Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2021-1364

2. Registrant Information.

Registrant Reference Number: 2872980

Registrant Name (Full Legal Name no abbreviations): Bayer CropScience Inc.

Address: 160 QUARRY PARK BLVD. SE Suite 200

City: CALGARY

Prov / State: AB

Country: Canada

Postal Code: T2C 3G3

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

Human

4. Date registrant was first informed of the incident.

05-FEB-21

5. Location of incident.

Country: CANADA

Prov / State: ALBERTA

6. Date incident was first observed.

26-JAN-21

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. 32524      PMRA Submission No.       EPA Registration No.

Product Name: TEMPRID SC INSECTICIDE

• Active Ingredient(s)
  • BETA-CYFLUTHRIN
    • Guarantee/concentration 10.5 %
  • IMIDACLOPRID
    • Guarantee/concentration 21 %

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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: Other / Autre

Préciser le type: Office building

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

Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding application.

To be determined by Registrant

12. In your opinion, was the product used according to the label instructions?

Yes

Subform II: Human Incident Report (A separate form for each person affected)

1. Source of Report.

Other

2. Demographic information of data subject

Sex: Female

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Skin
  • Symptom - Irritated skin

4. How long did the symptoms last?

Unknown / Inconnu

5. Was medical treatment provided? Provide details in question 13.

Yes

6. a) Was the person hospitalized?

No

6. b) For how long?

Unknown

7. Exposure scenario

Occupational

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

What was the activity? Please refer to field 13 on Subform II or field 17 of subform III for a detailed description regarding the activity

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?

<=15 min / <=15 min

12. Time between exposure and onset of symptoms.

<=30 min / <=30 min

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.)

2/5/2021 Caller is a pest control operator. His company applied the product per label directions 10 days ago in cracks and crevasses in an office apartment building at the end of the day. The employees came into the office building the next day and opened windows. One employee reported entering the office building and developed a burning sensation on her skin. She went to the doctor and was given Benadryl. Caller has no other details about the employee. There was no known direct exposure to the product by this employee.

To be determined by Registrant

14. Severity classification.

Moderate

15. Provide supplemental information here.

Correlation Score: 2 (Unlikely Relationship). The product was applied approximately 12 or more hours prior to the employee entering the office and the product was only applied to cracks and crevices. Given the application and time it is likely the product had ample opportunity to settle, dissipate and dry prior to the employee entering the office. While Beta-cyfluthrin can cause paresthesia reactions this would be in direct contact with the liquid product. She did not likely have any contact with the wet product. The product has not been shown to be a sensitizer but allergic reactions can occur in sensitive individuals and all other differential diagnoses have not been ruled out.