Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2015-2360

2. Registrant Information.

Registrant Reference Number: PROSAR case #: 1-40452035

Registrant Name (Full Legal Name no abbreviations): Syngenta Canada Inc.

Address: 140 Research Lane, Research Park

City: Guelph

Prov / State: Ontario

Country: Canada

Postal Code: N1G4Z3

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

Human

4. Date registrant was first informed of the incident.

02-MAY-15

5. Location of incident.

Country: CANADA

Prov / State: SASKATCHEWAN

6. Date incident was first observed.

02-MAY-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)

---

PMRA Registration No. 30438      PMRA Submission No.       EPA Registration No.

Product Name: Vibrance 500FS Seed Treatment

• Active Ingredient(s)
  • SEDAXANE

---

PMRA Registration No. 27577      PMRA Submission No.       EPA Registration No.

Product Name: Apron Maxx RTA Seed Treatment Fungicide

• Active Ingredient(s)
  • FLUDIOXONIL
  • METALAXYL-M (MEFENOXAM)

---

PMRA Registration No. 27045      PMRA Submission No.       EPA Registration No.

Product Name: Cruiser 5FS Insecticide

• Active Ingredient(s)
  • THIAMETHOXAM

---

7. b) Type of formulation.

Application Information

8. Product was applied?

No

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?

Unknown

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.

System

• Cardiovascular System
  • Symptom - Chest tightness

• General
  • Symptom - Taste altered
  • Specify - Unpleasant taste
  • Symptom - Malaise

4. How long did the symptoms last?

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

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

Occupational

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

Pesticide Spill

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

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.)

1-40452035 - The reporter, a firefighter, indicated that he and four other firefighters were exposed to lentils treated with a fungicide and an insecticide containing the active ingredients sedaxane, metalaxyl-m, fludioxonil and thiamethoxam. The seeds were also treated with a non-registrant fertilizer. The reporter stated that a semi-truck with a trailer filled with coated lentil seeds flipped over on the day of initial contact. The reason for the accident was unknown. The reporter (Subform II #1), four other firefighters (Subform II #2-5) and the truck driver shoveled the seeds out of the trailer so that the tow truck could pull semi. While they were shoveling it was really dusty and they did not wear respirators. At the time of the call the reporter and four other firefighters were complaining of chest tightness, a bad taste and not feeling well. The reporter was advised that the seed coating has a wide margin of safety but inhalation of the dust may cause short term respiratory irritation. On follow-up call, two days later, the reporter indicated that everybodys symptoms resolved in about 8 hours. No medical attention was needed. No additional 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: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• General
  • Symptom - Malaise

• Cardiovascular System
  • Symptom - Chest tightness

• General
  • Symptom - Taste altered
  • Specify - Unpleasant taste

4. How long did the symptoms last?

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

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

Occupational

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

Pesticide Spill

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

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.)

1-40452035 - The reporter, a firefighter, indicated that he and four other firefighters were exposed to lentils treated with a fungicide and an insecticide containing the active ingredients sedaxane, metalaxyl-m, fludioxonil and thiamethoxam. The seeds were also treated with a non-registrant fertilizer. The reporter stated that a semi-truck with a trailer filled with coated lentil seeds flipped over on the day of initial contact. The reason for the accident was unknown. The reporter (Subform II #1), four other firefighters (Subform II #2-5) and the truck driver shoveled the seeds out of the trailer so that the tow truck could pull semi. While they were shoveling it was really dusty and they did not wear respirators. At the time of the call the reporter and four other firefighters were complaining of chest tightness, a bad taste and not feeling well. The reporter was advised that the seed coating has a wide margin of safety but inhalation of the dust may cause short term respiratory irritation. On follow-up call, two days later, the reporter indicated that everybodys symptoms resolved in about 8 hours. No medical attention was needed. No additional 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: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• General
  • Symptom - Malaise

• Cardiovascular System
  • Symptom - Chest tightness

• General
  • Symptom - Taste altered
  • Specify - Unpleasant taste

4. How long did the symptoms last?

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

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

Occupational

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

Pesticide Spill

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

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.)

1-40452035 - The reporter, a firefighter, indicated that he and four other firefighters were exposed to lentils treated with a fungicide and an insecticide containing the active ingredients sedaxane, metalaxyl-m, fludioxonil and thiamethoxam. The seeds were also treated with a non-registrant fertilizer. The reporter stated that a semi-truck with a trailer filled with coated lentil seeds flipped over on the day of initial contact. The reason for the accident was unknown. The reporter (Subform II #1), four other firefighters (Subform II #2-5) and the truck driver shoveled the seeds out of the trailer so that the tow truck could pull semi. While they were shoveling it was really dusty and they did not wear respirators. At the time of the call the reporter and four other firefighters were complaining of chest tightness, a bad taste and not feeling well. The reporter was advised that the seed coating has a wide margin of safety but inhalation of the dust may cause short term respiratory irritation. On follow-up call, two days later, the reporter indicated that everybodys symptoms resolved in about 8 hours. No medical attention was needed. No additional 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: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• General
  • Symptom - Taste altered
  • Specify - unpleasant taste
  • Symptom - Malaise

• Cardiovascular System
  • Symptom - Chest tightness

4. How long did the symptoms last?

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

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

Occupational

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

Pesticide Spill

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

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.)

1-40452035 - The reporter, a firefighter, indicated that he and four other firefighters were exposed to lentils treated with a fungicide and an insecticide containing the active ingredients sedaxane, metalaxyl-m, fludioxonil and thiamethoxam. The seeds were also treated with a non-registrant fertilizer. The reporter stated that a semi-truck with a trailer filled with coated lentil seeds flipped over on the day of initial contact. The reason for the accident was unknown. The reporter (Subform II #1), four other firefighters (Subform II #2-5) and the truck driver shoveled the seeds out of the trailer so that the tow truck could pull semi. While they were shoveling it was really dusty and they did not wear respirators. At the time of the call the reporter and four other firefighters were complaining of chest tightness, a bad taste and not feeling well. The reporter was advised that the seed coating has a wide margin of safety but inhalation of the dust may cause short term respiratory irritation. On follow-up call, two days later, the reporter indicated that everybodys symptoms resolved in about 8 hours. No medical attention was needed. No additional 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: >19 <=64 yrs / >19 <=64 ans

3. List all symptoms, using the selections below.

System

• General
  • Symptom - Malaise

• Cardiovascular System
  • Symptom - Chest tightness

• General
  • Symptom - Taste altered
  • Specify - Unpleasant taste

4. How long did the symptoms last?

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

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

Occupational

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

Pesticide Spill

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

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.)

1-40452035 - The reporter, a firefighter, indicated that he and four other firefighters were exposed to lentils treated with a fungicide and an insecticide containing the active ingredients sedaxane, metalaxyl-m, fludioxonil and thiamethoxam. The seeds were also treated with a non-registrant fertilizer. The reporter stated that a semi-truck with a trailer filled with coated lentil seeds flipped over on the day of initial contact. The reason for the accident was unknown. The reporter (Subform II #1), four other firefighters (Subform II #2-5) and the truck driver shoveled the seeds out of the trailer so that the tow truck could pull semi. While they were shoveling it was really dusty and they did not wear respirators. At the time of the call the reporter and four other firefighters were complaining of chest tightness, a bad taste and not feeling well. The reporter was advised that the seed coating has a wide margin of safety but inhalation of the dust may cause short term respiratory irritation. On follow-up call, two days later, the reporter indicated that everybodys symptoms resolved in about 8 hours. No medical attention was needed. No additional information is available.

To be determined by Registrant

14. Severity classification.

Minor

15. Provide supplemental information here.