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Alarcon WA, Calvert GM, Blondell JM, et al. Acute Illnesses Associated With Pesticide Exposure at Schools. JAMA. 2005;294(4):455–465. doi:10.1001/jama.294.4.455
Author Affiliations: National Institute for
Occupational Safety and Health, US Centers for Disease Control and Prevention,
Cincinnati, Ohio (Drs Alarcon and Calvert); Office of Pesticide Programs,
US Environmental Protection Agency, Washington, DC (Dr Blondell); Department
of Pesticide Regulation, California Environmental Protection Agency, Sacramento
(Dr Mehler); Environmental and Injury Epidemiology and Toxicology Branch,
Texas Department of State Health Services, Austin (Mss Sievert and Propeck);
Pesticides and Surveillance Section, Washington Department of Health, Olympia
(Ms Tibbetts); Bureau of Community Environmental Health, Florida Department
of Health, Tallahassee (Mr Becker); Section of Environmental Epidemiology
and Toxicology, Louisiana Department of Health and Hospitals, New Orleans
(Mss Lackovic and Soileau); Occupational Health Branch, California Department
of Health Services, Oakland (Dr Das); Public Health Institute, Oakland, Calif
(Mr Beckman); Bureau of Occupational Health, New York State Department of
Health, Troy (Ms Male); Environmental and Occupational Epidemiology, Oregon
Department of Human Services–Health Services, Portland (Ms Thomsen);
and Division of Environmental and Occupational Epidemiology, Michigan Department
of Community Health, Lansing (Ms Stanbury).
Context Pesticides continue to be used on school property, and some schools
are at risk of pesticide drift exposure from neighboring farms, which leads
to pesticide exposure among students and school employees. However, information
on the magnitude of illnesses and risk factors associated with these pesticide
exposures is not available.
Objective To estimate the magnitude of and associated risk factors for pesticide-related
illnesses at schools.
Design, Setting, and Participants Analysis of surveillance data from 1998 to 2002 of 2593 persons with
acute pesticide-related illnesses associated with exposure at schools. Nationwide
information on pesticide-related illnesses is routinely collected by 3 national
pesticide surveillance systems: the National Institute for Occupational Safety
and Health’s Sentinel Event Notification System for Occupational Risks
pesticides program, the California Department of Pesticide Regulation, and
the Toxic Exposure Surveillance System.
Main Outcome Measures Incidence rates and severity of acute pesticide-related illnesses.
Results Incidence rates for 1998-2002 were 7.4 cases per million children and
27.3 cases per million school employee full-time equivalents. The incidence
rates among children increased significantly from 1998 to 2002. Illness of
high severity was found in 3 cases (0.1%), moderate severity in 275 cases
(11%), and low severity in 2315 cases (89%). Most illnesses were associated
with insecticides (n = 895, 35%), disinfectants (n = 830,
32%), repellents (n = 335, 13%), or herbicides (n = 279,
11%). Among 406 cases with detailed information on the source of pesticide
exposure, 281 (69%) were associated with pesticides used at schools and 125
(31%) were associated with pesticide drift exposure from farmland.
Conclusions Pesticide exposure at schools produces acute illnesses among school
employees and students. To prevent pesticide-related illnesses at schools,
implementation of integrated pest management programs in schools, practices
to reduce pesticide drift, and adoption of pesticide spray buffer zones around
schools are recommended.
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