Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2013-2888

2. Registrant Information.

Registrant Reference Number: x

Registrant Name (Full Legal Name no abbreviations): x

Address: x

City: x

Prov / State: x

Country: x

Postal Code: X

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

Human

4. Date registrant was first informed of the incident.

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

05-MAY-13

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. 28715      PMRA Submission No.       EPA Registration No.

Product Name: PIC PLUS FUMIGANT

• Active Ingredient(s)
  • CHLOROPICRIN
    • Guarantee/concentration 85 %

---

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: Agricultural-Outdoor/Agricole-extérieur

Préciser le type: tobacco - soil treatment prior to planting

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

The farmer was spreading Chloropicrin injected with nitrogen. The Sgt. indicates that the field is approximately 15 acres and the farmer applied the injection chemical yesterday. Explains that the family of 3 arrived at hospital, and medical staff alterted FD thinking that there was a gas leak. FD arrived on scene and determined the cause to be a pesticide sprayed on the farm. OPP reporting that there are no watercoureses nearby and the area is primarily farmland. There is nothing in close proximity to the land. SAC inquired about potential for drinking water impacts - no nearby DW sources, some private wells in the area. HU has been notified by OPP. Weather reported by OPP to be 8C with no wind. 43 acres treated with chloropicrin on this site. Started application 1pm Saturday on east side of this farm. On Sunday they did a 14 acre field across the road. Finished the west part of this farm yesterday (Tuesday). Appeared to be injecting about 8 inch deep.MOE observed field. Large root clods of rye plowdown crop are noticeable. Suspect root clods may have prevented consistent effective sealing of soil following injection of chloropicrin.

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: Unknown

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Eye
  • Symptom - Irritated eye

4. How long did the symptoms last?

Unknown / Inconnu

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

No

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)

Drift from the application site

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.

Eye

11. What was the length of exposure?

Unknown / Inconnu

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.)

The incident forced a family of three out of their home at 3am. They went to hospital with eye irritant complaints. FD and police were dispached to the site at 2:59 when a family was taken to hospital with eye irritation. FD is now going door-to-door requesting residents to keep their windows closed. There is a shelter-in-place initiated, but no further evacuations. OPP relays that this happened 3 times last year, and compared to the others, this is quite minor in severity. There is a precautionary 1/2 mile shelter-in-place established. No other symptoms to any other residences found at this time. OPP are still working on notifying all residents (estimated 15 homes). With the warm weather, the tobacco transplants are getting ready to go, farmers feels rushed to get the fields fumigated after a late spring so that the plants can go in the ground, last year, treatments were spread over about 3 weeks, this year the same treatments havea occurred in about 10 days. One report indicates that the site was only evacuated for 1 1/2 hours - the homeowners work in the middle of the night and felt eye irritation, went to Tim Horton's for 1 1/2 hours while it cleared, then returned home. It was reported that irrigation after application was not a viable option for these farmers; The FD apparently felt it was a much less severe situation than last years incidents, they had taken the training from distributor, and thought it was very helpful in dealing with the situation; According to distributor the road was not closed and the residents were only out of their home for about 1 1/2 hours; when he attended the site on Sunday morning, he felt that there was adequate soil moisture, so he couldnt explain why the material had come out of the soil; distributor indicated that about 15,000 acres have been fumigated so far this year; he is encouraging farmers to wait for some rain if possible, and to inject deeper (6-8 inches) and mound the soil higher (the older machines can mound about 6", newer machines higher). At 4am Sunday morning Pic Plus could be smelled at farm, when the police woke the family up.

To be determined by Registrant

14. Severity classification.

15. Provide supplemental information here.

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

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Unknown

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Eye
  • Symptom - Irritated eye

4. How long did the symptoms last?

Unknown / Inconnu

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

No

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)

Drift from the application site

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.

Eye

11. What was the length of exposure?

Unknown / Inconnu

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.)

The incident forced a family of three out of their home at 3am. They went to hospital with eye irritant complaints. FD and police were dispached to the site at 2:59 when a family was taken to hospital with eye irritation. FD is now going door-to-door requesting residents to keep their windows closed. There is a shelter-in-place initiated, but no further evacuations. OPP relays that this happened 3 times last year, and compared to the others, this is quite minor in severity. There is a precautionary 1/2 mile shelter-in-place established. No other symptoms to any other residences found at this time. OPP are still working on notifying all residents (estimated 15 homes). With the warm weather, the tobacco transplants are getting ready to go, farmers feels rushed to get the fields fumigated after a late spring so that the plants can go in the ground, last year, treatments were spread over about 3 weeks, this year the same treatments havea occurred in about 10 days. One report indicates that the site was only evacuated for 1 1/2 hours - the homeowners work in the middle of the night and felt eye irritation, went to Tim Horton's for 1 1/2 hours while it cleared, then returned home. It was reported that irrigation after application was not a viable option for these farmers; The FD apparently felt it was a much less severe situation than last years incidents, they had taken the training from distributor, and thought it was very helpful in dealing with the situation; According to distributor the road was not closed and the residents were only out of their home for about 1 1/2 hours; when he attended the site on Sunday morning, he felt that there was adequate soil moisture, so he couldnt explain why the material had come out of the soil; distributor indicated that about 15,000 acres have been fumigated so far this year; he is encouraging farmers to wait for some rain if possible, and to inject deeper (6-8 inches) and mound the soil higher (the older machines can mound about 6", newer machines higher). At 4am Sunday morning Pic Plus could be smelled at farm, when the police woke the family up.

To be determined by Registrant

14. Severity classification.

15. Provide supplemental information here.

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

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Unknown

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Eye
  • Symptom - Irritated eye

4. How long did the symptoms last?

Unknown / Inconnu

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

No

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)

Drift from the application site

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.

Eye

11. What was the length of exposure?

Unknown / Inconnu

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.)

The incident forced a family of three out of their home at 3am. They went to hospital with eye irritant complaints. FD and police were dispached to the site at 2:59 when a family was taken to hospital with eye irritation. FD is now going door-to-door requesting residents to keep their windows closed. There is a shelter-in-place initiated, but no further evacuations. OPP relays that this happened 3 times last year, and compared to the others, this is quite minor in severity. There is a precautionary 1/2 mile shelter-in-place established. No other symptoms to any other residences found at this time. OPP are still working on notifying all residents (estimated 15 homes). With the warm weather, the tobacco transplants are getting ready to go, farmers feels rushed to get the fields fumigated after a late spring so that the plants can go in the ground, last year, treatments were spread over about 3 weeks, this year the same treatments havea occurred in about 10 days. One report indicates that the site was only evacuated for 1 1/2 hours - the homeowners work in the middle of the night and felt eye irritation, went to Tim Horton's for 1 1/2 hours while it cleared, then returned home. It was reported that irrigation after application was not a viable option for these farmers; The FD apparently felt it was a much less severe situation than last years incidents, they had taken the training from distributor, and thought it was very helpful in dealing with the situation; According to distributor the road was not closed and the residents were only out of their home for about 1 1/2 hours; when he attended the site on Sunday morning, he felt that there was adequate soil moisture, so he couldnt explain why the material had come out of the soil; distributor indicated that about 15,000 acres have been fumigated so far this year; he is encouraging farmers to wait for some rain if possible, and to inject deeper (6-8 inches) and mound the soil higher (the older machines can mound about 6", newer machines higher). At 4am Sunday morning Pic Plus could be smelled at farm, when the police woke the family up.

To be determined by Registrant

14. Severity classification.

15. Provide supplemental information here.