Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2023-6196
2. Registrant Information.
Registrant Reference Number: 2023-20
Registrant Name (Full Legal Name no abbreviations): BASF Canada Inc.
Address: 5025 Creekbank Road, Building A, 2nd Floor
City: Mississauga
Prov / State: Ontario
Country: Canada
Postal Code: L4W 0B6
3. Select the appropriate subform(s) for the incident.
Human
4. Date registrant was first informed of the incident.
06-JUL-23
5. Location of incident.
Country: CANADA
Prov / State: SASKATCHEWAN
6. Date incident was first observed.
21-JUN-23
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. 27598
PMRA Submission No.
EPA Registration No.
Product Name: CENTURION Emulsifiable Concentrate Post-Emergent Herbicide
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: Agricultural-Outdoor/Agricole-extérieur
Préciser le type: Canola
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
The caller was spraying his crop and was adding the product to the sprayer when the product spilled onto his leg/pants and on top of his shoe.
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
- Skin
- Symptom - Rash
- Symptom - Flushed
- Symptom - Itchy skin
- Symptom - Red skin
- Symptom - Burns (superficial)
- Symptom - Inflammation of the skin
- Symptom - Other
- Specify - Leakage
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?
No
6. b) For how long?
7. Exposure scenario
Unknown
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)
Long pants
10. Route(s) of exposure.
Skin
11. What was the length of exposure?
>1 wk <=1 mo / > 1 sem < = 1 mois
12. Time between exposure and onset of symptoms.
>1 wk <=1 mo / > 1 sem < = 1 mois
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.)
The caller kept working after the exposure and did not immediately wash the product off until about 2 hours later. The product dried on his jeans/leg area. He later washed the product off his skin and his clothes. He indicated on July 2, 2023 that he developed a red, itchy rash on his leg. He used hydrocortisone cream, aloe vera, and camomile lotion for treatment. On July 6, 2023, he visited the ER for evaluation. The caller said that the doctor said it was a chemical burn from the product because he was wearing the same jeans and shoes that had not been washed. He then exposed his skin to sunlight and that's what caused the rash. On July 7, 2023, the caller communicated that the inflammation was going down, there's some leakage, but it is healing.
To be determined by Registrant
14. Severity classification.
Minor
15. Provide supplemental information here.