Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2008-5868

2. Registrant Information.

Registrant Reference Number: Prosar 1-16830221

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.

07-NOV-08

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

07-NOV-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)

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PMRA Registration No. 27577      PMRA Submission No.       EPA Registration No.

Product Name: Apron Maxx RTA

• Active Ingredient(s)
  • FLUDIOXONIL
  • METALAXYL-M (MEFENOXAM)

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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: Unknown / Inconnu

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

The product was applied on 11/07/2008.

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.

Other

2. Demographic information of data subject

Sex: Female

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

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Erythema
  • Symptom - Itchy skin
  • Symptom - Rash

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

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

11. What was the length of exposure?

>15 min <=2 hrs / >15 min <=2 h

12. Time between exposure and onset of symptoms.

>30 min <=2 hrs / >30 min <=2 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.)

1-16830221: A reporter called on 11/07/2008 to report the exposure of her co-worker to soybeans treated with a fungicide containing the active ingredient Metalaxyl. According to the reporter, she and her co-worker were handling the product for 2 hours just prior to the report. The co-worker was wearing gloves. The reporter stated that her co-worker had developed erythema and pruritis on her wrist. The reporter was advised that the product is not expected to cause skin irritation. The reporter was also advised that people may have individual sensitivities. A recommendation was made to have the co-worker wash the affected area for 20 minutes. A recommendation was also made to have her co-worker evaluated by a health care provider if her signs persisted or worsened. On follow up, the reporter stated that her co-worker's signs had resolved and she did not need to miss work. The reporter also stated that her co-worker had developed a small rash on her arms that was resolving at the time of the follow up. No further information was obtained.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.