This reference book for physicians and health care professionals is a quick guide to important sources of information on handling cases of pesticide poisoning. This handbook is divided into four sections.

FOR GENERAL INFORMATION ON FORMULATION, MODE OF ACTION, AND CHEMICAL CLASSES OF PESTICIDES TURN TO SECTION I.

Section I provides general information on pesticide formulations, targets and sites of use, modes of action, and chemical classifications. Turn to this section for general information on pesticide families and general modes of action.

FOR SOURCES OF INFORMATION ON PESTICIDE POISONING AND TREATMENT TURN TO SECTION II.

Section II provides specific sources of information available to physicians on pesticide poisoning and treatment. This section shows the physician where to find specific clinical information on labels, material safety data sheets (MSDS), in statements of formula, toxic inert ingredient statements, telephone emergency hot-lines, and clinical manuals. Turn to this section for guidance on where to get information specific to identification and treatment of poisoning.

FOR SOURCES OF INFORMATION ON PATIENT MANAGEMENT INCLUDING REFERENCES TO TREATMENT IN THE MORGAN MANUAL ON RECOGNITION AND TREATMENT OF PESTICIDE POISONING TURN TO SECTION III.

Section III provides a information on patient management. It includes information on organophosphates, carbamates, organochlorine compounds, biological insecticides, as well as fungicides and herbicides, together with page references to Daniel P. Morgan's excellent clinical manual on the recognition and treatment of pesticide poisoning. Turn to this section to find specific sources of information on recognition and treatment of various types of pesticide poisoning.

In each subsection of Section III, there are tables that include brand name, common name, site of use, and page references to the Morgan (1989) Recognition and Management of Pesticide Poisoning, 4th Edition, available from the Office of Pesticide Programs, United States Environmental Protection Agency, Washington, D.C. The Morgan manual provides specific treatment for many types of pesticide poisoning. We have placed the page references in our patient management section as a companion guide to the Morgan manual.

FOR A LIST OF IN-DEPTH REFERENCES TO PESTICIDE TOXICOLOGY AND HEALTH HAZARDS, TURN TO SECTION IV, PESTICIDE REFERENCES.

At the end of this guide is a bibliographic pesticide reference list of our information sources for preparing this reference. This also is a good source of information in depth on pesticide poisoning. For in depth knowledge at a time less hectic than when dealing with pesticide poisoning, this section may provide sources that amplify understanding of pesticide poisoning and clinical toxicology.

The intent of this manual is to complement the many other guides for medical evaluation and treatment of pesticide poisoning. Frequently other health conditions may mask the symptoms of poisoning produced by pesticide exposure. Pesticide poisoning symptoms also may mimic other health conditions. This manual may serve with others as a reference for recognizing and treating some common pesticide poisonings.

In all cases, sound medical judgement must prevail. This manual can only help medical specialists. It cannot replace experience, training, and diagnostic expertise. The design of this manual is to serve as an easily accessible guide to pesticides, symptoms, and information sources for managing patients with acute symptoms of poisoning.

This book is not a clinical guide and should not be used as such. It is a reference to guide the physician to sources of information, particularly other clinical guides, such as Dr. Daniel Morgan's excellent manual published by EPA. For a clinical guide, Morgan's (1989) Recognition and Management of Pesticide Poisonings (fourth edition) should be used with this reference work.

It is imperative that physicians fully understand the severity of pesticide health hazards and be prepared to recognize and manage this possible health problem in home pesticide users, pesticide applicators and handlers, chemical manufacturing, formulating, and supply workers, farm and ranch workers, foresters, public health workers, and employees of nurseries, greenhouses, and agribusinesses.

Children represent a large segment of poisoning victims every year. They are susceptible to exposure at home, play and work sites. Physicians must identify poisoning symptoms quickly and treat them effectively.

The manual has four sections. First is an introduction that provides general pesticide information. Second is where to get information fast on pesticides. Third is patient management and treatment with references to the Morgan (1989) manual. Fourth is a list of in-depth pesticide reference works.

References and tables give short descriptions. The manual also provides resource information and telephone numbers. All may serve as a guide to physicians in recognizing pesticide poisoning.

The third section has a general introduction to crops and pesticide information. To help the physician, the guide divides chemicals into common names, trade names, and crops that receive treatments by them. The manual segregates products by use, target pest, and general chemical class. The last section provides a general reference to patient management and treatment.

Pesticide exposure and poisoning occasionally results in serious illness. A guidance manual is beneficial for health care professionals who have little experience in recognizing the signs and symptoms or in the treatment of pesticide poisonings, which often mimic other illnesses. The Environmental Protection Agency manual on Recognition and Management of Pesticide Poisonings (fourth edition) by Donald P. Morgan, M.D., Ph.D. is a primary resource. A ready, quick reference, with current information on the symptomatology of pesticide exposure and the immediate management and treatment of the patient as well as a listing of the primary pesticides used on crops grown in Texas, for physicians and other health care personnel is important. This quick guide for physicians will not replace the Morgan manual as a resource. However, we hope it will provide more specific information about pesticides used in Texas as well as providing a summary of poisoning symptoms and information sources on patient management and treatment.

When presented with all the poisons that present health hazards to the public, pesticides form a comparatively small group. This is still a sizeable number. More than 3,000 active ingredients are present in many more registered products. EPA records show more than 100,000 separate registered pesticide products. EPA has canceled registration for more than 40,000 others in the past 5 years. The state of Texas alone has more than 11,000 separate pesticides registered by the Texas Department of Agriculture. They include insecticides, fungicides, herbicides, disinfectants, and plant growth regulators.

Recent Federal regulations such as the Worker Protection Standard (WPS) make a commitment to protect the health of some agricultural workers. Before WPS, State legislation in California, Texas, and Arizona sought to protect farm workers from pesticide health hazards. The Texas Agricultural Hazard Communication Act makes a commitment to protect Texas farm workers but ignores people outside agriculture.

The Federal Community Right-to-Know Act sought to protect a broader segment of the public from chemical hazards. Although it dealt with poisons, it did not deal exclusively with pesticides. EPA's pesticide label improvement program also makes an effort to protect a broader segment of the public. When compared to other health problems treated by physicians, pesticide poisoning is rare. The following information is to help physicians and health care workers in recognizing and treating pesticide poisonings. The Agricultural Extension Service of Texas A&M University in conjunction with the U.S. Department of Agriculture directs educational efforts on pesticide safety through county agents and specialists.

The Health Education Training Centers Alliance of Texas (HETCAT) has among its goals disease prevention and health promotion, especially in the underseved border area. This manual is part of a cooperative effort by HETCAT and Texas Agricultural Extension Service. Its purpose is to inform health care providers about pesticide health hazards. It is part of an initiative to make more pesticide information available to physicians and health care professionals.

HETCAT would be interested in hearing from the users of this manual as to its usefulness. If you would like to write and give us your comments, please use the address below.

Dr. Alfonso Holguin, M.D., M.P.H.
Project Director for HETCAT
University of Texas Health Science Center of San Antonio
7703 Floyd Curl Drive
San Antonio, Texas 78225

Additional copies of this manual are available from:

Health Education Training Centers Alliance of Texas
UTHSC at San Antonio
7703 Floyd Curl Drive
San Antonio, Texas 78284-7787
(512)614-2540

Texas Agricultural Extension Service
Agricultural Chemicals
Agronomy Field Laboratory, Room 115
College Station, Texas 77843-2474
(409)845-3849

or your local County Extension Agent

 Table of Contents | Preface | Section I | Section II | Section III | References