Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2018-2925

2. Registrant Information.

Registrant Reference Number: ProPharma Group case #: 1-52863787

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.

20-JUN-18

5. Location of incident.

Country: UNITED STATES

Prov / State: PENNSYLVANIA

6. Date incident was first observed.

Unknown

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.       PMRA Submission No.       EPA Registration No. 100-1550

Product Name: HERITAGE ACTION

• Active Ingredient(s)
  • ACIBENZOLAR-S-METHYL
    • Guarantee/concentration 1.18 %
  • AZOXYSTROBIN
    • Guarantee/concentration 50 %

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 100-1364

Product Name: DACONIL ACTION

• Active Ingredient(s)
  • ACIBENZOLAR-S-METHYL
    • Guarantee/concentration .11 %
  • CHLOROTHALONIL
    • Guarantee/concentration 53.94 %

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 100-1192

Product Name: CONCERT FUNGICIDE

• Active Ingredient(s)
  • CHLOROTHALONIL
    • Guarantee/concentration 38.5 %
  • PROPICONAZOLE
    • Guarantee/concentration 2.9 %

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 100-729

Product Name: PRIMO

• Active Ingredient(s)
  • TRINEXAPAC-ETHYL
    • Guarantee/concentration 12 %

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 100-1633

Product Name: SECURE ACTION

• Active Ingredient(s)
  • ACIBENZOLAR-S-METHYL
    • Guarantee/concentration .6 %
  • FLUAZINAM
    • Guarantee/concentration 40 %

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PMRA Registration No.       PMRA Submission No.       EPA Registration No. 100-1534

Product Name: VELISTA FUNGICIDE

• Active Ingredient(s)
  • PENTHIOPYRAD
    • Guarantee/concentration 50 %

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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).

1-52863787 - The products were applied to a golf course over multiple years. The reporter indicated that multiple other pesticides manufactured by Bayer and Nufarm were also used on the property at the same time the Syngenta products were used. The active ingredients for these non-company pesticides are not known.

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: Male

Age: >64 yrs / > 64 ans

3. List all symptoms, using the selections below.

System

• Nervous and Muscular Systems
  • Symptom - Other
  • Specify - Parkinson's Disease

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)

Contact with treated area

What was the activity? recreational golfing

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?

>1 yr / > 1 an

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.)

1-52863787 - The reporter, a golf-course superintendent, indicates an exposure to multiple pesticides containing the active ingredients azoxystrobin, acibenzolar-s-methyl, chlorothalonil, propiconazole, cimectacarb, fluazinam, and penthiopyrad. The reporter indicates a longtime member of the golf club claimed 2 years ago, and again an unknown number of days before the day of initial contact with the registrant, that he was diagnosed with Parkinson's disease. The member also claimed his doctors stated the Parkinson's disease was caused by exposure to the pesticides at the golf course over a 40 year period. No additional information is available.

To be determined by Registrant

14. Severity classification.

Major

15. Provide supplemental information here.