The NPIS pesticide surveillance system was established in 2004 under approval of the Pesticides Safety Directorate and funded by the UK Department for Environment, Food and Rural Affairs. The work was implemented to better describe the incidence and character of pesticide exposures in the UK that result in contact with health professionals (thereby selecting for more serious exposures). Surveillance data is collated and both quarterly and annual reports are submitted to the government's Advisory Committee on Pesticides (ACP) via the Health and Safety Executive's Chemicals Regulation Directorate (CRD).
Currently, 1,897 TOXBASE entries for pesticides and biocides are being tracked, an increase from the 1,800 tracked during 2014/15. Incident information is obtained in two ways, from follow-up of TOXBASE enquiries by an online or postal questionnaire or from data collected from during NPIS telephone enquiries.
During the year 2015-16, there were 3,197 accesses to TOXBASE about pesticides of interest and information on 753 potential exposures was available from the NPIS telephone enquiry service. From TOXBASE sessions, one electronic and 360 follow-up post or email questionnaires were returned. Cases involving animals or head lice treatment products, enquiry sessions from locations in the Republic of Ireland, identifiable duplicate sessions involving the same patient, and sessions that were later reported not to have involved a pesticide, were excluded from the analysis.
Overall, information was gathered on 1,131 potential exposures involving pesticides during 2015/16, an overall return rate of 32.0%. Six exposures involved multiple patients, producing a further six potential exposures and a total of 1,137. This number is almost identical to the number of cases identified in 2014/15 (1,131).
Of the 1,137 potential exposures available for analysis, there were 32 cases where symptoms were not thought on the balance of probabilities by the respondent or by NPIS Edinburgh to be related to the pesticide exposure because of, for example, a pre-existing illness or reasonable grounds to link symptoms to a concomitant infection. These cases were excluded, leaving 1,107 exposures for further analysis. The results presented below include both unintentional acute (953 cases; 86.2%) or chronic (30; 2.7%) exposures and deliberate self-harm exposures (DSH) (98; 8.9%). The circumstances of exposure in 26 (2.4%) cases were unknown.
Most exposures were graded as PSS 0 (604 cases; 54.7%) or PSS 1 (431; 39.0%) by the NPIS. Smaller proportions were graded moderate (PSS 2; 35; 3.2%), severe (PSS 3; 3; 0.3%) or of uncertain severity (23; 2.1%). One fatality was reported (compared with three in 2014/15), in this case following ingestion of paraquat.
Agents of interest
The agents most commonly involved in exposures are shown in Table 1. In addition, there were 124 cases involving unknown rodenticides, 48 cases of unknown herbicides, 22 of unknown ant killers, 21 of unknown insecticides, three of unknown wood preservatives and 21 of unknown pesticides.
Table 1. Pesticides most frequently reported by respondents in suspected pesticide exposures during 2015/16 compared with 2014/15, ordered by rank in 2015/16.
In 2015/16, patients potentially exposed to pesticide products comprised 539 adults (13 years or older – 48.7%) and 537 children (12 years or younger – 48.6%), with 29 of unknown age (2.6%). There were 601 (54.3%) male patients and 485 (43.9%) female patients and 19 cases (1.7%) where the gender was not specified.
The classes of product most commonly involved in exposures are shown in Figure 1. Multiple/combination products were involved in some incidents.
There were eight enquiries involving pregnant patients reported in 2015/16 (13 in 2014/15). All eight exposures were unintentional and acute. None were severe.
|Figure 1. Pesticide exposures by class of product (as reported by respondent) in 2015/16 (1,157 agents).|
Information from the NPIS Annual Report 2015/16.
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