Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-3841

2. Registrant Information.

Registrant Reference Number: PROSAR Case - 1-16531358

Registrant Name (Full Legal Name no abbreviations): Syngenta Crop Protection Canada, Inc.

Address: 140 Research Lane, Research Park

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G4Z3

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

Human

4. Date registrant was first informed of the incident.

15-AUG-08

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

01-AUG-08

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)

---

PMRA Registration No. 27192      PMRA Submission No.       EPA Registration No.

Product Name: Touchdown iQ Liquid Herbicide

• Active Ingredient(s)
  • GLYPHOSATE (PRESENT AS MONO-AMMONIUM SALT OR DIAMMONIUM SALT)

---

7. b) Type of formulation.

Application Information

8. Product was applied?

Yes

9. Application Rate.

Unknown

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

Site: Res. - Out Home / Rés - à l'ext.maison

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

The reporter applied the product for two months prior to the call and continued to use product.

To be determined by Registrant

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

Unknown

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: Male

Age: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• Nervous and Muscular Systems
  • Symptom - Dizziness

• Gastrointestinal System
  • Symptom - Nausea

• Nervous and Muscular Systems
  • Symptom - Headache

• Gastrointestinal System
  • Symptom - Vomiting

4. How long did the symptoms last?

Unknown / Inconnu

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

Unknown

6. a) Was the person hospitalized?

Unknown

6. b) For how long?

7. Exposure scenario

Non-occupational

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

Application

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

Unknown

10. Route(s) of exposure.

Skin

Oral

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

>8 hrs <=24 hrs / > 8 h < = 24 h

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.)

1-16531358: The reporter called on 8/15/2008, to report exposure to an herbicide with the active ingredient Glyphosate. According to the reporter, he had been spraying the product for two months prior to the call. On approximately 8/1/2008, the reporter got the product all over himself including some in his mouth. The report did not shower immediately after exposure to the product. Later that day, the reporter developed a headache, dizziness and nausea. The reporter stated that every time he used the product, he developed the same symptoms and vomited the last two times of product use. The safety profile of the product was discussed including the fact that small ingestions of the product are unlikely to result in adverse health effects other than mild GI upset. Recommendations were made to replace fluids from nausea and vomiting with milk or water. If symptoms persist it was recommended that the caller seek medical attention. No further information was provided.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.

Small quantity ingested is highly unlikely to result in symptoms, as reported, other than mild GI upset.