California surveillance for pesticide-related illness and injury

Coverage, bias, and limitations

Louise N. Mehler, Marc B Schenker, Patrick S Romano, Steven J. Samuels

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The California Pesticide Illness Surveillance Program (PISP) is a major resource for pesticide illness epidemiology. This work attempts to improve characterization of pesticide illness in California, evaluate case ascertainment of the PISP and identify PISP's limitations and biases for studying the incidence and epidemiology of pesticide-related illness. Abstractors collected standardized information from 1994-1996 PISP files, poison control logs, hospital records, and death certificates. Linkage produced a merged file of all records that documented consideration of pesticide exposure as a cause of ill health. We identified 23 deaths and estimated 1,310 hospitalizations attributable to pesticide exposure, corresponding to 0.024 fatalities and 1.38 hospitalizations (95% confidence interval [CI] = 1.01-1.74) per 100,000 California population person-years. Most intoxications followed domestic exposures and were not reported to the surveillance program, which identified primarily occupational exposures. Excluding groups of five or more, we estimated 16% ascertainment (CI = 0.05-0.27) for non-agricultural occupational cases. Agricultural connections increased the probability of ascertainment to about 50%, cultural and economic barriers notwithstanding. Surveillance records existed for all identified episodes in which five or more people were exposed. California pesticide surveillance data appear complete for mass exposures, and adequate to characterize agricultural and occupational exposures. Work is needed to explore domestic exposures and occurrences beyond the reach of the health care system.

Original languageEnglish (US)
Pages (from-to)67-79
Number of pages13
JournalJournal of Agromedicine
Volume11
Issue number2
DOIs
StatePublished - 2006

Fingerprint

Pesticides
pesticides
monitoring
Wounds and Injuries
occupational exposure
Occupational Exposure
epidemiology
confidence interval
Epidemiology
Hospitalization
Confidence Intervals
death
Death Certificates
Hospital Records
Poisons
health services
poisoning
Economics
Delivery of Health Care
incidence

Keywords

  • California [epidemiology]
  • Pesticides [toxicity]
  • Poisoning
  • Population
  • Program evaluation
  • Surveillance

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Agricultural and Biological Sciences(all)

Cite this

California surveillance for pesticide-related illness and injury : Coverage, bias, and limitations. / Mehler, Louise N.; Schenker, Marc B; Romano, Patrick S; Samuels, Steven J.

In: Journal of Agromedicine, Vol. 11, No. 2, 2006, p. 67-79.

Research output: Contribution to journalArticle

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