and nurture a safety cultureDevelop, implement and actively enforce

pesticide safety policies Ensure adequate availability, use and

decontamination of protective equipment

More Information

Go to www.Lni.wa.govClick on the Topics Index at the top of the pageFind “Cholinesterase”Click on “Cholinesterase monitoring”

Call 1-800-4BE-SAFE (423-7233) and select “pesticide blood testing”

E-mail: [email protected] – [email protected] – Spanish

Thank You!

Margaret Tucker

WA State Dept. of Agriculture

(360) 902-2015

[email protected]

agr.wa.gov/PestFert/

Cholinesterase Monitoring ~ What Washington is Learning

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