Cholinesterase Monitoring ~ What Washington is Learning

1. Cholinesterase Monitoring ~ What Washington is Learning Margaret Tucker WA State Department of Agriculture

2. What Will Be Covered • Program overview • ChE results to date • Findings of workplace investigations • Training focus

3. 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

4. Program overview • Who must comply? • Growers with employees who handle Category 1 or 2 organophosphate or N-methyl carbamate pesticides

5. Program overview • What must they do? • Document hours of handling of covered pesticides • Offer testing to employees who handle covered pesticides

6. 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

7. Program Overview • If ChE depression > 20%, employer must: • Perform an investigation of: • work practices • clothes • respiratory protection • sanitation • Keep a record of the investigation • Record actions taken to correct problems

8. 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 exposure • Covered by medical removal protection benefits • May return to handling tasks when ChE levels within 20% of baseline

9. 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

10. 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) 9 (1.6% of those receiving follow-up test) 56 (9.7% of those receiving follow-up test) Summary of ChE Monitoring Data Total

11. 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

12. Preliminary Data from 2005 Research Investigations • ChE-inhibitingpesticides handled by workerswith significant ChE depressions • Lorsban • Sevin • Guthion • Carzol

13. Preliminary Data from 2005 Research Investigations 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

14. Preliminary Data from 2005 Research Investigations 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

15. Preliminary Data from 2005 Research Investigations Decontamination • PPE decontamination inadequate 11 • Application equipment deconinadequate 3 • PPE removed & placed on contaminated surface (e.g. tractor) 3

16. Preliminary Data from 2005 Research Investigations 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

17. Preliminary Data from 2005 Research Investigations 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

18. Preliminary Data from 2005 Research Investigations • Change of clothes not provided 2 • Improper respirator storage 1 • No respiratory protection program 1 • Improper respirator maintenance 1

19. Preliminary Data from 2005 Research Investigations • Preliminary data highlights many factors making simple conclusions difficult • Only evaluating employees with depressions • How do their practices differ from those without depressions?

20. Preliminary Data from 2005 Research Investigations 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

21. Preliminary Data from 2005 Research Investigations 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”

22. Training Focus • At all levels: • Growers • Safety officers • Foremen and crew bosses • Handlers • Coordinated, partnership effort: • Industry, WSDA, WSU, DOH, L&I, PNASH

23. 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

24. 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

25. Training Focus • Growers, Safety Officers, Foreman • Communicate results of L&I investigations • Encourage them to: • Create and nurture a safety culture • Develop, implement and actively enforce pesticide safety policies • Ensure adequate availability, use and decontamination of protective equipment

26. More Information • Go to www.Lni.wa.gov Click on the Topics Index at the top of the page Find “Cholinesterase” Click on “Cholinesterase monitoring” • Call 1-800-4BE-SAFE (423-7233) and select “pesticide blood testing” • E-mail: toug235@Lni.wa.gov – English serp235@Lni.wa.gov – Spanish

27. Thank You! Margaret Tucker WA State Dept. of Agriculture (360) 902-2015 mtucker@agr.wa.gov agr.wa.gov/PestFert/