Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2014-4211

2. Registrant Information.

Registrant Reference Number: PROSAR case #: 1-38048746

Registrant Name (Full Legal Name no abbreviations): Scotts Canada Ltd.

Address: 2000 Argentia Road, Plaza 2, Suite 300

City: Mississauga

Prov / State: Ontario

Country: Canada

Postal Code: L5N1V8

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

Human

4. Date registrant was first informed of the incident.

06-AUG-14

5. Location of incident.

Country: CANADA

Prov / State: ONTARIO

6. Date incident was first observed.

06-AUG-14

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. 29694      PMRA Submission No.       EPA Registration No.

Product Name: Ecosense Weed B Gon RTU Weed Control

• Active Ingredient(s)
  • IRON (PRESENT AS FEHEDTA)

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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: Pub. Area - Outdoor/Zone publique - ext

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?

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

3. List all symptoms, using the selections below.

System

• Gastrointestinal System
  • Symptom - Vomiting
  • Symptom - Nausea

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.

Respiratory

11. What was the length of exposure?

Unknown / Inconnu

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.)

1-38048746 - The reporter, the facility manager for a federal employment agency, indicated that 3-4 workers at the facility were exposed to an herbicide containing the active ingredient Ferric HEDTA. The reporter stated that the landlord applied the product around the outside of the building about two hours prior to initial contact with the registrant. The reporter is uncertain if the product was diluted or applied appropriately. At the time of the initial call 2-3 workers (Subform II #2, #3 and #4) had a cough and throat irritation and one worker (Subform II #1) was nauseous and had vomited. None of the workers had sought medical attention. The reporter is uncertain how the workers were exposed to the product he is considering whether or not the fumes may have come through open doors or windows. The reporter was advised that the product has a wide margin of safety but with inhalation transient respiratory irritation and transient nausea are possible. The reporter could not be reached on follow-up. No further information is available.

To be determined by Registrant

14. Severity classification.

Minor

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

• Respiratory System
  • Symptom - Coughing

• Gastrointestinal System
  • Symptom - Sore throat

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.

Respiratory

11. What was the length of exposure?

Unknown / Inconnu

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.)

1-38048746 - The reporter, the facility manager for a federal employment agency, indicated that 3-4 workers at the facility were exposed to an herbicide containing the active ingredient Ferric HEDTA. The reporter stated that the landlord applied the product around the outside of the building about two hours prior to initial contact with the registrant. The reporter is uncertain if the product was diluted or applied appropriately. At the time of the initial call 2-3 workers (Subform II #2, #3 and #4) had a cough and throat irritation and one worker (Subform II #1) was nauseous and had vomited. None of the workers had sought medical attention. The reporter is uncertain how the workers were exposed to the product he is considering whether or not the fumes may have come through open doors or windows. The reporter was advised that the product has a wide margin of safety but with inhalation transient respiratory irritation and transient nausea are possible. The reporter could not be reached on follow-up. No further information is available.

To be determined by Registrant

14. Severity classification.

Minor

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

• Respiratory System
  • Symptom - Coughing

• Gastrointestinal System
  • Symptom - Sore throat

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.

Respiratory

11. What was the length of exposure?

Unknown / Inconnu

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.)

1-38048746 - The reporter, the facility manager for a federal employment agency, indicated that 3-4 workers at the facility were exposed to an herbicide containing the active ingredient Ferric HEDTA. The reporter stated that the landlord applied the product around the outside of the building about two hours prior to initial contact with the registrant. The reporter is uncertain if the product was diluted or applied appropriately. At the time of the initial call 2-3 workers (Subform II #2, #3 and #4) had a cough and throat irritation and one worker (Subform II #1) was nauseous and had vomited. None of the workers had sought medical attention. The reporter is uncertain how the workers were exposed to the product he is considering whether or not the fumes may have come through open doors or windows. The reporter was advised that the product has a wide margin of safety but with inhalation transient respiratory irritation and transient nausea are possible. The reporter could not be reached on follow-up. No further information is available.

To be determined by Registrant

14. Severity classification.

Minor

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

• Respiratory System
  • Symptom - Coughing

• Gastrointestinal System
  • Symptom - Sore throat

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.

Respiratory

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.)

1-38048746 - The reporter, the facility manager for a federal employment agency, indicated that 3-4 workers at the facility were exposed to an herbicide containing the active ingredient Ferric HEDTA. The reporter stated that the landlord applied the product around the outside of the building about two hours prior to initial contact with the registrant. The reporter is uncertain if the product was diluted or applied appropriately. At the time of the initial call 2-3 workers (Subform II #2, #3 and #4) had a cough and throat irritation and one worker (Subform II #1) was nauseous and had vomited. None of the workers had sought medical attention. The reporter is uncertain how the workers were exposed to the product he is considering whether or not the fumes may have come through open doors or windows. The reporter was advised that the product has a wide margin of safety but with inhalation transient respiratory irritation and transient nausea are possible. The reporter could not be reached on follow-up. No further information is available.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.