Incident Report

Subform I: General Information

1. Report Type.

Update the report

Incident Report Number: 2015-1565

2. Registrant Information.

Registrant Reference Number: ON2015-1565

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.

13-APR-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. 11565      PMRA Submission No.       EPA Registration No.

Product Name: GARDEX 1% BAYGON RESIDUAL INSECTICIDE

• Active Ingredient(s)
  • PROPOXUR

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PMRA Registration No. 24858      PMRA Submission No.       EPA Registration No.

Product Name: KONK 400 RESIDUAL INSECTICIDE SPRAY WITH BAYGON

• Active Ingredient(s)
  • PIPERONYL BUTOXIDE
  • PROPOXUR

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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 - Indoor/Zone publique - int

Préciser le type: Public school

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

Four litres of the product Gardex 1% Baygon Residual Insecticide (PCP# 11565) were applied to all rubber baseboard trims of the kindergarten kitchen, to the kindergarten washroom perimeters and the staff washroom perimeters, under the washer and dryer, hot water tank, sinks, under children s coat/cubicles, behind the counter backsplash and inside cupboards and drawers. The second product, Konk 400 (PCP# 24858), is an aerosol product and was applied to the cracks and crevices of cupboards, counter backsplash, rubber baseboard trims, pipe entries, fridge compressor area, under the washer and dryer, hot water tank, under sinks, soap and paper dispensers, children coat/cubbies, and drawers in order to flush and or stimulate activity and locate roach harbourage. 454 grams of this product were applied.

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

• General
  • Symptom - Malaise
  • Specify - ill effects

• Gastrointestinal System
  • Symptom - Nausea

• Nervous and Muscular Systems
  • Symptom - Headache

• Gastrointestinal System
  • Symptom - Diarrhea

• Respiratory System
  • Symptom - Irritated throat
  • Specify - Status Update
  • Symptom - Scratchy throat
  • Specify - Status Update

• Eye
  • Symptom - Burning eye
  • Specify - Status Update

• Skin
  • Symptom - Itchy skin
  • Specify - Status Update

• General
  • Symptom - Weakness
  • Specify - Status Update
  • Symptom - Sweating
  • Specify - Status Update

• Nervous and Muscular Systems
  • Symptom - Confusion
  • Specify - Status Update
  • Symptom - Loss of coordination
  • Specify - Status Update - clumsiness

• General
  • Symptom - Chemical taste in mouth
  • Specify - Status Update - bad taste/sensation in mouth

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)

Contact with treated area

Amount of time between application and contact 2

Day(s) / Jour(s)

What was the activity? Work (school)

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.

Unknown

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.)

During the weekend of April 11, a PCO treated three areas of the school to control cockroaches. Some staff and children began to feel unwell on Monday April 13. There was a smell in the school. On the weekend of April 18, 30 cleaners were at the school. They disinfected with bleach and water twice and washed three times with soap and water. All soft materials (e.g. blankets, dolls, papers, etc.) were discarded. They moved all shelving and cleaned behing everything. During the clean up, the smell was reportedly very good. However, reports on April 20 indicated that the smell was at 80% as bad as it was the week prior. On April 20, a staff meeting in the school library had to be relocated to another room, as staff members were still feeling negative health effects. It was reported that a Health and Safety member who had been in and out of the school all the first week went to emergency on April 19. The school was closed on April 16 through April 24. On March 15, 2015 during March break, the school was treated with Dragnet. STATUS UPDATE RECEIVED 2015-06-12 Final Report of the Ottawa Public Health investigation: 18 teachers reported symptoms that included scratchy or irritated throat (16), headache (16), burning eyes (15), scratchy/itchy skin (9), nausea (8), weakness (5), sweating (1), confusion (5), clumsiness (4), diarrhea (4). Among teachers feeling ell, 69% reported symptom on set on April 13, and by the following day, 81% had reported symptoms. Some people reported ongoing symptoms after removal from the environment. 15 children reported symptoms that included scratchy or irritated throat (5), headache (6), burning eyes (3), scratchy/itchy skin (3), nausea (7), vomiting (4) weakness (2), sweating (1), diarrhea (3). 10 people reported that symtpoms were aggravated as a result of attending a staff meeting at the school on the morning of April 20 (symptoms were headache, nausea, irritated throat, diarrhea, bad taste or sensation in mouth).

To be determined by Registrant

14. Severity classification.

15. Provide supplemental information here.

Status update 2015-06-12: Final Report of the Ottawa Public Health investigation: 18 teachers reported symptoms that included scratchy or irritated throat (16), headache (16), burning eyes (15), scratchy/itchy skin (9), nausea (8), weakness (5), sweating (1), confusion (5), clumsiness (4), diarrhea (4). Among teachers feeling ell, 69% reported symptom on set on April 13, and by the following day, 81% had reported symptoms. Some people reported ongoing symptoms after removal from the environment. 15 children reported symptoms that included scratchy or irritated throat (5), headache (6), burning eyes (3), scratchy/itchy skin (3), nausea (7), vomiting (4) weakness (2), sweating (1), diarrhea (3). 10 people reported that symtpoms were aggravated as a result of attending a staff meeting at the school on the morning of April 20 (symptoms were headache, nausea, irritated throat, diarrhea, bad taste or sensation in mouth).