Illness, injuries, and deaths from pesticide exposures in California 1949-1988.

Data on human acute illness/injury and death associated with pesticide exposure in California for the 40-yr period, beginning with 1949, were reviewed. Even though California has better data of this type than most government jurisdictions in the world, there are some shortcomings. In the early part of this period, nonoccupational data were scant because poison information centers were just being developed. Also in the early period, many occupational exposures were not recorded in state statistics although a good system to allow for such reporting was in place. California data currently available still do not take into account (i) persons who are exposed and become ill, but do not visit a physician or call a poison center, and (ii) most occupational exposures of the self-employed, U.S. military employees, U.S. government employees, maritime workers, and interstate railroad workers. In 1987, 268,092,595 kg of pesticides were sold and estimated as used in the state. Although the amount of pesticides used annually in California is estimated to have increased 4-fold in this 40-yr period, it is believed that the actual number of pesticide-related occupational illnesses/yr increased very little. Cholinesterase inhibitors and methyl bromide were most often involved in the more serious occupational systemic poisonings throughout the time period. Well-educated and trained farmers and other pesticide handlers as well as a strict regulatory system have contributed to keeping the number and the extent of pesticide exposure in check, considering the widespread use of pesticides, some of which are quite toxic and potentially hazardous if misused. In 1987, there were 1,507 cases of occupational illness identified, with 744 of these demonstrating systemic toxic symptoms. In 1987, approximately 17,000 human pesticide exposure incidents, almost all of which were nonoccupational, were handled by poison control centers. It is estimated that about 30 to 60% developed signs or symptoms. Occupational deaths for the past 10 yr have averaged about 1/yr. Suicides by use of pesticides are estimated at 15/yr, and nonsuicides, nonoccupational deaths are estimated at 5/yr. This paper does not address chronic effects such as cancer induction, developmental effects, or reproductive effects that may be suspected as being the result of pesticide exposure. Data presented in this report may be useful in estimating the number of poisonings that may occur in other geographic settings. Numerous variables that must be considered in making such estimates are discussed.