Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-1991

2. Registrant Information.

Registrant Reference Number: x

Registrant Name (Full Legal Name no abbreviations): x

Address: x

City: x

Country: 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: BRITISH COLUMBIA

6. Date incident was first observed.

16-APR-15

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. 24977      PMRA Submission No.       EPA Registration No.

Product Name: FORAY 48B BIOLOGICAL INSECTICIDE AQUEOUS SUSPENSION

• Active Ingredient(s)
  • BACILLUS THURINGIENSIS BERLINER SSP KURSTAKI STRAIN HD-1

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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

Préciser le type: Aerial

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

Aerial spraying on 2015-04-15, 2015-04-16, 2015-04-17, 2015-04-30, 2014-05-01, 2015-05-02, 2015-05-10, 2015-05-11, 2015-05-12 2015-04-18 Aerial spraying. repeated low level and high level. Spray haze hanging in the air for hours - looks like fog. Helicopters repeatedly spraying homes, land. So much spray on car windows, coudn't see out. Had to wash off before driving. Air reeks of chemicals. 2015-05-09 Realized the spraying would take place over the (name) Flea Market on one of their busiest days of the year - Mothers day. The Flea Market opens at 4:00am to vendors, set up from 4:00 am to the opening to the general public at 6:00am. I attempted to contact the city (name) and provincial government contacts to stop the spraying on Sunday. No response from anyone. 2015-05-08 Messages not returned so I called and finally reached [name] of the B.C. Ministry of Forests, Lands and Natural Resources Operations. When I asked when the Ministry was going to announce the cancellation of the remainder of the spray program due to the multitude of people indicating adverse health effects from the spray, he said I could keep waiting that there were no plans to cancel. [Name] didnt seemed phased at all by problems the general public was having. He kept refering to Health Canadas approval of Foray 48B and that it was safe. [Name] confirmed the spraying would take place starting Sunday. May 10,2015 in our area (location) from 5:00am to 7:30am. (name) also said the principals of schools in the spray areas were notified of the spraying program and the decision to wash down playgrounds was left up to them. From my understanding no additionnal funding was provided to the schools for clean up. Spraying times often did not leave enough time to perform clean up prior to the start of school. Children continue to play on contaminated equipment.

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.

2. Demographic information of data subject

Sex: Unknown

Age: >1 <=6 yrs / > 1 < = 6 ans

3. List all symptoms, using the selections below.

System

• Nervous and Muscular Systems
  • Symptom - Headache

• Respiratory System
  • Symptom - Runny nose

• Skin
  • Symptom - Pallor

• General
  • Symptom - Fatigue

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)

Other

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.

Unknown

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

Unknown / Inconnu

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.)

2015-04-16 Our four grandchildren are sick with runny noses, coughs, pale skin, fatigue. Ages #, #, #, and #. Their mother was also sick with a headache, runny nose. She remarks it doesn't look like a cold, it looks like some kind of allergic reaction. The three youngest stayed home from school. 2015-05-15 Mother still suffering from sore throat. Children have runny noses

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.

2. Demographic information of data subject

Sex: Unknown

Age: >6 <=12 yrs / > 6 < = 12 ans

3. List all symptoms, using the selections below.

System

• Respiratory System
  • Symptom - Runny nose
  • Symptom - Coughing

• Skin
  • Symptom - Pallor

• General
  • Symptom - Fatigue

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)

Other

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.

Unknown / Inconnu

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.)

2015-05-16 Our four grandchildren are sick with runny noses, coughs, pale skin, fatigue. Ages #, #, #, and #. Their mother was also sick with a headache, runny nose. She remarks it doesn't look like a cold, it looks like some kind of allergic reaction. The three youngest stayed home from school. 2015-05-15 Mother still suffering from sore throat. Children have runny noses

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.

2. Demographic information of data subject

Sex: Unknown

Age: >6 <=12 yrs / > 6 < = 12 ans

3. List all symptoms, using the selections below.

System

• Respiratory System
  • Symptom - Runny nose
  • Symptom - Coughing

• Skin
  • Symptom - Pallor

• General
  • Symptom - Fatigue

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)

Other

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.

Unknown / Inconnu

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.)

2015-05-16 Our four grandchildren are sick with runny noses, coughs, pale skin, fatigue. Ages #, #, #, and #. Their mother was also sick with a headache, runny nose. She remarks it doesn't look like a cold, it looks like some kind of allergic reaction. The three youngest stayed home from school. 2015-05-15 Mother still suffering from sore throat. Children have runny noses

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.

2. Demographic information of data subject

Sex: Unknown

Age: >6 <=12 yrs / > 6 < = 12 ans

3. List all symptoms, using the selections below.

System

• Nervous and Muscular Systems
  • Symptom - Headache

• Skin
  • Symptom - Pallor

• Respiratory System
  • Symptom - Coughing
  • Symptom - Runny nose

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)

Other

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.

Unknown / Inconnu

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.)

2015-04-16 Our four grandchildren are sick with runny noses, coughs, pale skin, fatigue. Ages #, #, #, and #. Their mother was also sick with a headache, runny nose. She remarks it doesn't look like a cold,it looks like some kind of allergic reaction. The three youngest stayed home from school. 2015-05-15 Mother still suffering from sore throat. Children have runny noses

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.

2. Demographic information of data subject

Sex: Female

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Nervous and Muscular Systems
  • Symptom - Headache

• Respiratory System
  • Symptom - Runny nose

• General
  • Symptom - Other
  • Specify - allergic reaction

• Respiratory 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)

Other

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.

Unknown

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

Unknown / Inconnu

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.)

2015-05-16 Our four grandchildren are sick with runny noses, coughs, pale skin, fatigue. Ages #, #, #, and #. Their mother was also sick with a headache, runny nose. She remarks it doesn't look like a cold,it looks like some kind of allergic reaction. The three youngest stayed home from school. 2015-05-15 Still suffering from sore throat. Children have runny noses

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.

2. Demographic information of data subject

Sex: Male

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Nervous and Muscular Systems
  • Symptom - Headache

• Gastrointestinal System
  • Symptom - Stomachache
  • Specify - upset stomach

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)

Other

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?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

Unknown / Inconnu

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.)

2015-04-17 Aerial spraying. Husband sprayed directly trying to get to the car to go to work. 2015-04-30 Aerial spraying. Husband sprayed directly just trying to get to the car to go to work. 2015-05-01 Husband sprayed directly again just trying to get to the car to go to work. He has a headache and upset stomach over two days.

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.

Data Subject

2. Demographic information of data subject

Sex: Female

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Respiratory System
  • Symptom - Bronchitis
  • Symptom - Runny nose
  • Symptom - Coughing

• Gastrointestinal System
  • Symptom - Sore throat
  • Specify - extreme sore throat

• Respiratory System
  • Symptom - Difficulty Breathing

• Eye
  • Symptom - Other
  • Specify - woke up unable to control my eyes

• Respiratory System
  • Symptom - Other
  • Specify - suffocating feeling

• Nervous and Muscular Systems
  • Symptom - Difficulty walking

• General
  • Symptom - Metallic taste in the mouth
  • Specify - taste the spray
  • Symptom - Other
  • Specify - allergic reaction

• Nervous and Muscular Systems
  • Symptom - Muscle twitching

• Eye
  • Symptom - Other
  • Specify - eyelid twitching

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)

Other

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.

Skin

Respiratory

11. What was the length of exposure?

Unknown / Inconnu

12. Time between exposure and onset of symptoms.

Unknown / Inconnu

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.)

2015-04-18 Runny nose, coughing. 2015-04-19 Still experiencing some allergy symptoms which continue throughout the week. 2015-04-25 Sore throat, runny nose, coughing. 2015-04-26 Extreme sore throat, runny nose, coughing, starting to have trouble breathing, bronchitis. 2015-04-27 Woke up unable to control my eyes, they kept shooting to the right, both of them. Took a few minutes to gain control. So out of the ordinary, remarked to my husband on how strange it was. Continued with previous symptoms but now problems in lungs, bronchitis. A lot of trouble breathing. 2015-04-28 Feel like I'm suffocating. Had previous prescription for inhalers. Too sick to walk to pharmacy a short few blocks away, husband filled prescription for inhalers for asthma, bronchitis. Still a lot of trouble breathing. 2015-04-29, Still feeling ill effects. Trouble breathing, inhalers begin helping somewhat but still a lot of coughing, my lungs hurt. 2015-04-30 Im still having trouble breathing. Spraying stopped approximately 7:00am. Walked to see doctor at 8:00am. Saw friend walking daughter to school. We could all taste the spray and the smell invaded our noses. Kids, parents, people everywhere as they are going to school and work. I could feel droplets from the sky hit my skin and it wasn't raining. This was an hour after spraying ceased. Saw doctor who coundnt test for pathogens as no idea as to what as in the spray. Confirmed I was suffering from allergic reaction. Registered myself and familty with (name) as ill from spraying of Foray 48B. (name) opens a case study file. 2015-05-02 Started experiencing sporadic, repeated eyelid twitching and muscle twitching in legs. This continues until May 15 2015.2015-05-12 I am still suffering from coughing, breathing issues, runny nose. I called Health Canada in Ottawa, refered to Pesticide Compliance Program in Ottawa who had their Burnaby B.C office call me later in the morning. Received call from Shaun Dhaliwal, Regional Pesticide Officer in Burnaby. After the spraying stopped I wore face protection when hosing down entire property, felt sick to my stomach and more coughing when finished. 2015-05-13 Woke up with sore throat, runny nose, coughing ,fatigue. Principal for grandchildren's elementary school off work due to vomiting. The school is a five minute walk from our home. 2015-05-14 Still have coughing, runny nose and sore throat. 2015-05-15 Bad sore throat, runny nose, coughing. Daughter also still suffering from sore throat. Children have runny noses.

To be determined by Registrant

14. Severity classification.

15. Provide supplemental information here.