Acute exposure to pesticides is associated with nausea, headaches, rashes, eye irritation, seizures, and, in severe cases, death. We characterized pesticide-related hospitalizations in Texas among children and teenagers for 2004–2013 to characterize exposures in this population, which is less well understood than pesticide exposure among adults. We abstracted information on pesticide-related hospitalizations from hospitalization data using pesticide-related International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes and E-codes. We calculated the prevalence of pesticide-related hospitalizations among children and teenagers aged ≤19 years for all hospitalizations, unintentional exposures, intentional exposures, pesticide classifications, and illness severity. We also calculated age- and sex-specific prevalence of pesticide-related hospitalizations among children. The prevalence of pesticide-related hospitalizations among children and teenagers was 2.1 per 100,000 population. The prevalence of pesticide-related hospitalizations per 100,000 population was 2.7 for boys and 1.5 for girls. The age-specific prevalence per 100,000 population was 5.3 for children aged 0–4 years, 0.3 for children and teenagers aged 5–14 years, and 2.3 for teenagers aged 15–19 years. Children aged 0–4 years had the highest prevalence of unintentional exposures, whereas teenagers aged 15–19 years had the highest prevalence of intentional exposures. Commonly reported pesticide categories were organophosphates/carbamates, disinfectants, rodenticides, and other pesticides (e.g., pyrethrins, pyrethroids). Of the 158 pesticide-related hospitalizations, most were coded as having minor (n=86) or moderate (n=40) illness severity. Characterizing the prevalence of pesticide-related hospitalizations among children and teenagers leads to a better understanding of the burden of pesticide exposures, including the type of pesticides used and the severity of potential health effects. This study found differences in the frequency of pesticide-related hospitalizations by sex, age, and intent (e.g., unintentional vs. intentional).

Traditionally, structured or coded data fields from a crash report are the basis for identifying crashes involving different types of vehicles, such as farm equipment. However, using only the struc...

Objective: To honor Tom Waters’s work on emerging occupational health issues, we review the literature on physical along with chemical exposures and their impact on functional outcomes. Background: Many occupations present the opportunity for exposure to multiple hazardous exposures, including both physical and chemical factors. However, little is known about how these different factors affect functional ability and injury. The goal of this review is to examine the relationships between these exposures, impairment of the neuromuscular and musculoskeletal systems, functional outcomes, and health problems with a focus on acute injury. Method: Literature was identified using online databases, including PubMed, Ovid Medline, and Google Scholar. References from included articles were searched for additional relevant articles. Results: This review documented the limited existing literature that discussed cognitive impairment and functional disorders via neurotoxicity for physical exposures (heat and repetitive loading) and chemical exposures (pesticides, volatile organic compounds [VOCs], and heavy metals). Conclusion: This review supports that workers are exposed to physical and chemical exposures that are associated with negative health effects, including functional impairment and injury. Innovation in exposure assessment with respect to quantifying the joint exposure to these different exposures is especially needed for developing risk assessment models and, ultimately, preventive measures. Application: Along with physical exposures, chemical exposures need to be considered, alone and in combination, in assessing functional ability and occupationally related injuries.

Context: Although national poison center data show that pesticides were the 8th most commonly reported substance category (3.27%) for children aged ≤5 years in 2014, there is limited information on childhood and adolescent pesticide exposures. Objective: This study assessed pesticide-related poison center exposures in children and adolescents aged ≤19 years from 2000–2013 in Texas to characterize the potential burden of pesticides. Materials and methods: Pesticide-related poison center exposures among children and adolescents aged ≤19 years reported to Texas poison centers were identified. The distribution of exposures was estimated by gender, age category, medical outcome, management site, exposure route, and pesticide category. Results: From 2000 to 2013, there were 61,147 pesticide-related poison center exposures in children and adolescents aged ≤19 years. The prevalence was highest among males at 864.24 per 100,000 population. The prevalence of unintentional exposures was highest among children aged ≤5 years at 2310.69 per 100,000 population, whereas the prevalence of intentional exposures was highest among adolescents aged 13–19 years at 13.82 per 100,000 population. A majority of medical outcomes reported were classified as having no effect (30.24%) and not followed, but minimal clinical effects possible (42.74%). Of all the exposures, 81.24% were managed on site. However, 57% of intentional exposures were referred to or treated at a health-care facility. The most common routes of exposure were ingestion (80.83%) and dermal (17.21%). The most common pesticide categories included rodenticides (30.02%), pyrethrins/pyrethroids (20.69%), and other and unspecified insecticides (18.14%). Discussion: The study found differences in the frequency of exposures by intent for sex and age categories, and identified the most common medical outcomes, management site, exposure route, and pesticide category. Conclusion: Through characterizing pesticide-related poison center exposures, future interventions can be designed to address groups with higher prevalence of exposure.

Objective: Crash reports contain precoded structured data fields and a crash narrative that can be a source of rich information not included in the structured data. The narrative can be useful for identifying vulnerable roadway users, such as agricultural workers. However, using the narratives often requires manual reviews that are time consuming and costly. The objective of this research was to develop a simple and relatively inexpensive, semi-automated tool for screening crash narratives and expediting the process of identifying crashes with specific characteristics, such as agricultural crashes. Methods: Crash records for Louisiana from 2010 to 2015 were obtained from the Louisiana Department of Transportation (LaDOTD). Records with narratives were extracted and stratified by vehicle type. The majority of analyses focused on a vehicle type of farm equipment (Type T). Two keyword lists, an inclusion list and an exclusion list, were created based on the published literature, subject-matter experts, and findings from a pilot project. Next, a semi-automated tool was developed in Microsoft Excel to identify agricultural crashes. Lastly, the tool’s performance was assessed using a gold standard set of agricultural narratives identified through manual review. Results: The tool reduced the search space (e.g., number of narratives that need manual review) for narratives requiring manual review from 6.7 to 59.4% depending on the research question. Sensitivity was high, with 96.1% of agricultural crash narratives being correctly classified. Of the gold standard agricultural narratives, 58.3% included an equipment keyword and 72.8% included a farm equipment brand. Conclusion: This article provides information on how crash narratives can supplement structured crash data. It also provides an easy-to-implement method to facilitate incorporating narratives into safety research along with keyword lists for identifying agricultural crashes.

In the United States, there is limited literature on occupational pesticide exposures despite being associated with adverse health outcomes, including in large states such as Texas. The purpose of this article is to characterize occupational pesticide poison center exposures in Texas. Descriptive statistics were used to describe exposures (eg, exposure routes, type of pesticide, medical outcome, clinical effects, and temporal/seasonal patterns). From 2000 to 2015, there were 2,303 occupational pesticide poison center exposures. Common types of reported pesticides were insecticides (67.3%), herbicides (17.7%), and repellents (5.8%). The highest proportion of exposures were among those aged 20 to 29 years (24.9%). The top clinical effect categories were gastrointestinal (25.8%), neurological (19.2%), and dermal (14.9%). Characterizing occupational pesticide poison center exposures can support improved surveillance systems and guide future research or interventions.