Incident Report

Subform I: General Information

1. Report Type.

New incident report

Incident Report Number: 2024-2330

2. Registrant Information.

Registrant Reference Number: X

Registrant Name (Full Legal Name no abbreviations): X

Address: X

City: X

Prov / State: X

Country: X

Postal Code: 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.

06-MAY-24

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 SUBSPECIES KURSTAKI (ALL STRAINS)

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7. b) Type of formulation.

Liquid

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).

BC's [Ministry] aerial sprayed Foray 48B on [Location] on May 6th, 2024. Although the ministry has stated that where they tested the wind, wind speeds did not exceed the permitted 8 km/h, the area sprayed is adjacent to [Lake] which provides drinking water to 1400 homes as well as agricultural irrigation. This lake and the watershed that surrounds it are home to a plethora of aquatic life, birds and plants and support biodiversity. [Lake] has been under threat by drought, algae blooms and other issues over the past several years. On May 6, the wind picked up substantially over the lake during the aerial spray. The wind was blowing in a S-SW direction, causing a wind tunnel affect over [Location] and blowing the pesticide back towards the water. The plane began to spray as soon as it crossed the lake, with winds estimated at 19 to 30 km/h using the Beaufort wind scale. The safety data sheet for Foray 48B cautions the product and its runoff should be kept out of drains, sewers, ditches and waterways. Further, Health Canada's Pest Management Regulatory Agency (PMRA) defines a sensitive aquatic habitat as a lake or creek adjacent to or within a spray area and requires that these habitats be protected from spray drift if downwind from the treatment area. [Creek], the sole outlet stream of [Lake] and home to coho salmon and cutthroat trout, is directly in the designated treatment zone.

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: Unknown

Age: Unknown / Inconnu

3. List all symptoms, using the selections below.

System

• Nervous and Muscular Systems
  • Symptom - Headache

• General
  • Symptom - Metallic taste in the mouth
  • Symptom - Malaise
  • Symptom - Fatigue

• Respiratory System
  • Symptom - Stuffy 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)

Drift from the application site

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.

<=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.)

I live on the north end of the lake, the wind was blowing the spray directly towards my home. I never get headaches, but within 15 minutes of the spray ending I had a headache, a stuffy nose, a metallic taste in my mouth, and I suffered fatigue and a general malaise for the rest of the day.

To be determined by Registrant

14. Severity classification.

15. Provide supplemental information here.