First Aid for Pesticide Poisoning
Call a Doctor
First Aid is the initial effort to help a victim while medical help is on the way. Step one in any poisoning emergency is to call an ambulance or doctor. The only exception is when you are all alone with the victim. Then you must see that he is breathing and that he is not further exposed before leaving him to make your phone call. Always save the pesticide and label for the doctor.
While Waiting Do This For:
Poison on the Skin
WARNING: Do not allow any pesticide to get on you while you are helping the victim.
- The faster the poison is washed off the patient, the less injury that will result.
- Drench skin and clothing with water (shower, hose, faucet, pond).
- Remove clothing.
- Cleanse skin and hair thoroughly with soap and water. Detergents and commercial cleansers are better than soap.
- Dry and wrap in a blanket.
Chemical Burns of the Skin
- Wash with large quantities of slow running water.
- Remove contaminated clothing.
- Immediately cover loosely with a clean, soft cloth.
- Avoid use of ointments, greases, powders, and other drugs in first aid treatment of burns.
- Recognize the signs of pesticide poisoning and know first aid treatment for it.
- Know the importance of a pesticide first aid kit and what it should contain.
Understand the importance of poison control centers and how to get immediate information on types of poisonings and their treatment.
Poison in the Eye
- It is most important to wash the eye out quickly but as gently as possible.
- Hold eyelids open and wash eye with a gentle stream of clean running water.
- Continue washing for fifteen minutes or more. It is important to use a large volume of water. If possible, at least five gallons should be used to flush the eye properly.
- Do not use chemicals or drugs in wash water. They may increase the extent of the injury.
- Cover the eye with a clean piece of cloth and seek medical attention immediately.
Inhaled Poisons (dusts, vapors, gases)
- If victim is in an enclosed space, do not go in after him unless you are wearing an air-supplied respirator.
- Carry patient (do not let him walk) to fresh air immediately.
- Open all doors and windows.
- Loosen all tight clothing.
- Apply artificial respiration if breathing has stopped or is irregular.
- Keep victim as quiet as possible.
- If victim is convulsing, watch his breathing and protect him from falling and striking his head. Keep his chin up so his air passage will remain free for breathing.
- Prevent chilling (wrap patient in blankets but don't overheat).
- Do not give the victim alcohol in any form.
Swallowed Poisons -- When should you make the victim vomit?
The most important choice you have to make when aiding a person who has swallowed a pesticide, is whether or not to make him vomit. The decision must be made quickly and accurately, by a health care professional because the victim's life may depend on it. Usually it is best to get rid of the swallowed poison fast ...
But you should know this:
- Never induce vomiting if the victim is unconscious or is having convulsions. The victim could choke to death on the vomitus.
- Never induce vomiting if the victim has swallowed a corrosive poison. Find out what poison the person has ingested. A corrosive poison is strong acid or alkali. The victim will complain of severe pain and will show signs of severe mouth and throat burns. A corrosive poison will burn the throat and mouth as severely coming up as it did going down. Dilute the poison as quickly as possible. For acids or alkalis, use milk or water. For patients one to five years old, use one to two cups; for patients five years and older, use up to one quart. For acids, milk of magnesia may also be used (two tablespoons in one cup of water).
- Never induce vomiting if the person has swallowed petroleum products such as kerosene, gasoline, oil, or lighter fluid. Most pesticides which come in liquid formulations are dissolved in petroleum products. The words "emulsifiable concentrate" or "solution" on the pesticide label are signals NOT to induce vomiting in the poison victim if he has swallowed the concentrates. Concentrated petroleum products (like corrosive poisons) cause severe burns. They will burn as severely when vomited up. If he has swallowed a dilute form of these formulations, he should be forced to vomit immediately.
How to Induce Vomiting
- Do not waste a lot of time inducing vomiting. Use it only as first aid until you can get the victim to a hospital. Make sure the victim is lying face down or kneeling forward while retching or vomiting. Do not let him lie on his back, because vomitus could enter the lungs and do more damage.
- First give the patient large doses of milk or water. One to two cups for victims up to five years old; up to a quart for victims five years and older.
- If victim is alert and respiration is not depressed, give syrup of ipecac followed by one to two glasses of water to induce vomiting. Adults (twelve years and over): 30 ml (two tablespoons); children under twelve years: 15 ml (one tablespoon). Activity hastens the effect of the syrup of ipecac.
- Collect some of the vomitus for the doctor he/she may need it for chemical tests.
- The best first aid is to dilute the poison as quickly as possible with milk or preferably with water. It is very important that the victim get to the hospital without delay. Many communities have rescue units with ambulances manned by Emergency Medical Technicians who can communicate with the hospital and can begin treatment enroute.
- If a rescue unit is not available in your area, you will have to transport the patient. Call the hospital emergency room or poison control center for instructions so that they can prepare for the victim's arrival. If the poison control center agrees, use activated charcoal as a "sponge" to absorb excess poisons after the instructions for corrosive or noncorrosive poisons are followed.
- Activated charcoal it absorbs many poisons at a high rate. Mix it with water into a thick syrup for the victim to drink. Activated charcoal is available from a drug store.
- Atropine tablets should not be taken in a poisoning emergency. The dose is much too small. Often the victim cannot or should not take oral medicine. The atropine can hide or delay early symptoms of poisoning. The victim may be fooled into thinking he is okay and may even go back to work. It is possible that a doctor may not detect the problem because the symptoms are hidden by the atropine.
WARNING: Atropine can be poisonous if misused. It should never be used to prevent poisoning. Workers should not carry atropine for first aid purposes. It should be given only under a doctor's directions.
Sometimes poisoning victims go into shock. If untreated or ignored, the victim can die from shock even if the poisoning injuries would not be fatal.
The skin will be pale, moist, cold and clammy. The eyes are vacant and lackluster with dilated pupils. The breathing will be shallow and irregular. The pulse is very weak, rapid and irregular. The victim may be unconscious or in a faint.
- Unless he/she is vomiting, keep the victim flat on his back with his legs up 1-1 1/2 feet above his head.
- Keep the victim warm enough to prevent shivering. Do not overheat.
- Keep the victim quiet and reassure him often.
WARNING: Never try to give anything orally to an unconscious victim.
Poison Control Centers
Poison control centers have been established to give pertinent information on all types of poisonings, including pesticide poisoning. The applicator should have posted near his phone the telephone number of the nearest poison control center, and his doctor should also have the number available.
In any poisoning emergency, think first of water. Your first aim is to dilute the pesticide no matter where it is. Then get the victim to a doctor fast.
First Aid Kit for Field and On-the-Job Use
A well-equipped first aid kit which is always readily available can be important in a pesticide emergency. Make up your own pesticide first aid kit from a lunch pail, tool box, or a sturdy wooden box. It should have a tight-fitting cover with a latch, so that it won't come open or allow pesticides to leak inside. Label it clearly with paint or a water proof marker.
- A small plastic bottle of a common Detergent. It is used to wash pesticides quickly off the skin.
- A small package or bag of Activated Charcoal. Mixed with water and swallowed, activated charcoal acts as an absorber of all pesticides.
- A Shaped Plastic Airway for mouth-to-mouth resuscitation.
- A thermos or large plastic bottle (at least one quart) of Clean Water. If there is no clean water in an emergency, use any pond or stream water that is available.
- Simple Band Aids, Bandages and Tape. All cuts and scrapes should be covered to prevent pesticides from easily entering the body.
- A Blanket is very useful. It should be kept in a place where it will not be contaminated by pesticides.
- Suitable Coins should always be taped to the inside cover of the first -aid kit. They are for an emergency phone call.
- A small, plastic Empty Jar with a tight-fitting lid is useful as a drinking glass for the victim, in order to induce vomiting or feed activated charcoal. It can also be used for collecting vomitus to take to the doctor.
Recognition and Management of Pesticide Poisoning
Routes of Pesticide Exposure
Pesticides can enter the body through the following four routes of entry:
- Skin (Dermal)
- Eyes (Ocular)
- Nose (Inhalation)
- Mouth (Ingestion)
The majority of the reported cases of non-agricultural pesticide exposure involved skin contact. However, workers who work in enclosed space production areas may mention they are more concerned about inhaling pesticides, while handlers may state they are worried about splashing pesticides in their eyes during mixing and loading tasks. Certain situations increase the risk of pesticide exposure through the eyes, nose, mouth or skin.
Situations that may Lead to Pesticide Exposure Through the Skin
Situations that may Lead to Pesticide Exposure Through the Eyes
- Workers who choose to wear a short-sleeve shirt on a warm day leave their forearms exposed to pesticide residues. Warm weather causes people to sweat and this sweat can help pesticides enter into a person’s body through their pores.
- Pesticides can also enter through cuts or sores on a person’s skin.
- Workers or handlers who carry and use their cell phones while they are working with pesticides or areas where pesticides have been applied, might transfer pesticide residues from their phones to their faces or hands when they answer a call or respond to a text.
- Skin exposure can occur by wearing work clothes that have pesticide residues on them.
- Pesticide residues can transfer from contaminated hands to other parts of the body if workers or handlers do not wash their hands thoroughly before eating, drinking, smoking or using the restroom.
- Skin exposure can also occur when a pesticide drifts onto people who are working near an application.
- Handlers or early-entry workers may absorb pesticides through their skin if they fail to wear the label-required gloves or if they don’t wash their gloves with soap and water before removing them.
- Handlers may take off their gloves to adjust, clean or repair pesticide application equipment, which may contain pesticide residues.
- Handlers may accidentally splash a pesticide onto their skin when mixing a pesticide or loading a spray tank.
Situations that may Lead to Inhalation of Pesticides
- Workers can transfer pesticide residues to their eyes if they touch their eyes after coming into contact with treated surfaces.
- Sweat could run down a worker’s or handler’s forehead and carry pesticide residues into their eyes.
- A handler may rub their eye with a contaminated glove.
- A handler may splash or spray pesticides in their eyes when mixing and loading pesticides, adjusting application equipment or applying a product overhead without wearing proper eye protection.
- If a handler is wearing the required protective eyewear and it slips down his or her face or if the handler removes the eye protection when it fogs up, the handler can get pesticides in their eyes.
Situations that may Lead to Ingesting or Swallowing a Pesticide
- Workers may be at risk of inhaling pesticides if they continue to work while in an application exclusion zone (AEZ) or in enclosed spaces such as greenhouses before the REI has expired.
- A worker or handler may smoke a cigarette near an area where pesticides are stored or applied. Tobacco absorbs pesticides and therefore that person could inhale the pesticide vapors.
- If a pesticide container leaks in a storage area, people who enter the area may inhale the vapors from the spilled product.
- A handler may mix two incompatible pesticides together, which can create toxic fumes when combined.
- Pesticide exposure can occur if a handler fails to wear the label required respirator, does not change the cartridge, uses the wrong cartridge, or uses a respirator that does not fit correctly.
- Workers or handlers who fail to wash their hands before eating or drinking may get pesticide residues in their mouths.
- If an employee takes a snack or lunch break too close to an area where pesticides are stored or used, the food or drink could become contaminated.
- A worker or handler who takes produce home directly from the field may get exposed to pesticide residues that are still on the produce.
- Workers and handlers can swallow pesticides if they drink water from irrigation canals, pipes or sprinklers as irrigation water may contain pesticide residues.
- A person may accidentally swallow a pesticide if they take a sip from a beverage container that someone has illegally used to store or measure pesticides.
Hazards of Pesticides Resulting from Toxicity and Type of Exposure Toxicity is the potential of any pesticide to cause harm. Pesticides are often toxic to the target pests for which they are intended. Some pesticides can also be toxic to humans. Additionally, people differ in their susceptibility to injury from pesticides, which can depend on their health, age or other factors. For these reasons workers and handlers should always take steps to minimize their exposure to pesticides. Even the least toxic pesticides may cause illness.
Signs and Symptoms of Common Types of Pesticide Poisonings
Symptoms are any abnormal condition or change in health function that a person sees or senses, or that can be detected by medical examination or laboratory tests. These symptoms may indicate the presence of a disease, disorder or an illness or injury.
Poisoning symptoms vary among classes of pesticides and pesticides within a class. For example, pesticides that control weeds (herbicides) can be less toxic to humans than some pesticides used to control insects (insecticides). The severity of symptoms is usually proportional to the amount of pesticide entering the person’s body and the person’s sensitivity to certain chemical ingredients.
If a worker or handler feels sick while working in a pesticide-treated area or when handling a pesticide, it may be difficult to determine if the symptoms are related to a pesticide exposure. Common pesticide symptoms mimic those of a cold, flu, heat stress, morning sickness, food poisoning or a hangover.
The following is a list of symptoms that may result from pesticide exposure:
- eye irritation
- chest pain
- nose and throat pain
- breathing difficulties
- skin rash
- blurred vision
- excessive salivation or drooling
- very small, pinpoint pupils
- muscle aches or cramps
- lack of muscle control
- convulsions or seizures
In addition, people exposed to certain fumigants may experience
- irrational behavior, or
- elevated body temperatures.
The type and severity of exposure symptoms can be influenced by several factors, such as the
- pesticide itself,
- toxicity of the product,
- amount and concentration of the pesticide at the time of exposure,
- length of exposure,
- amount absorbed into the body,
- route of entry, or
- how fast the body absorbs and excretes it.
One pesticide may cause only mild eye irritation if splashed in a person’s eye, while exposure to another product may result in blurred vision or blindness. Some pesticides are extremely toxic if swallowed but not as harmful if spilled on the skin. Finally, there are pesticides that, when used correctly and according to the safety measures listed on the label, cause no known adverse health effects.
Another factor that can significantly influence the type and severity of reaction to pesticide exposure is the overall health and genetic makeup of the individual. Each person is different. People who are elderly, very young, sick, or who have compromised immune systems may have less tolerance to some types of pesticides. Furthermore, people who have medical conditions, such as asthma, may experience breathing difficulties when working in an area where pesticides have been applied even after the REI has expired.
Pesticide exposure can be hazardous for pregnant women and may result in miscarriage or cause harm to their unborn child.
Children are often more susceptible to the effects of pesticides as their bodies and internal organs are still developing and may be negatively impacted by exposure. For this reason, all handlers who work directly with pesticides or workers who enter an area still under a REI (early-entry workers) must be at least 18 years old.
Acute, Chronic and Delayed Effects of Pesticide Exposure and Sensitization Many pesticide exposure symptoms will show up immediately following an exposure incident; other symptoms can be delayed and result in long-term (chronic) health effects or chemical sensitivity.
Immediate or Acute Health Effects
The onset of acute illness or injury occurs shortly after or within 24 hours following an exposure. These illnesses or injuries can be serious and may result in lost work time and/or medical treatment. In the most serious cases, acute health effects could result in death. Examples of acute health effects include
- headache or dizziness;
- red or watery eyes;
- rash, irritated, or burning skin; and
- throat irritation or difficulty breathing.
Delayed, Long-Term or Chronic Health Effects
Long-term or chronic effects are illnesses or injuries that develop or persist over long periods of time. They may result from a single exposure incident involving an extremely toxic pesticide or a large amount of pesticide. It may also result from many repeated exposures at a level that is too low to produce noticeable immediate illnesses or injuries. Therefore, it is extremely important for workers and handlers to take all of the necessary steps to protect themselves from a pesticide exposure. Symptoms from repeated pesticide exposure may not show up for weeks, months, or even years. These delayed symptoms may be difficult to associate with their cause because of the lapse of time between exposure and observable effects.
Delayed and long-term or chronic health effects associated with exposure to certain pesticides include
- fertility problems,
- respiratory illness,
- nervous system disorders,
- birth defects,
- damage to the organs or immune system, and
- skin disorders.
Sensitization is the gradual development of an allergic reaction to a type of pesticide or chemicals in general. Some people get headaches, rashes, or experience dizziness each time they work with a pesticide or enter an area where pesticides were recently used.
Workers and handlers may better understand sensitization if it is compared to an allergic reaction to poison oak or poison ivy. Not everyone will have an adverse skin reaction the first few times they come in contact with the plants. However, after repeated exposures some people will become sensitized and develop a rash that becomes worse with each additional exposure.
Some people will experience sensitization after working with a product for several years. Not everyone will develop a sensitivity to pesticides, but those who do should avoid exposure to the pesticide creating the adverse reaction.
Pesticide Types and Formulations, Toxicity Signal Words and Residues
Most people are familiar with insecticidal aerosol sprays they may use in their homes and liquid herbicides they may use to control weeds in their yards. There are several types of pesticides and formulations used on non-agricultural establishments.
Some of the most commonly-used types of pesticides are
- Avicides – to control birds
- Insecticides – to control insect pests
- Herbicides – to control weeds
- Rodenticides – to control rats, mice, and other rodents
- Fungicides – to control fungi (fungus) and disease organisms
- Miticides – to control mites
- Nematicides – to control nematodes
Pesticides are formulated in different ways and are applied to structures and surrounding landscapes in a variety of forms.
Some of the most commonly-used formulations are
Toxicity Signal Word
The signal words on the pesticide label reflect the relative degree of the product’s acute (immediate) toxicity. Signal words include Danger, Danger-Poison, Warning, and Caution.
Danger or Danger-Poison
The most acutely toxic pesticides have the signal word “Danger” on the label. If the pesticide is highly acutely toxic when inhaled, swallowed or absorbed through the skin, the product will also have the word “Poison” along with a skull and crossbones symbol on the label.
Pesticides that are moderately acutely toxic to people have the signal word “Warning” on the label.
Pesticides that are slightly acutely toxic have the signal word “Caution” on the label. Some low acutely toxic pesticides may have no signal word.
Pesticide residues may be found in or on treated surfaces such as
- target areas where pesticides are applied
- plants and soil;
- vehicles, sprayers, and other application equipment;
- work clothing, shoes, and PPE (including gloves);
- pesticide mixing and loading areas;
- air that drifts from a nearby pesticide application;
- irrigation water as a result of pesticide runoff or chemigation; and
- pesticide containers, shelves, and the air inside pesticide storage areas