Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2007-8678

2. Registrant Information.

Registrant Reference Number: 255124

Registrant Name (Full Legal Name no abbreviations): Dow AgroSciences Canada Inc.

Address: 450-1st Street S.W., Suite 2100

City: Calgary

Prov / State: AB

Country: Canada

Postal Code: T2P 5H1

3. Select the appropriate subform(s) for the incident.

Human

4. Date registrant was first informed of the incident.

30-OCT-07

5. Location of incident.

Country: UNITED STATES

Prov / State: CALIFORNIA

6. Date incident was first observed.

30-MAR-07

Product Description

7. a) Provide the active ingredient and, if available, the registration number and product name (include all tank mixes). If the product is not registered provide a submission number.

Active(s)

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 62719-4

Product Name: Vikane Gas Fumigant62719-4

• Active Ingredient(s)
  • SULFURYL FLUORIDE
    • Unknown

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7. b) Type of formulation.

Other (specify)

Gas fumigant

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

10. Site pesticide was applied to (select all that apply).

Site: Res. - In Home / Rés. - à l'int. maison

11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Data Subject

2. Demographic information of data subject

Sex: Female

Age: >64 yrs / > 64 ans

3. List all symptoms, using the selections below.

System

• Gastrointestinal System
  • Symptom - Irritated throat

• General
  • Symptom - Other
  • Specify - Vocal cord Tumor

• Gastrointestinal System
  • Symptom - Dry throat

4. How long did the symptoms last?

>6 mos / > 6 mois

5. Was medical treatment provided? Provide details in question 13.

Yes

6. a) Was the person hospitalized?

No

6. b) For how long?

7. Exposure scenario

Non-occupational

8. How did exposure occur? (Select all that apply)

Other

9. If the exposure occured during application or re-entry, what protective clothing was worn? (select all that apply)

None

10. Route(s) of exposure.

Unknown

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

>24 hrs <=3 days / >24 h <=3 jours

13. Provide any additional details about the incident (eg. description of the frequency and severity of the symptoms, type of medical treatment, results from medical tests, outcome of the incident, amount of pesticide exposed to, etc.)

10/30/2007Caller states that her condo was fumigated with Vikane in March of this year (unable to provide an exact date). Caller states that after she came back in the home she began to have throat dryness and irritation. Her symptoms persisted all summer long during which she saw a physician on multiple occasions. On 10/25 she was finally diagnosed with a vocal cord tumor. Caller states that someone came to check the condo, but everything appeared to be OK and there was no detectable chemical compounds.

To be determined by Registrant

14. Severity classification.

Major

15. Provide supplemental information here.

The information contained in this report is based on self-reported statements provided to the registrant during telephone Interview(s). These self-reported descriptions of an incident have not been independently verified to be factually correct or complete descriptions of the incident. For that reason, information contained in this report does not and can not form the basis for a determination of whether the reported clinical effects are causally related to exposure to the product identified in the telephone interviews. Re-entry into a treated dwelling is not permitted until measured Vikane air concentrations drop below 5 ppm within the treated structure, a level known to be well below the threshold for potential toxicity, therefore, this patient should not have experienced any exposure to Vikane gas. Furthermore, the weight of scientific evidence does not suggest any possibility of tumorogenic effects following acute exposure to sulfuryl fluoride should such an exposure occur.