Surveillance of acute plant protection pesticide-related poisonings in Italy

Objective: Regulation 2009/1185/EU on sustainable use of pesticides requires reporting from European Member States on plant protection pesticide (PPP)-related poisonings. These data can provide an informative basis to identify emerging problems, support development of preventive and regulatory measures and evaluate their impact. In Italy, surveillance of acute PPP-related poisonings (SAPReP), based on Poison Control Centre data, has been implemented since 2001 by the Italian National Institute of Health and the National Poison Control Centre in Milan. The present contribution is aimed at characterizing PPP-related poisonings identified in Italy. Methods: Information on cases notified to SAPReP during 2007–2012 were reviewed and classified according to standard rules: the reported exposures were grouped according to main category of use and chemical class, as indicated by Regulation (EC) No 1185/2009 concerning statistics on pesticides. Each case was reviewed to evaluate the association between exposure and clinical effects. Severity of poisonings was assessed according to Poisoning Severity Score.[1] Results: There were 2108 cases of accidental PPP-related poisonings over the study period. Most involved males (1442, 68%; females 442, 20%; gender unknown 224, 12%). About 50% of poisonings occurred at work, in agricultural settings, and 36% at home. Some 70% of exposures occurred between May and September. Severity of poisoning was low in 84% of cases (1774), moderate in 14% (305) and high in 1% (28). One fatal case was identified. Clinical effects most frequently reported included gastrointestinal (1316; 28%), ocular (933; 20%), dermatological (585; 13%), and respiratory (562; 12%) signs/symptoms. Insecticides/acaricides were involved in 42% of poisonings, fungicides/bactericides in 16%, herbicides in 15%, and soil sterilants in 13%. Five mass exposures were identified: two incidents were caused by off-site drift of metam sodium, a soil sterilant, and involved 86 and 103 by-standers, respectively; two incidents were caused by chlorpyrifos methyl, an organophosphate insecticide/acaricide (one occurred in a hospital, 10 cases; one occurred in agricultural setting, 20 agricultural workers); one incident was caused by phenthoate and involved 40 agricultural workers. Conclusion: Our findings indicate that acute pesticidesrelated poisonings continue to be an important health factor in Italy. Furthermore, it provides an example of how reporting PPPrelated poisoning could be standardised in order to support comparability between data collected by Member States