Policy Watch:
North Carolina Institutes a New Pesticide Illness & Injury
Surveillance Program
New rule requiring physician reporting goes into effect

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It is estimated that North Carolina agriculture uses 62 million pounds of pesticides annually. Farmworkers are the population most at-risk by far for illness and injury from pesticide exposures.

Health care providers are now required to report suspected pesticide illness and injury in North Carolina under a new rule beginning January 1, 2007.

The Commission for Health Services passed the rule, which was proposed by the NC Division of Public Health, after receiving significant support from health care providers, farmworker advocates and others concerned about peesticide illness and injury in the state.

The rule will require that health care providers report illnesses and injuries related to pesticide exposure to the NC Department of Health and Human Services (cases may be reported by phone via Carolinas Poison Center, or by phone or fax directly to DHHS staff). Mandated physician reporting is a critical component to pesticide surveillance programs. The reports would serve as the first step in a system that would then investigate exposures, collect and record data, share findings with coordinated national data banks, and recommend, design and implement interventions to prevent future injury and illness from pesticide exposure. The program currently relies on limited federal grant funding.

The U.S. Environmental Protection Agency (EPA) estimates that, nationwide, there are 10,000 to 20,000 incidents of physician-diagnosed pesticide illnesses and injuries per year in farm work alone. This estimate represents significant underreporting – and no comprehensive national data are available on the extent of pesticide illnesses.

According to the National Institutes for Occupational Safety & Health (NIOSH), state-based reporting systems are the best available data source for identifying epidemics, clusters of diseases, emerging pesticide problems, and populations at risk. Currently, about half the states require that pesticide incidents be reported. However, only six states have a formal pesticide illness reporting and investigation system, and another three states have more limited systems. North Carolina is the most recent state to implement such a system.

Health care providers seeking more information about this new program can visit the website of the NC Division of Public Health, Ocuppational & Environmental Epidemiology Branch, or call (919) 707-5900.

Additional background information

According to the US Government Accountability Office (GAO), comprehensive information on pesticide illness and injury does not exist—whether for farmworkers, farm children, or the general population. The data sources that are available to track acute (short-term) pesticide illnesses are incomplete, and their limitations result in serious underestimation of both the frequency and the severity of such illnesses. A GAO study conducted in 1993 found that without a means of monitoring pesticide illnesses, there was no way to determine whether risk assessment or management practices were effective in preventing hazardous exposure incidents. GAO has reiterated that this problem remains largely unaddressed today.

It is estimated that North Carolina agriculture uses 62 million pounds of pesticides annually. Farmworkers are the population most at-risk by far for illness and injury from pesticide exposures. A significant number of the nation’s estimated 2.5 million hired farmworkers are children between the ages of 14 and 17. The proposed surveillance program in North Carolina would prioritize occupational pesticide exposures for investigation.