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Consumer Product Safety

Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2012-2895

2. Registrant Information.

Registrant Reference Number: NZB-02

Registrant Name (Full Legal Name no abbreviations): Novozymes BioAg Limited

Address: 3935 Thatcher Avenue

City: Saskatoon

Prov / State: Saskatchewan

Country: Canada

Postal Code: S7R1A3

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


4. Date registrant was first informed of the incident.


5. Location of incident.

Country: CANADA


6. Date incident was first observed.


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.


PMRA Registration No. 29146      PMRA Submission No.       EPA Registration No. 70127-7

Product Name: Metarhizium anisopliae strain F52

  • Active Ingredient(s)

7. b) Type of formulation.

Application Information

8. Product was applied?


9. Application Rate.

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

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

To be determined by Registrant

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


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.


  • Respiratory System
    • Symptom - Respiratory pain
    • Symptom - Nose bleed
  • Nervous and Muscular Systems
    • Symptom - Other
    • Specify - Stinging
    • Symptom - Numbness
    • Specify - numb tongue

4. How long did the symptoms last?

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

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


6. a) Was the person hospitalized?


6. b) For how long?

7. Exposure scenario


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


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

10. Route(s) of exposure.


11. What was the length of exposure?

>2 hrs <=8 hrs / >2 h <=8 h

12. Time between exposure and onset of symptoms.

>2 hrs <=8 hrs / > 2 h < = 8 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.)

This incident occurred in our manufacturing plant. While the employee was wearing PPE's (half mask respirator with fresh filters), this was not the proper PPE's for the manufacturing plant. Full Tyvek suit, PAPR, gloves and safety glasses are required. This particular employee is not a product manufacturing employee and therefore was unaware of the updated PPE requirements. Further training and communication has been provided to employees to ensure everyone is aware of current PPE requirements. Employee had minor symptoms that lasted for approximately one day and has had no further complications. No lost time from work was reported. Employee has been informed of the proper PPE's to be worn.

To be determined by Registrant

14. Severity classification.


15. Provide supplemental information here.

Increased signage has been provided on the entry to the manufacturing location and additional training on proper PPE's was provided to staff.