Occupational Exposure Data Tracking

1. Occupational Exposure Data Tracking Development of Cooperative Agreements With Poison Control Centers

2. Agencies Involved • Rocky Mountain Poison Control Center • Colorado Department of Public Health and Environment • Colorado Department of Agriculture • Colorado State University

3. Project Is Driven By • EPA Grant Guidance FY 05 - 07 • Core Activities: • Information Regarding Pesticide Incidents • Targeting to Identify High Risk Situations for Agricultural Workers/Handlers • Coordination Regarding Pesticide Incidents

4. Information Regarding Pesticide Incidents • States/tribes need toestablish a basic working relationship and contact point with their central public health agency(or the appropriate entity having jurisdiction over pesticide incident reporting) to obtain basic information on the annual number of occupational pesticide exposures/illnesses that have been reported to that agency.

5. Information Regarding Pesticide Incidents • States/tribes should be cognizant of this information so they areinformed about the extent of occupational pesticide exposures and/or illnesses being reported so they can identify potential issues or trends that may warrant additional outreach and/or compliance monitoring efforts,and so they can coordinate incident response as appropriate.

6. Targeting to Identify High Risk Situations for Agricultural Workers/Handlers • All states/tribes were to have developed a WPS targeting strategy as part of their original WPS State Implementation Plans and compliance monitoring strategies. States/tribes should routinely update their targeting strategy to ensure their worker protection outreach and compliance monitoring activities are focused on establishments and/or situations that pose the highest risk to pesticide workers and handlers.

7. Coordination Regarding Pesticide Incidents • Migrant clinics and public health offices often serve as a main entry point for pesticide workers who are seeking treatment for pesticide-related illnesses or injuries and wish to report an alleged pesticide incident involving occupational pesticide exposure. As such, states/tribes need to do basic outreach to these entities and work with them so that persons seeking services at these places are more likely to be given information about proper procedures for making pesticide tips/complaints and state/tribal jurisdictions regarding pesticide programs.

8. Rocky Mt. Poison Control • The Rocky Mountain Poison and Drug Center (RMPDC) is one of the oldest centers in the nation and is a vital, lifesaving service. • Certified regional poison center as recognized by the American Association of Poison Control Centers (AAPCC) • Serves as a regional drug information center. It also provides poison and drug information services to medical professionals and consumers in other states through contractual agreements.

9. Coverage Areas • Coverage: • Colorado • Montana • Idaho • Hawaii • Clark County, Nevada

10. RMPC Services • RMPDC services: • Access to medical toxicologists 24-hours per day • Language lines which can translate more than 260 languages • Teletype for the hearing impaired • Strict confidentiality of proprietary information • Preparedness for handling unexpected situations such as a large-scale poisoning, product tampering, recalls, and media events.

11. RMPC Data System • Fields Collected: • Name, City, Zip • Exposure type, occupational, site of exposure • Product, formulation, EPA # • Case notes: What happened?? • Age, gender, acuity, symptoms • Outcome and causation

13. Info CDA Requested • 90% of requested information RMPC already collects • Additional fields or more detail in current fields: • Who exposed them to the pesticide (CA, self, employer, etc.) • Site of exposure – Notes on how incident occurred • If occupational (Ag. vs. Non-Ag) • Occupational task being performed • Would they like to file a formal complaint • CDA contact information

14. RMPC Concerns • Amount of additional detail they would need to collect • HIPAA: • Took effect on April 14, 2006. • HIPAA helps ensure that all medical records, medical billing, and patient accounts meet certain consistent standards with regard to documentation, handling and privacy. • Reporting needs of CDA and CSU • Funding for programming, training personnel, and on-going reporting

15. CDA Monthly Reports • CDA: • Number of incidents by county/zip • Type of incidents • Occupational/Non-occupational • Ag vs Non-Ag • Risk based inspections, training and outreach based on information obtained

16. CSU Monthly Reports • CSU: • Number of incidents by county • Type of incidents • Ag vs Non-Ag • Notes on what and how incident occurred • Training and outreach based on information obtained

17. Cost • CDA currently working on the contract • RMPC • $10K: Database programming, training of personnel, development of requested reports • Monthly reports • $250 /mo • Other States can enter into a contract with RMPC to obtain reports • RMPC willing to develop reports and provide information on a State specific basis…. May $....

18. Other States • Those currently under RMPC reporting area can join in – contract RMPC to provide reports • RMPC: Other State poison control centers need funding: • EPA Region / State Ag. Departments may be able to provide assistance to upgrade systems • Any suggestions on information to collect, we may have overlooked or not considered?

19. National Hotline

20. Contact Information • Rocky Mountain Poison Control: • Anna Seroka, Med, RN RMPC Business Manager 990 Bannock Street, 4th Floor Denver, CO. 80204 303-739-1252 - anna.seroka@rmpdc.org • Alvin Fronstein MD, FACEP RMPC Medical Director 990 Bannock Street, 4th Floor Denver, CO. 80204 • 303-739-1252 - abronstein@rmpdc.org