T&E Item 1
March 16,2015
Worksession
MEMORANDUM
March 12,2015
TO:
FROM:
Transportation, Infrastructure, Ent;1,
t
Environment Committee
Josh Hamlin, Legislative Attomen
SUBJECT:
Worksession:
Bill 52-14, Pesticides - Notice Requirements - Non-Essential
Pesticides Prohibitions
Expected Attendees
Panel 1:
Lisa Feldt, Director, Department of Environmental Protection (DEP)
Stan Edwards, Chief, DEP Division of Environmental Policy and Compliance
Carol Holko, Assistant Secretary, Plant Industries
&
Pest Management, Maryland
Department of Agriculture
Dan Kenny, Branch Chief, Herbicide Branch, Office of Pesticide Programs, Registration
Division, U.S. Environmental Protection Agency
Panel 2:
Dr. Jerome Paulson, MD, FAAP Professor Emeritus in Pediatrics at the George
Washington University School of Medicine and Health Sciences and Professor
Emeritus in Environmental
&
Occupational Health at the George Washington
University Milken Institute School of Public Health
Dr. Lome
K.
Garrettson, MD, FAAP, F AACT, Professor Emeritus, Emory University,
Departments of Pediatrics and Environmental and Occupational Medicine
Dr. Stuart Z. Cohen, Ph.D., CGWP, Environmental and Turf Services, Inc.
Bill 52-14, Pesticides - Notice Requirements - Non-Essential Pesticides - Prohibitions,
sponsored by then Council Vice President Leventhal and Councilmembers EIrich, Riemer, Floreen,
and Navarro was introduced on October 28. Public hearing on the Bill began on January 15, and
was continued on February 12.
An
additional Transportation, Infrastructure, Energy and
Environment Committee worksession is tentatively scheduled for March 30,2015 at 9:30 a.m.
Bill 52-14 would:
(1)
require posting of notice for certain lawn applications ofpesticide;
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(2)
(3)
(4)
(5)
prohibit the use of certain pesticides on lawns;
prohibit the use of certain pesticides on certain County-owned property;
require the County
to
adopt an integrated pest management program for certain
County-owned property; and
generally amend County law regarding pesticides.
Council Vice President Leventhal has explained the purpose of this Bill in his October 22,
2014 memorandum to Councilmembers (See ©14-64).1
Background
Shared Regulation ofPesticides
The regulation of pesticides is the shared responsibility of federal, state, and local
governments. This shared approach, known as "environmental federalism," is consistently
applied among several federal environmental protection laws,
2
and has evolved largely over the
last 50 years.
At the national level, the Federal Insecticide, Fungicide and Rodenticide Act ("FIFRA") is
the primary vehicle for pesticide regulation. FIFRA was enacted in 1947, and has evolved from
being primarily a labeling statute to become a somewhat more broad regulation. In 1972,
administration of FIFRA was transferred to the newly created Environmental Protection Agency
("EPA"), which is responsible for classifying pesticides based on a review of the scientific
evidence of their safety and impact on the health of individuals and the environment. FIFRA also
requires EPA to maintain a registry of all but "minimum risk" pesticides.
3
In addition to the
classification and registry of pesticides, FIFRA provides a uniform national standard for labeling
pesticides. FIFRA does not comprehensively regulate pesticides, however, and does not include
public notice or permit requirements for the use of pesticides.
Under FIFRA, the states are the primary enforcers ofpesticide use regulations, and FIFRA
expressly authorizes states to enact their own regulatory measures concerning the sale or use of
any federally registered pesticides in the state, provided the state regulation is at least as restrictive
as FIFRA itself. In Maryland, pesticides are regulated by the Maryland Department ofAgriculture,
through the enforcement of Subtitles I and 2 of Title 5 of the Agriculture Article of the Maryland
additional background on this Committee's recent consideration of pesticides and pesticide use in Montgomery
County, see the packet for the September 9, 2013 discussion at:
http://www6.montgomerycountymd.gov/contentlcouncil/pdf/age
ndalcm/20131130909/20
130909 TE3.pdf. Video of
the discussion is available, beginning at 22: 10, at:
http://montgomerycountymd.granicus.com/MediaPlayer.php?view id==6&clip id=5704.
2
The 1972 Federal Water Pollution Control Act, the 1986 amendments to the Safe Drinking Water Act, the Toxic
Substances Control Act, the Resource Conservation and Recovery Act, and the Oil Pollution Control Act of 1990 all
provide for state and local regulatory roles.
3
Minimum risk pesticides are a special class of pesticides that are not subject to federal registration requirements
because their ingredients, both active and inert, are
demonstrably
safe for the intended use. Information about
EPA's treatment of minimum risk pesticides can
be
found at:
http://www.epa.gov/oppbppdllbiopesticideslregtools/25b/25b-fag.htm
1
For
2
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Code.
4
Maryland law and regulations generally create a pesticide registration and labeling regime
at the state level, and a licensing program for the application of certain pesticides. Title 5 does not
include any express preemption language, and does not appear to generally regulate pesticides so
comprehensively that preemption can be implied. As a general matter, therefore, the County may
regulate pesticides, at least as restrictive as, and consistent with, federal and State law.
The authority of local governments to regulate pesticides was the subject of significant
litigation in the 1980s, with a County law struck down as preempted by FIFRA.
In
Maryland Pest
Control Assn. v. Montgomery County, Maryland,
646 F. Supp. 109 (D. Md. 1986), the U.S. District
Court held that FIFRA preempted the County's local law imposing pesticide posting and notice
requirements. The Court held that if Congress had wanted to include local governments in the
regulation of pesticides, it would have expressly done so. However, in
Wisconsin Public
Intervenor v. Mortier,
111 S. Ct. 2476 (1991), the U.S. Supreme Court held, contrary to the
Maryland Pest Control Assn.
decision, that a unit of local government has the power, under
FIFRA, to regulate pesticides within its own jurisdiction, provided that the local regulation is at
least as restrictive as, and consistent with, FIFRA and any applicable state law. Since
Mortier
was
decided, many states have expressly preempted local jurisdictions from regulating pesticides, but
Maryland is one of seven states which do not preempt local regulation of pesticides.
5
The County
currently imposes certain notice, storage, handling, and consumer information requirements in
Chapter 33B of the County Code.
Laws in Other Jurisdictions
Due
to
the fact that the vast majority of states have preempted local jurisdictions from
regulating pesticides, there are only two examples of local jurisdictions that have banned pesticide
use on public and private property
6:
Takoma Park, Maryland
7,
and Ogunquit, Maine. s Several
local jurisdictions have enacted legislation or adopted administrative policies related to pesticide
reduction on public property, integrated pest management (IPM), and pesticide free parks.
9
Locally in addition to Takoma Park, the District of Columbia enacted the Pesticide Education and
Control Amendment Act Of 2012
10
which restricts the application of certain pesticides near
waterways and at schools, day care centers and on District property, and imposes certain reporting
and data collection requirements. Most recently, Richmond, California, which has had an IPM
ordinance since 2012, passed a resolution to implement a "twelve month long ban on the use of all
toxic pesticides, including those containing glyphosate, on all weed abatement activities
conducted, contracted, or managed by the city ..
.',11
Subtitle 1 is entitled the "Maryland Pesticide Registration and Labeling Law." Subtitle 2 is the "Pesticide
App1icator's Law."
s
http://www.bevondpesticides.org!lawn/activist!documents/StatePreemption.pdf
6
http://www .telegraph.co.uklnews/wor Idnews/ 10959057IEnd-of-the-perfect-American-lawn-Campaigners-caII-for­
pesticide-ban.htrnl
7
http://www.takomaparkmd.gov/safegrow
8
http://ogunquitconservation.org!ogunquitconservation.org/PesticideOrdinanceOverview.html
9
http://www.
beyond pesticides. org!lawnlactivist!
10
The signed Act is at: http://lims.dccouncil.us/Downloadl26399/B 19-0643-SignedAct.pdf. The Committee report
is at: http://lims.dccouncil.us/Download/2594/B 19-0643-COMMITTEEREPORT.pdf
t t
Discussion of the resolution begins at page 99 of the pdf of the agenda packet found at:
http://sireweb.ci.richmond.ca.us/sirepub/cache/2/mz3m 1yjgzymhc5rcpumaI
wre/426
17 1030920151 05517360.PDF
4
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Perhaps the most comprehensive pesticide restriction law in North America took effect in
the Canadian province of Ontario in
2009.
12
The Ontario law contains several classifications of
pesticides, and generally bans the cosmetic use of over
100
pesticides.
13
Six other provinces have
followed Ontario in restricting cosmetic use of pesticides.
14
British Columbia, however,
considered, but did not implement a provincial
ban
on cosmetic pesticides.
15
Pending legislation in the Maryland General Assembly
The Maryland General Assembly is currently considering two bills related to pesticides
which have objectives similar to Bill
52-14.
The bills would:
(1)
impose labeling requirements
and future sale and use restrictions on neonicotinoid pesticides; and (2) prohibit, except in
emergencies, the application of lawn care pesticides to certain areas used by children under the
age of 18 years.
House Bill
605,16
cross-filed with Senate Bill
163,
would establish a labeling requirement
for any seed, plant material, nursery stock, annual plant, bedding plant, or other plant that has been
treated with a neonicotinoid pesticide
J7
and would establish restrictions, effective January
1,2016,
on the sale and use of neonicotinoid pesticides. The future restrictions would:
(l)
limit the use of
neonicotinoid pesticides to applicators certified by the Maryland Department of Agriculture
(MDA), and farmers using the pesticide for agricultural purposes; and (2) require a seller of
neonicotinoid pesticides to be permitted by MDA to sell restricted-use pesticides. House Bill
605
is scheduled in the House Environment and Transportation Committee at
1:00
pm on March
13.
House Bill 995
18
would generally prohibit the application of certain pesticides on the
grounds of certain child care centers, schools, and recreation centers and on certain other
recreational fields. The prohibition would apply to pesticides registered by the EPA and labeled
pursuant to the FIFRA for use in lawn, garden, or ornamental sites and areas. A person would be
able to apply for an emergency exemption from the prohibition when necessary to eliminate an
immediate threat to human health. House Bill 995 is also scheduled in the House Environment
and Transportation Committee at 1:00 pm on March 13.
Bill 52-14
http://www.davidsuzuki.orgiissues/ht!alth/science/pesticidesIhighlights-of-ontarios-cosmetic-pesticide-banl
13
https:llwww.ontario.calenvironment-and-energy/pesticides-home-lawns-and-gardens
14
http://news.gov.mb.calnewslindex.html?item=30526
15
The Report of the British Columbia Special Committee on Cosmetic Pesticides, which was "convinced that
further restrictions on the use and sale of pesticides in British Columbia are necessary" but was "unable to reach a
consensus on the need for a provincial ban on pesticide use for cosmetic purposes" is at:
https://www.leg.bc.calcmt/39thparl/session-4/cp/reportslPDFlRpt-CP-39-4-Report-2012-MAY-17.pdf
16
http://mga\eg.maryJand.gov/webmgalfrmMain
.as
px?id=hb0605&stab=O 1
&pid"'bi II page&tab=subject3 &ys=20 15RS
17
The required label would read:
"WARNING: Bees are essential to many agricultural crops. This product has been treated with
neonicotinoid pesticides, found to be a major contributor to bee deaths and the depletion of the bee
population."
12
IS
http://mgaleg.maryland.gov/webmga/frmMain.aspx?id=hb0995&stab=O I&pid=billpage&tab=subject3&ys=20 15RS
4
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Bill 52-14 includes provisions related to the application of pesticides on County-owned
and private property, and requires the County to adopt an Integrated Pest Management (IPM) plan.
IPM is a method of pest control which minimizes the use of chemical pesticides by focusing on
pest identification, monitoring and assessing pest numbers and damage, and using a combination
of biological, cultural, physical/mechanical and, when necessary, chemical management tools.
19
Bill 52-14 will:
1) Require the posting of notice when a property owner applies a pesticide to an area of lawn
more than 100 square feet, consistent with the notice requirements for when a landscaping
business treats a lawn with a pesticide;
2) Require the Executive to designate a list of "non-essential" pesticides including:
• all pesticides classified as "Carcinogenic to Humans" or "Likely to Be Carcinogenic to
Humans" by the
u.s.
EPA;
• all pesticides classified by the U.S. EPA as "Restricted Use Products;"
• all pesticides classified as "Class 9" pesticides by the Ontario, Canada, Ministry of the
Environment;
• all pesticides classified as "Category 1 Endocrine Disruptors" by the European
Commission; and
• any other pesticides which the Executive determines are not critical to pest
management in the County.
3) Generally prohibit the application of non-essential pesticides to lawns, with exceptions for
noxious weed and invasive species control, agriCUlture and gardens, and golf courses;
4) Require the Executive to conduct a public outreach and education campaign before and
during the implementation of the Bill;
5) Generally prohibit the application ofnon-essential and neonicotinoid pesticides to County­
owned property; and
6) Require the County to adopt an Integrated Pest Management program.
Bill 52-14 has an expiration date of January 1, 2019.
Public Hearings and Correspondence
The Committee held public hearings on the Bill on January 15 and February 12, with 38
people testifying in January, and 30 speaking in February. In addition to the public hearing
testimony, the Bill has been, and continues to be, the subject of a huge amount of written
correspondence. The testimony and correspondence have coalesced around several recurring
themes, which frame major issues for the Committee to examine as it considers the Bill. These
themes include: (l) existing regulation of pesticides, particularly at the State and federal level is,
or is not, sufficient; (2) chemical pesticides pose, or do not pose, serious threats to human health;
(3) pesticides threaten, or do not threaten, the health of pollinators and the Chesapeake Bay
watershed; and (4)
it
is, or is not, possible or feasible to maintain lawns and playing fields without
the use of chemical pesticides.
19
http://www.epa.gov/oppOOOOl/factsheets/ipm.htm
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Agenda for March Worksessions
Two T &E worksessions on Bill 52-14 are scheduled for March 2015: March 16 and March
30. Council President Leventhal noted in his memorandum accompanying the Bill at introduction
that this issue is extraordinarily complex, and that a thoughtful approach with input from experts
in the field will be critical to a well-informed decision. With that in mind, the March worksessions
will be focused on allowing the Committee to explore, with guidance from several experts, the
several issues related to pesticide regulation. At the March 16
th
worksession, the Committee will
have the opportunity to hear first from a panel of regulators working at the County, State, and
federal levels of government. A second panel at this worksession will consist of physicians with
expertise in environmental health and toxicology, and an environmental chemist with 39 years of
experience in environmental and human risk assessment, with a focus on pesticides. The March
30 worksession will be structured to allow the Committee to engage in dialogue with experts in
pollinator and Chesapeake Bay watershed health,
turf
management experts, and public- and
private-sector landscaping professionals. Collectively, these worksessions should give the
Committee the information it needs to answer the questions of
whether
there is a need to further
regulate pesticides,
why
a need exists (if it exists), and
how
best to meet that need.
Panell: Existing Regulatory Framework
One recurring question in public hearing testimony and correspondence regarding Bill 52­
14 was whether additional regulation is necessary in view of the existing work done at the State
and federal levels. The first panel for this worksession will be composed of representatives of the
County's Department of Environmental Protection, the Maryland Department of Agriculture, and
the U.S. Environmental Protection Agency. Each of these entities plays a complementary role in
the regulation of pesticides in the County, and an understanding of these roles, and the scope of
the work done at each level will assist the Committee in answering that question.
County Pesticide Regulation
Chapter 33B, Pesticides, of the County Code, currently consists of four key requirements.
Chapter 33B requires:
• a custom applicator2
o
to provide certain information to new customers before and after the
application of a pesticide;
• posting of notice after application ofpesticide to a lawn by a custom applicator;
• retail sellers of pesticides to provide notice signs that are required by the County, as well
as the product label required under FIFRA; and
• retail sellers of pesticides to comply with certain transport, display, and storage
requirements.
State Pesticide RegUlation
There are two components of Maryland law regulating pesticides that are pertinent to the
consideration of a restriction on the use of pesticides for lawn care: the Maryland Pesticide
20
"Custom applicator" is defined in Chapter 33B as "a person engaged in the business of applying pesticides."
6
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Registration and Labeling Law, and the Pesticide Applicator's Law. Selected materials related to
MDA's pesticide regulation, taken from the MDA website, are at
1.082-134.
Maryland Pesticide Registration and Labeling Law
State law2
1
requires the registration of each brand or product name of a pesticide before it
can be distributed in the State. The registration must be made annually. The law also imposes
packaging and labeling requirements on certain pesticides. The Maryland Secretary ofAgriculture
may suspend or cancel the registration of a pesticide if it does not comply with State law, and the
law provides for several enforcement mechanisms, including administrative monetary penalties,
stop-sale orders, and seizure and condemnation of noncompliant pesticides.
Pesticide Applicator's Law
State law22 also establishes a licensing and certification regime for several practices
involving pesticide application. Under this regime, pesticide business licenses, pest control
consulting licenses, not-for-hire licenses, public agency permits, and certification of commercial
applicators and certain private applicators are required. The law also requires certain information
to be supplied by licensees to customers, and the posting ofsigns at the time ofcertain applications
ofpesticides. The law also requires each county board ofeducation to implement in its schools an
Integrated Pest Management system approved by MDA. A synopsis of the provisions of the
Pesticide Applicator's Law and associated regulations is at
1.0127-134.
Federal Pesticide Regulation
Federal law requires that all pesticides must be registered by the EPA prior to sale or
distribution in the United States. EPA must determine that a pesticide, used according to label
directions, can be used with a reasonable certainty of no harm to human health and without posing
unreasonable risks to the environment before registering it. EPA requires more than
100
different
scientific studies and tests from applicants in making such determinations. EPA also sets
"tolerances" (maximum pesticide residue levels), for pesticides that may be used on food or feed
crops, for the amount of the pesticide that can legally remain in or on foods. Key components of
EPA's role in pesticide regulation are briefly described below;23 a more in-depth, yet still concise,
discussion of EPA's pesticide regulatory programs can be found in the "Agency Response to
'Pesticides in the Air - Kids at Risk: Petition to EPA to Protect Children from Pesticide Drift
(2009)'"
at
1.0135-179.
24
Pre-Registration Evaluation
Maryland Code, Agriculture Article, Title 5. Pesticide and Pest Control, Subtitle 1. Maryland Pesticide
Registration and Labeling Law (§§5-101 through 5-211).
22
Maryland Code, Agriculture Article, Title 5. Pesticide and Pest Control, Subtitle 2. Pesticide Applicator's Law
(§§5-201 through 5-114)
23
The infonnation in this section is largely summarized from the EPA website. More comprehensive infonnation
about EPA's pesticide regulation can be found at: http://www2.epa.gov/pesticide-registration
24
Specific discussion of the EPA's regulatory program is at ©146-159.
21
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Before registering a pesticide, EPA evaluates it for impacts on human health in a process
called risk assessment. EPA pesticide risk assessment is a four step process:
1. Hazard Identification: The identification of potential health effects that may occur from
different types of pesticide exposure.
2. Dose-Response Assessment: Consideration of the dose levels at which adverse effects are
observed in test animals, and using that data to calculate an equal dose in humans.
3. Exposure Assessment: Consideration of how a person may be exposed to a pesticide: (1)
inhalation; (2) absorption through the skin (dermal); and through the mouth or digestive
tract (oral).
4. Risk Characterization: Combining the hazard, dose-response, and exposure assessments to
describe the overall risk from a pesticide.
In conducting risk assessments, EPA considers studies conducted over different periods of time
that measure specific effects. These include measurements of:
1. Acute toxicity (short-term or single exposure);
2. Sub-chronic toxicity (exposure over an intermediate period of time, i.e., 60-90 days);
3. Chronic toxicity (long-term exposure, repeated exposure over most of the test animal's
life span); and
4. Developmental and reproductive effects (effects on the fetus of an exposed female, and
effects of exposure on the ability to successfully reproduce).
Registration Classifications
EPA registers pesticides and their use on specific pests and under specific circumstances.
A pesticide registered for use on apples may not be used legally on grapes, or an insecticide
registered for "outdoor use" may not legally be used inside a bUilding.
In
some circumstances, use
of a registered pesticide may be
restricted
to pesticide applicators with special training. EPA
classifies pesticides into two categories: general use pesticides and restricted use pesticides.
Restricted use pesticides - which make up about a quarter of total pesticides used - must only be
applied by or under the direct supervision of trained and certified applicators.
25
Registration Review
In
2006, EPA initiated a new program called registration review to reevaluate all pesticides
on a regular cycle. The program's goal is to review each pesticide's active ingredient every 15
years to make sure that as the ability to assess risks to human health and the environment evolves
and as policies and practices change, all pesticide products in the marketplace can still
be
used
safely.
Reregistration
&
Tolerance Reassessment
EPA has completed a one-time program to review older pesticides (those initially
registered before November 1984) under FIFRA to ensure that they meet current scientific and
2S
The current list of Restricted Use Products (RUPs) is at: http://www.epa.gov/opprdOO l/rup/rupreport.pdf
8
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regulatory standards. This process, called reregistration, considers the human health and ecological
effects of pesticides and results in actions to reduce risks that are of concern. Implementation of
the decisions will continue beyond the 2008 completion of the reviews.
Pesticide Labeling
Pesticide labeling is a key component of EPA's regulation of pesticides. EPA reviews the
product label as part of the registration process for pesticides. The label provides critical
information about how to handle and safely use the pesticide product and avoid harm to human
health and the environment.
Possible issues to be explored with Panel 1 include:
• Enforcement of existing County pesticide laws;
• The adequacy of State and federal laws in protecting the public from misuse of pesticides
by non-commercial users;
• The adequacy of EPA's reliance on applicant-submitted data and animal testing in its risk
assessment process; and
• The frequency with which EPA denies or cancels a pesticide registration.
Panel 2:
Human Health Concerns and Risk Assessment
Health Concerns and Pesticides
There is growing evidence of harmful effects associated with long-term use of or exposure
to chemical pesticides.
26
While there is not at present a consensus on causation, pesticide exposure
has been linked to the following health problems: birth defects
27 ;
numerous cancers, including
non-Hodgkins lymphoma
28 ;
Parkinson's disease and other neurological disorders
29 ;
immune
system problems
30 ;
and male infertility?'
In
addition to potential links to human health problems,
neonicotinoids, a class ofinsecticide chemically related to nicotine, have been linked to population
declines in bees, which serve an important function in pollination.
32
A view of the health concerns associated with pesticide exposure, and the basis for those
concerns is presented in the attachments to this memorandum. Council President Leventhal has
discussed many of the health issues surrounding pesticide use in his memorandum at
©
14-64.
Attachments to the memorandum include the Policy Statement of the American Academy of
Pediatrics (AAP) on Pesticide Exposure in Children
18-25), as well as a number of studies and
articles referenced in the memorandum. The Technical Report that is the basis for the the AAP
Policy Statement on Pesticide Exposure in Children is at
©
180-207. A collection ofpeer-reviewed
http://www.nrdc.org/healthlkids/ocar/chap5.asp
27
http://www.webmd.com/babY/newsI20090327/do-pesticides-make-birth-defects-crop-up
28
http://www.cfp.calcontentl531l011704.short
29
http://www.scientificamerican.com/article/parkinsons-disease-and-pesticides-whats-the-connectionl
30
http://www. wri.org/pub!icationlpesticides-and-immune-system
31
http://weedingtech.convnew-study-suggests-exposure-to-roundup-herbicide-could-lead-to-male-infertility-21
32
http://usnews.nbcnews.com/news/20
12/03/2911
0921493-neonicotinoid-pesticides-tied-to-crashing-bee­
populations-2-studies-find
26
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studies and relevant reports on pesticides and human and environmental health, submitted by Safe
Grow Montgomery, is at ©208-212. Dr. Philip 1. Landrigan, MD, MSc,33 has submitted a letter
(©213-221) to the Council expressing his views on the health effects of pesticide exposure. Dr.
Garrettson, who will be part ofPanel 2, has submitted several abstracts from studies demonstrating
links between pesticides and health problems, with a focus on reproductive health (©224-235).
Dr. Cohen will be part of Panel 2, and will be presenting a counterpoint to the position that
pesticides present unacceptable risks to human health and are inadequately regulated. He has
submitted copies of the Powerpoint slides he will be presenting at the worksession, as well as a
letter responding to a number of issues raised at the public hearing related to concerns about the
health risks of pesticides (©236-285).
Councilmember Berliner invited a representative of the National Cancer Institute (NCI) at
the National Institutes of Health (©286-287) to attend this worksession. Stephen
J.
Chanock, MD,
Director of the Division of Cancer Epidemiology and Genetics at NCI, by letter dated March 11,
respectfully declined the invitation, saying that "NCI scientists do not typically weigh in on
regulatory or public policy decisions." Dr. Chanock's letter does provides some discussion of the
state of science with regard to carcinogenicity of pesticides (©288-290).
Possible issues to be explored with Panel 2 include:
• Whether the relationship between pesticide use and health problems is causal, correlational,
or neither;
• Whether certain pesticides present are particularly dangerous to human health;
• Whether pesticide risks are predominantly related to agricultural use/food consumption or
lawn care uses; and
• Whether measures short of a prohibition can be effective in reducing pesticide exposure.
This packet contains:
Circle #
Bill 52-14
1
Legislative Request Report
13
Council Vice President Leventhal Memo and attachments
14
Fiscal and Economic Impact statement
65
County Code Chapter 33B
73
COMCOR Chapter 33B - Pesticides
79
MDA Materials
Letter from Acting Secretary Joseph Bartenfelder, February 6, 2015 82
AgBrief Pesticide Regulation
84
Pest Control and Pesticide Information for Homeowners
86
Pesticides and Child Safety
89
Citizen's Guide to Pesticide Enforcement/Complaints
92
Maryland Pesticide Data Report for 2013
96
111
Maryland Pesticide Statistics for 2011
33
Dr. Landrigan is a pediatrician, epidemiologist, and Dean for Global Health
in
the rcahn School of Medicine at
Mount Sinai, Professor and Chairman of the Department of Preventive Medicine. And Professor of Pediatrics.
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Synopsis ofthe Maryland Pesticide Applicator's Law
EPA Materials
EPA Response to "Pesticides in the Air Kids at Risk: Petition
to the EPA to Protect Children from Pesticide Drift
AAP Technical Report, "Pesticide Exposure in Children"
Safe Grow Montgomery, Peer Reviewed Studies and Relevant Reports
Letter from Dr. Philip J. Landrigan
Brief Biographical Sketch for
Dr.
Jerome A. Paulson, MD
Brief Curriculum Vitae for
Dr.
Lome Garrettson, MD
Garrettson Materials
Cohen Materials
Powerpoint slides for worksession
Tabular summary of letter to Council President Leventhal
Letter to Council President Leventhal
Condensed Curriculum Vitae
US EPA pesticide data requirements
Berliner letter to NCI, March 3, 2015
Chanock letter to Berliner, March 11,2015
127
135
180
208
213
222
224
225
236
248
251
283
285
286
288
F:\LAW\BILLS\1452 Pesticides\T&E Memo 031615.Docx
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Bill No.
52-14
Notice
Concerning: Pesticides
Requirements
Non-essential
Pesticides - Prohibitions
Revised: October 22, 2014
Draft
No. ---=.9_ _ _ _ _ _ _ __
Introduced:
October 28, 2014
Expires:
April 28, 2016
Enacted: _ _ _ _ _ _ _ __
Executive: --'-_ _ _ _ _ _ __
Effective: _ _ _ _ _ _ _
~_
Sunset Date: January 1, 2019
Ch. _ _, Laws of Mont. Co. _ __
COUNTY COUNCIL
FOR MONTGOMERY COUNTY, MARYLAND
By: COWlcil Vice President Leventhal and Councilrnembers EIrich, Riemer, Floreen, and Navarro
AN ACT
to:
(1) require posting ofnotice for certain lawn applications ofpesticide;
(2) prohibit the use ofcertain pesticides on lawns;
(3) prohibit the use ofcertain pesticides on certain County-owned property
(4) require the County to adopt an integrated pest management program for certain COWlty­
owned property; and
(5) generally amend COWlty law regarding pesticides.
By amending
Montgomery County Code
Chapter 33B, Pesticides
Sections 33B-l, 33B-2, 33B-3, 33B-4, 33B-5, 33B-6, and 33B-7
By adding
Montgomery County Code
Chapter 33B, Pesticides
Articles 2, 3, 4, and 5
Sections 33B-8, 33B-9, 33B-1O, 33B-ll, 33B-12, and 33B-13
Boldface
Underlining
[Single boldface brackets]
Double underlining
[(Double boldface brackets]]
1<
1<
1<
Heading or defined term.
Added to existing law by original bill.
Deletedfrom existing law by original bill.
Added by amendment.
Deletedfrom existing law or the bill by amendment.
Existing law unaffected by bill.
The County Council for Montgomery County, Maryland approves the following Act:
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BILL
No. 52-14
1
Sec.
1.
Sections
33B-l, 33B-2, 33B4, 33B-5, 33B-6
and
33B-7
are
2
3
4
5
amended, and Sections
33B-8, 33B-9, 33B-IO, 33B-ll, 33B-12,
and
33B-13
are
added as follows:
ARTICLE
1.
General Provisions
33B-l.
Definitions.
In this [chapter] Chapter:
6
7
Agriculture
means the business, science, and art of cultivating and managing
the soil, composting, growing, harvesting, and selling sod, crops and livestock,
and the products of forestry, horticulture and hydroponics; breeding, raising, or
managing livestock, including horses, poultry, fish, game and fur-bearing
animals, dairying, beekeeping and similar activities, and equestrian events and
activities.
8
9
10
11
12
13
Custom applicator
means a person engaged in the business of applying
pesticides.
14
15
Department
means the Department of Environmental Protection.
Director
means Director of the Department of Environmental Protection[,] or
the Director's designee.
16
17
18
19
Integrated pest management
means
§:
process for managing pests that:
ill
uses monitoring to detennine pest
injut:y
levels;
combines biological
2
cultural, mechanical, physical, and chemical
tools and other management practices to control pests in
cost effective,
and
environmentally
sound
§:
20
21
rn
safe,
that
22
23
24
manner
contributes to the protection of public health and sustainability;
ill
uses knowledge about pests, such as infestations, thresholds, life
histories, environmental requirements, and natural control of
pests; and
25
26
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BILL No. 52-14
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uses non-chemical pest-control methods and the careful use of
least-toxic chemical methods when non-chemical methods have
been exhausted or are not feasible.
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31
Larvicide
means
~
pesticide designed to kill larval pests.
Lawn
means an area of land, except agricultural land, that is:
32
33
34
(1)
[Mostly] mostly covered by grass, other similar herbaceous
plants, shrubs, or trees; and
(2)
[Kept] kept
trim
by mowing or cutting.
~
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36
Lawn
includes an athletic playing field other than
golf course.
Lawn
does
not include
~
garden.
Neonicotinoid
means
~
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class of neuro-active pesticides chemically related to
nicotine.
Neonicotinoid includes acetamiprid, clothianidin, dinotefuran,
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imidacloprid, nitenpyram, nithiazine. thiacloprid, and thiamethoxam.
Non-essential pesticide
means
~
pesticide designated as
~
non-essential
pesticide under Section 33B-4.
Pest
means an insect, snail, slug, rodent, nematode, fungus, weed, or other
42
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form of plant or animal life or microorganism (except a microorganism on or
in a living human or animal) that is normally considered to be a pest or defmed
as a pest by applicable state regulations.
Pesticide
means a substance or mixture of substances intended or used to:
46
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48
(1)
(2)
(3)
prevent, destroy, repel, or mitigate any pest;
be used as a plant regulator, defoliant, or desiccant; or
be used as a spray adjuvant, such as a wetting agent or adhesive.
49
50
However,
pesticide
does not include an antimicrobial agent, such as a
disinfectant, sanitizer, or deodorizer, used for cleaning that is not considered a
pesticide under any federal or state law or regulation.
51
52
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BILL
No.
52-14
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Private lawn application
means the application of
f!
pesticide to
f!
lawn on
property owned by or leased to the person applying the pesticide.
Private
lawn application
does not include:
ill
ill
applying
f!
pesticide for the purpose of engaging in agriculture;
applying
f!
pesticide around or near the foundation of
f!
building
for purpose of indoor pest control;
ill
applying
f!
pesticide to
f!
golf course or turf farm.
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61
Vector
means an animal, insect, or microorganism that carries and transmits an
infectious pathogen into another organism.
[33B-4.] 33B-2. Signs with retail purchase of pesticide.
A person who sells at retail a pesticide or material that contains a pesticide
must make available to a person who buys the pesticide or material that contains a
pesticide;
(a)
[Notice] notice signs and supporting information that are approved by
the [department] Department; and
(b)
[The] the product label or other information that the federal Insecticide,
Fungicide, and Rodenticide Act (FIFRA) [, 7 U.S.C. 136 et seq.,]
requires for sale ofthe pesticide.
The Department must enforce this Section and must annually inspect each
person who sells at retail
f!
pesticide or material that contains
f!
pesticide.
[33B-5] 33B-3. Storage and handling of pesticides.
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75
*
[33B-6] 33B-4. Regulations.
(a)
*
*
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The [County] Executive must adopt regulations to carry out this Chapter
under method (2).
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BILL
No.
52-14
78
79
(b)
The Executive must include in the regulations adopted under this
[section] Section the minimum size or quantity of pesticide subject to
[section 33B-4] Section 33B-2.
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W
The Executive must include in the regulations adopted under this
Section g list of non-essential pesticides.
pesticides must include:
The list of non-essential
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all pesticides classified as "Carcinogenic to Humans" or "Likely
to Be Carcinogenic to Humans"
by
the U.S. Environmental
Protection Agency;
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@
all pesticides classified
by
the U.S. Environmental Protection
Agency as g "Restricted Use Product";
all pesticides classified as g "Class 9" pesticide
by
the Ontario,
Canada, Ministry ofthe Environment;
all pesticides classified as g "Category
1
Endocrine Disruptor"
by
the European Commission; and
any .other pesticides which the Executive determines are not
critical to pest manggement in the County.
90
91
92
93
94
95
The Executive must include in the regulations adopted under this
Section
g
list of invasive species that may be detrimental to the
environment in the County.
96
97
98
99
100
101
102
103
104
W
The Executive must review and update the lists of non-essential
pesticides and invasive species designated under subsections
W
and
@
by
July
1
of each year.
[33B-7] 33B-S. Penalty for violating chapter.
(a)
(b)
Any violation of this Chapter is a class C violation.
Each day a violation continues is a separate offense.
ARTICLE 2. Notice Requirements.
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BILL No. 52-14
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[33B-2] 33B-6. Notice about pesticides to customer.
(a)
In
this [section] Section:
(1)
Customer means a person who makes a contract with a custom
applicator to have the custom applicator apply a pesticide to a
lawn.
(2)
New customer includes a customer who renews a contract with a
custom applicator.
(b)
A custom applicator must give to a new customer:
(1)
[Before] before application, a list of:
[a.)(A)
used;
[b.](ID
[The] the generic name of each pesticide that might
[The] the trade name of each pesticide that might be
be used; and
[c.](Q
[Specific) specific customer safety precautions for
each pesticide that might be used; and
(2)
[After] after application, a list of:
[a.](A)
and
[b.](ID
[The] the generic name of each pesticide actually
[The] the trade name of each pesticide actually used;
used; and
(3)
[A]
~
written notice about pesticides prepared by the [department]
Department under subsection (c) [ofthis section].
(c)
The [department] Department must prepare, keep current, and provide
to a custom applicator a written notice about pesticides for the custom
applicator to give to a customer under subsection (b) [of this section].
(d)
The notice prepared by the [department] Department under subsection
(c) [ofthis section) must include:
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BILL
No. 52-14
132
(1)
[Government] government agency phone numbers to call to:
[a·1®
[Make] make a consumer complaint;
[Receive1
receIve
technical
information
on
133
134
135
[b·1@
pesticides; and
[c.]
(Q
[Get] get assistance
ill
136
137
138
the case of a medical
emergency;
(2)
[A]
~
list of general safety precautions a customer should take
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142
when a lawn is treated with a pesticide;
(3)
[A1
~
statement that a custom applicator must:
[a.](A)
[Be] be licensed by the Maryland Department of
Agriculture; and
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[b.]@
(4)
[A]
~
[Follow] follow safety precautions; and
statement that the customer has the right to require the
custom applicator to notify the customer before each treatment of
the lawn ofthe customer with a pesticide.
146
147
148
[33B-3] 33B-7. Posting signs after application
by
custom applicator.
(a)
Immediately after a custom applicator treats a lawn with a pesticide, the
custom applicator must [post a sign on the lawn] place markers within
or along the perimeter ofthe area where pesticides will be applied.
(b)
A [sign posted] marker required under this [section] Section must:
(1)
[Be] be clearly visible [from the principal place of access to] to
persons immediately outside the perimeter of the property;
(2)
[Be] be a size, form, and color approved by the [department]
Department;
(3)
[Be] be made of material approved by the [department]
Department; [and]
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BILL
No.
52-14
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(4)
[Have] have wording with content and dimensions approved by
the [department] Department[.]; and
ill
be in place on the day that the pesticide is applied.
33B-S. Posting signs after
application
!!I
property owner
Q!
tenant.
ill
A person who performs !! private lawn application treating an area
more than 100 square feet must place markers within or along the
perimeter of the area where pesticides will be applied.
(Q)
A marker required under this Section must:
ill
ill
ill
ffi
ill
be clearly visible to persons immediately outside the perimeter of
the property;
be !! size, form, and color approved
Qy
the Department;
be made ofmaterial approved
Qy
the Department; and
have wording with content and dimensions approved
Qy
the
Department; and
be in place on the day that the pesticide is applied.
ARTICLE 3. Application restrictions.
33B-9. Prohibited application.
A person must not!!PPlY!! non-essential pesticide to!! lawn.
33B-IO. Exceptions and Exemptions.
.cru
A person may !!PPlY !! non-esssential pesticide for the following
purposes:
ill
ill
ill
ffi
for the control of weeds as defmed in Chapter 58, Weeds;
for the control of invasive species listed in !! regulation adopted
under Subsection 33B-4(d);
for pest control while engaged in agriculture; and
for the maintenance of!! golf course.
181
182
183
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BILL
No.
52~14
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205
206
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209
(hl
A person may
ill2P1Y
to the Director for an exemption from the
prohibition of Section 33B-9 for
!!
non-essential pesticide. The Director
may
gmm
an exemption to
ill2lllY
!!
non-essential pesticide on property
where application is prohibited under Section 33B-9 if the applicant
shows that:
ill
ill
ill
(£)
effective alternatives are unavailable;
granting an exemption will not violate State or federal law; and
use of the non-essential pesticide is necessary to protect human
health or prevent significant economic damage.
A person may
mmlY
to the Director for an emergency exemption from
the prohibition in Section 33B-9 if
!!
pest outbreak poses an imminent
threat to public health or if significant economic damage would result
from the inability to use
!!
pesticide prohibited
Qy
Section 33B-9. The
Director may impose specific conditions for the granting of emergency
exemptions.
33B-ll. Outreach and Education Campaign.
The Executive must implement
!!
public outreach and education campaign
before and during implementation of the provisions of this Article. This campaign
should include:
ill)
(Q)
informational mailers to County households;
distribution of information through County internet and web-based
resources;
(£)
radio and television public service announcements;
news releases and news events;
information translated into Spanish, French, Chinese, Korean,
Vietnamese, and other languages, as needed;
@
{!U
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Bill No. 52-14
210
211
212
213
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219
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221
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223
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227
228
229
230
231
232
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235
236
ill
(g)
extensive use of County Cable Montgomery and other Public,
Educational, and Government channels funded
Qy
the County; and
posters and brochures made available at County events, on Ride-On
buses and through Regional Service Centers, libraries, recreation
facilities, senior centers, public schools, Montgomery College, health
care providers, hospitals, clinics, and other venues.
ARTICLE 4. County Pronerty
33B-12. Prohibition
Q!!
County-owned property.
ill)
Prohibition.
Except as provided in subsection
(Q1
~
person must not
apply to any property owned
Qy
the County:
ill
ill
(hl
~
non-essential
pesticide; or
~
nionicotinoid.
Exceptions.
ill
A person may use any larvicide or rodenticide on property owned
Qy
the County as
~
public health measure to reduce the spread of
disease vectors under recommendations and guidance provided
Qy
the Centers for Disease Control and Prevention, the United
States Environmental Protection Agency, or the State Department
of Agriculture. Any rodenticide used must be in
§!
tamper-proof
~
product, unless the rodenticide is designed and registered for
specific environment inaccessible
to
humans and pets.
ill
ill
A person may use
~
non-essential pesticide or neonicotinoid for
the purposes set forth in Subsection 33B-IO(a).
A person may use
~
non-essential pesticide or neonicotinoid on
property owned
Qy
the County if the Director determines, after
consulting the Directors of General Services and Health and
Human Services, that the use of pesticide is necessary to protect
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BILL
No. 52-14
237
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239
human health or prevent imminent and significant economic
damage, and that no reasonable alternative is available.
If!!
pesticide is used under this paragraph, the Director must, within
30 days after using the pesticide. report to the Council on the
reasons for the use ofthe pesticide.
33B-13. Integrated pest management.
240
241
242
243
W
Adoption
gf
program.
The Department must adopt,
Qy
!! method
ill
244
245
246
247
248
regulation, an intewted pest management program for property owned
Qy
the County.
@
Requirements.
Any program adopted under subsection
W
must require:
249
250
251
252
253
ill
ill
ill
(1)
monitoring the turf or landscape;
accurate record-keeping documenting any potential pest problem;
evaluating the site for any injury caused
Qy
!! pest and
determining the appropriate treatment;
using!! treatment that is the least damaging to the general
environment and best preserves the natural ecosystem;
ill
using !! treatment that will be the most likely to produce long­
term reductions in pest control requirements and is operationally
feasible and cost effective in the short and long term;
254
255
256
257
258
®
using !! treatment that minimizes negative impacts to non-target
organIsms;
259
260
261
262
ill
f.ID
{2}
using !! treatment that is the least disruptive of natural controls;
using !! treatment that is the least hazardous to human health; and
exhausting the list of all non-chemical and organic treatments
available for the targeted pest before using any synthetic
chemical treatments.
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BILL
No.
52-14
263
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266
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271
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273
{£}
The Department must provide training in integrated pest management
for each employee who is responsible for pest management.
Sec. 2. Initial Lists of Non-Essential Pesticides and Invasive Species.
The
Executive must submit the lists of non-essential pesticides and invasive species
required by Subsections 33B-4(c) and (d) to the Council for approval by October 1,
2015.
Sec. 3. Effective Date.
The prohibitions on use of non-essential pesticides
contained
in
Section 33B-9 and the prohibitions on use of non-essential pesticides
and neonicotinoids contained
in
Section 33B-I2 take effect on January 1,2016.
Sec. 4. Expiration.
This Act and any regulation adopted under it expires on
January 1,2019.
Approved:
274
275
George Leventhal, President, County Council
Date
276
Approved:
277
Isiah Leggett, County Executive
Date
278
This is a correct copy o/Council action.
279
Linda M. Lauer, Clerk of the Council
Date
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LEGISLATIVE REQUEST REPORT
Bill 52-14
Pesticides
-
Notice Requirements
-
Non-Essential Pesticides
-
Prohibitions
DESCRIPTION:
This Bill would require posting of notice for certain lawn
applications of pesticide, prohibit the use of certain pesticides on
lawns, prohibit the use of certain pesticides on certain County-owned
property and require the County to adopt an integrated pest
management program for certain County-owned property.
Long tenn use of and exposure to certain chemical pesticides has
been linked to several health problems, including birth defects,
cancer, neurological problems, immune system problems, and male
infertility.
To protect the health of families, especially children, from the
unnecessary risks associated with the use of certain pesticides that
have been linked to a wide-range of diseases.
Department of Environmental Protection
To be requested.
To
be
requested.
To be requested.
To be researched.
Josh Hamlin, Legislative Attorney
To be researched.
PROBLEM:
GOALS AND
OBJECTIVES:
COORDINATION:
FISCAL IMPACT:
ECONOMIC
IMPACT:
EVALUATION:
EXPERIENCE
ELSEWHERE:
SOURCE OF
INFORMATION:
APPLICATION
WITHIN
MUNICIPALITIES:
PENALTIES:
Class C violation
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MONTGOMERY COUNTY COUNCIL
ROCKVILLE, MARYLAND
GEORGE LEVENTHAL
COUNCILMEMBER
AT-LARGE
MEMORANDUM
October
22, 2014
TO:
FROM:
Councilmembers
George Leventhal, Council Vice President
Pesticide Legislation
~~
SUBJECT:
This coming Tuesday. October
28,
I will be introducing legislation aimed at protecting the health
of families - and especially children - from the unnecessary risks associated with the use of
certain cosmetic pesticides that have been linked to a wide-range of diseases, and which provide
no health benefits.
As you know, for the better part of the last year,
L
have been working towards introducing
legislation on this matter. Since the September
2013
meeting of the T &E committee, I have met
with countless stakeholders, on both sides of the issue, to learn more about how pesticides are
being applied in the county, what other governments are doing to ensure that the public's health is
being protected, and what the latest research tells us about their risks. The legislation that Jam
introducing on Tuesday incorporates feedback I received from proponents and opponents on the
previous draft of the bill, which I shared with your offices back in May. The result is a bill that
balances the rights of homeowners to maintain a beautiful lawn with the rights of residents who
prefer to not
be
exposed to chemicals that have known health effects; I view this bill as a starting
point in our discussion which can be tweaked along the way.
I want to preface my concerns by affirming the value of pesticides when they are used to protect
public health, the environment, our food or our water supply, but when pesticides are used solely
to improve the appearance of landscapes, they can cause more harm than good. [n my view,
cosmetic pesticides present a substantial threat to the health oftoday's children. The American
Academy of Pediatrics states that children face the greatest risk from the chemicals they contain,
and that epidemiologic evidence demonstrates associations between early life exposure to
pesticides and pediatric cancers, decreased c,ognitive function and behavioral problems such as
ADHD.! Certain toxic chemicals can cause permanent brain damage in children even at low
levels of exposure that would have little to no adverse effect in an adult.2 A child doesn't even
I
2
Pediatrics,
Pesticide Exposure in Children, Volume 130, No.6, 1757 - 1763, December, 2012
Dr. Phillippe Grandjean, MD, Dr. Phillip Landrigan, MD,
The Lal!cer .".'eurology,
Neurobehavioral Effects of
FLOOR, ROCKVILLE, MARYLAND
STELLA
DeveloDmental Toxicitv Volume 13.
lssue
3
H10
rvrA~YLAN'O}I;VtNUE,
6TH
1·W.'HR
March 'O!
4
8.
WERNER OFFICE BUILDING
240n77-7811
20850
OR
24Dn77-7900, TTY
240n77-7914,
FAX240n77·7989
WWW,MONTGOMERYCOUNTYMD,GOV/COUNCIL
~
PRINTED ON RECYCLO:O PAPO:R
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have to be directly exposed to a pesticide to suffer negative health outcomes. During pregnancy,
chemicals in women can cross the placenta and result in higher fetal exposure than the mother has
been exposed to. Prenatal exposure to certain chemicals has been documented to increase the risk
of cancer in childhood,3 Virtually every pregnant woman in the United States is exposed to
mUltiple chemicals during a sensitive period offetal development that have been linked to
4
adverse reproductive and developmental outcomes.
Adults are also at risk ofdeveloping serious health problems due to pesticide exposure.
Researchers at the National Institutes of Health have linked pesticide use to a wide range of
diseases and conditions. Exposure to certain pesticides has been linked to Parkinson's disease,
diabetes, leukemia, lymphoma, lupus, rheumatoid arthritis, dementia, reproductive dysfunction,
Alzheimer's disease, and variety of cancers including breast. colol1, prostate and lung cancer,s
In addition to the adverse health effects to humans, pesticides can also affect animals, both pets
and wildlife, and our waterways. A recent study by the United States Geological Survey has
found that 90% of urban area waterways now have pesticide levels high enough to harm aquatic.
life, and moreover, the USGS said the harm to aquatic life was likely understated in their report.
6
Terrestrial wildlife is also being harmed by the use ofcertain pesticides. The most concerning
example involves honeybees, which pollinate nearly one-third of the food we eat, and a particular
class of pesticides called neonicotinoids. Neonicotinoids have been repeatedly and strongly linked
with the collapse of honey bee colonies. In just the last year, Maryland lost nearly 50 percent of
its honeybee population, an increase over previous years, which averaged about a one-third loss
annually.?
Before I describe what this bill does, let me describe what this bill does not do. This bill does not
ban the use of all pesticides;
it
would, however, restrict the use of certain toxic chemicals that are
most dangerous to human health. This bill does not prohibit the use of any pesticide for gardens.
And this bill would not prohibit the use of any pesticide for agricultural use. What this bilI does
do is seek to limit children's exposure to hannful pesticides in places where children are most
likely to be exposed to them. That being said, the major provisions of the bill are:
I) Require the posting of notice when a property owner applies a pesticide to an area of
lawn more than 100 square feet, consistent with the notice requirements for when a
landscaping business treats a lawn with a pesticides;
2) Require the Executive to designate a list of "non-essential" pesticides inCluding:
• all pesticides classified as "Carcinogenic to Humans" or "Likely to Be
Carcinogenic to Humans" by the U.S. EPA;
• all pesticides classified by the U.S. EPA as "Restricted Use Products;"
, American College a/Obstetricians
&
Gynecologists.
Committee Opinion
No. 575.
American
College
ofObsletricians
and
Gynecologists.
931-5.
October
2013
4
Environmental Health Perspectives.
Environmental Chemicals in
Pregnant
Women
in
the United States: NHANES
2003-2004.
Tracey
J.
Woodru/T.
Ami
R. Zota, Jackie M. Schwanz, Volumc
119,
No.6, 878-885. June
2011
;. Jan Ehrman.
NIH
Record,
Pesticide Use Linked to Lupus, Rheumatoid Arthritis,
http://nihrecord.nih.gov!ncwslettersl2011103 18 2011/sl01"v4.htm (accessed
August
3,
2014)
6
U.s. Geological Survey,
An
Oven'iew Comparing Results from Two Decades of Monitoring for Pesticides in the
Nation's
Streams and Rivers,
1992-2001
and
2002-2011,
Wesley W.
Stone,
Robert
J.
Gilliom, Jeffrey D. Martin,
hUI':!lpubs.usSs.gov/sir/20 14f5154fpdffsir20
14-5
r
54.pdf
(accessed
October
20,
2014)
1
Tim Wheeler, Mysterious bee die·off continues, extends beyond winfer,
Baltimore
Sun.,
http://ani des. hal ti
moresu
n
.COffif2
0
J
4-05-
15/tearu res/ha
I-mvsterious-bee-dieoff·cont
i
nlies-nearly-hal
man" and-
hives­
1051·201405
J
5 I bee-informed-partnership-honey-bee-beekeeners
(accessed October
20, 2014)
 PDF to HTML - Convert PDF files to HTML files
3)
4)
5)
6)
7)
• all pesticides classified as "Class 9" pesticides by the Ontario, Canada, Ministry
of the Environment; and
• all pesticides classified as "Category
1
Endocrine Disruptors" by the European
Commission
Generally prohibit the application of non-essential pesticides to lawns, with exceptions
for noxious weed and invasive species control, agriculture and gardens, and golf courses;
Require the Executive to conduct a public outreach and education campaign before and
during the implementation of the Bill;
Generally prohibit the application of
a
non-essential or neonicotinoid pesticide to
County-owned property; and
Require the County to adopt an Integrated Pest Management program.
Sunset the act and any regulation adopted under it on January 1, 2019
The pesticide industry will respond to this legislation by saying "the science isn't there" and that
"all pesticides are extensively tested and approved as safe by the EPA," but while both statements
sound believable, they belie the truth.
In
response to the charge that the science isn't there to
legislate, the absence of incontrovertible evidence does not justify inaction. As evidenced by this
memo, the number of studies from respected institutions of science linking pesticides to a variety
of cancers, neurodeve\opmelltal disorders and diseases is abundant and persuasive. Furthermore,
due to the inestimable number of chemical combinations possible from the thousands of products
on the market and the complex interactions with the human body. the research that opponents to
this legislation will demand will never be possible within the ethical confines of research. The
real danger lies not in being exposed to one chemical, but a mixture of chemicals. The EPA risk
assessment fails to look at the synergistic effects of multiple chemicals, even though studies show
that exposure to multiple chemicals that act on the same adverse outcome can have a greater
effect than exposure to an individual chemical.
s
And to the charge that a pesticide must be safe ifit has been approved by the EPA, the
Government Accountability Office (GAO) has found that many pesticides are currently being
approved for consumer use by the EPA without receipt and review of data that the manufacturer
is required to provide on the safety of the chemicals.
9
Alarmingly, in some cases the manufacturer
was given two years
to
submit studies on the effects of a pesticide. and ten years later no studies
had been received or reviewed by the EPA.
10
What's more, the EPA itself publishes an entire
manual-
Recognition and
Management
ofPesticide Poisonings
-
for healthcare professionals that
acknowledges the toxic nature and effects of many pesticides. As an educated populace, we like
to think that we have a high bar for pesticide safety in this country, but sadly. when a pesticide
has been approved by the EPA, it connotes little about its safety.
Lawn care does not have to be poisonous to people, pets, wildlife, or our waterways.
It
is simply
false to say that you can't have
a
lush, green lawn - free of weeds without the use of toxic
pesticides. Through proper management of the soil, along with the use of natural, organic
alternatives to synthetic pesticides, a high quality landscape can be achieved. And under my
8
National Research Council.
Committee on Improving
Risk
Analysis
Approaches Used
by
the U.S.
EPA
Science and
Decisions: Advancing Risk AssessmenL Washington, DC: National Academies Press; 2008
.
9
United States Govel71ment Accountability Office.
Pesticides - EPA Should Take Steps to Improve its Oversight of
Conditional Registrations, hUD:I/www.gao.gQv(assets/660/656825.pdf(accessed October 20,2014)
10
United States Gavernment Accountability Office,
Pesticides - EPA Should Take Steps to Improve its Oversight of
Conditional Registrations, http://www.gao.gov/asscLc;/660/656825.pdf(accessed October 20, 2014)
 PDF to HTML - Convert PDF files to HTML files
legislation, residents will still be free to hire any lawn care professional to treat their lawn or to
manage their own lawn care.
Much like the public debate that occurred in the 1950's before cigarettes were found to be cancer­
causing, ( believe we are approaching a similar turning point in the discourse on pesticides as the
public is made more aware of the known health effects. In
a
poll taken earlier this year, more than
three-quarters of Marylanders expressed concern about the risk that pesticides pose to them or
their families, and when respondents learned of the adverse health effects that pesticides are
linked to, 90% of Marylanders expressed concern.
I I
America lags behind by the rest of the developed world in recognizing the serious risks that
certain pesticides pose to health and life. The GAO's report confirms that the regulatory approach
taken by the EPA is broken and failing the public. In the face of mounting scientific evidence,
and in the absence ofaction on the federal level, ( find
it
impossible not to act now to protect the
health of our children. In Montgomery County, we regularly take a precautionary approach to
public health and environmental issues, such as with the forthcoming legislation on e-cigarettes
and the Council's action on Ten Mile Creek.
OUI"
approach to pesticides should be no different.
J
have attached all of the studies that
I
have cited in this memo for your reference, but
I
hope you
will take time to review research beyond what
I
have provided. If, after reviewing the research,
you feel compelled to act as I do,
I
would welcome your co-sponsorship on this bilL
This issue is among the most technically complex which the Council has ever faced. Therefore, it
is critical that we approach this in a thoughtful manner and that we consult with a variety of
experts who are knowledgeable in the field so we can make a wel.l-infOlmed decision regarding
this important public health issue.
11
OpinionWorks,
Maryland
Voter Survey on
Pesticides
http://www.mdpestnet.org!wp­
cQntentluploads/20 14102lfeslicide-Poll-Memo-2-1 Q-14.pdf (Accessed on October 20. 2014)
@)
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P
E
D I AT RIC S®
OFFICIAL JOURNAL Of THE AMERICAN ACADEMY Of PEDIATRICS
Pesticide Exposure in Children
COUNCIL ON ENVIRONMENTAL HEALTH
Pediatrics
2012;130;e1757; originally published online November 26, 2012;
DOl: 10.1 542/peds.201 2-2757
The online version of this article, along with updated information and services, is
located on the World Wide Web at:
http://pediatrics.aappublications.org/content/130/6/e1757.full.html
PEDIATRICS
is
the official journal of the American Academy of Pediatrics. A monthly
publication, it has been published continuously since 1948. PEDIATRICS is owned,
published, and trademarked by the American Academy of Pediatrics, 141 Northwest Point
Boulevard, Elk Grove Village, Illinois, 60007. Copyright
©
2012 by the American Academy
of Pediatrics. All rights reserved. Print ISSN: 0031-4005. Online ISSN: 1098-4275.
American Academy of Pediatrics
DEDICATED TO THE HEALTH OF ALL CHILDREW
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American Academy
of Pediatrics
W .
~
DEOICATED TO THE. HULTH Of
AU.
CHJI..OREN'"
Organizational Principles to Guide and Define the Child
Health Care System and/or Improve the Health of all Children
POLICY STATEMENT
Pesticide Exposure in Children
COUNCIL ON ENVIRONMENTAL HEALTH
KEY WORDS
pesticides, toxicity, children, pest control, integrated pest
management
ABBREVIATIONS
EPA-fnvironmental Protection Agency
IPM-integrated pest management
abstract
This statement presents the position of the American Academy of Pe­
diatrics on pesticid.es. Pesticides are a collective term for chemicals
intended to kill unwanted insects, plants, molds, and rodents. Children
encounter pesticides daily and have unique susceptibilities to their po­
tential toxicity. Acute poisoning risks are clear, and understanding of
chronic health implications from both acute and chronic exposure are
emerging. Epidemiologic evidence demonstrates associations between
early life exposure to pesticides and pediatric cancers, decreased cog­
nitive function, and behavioral problems. Related animal toxicology
studies provide supportive biological plausibility for these findings.
Recognizing and reducing problematic exposures will require attention
to current inadequacies in medical training, public health tracking, and
regulatory action on pesticides. Ongoing research describing toxico­
logic vulnerabilities and exposure factors across the life span are
needed to inform regulatory needs and appropriate interventions. Pol­
icies that promote integrated pest management, comprehensive pes­
ticide labeling, and marketing practices that incorporate child health
considerations will enhance safe use.
Pediatrics
2012;130:e1757-e1763
This document is copyrighted and is property of the American
Academy of Pediatrics and its Board of Directors. All authors
have filed conflict of interest statements with the American
Academy of Pediatrics. Any conflicts have been resolved through
a process approved by the Board of Directors. The American
Academy of Pediatrics has neither solicited nor accepted any
commercial involvement in the development of the content of
this publication.
All policy statements from the American Academy of Pediatrics
automatically expire 5 years after publication unless reaffirmed,
revised, or ratired at or before that time.
INTRODUCTION
www.pediatrics.org/cgi/doi/10.1542/peds2012-2757
dOi:10.15421peds2012-2757
PEDIATRICS (lSSN Numbers: Print,
0031-4005;
Online,
1098-4275).
CopyriSlht
@
2012 by the American Academy of Pediatrics
Pesticides represent a large group of products designed to kill or harm
living organisms from insects to rodents to unwanted plants or ani­
mals (eg, rodents), making them inherently toxic (Table
1).
Beyond
acute poisoning, the influences of low-level exposures on child health
are of increasing concern. This policy statement presents the position
of the American Academy of Pediatrics on exposure to these products.
It was developed in conjunction with a technical report that provides
a thorough review of topics presented here: steps that pediatricians
should take to identify pestiCide poisoning, evaluate patients for
pesticide-related illness, provide appropriate treatment, and prevent
unnecessary exposure and pOisoning.' Recommendations for a regula­
tory agenda are provided as well, recognizing the role of federal agen­
cies in ensuring the safety of children while balancing the positive
attributes of pesticides. Repellents reviewed previously (eg, N,N-diethyl­
meta-toluamide, commonly known as DEET; picaridin) are not discussed.
2
SOURCES AND MECHANISMS OF EXPOSURE
Children encounter pesticides daily in air, food, dust. and soil and on
surfaces through home and public lawn or garden application,
household insecticide use, application to pets, and agricultural product
PEDIATRICS Volume 130, Number S, December 2012
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TABLE 1
Categories of Pesticides and Major Classes
Pesticide category
Insecticides
Major Classes
Organophosphates
Carbamates
Pyrethroids/pyrethrins
Organochlorines
Neonicotinoids
N-phenylpyrazoles
Phosphonates
Chlorophenoxy herbicides
Oipyridyl herbicides
Nonselective
Anticoagulants
Convulsants
Metabolic poison
Inorganic compounds
Thiocarbamates
Triazoles
Strobilurins
Halogenated organic
Organic
Inorganic
Arsenicals
Pyridine
Examples
.Malathion, methyl parathion, acephate
Aldicarb, carbaryl, methomyl, propoxur
Cypermethrin, fenvalerate, permethrin
Lindane
Imidacloprid
Fipronil
Glyphosate
2,4-D, mecoprop
Oiquat, paraquat
Sodium chlorate
Warfarin. brodifacoum
strychnine
Sodium f1uoroacetate
Aluminum phosphide
Metam-sodium
Fluconazole, myclobutanil, triadimefon
Pyraclostrobin, picoxystrobin
Methyl bromide. Chloropicrin
Carbon disulfide, Hydrogen cyanide, Naphthalene
Phosphine
lead arsenate, chromated copper arsenate, .
arsenic trioxide
4-aminopyridine
National Poison Data System or the Na­
tional Institute for Occupational Safety
and Health's Sentinel Event Notifica­
tion System for Occupational Risksp.2B
capture limited information about acute
poisoning and trends over time.
There is also no national systematic
reporting on the use of pestiCides by
consumers or licensed professionals. The
last national survey of consumer pesti­
cide use in homes and gardens was in
1993
(Research Triangle Institute study).29
Improved physician education, accessi­
ble and reliable biomarkers, and better
diagnostic testing methods to readily
identify suspected pesticide illness
would significantly improve reporting
and surveillance. Such tools would be
equally important in improving clinical
decision-making and reassuring fami­
lies if pesticides can be eliminated from
the differential diagnosis.
The Pesticide Label
Herbicides
Rodenticides
Fungicides
Fumigants
Miscellaneous
residues.3-9 For many children, diet
may be the most influential source, as
illustrated by an intervention study
that placed children on an organic
diet (produced without pesticide) and
observed drastic and immediate de­
crease in urinary excretion of pesticide
metabolites.10 In agricultural settings"
pesticide spray drift is important for
residences near treated crops or by
take-home exposure on clothing and
footwear of agricultural workers.9.1
1,12
Teen workers may have occupational'
exposures on the farm or in lawn
care.1 Heavy use of pesticides may
3-15
also occur in urban pest control.
16
Most serious acute poisoning occurs
after unintentional ingestion, although
poisoning may also follow inhalational
exposure (particularly from fumigants)
or significant dermal exposure.
ll
the major pesticides classes.
It
high­
lights the similarities of common clas­
ses of pesticides (eg, organophosphates,
carbamates, and pyrethroids) and
underscores the importance of dis­
criminating among them because treat­
ment modalities differ. Having an index
of suspicion based on familiarity with
toxic mechanisms and taking an envi­
ronmental history provides the oppor­
tunity for discerning a pesticide's role in
clinical decision-making.1B Pediatric care
providers have a poor track record for
recognition of acute pesticide poison­
ing.1 This reflects their self-reported
s.-21
lack of medical education and self­
efficacy on the topic.
22- 2s
More in-depth
review of acute toxicity and manage­
ment can be found in the accompanying
technical report or recommended
resources in Table 3.
The local or regional poison control center
plays an important role as a resource for
MY
suspected pestiCide poisoning.
There is no current reliable way to de­
termine the incidence of pesticide ex­
posure and illness in US children. Existing
data systems, such as the American
Association of Poison Control Centers'
The pesticide label contains informa­
tion for understanding and preventing
acute health consequences: the active
ingredient; signal words identifying
acute toxicity potential; US Environ­
mental Protection Agency (EPA) regis­
tration number; directions for use,
including protective equipment rec­
ommendations, storage, and disposal;
and manufacturer's contact informa­
tion.
3o
Basic first aid advice is pro­
vided, and some labels contain a "note
for physicians" with specifiC relevant
medical information. The label does
not specify the pesticide class or
"other"/"inert" ingredients that may
have significant toxicity and can ac­
count for up to
99%
of the product.
Chronic toxicity information is not in­
cluded, and labels are predominantly
available in English. There is significant
use of illegal pesticides (especially in
immigrant communities), off-label use,
and overuse, underscoring the impor­
tance of education, monitoring, and
enforcement.
3l
ACUTE PESTICIDE TOXICITY
Clinical Signs and Symptoms
High-dose pesticide exposure may re­
sult in immediate, devastating, even
lethal consequences. Table 2 summa­
rizes features of clinical toxicity for
e1158
FROM THE AMERICAN ACADEMY OF PEDIATRICS
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TABLE 2
Common Pesticides: Signs, Symptoms, and Management Considerations'
Acute
Organophosphate and N-methyl carbamate
insecticides
and Svn1ot£lms
Clinical Considerations
• Obtain red blood cell. and plasma cholinesterase
levels
• Atropine is prima,ry antidote
• Pralidoxime is also an antidote for organophosphate
and acts as a cholinesterase reactivator
• Because cartlamates generally produce a reversible
cholinesterase inhibition, pralidoxime is not
indicated in these pOisonings
• Headache, nausea, vomiting, abdominal pain, and
dizziness
• Hypersecretion: sweating, salivation, lacrimation,
rhinorrhea, diarrhea, and bronchorrhea
• Muscle fasciculation and weakness, and respiratory
symptoms (bronchospasm, cough, wheezing. and
respiratory depression)
• Bradycardia. although early on. tachycardia may be
present
• Miosis
• Central nervous system: respiratory depreSSion,
lethargy, coma. and seizures
• Similar findings found in organophosphates
including the hypersecretion, muscle fasciculation,
respiratory symptoms. and seizures
• Headache, fatigue. vomiting, diarrhea. and irritability
• Dermal: skin irritation and paresthesia
Pyrethroid insecticides
• At times have tleen mistaken for acute
organophosphate or carbamate poisoning
• Symptomatic treatment
• Treatment with high doses of al:rQpine may yield
significant adverse results
• Vitamin E oil for dermal symptoms
• Supportive care
Neonicotinoid insecticides
• Disorientation, severe agitation. drowsiness,
dizziness, weakness; and in some situations.
loss of consciousness
• Vomiting, sore throat. abdominal pain
• Ulcerations in upper gastrointestinal tract
Nausea and vomiting
Aphthous ulcers
Altered mental status and coma
Seizures
Central nervous system: mental status changes
and seizures
• Paresthesia. tremor, ataxia and hyperreflexia
• Nausea and vomiting
• Aspiration pneumonia type syndrome
• HypotenSion, altered mental status, and oliguria in
severe cases
• Pulmonary effects may in fact be secondary to
organic solvent
• Skin and mucous membrane irritation
• Vomiting, diarrhea, headache, confusion
• Metabolic acidosis is the hallmark
• Renal failure. hyperkalemia, and hypocalcemia
• Probable carcinogen
• Bleeding: gums, nose. and other mucous
membrane sites
• Bruising
Fipronil (N-phenylpyrazole insectiCides)
Consider sedation for severe agitation
No available antidote
No available diagnostic test
Supportive care
No availatlle antidote
No available diagnostic test
Lindane (organochlorine insecticide)
• Control acute seizures with lorazepam
• lindane blood level avai lable as send out
• Supportive care
• Pulmonary effects may be secondary to organic
solvent
Glyphosate (phosphonate hertlicides)
Chlorophenoxy herbicides
• Consider urine alkalinization with sodium
bicarbonate in IV fluids
Rodenticides (long-acting anticoagulants)
• Consider PT (international normalized ratio)
• Otlservation may be appropriate for some clinical
scenarios in which it is not clear a child even
ingested the agent
• Vitamin K indicated for active bleeding (IV vitamin PO
or for elevated PT
vitamin
IV, intravenous; PT. prcrthrombin time.
• Expanded version of this table is available in the accompanying technical report
1
CHRONIC EFFECTS
Dosing experiments in animals clearly
demonstrate the acute and chronic
toxicity potential of multiple pesticides.
Many pesticide chemicals are classi­
fied by the
US
EPA as carcinogens. The
past decade has seen an expansion
of the epidemiologic evidence base
supporting adverse effects after
acute and chronic pesticide exposure
in children. This includes increasingly
sophisticated studies addressing
combined exposures and genetiC
susceptibility.'
Chronic toxiCity end points identified in
epidemiologic stUdies include adverse
birth outcomes including preterm
birth, low birth weight, and congenital
PEDIATRICS Volume
130.
Number 6. December
2012
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e1759
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it
~
s:
...
TABLE 3
Pesticide and Ghild Health Resources for the Pediatrician
Topic/Resource
Management of acute pesticide poisoning
Recognition and Management of Pesticide POisonings
Regional Poison Control Centers
Chronic exposure information and specialty consultation
The National Pesticide Medical Monitoring Program
(NPMMP)
Pediatric Environmental Health Specialty Units (PEHSUs)
Additional Information
Print: fifth (1999) is available in Spanish, English; 6th edition available
2013
Contact Information
http://www.epa.gov/pasticides/safety/healthcare/handbook/
handbook.htm
1 (800)
222-1222
npmmp@oregonstate.edu or by fax at (541) 737-9047
~
i
~
!j;
C;)';;
>
~~
-
.....
~gJ
Cooperative agreement between Oregon State University and the US EPA.
NPMMP provides informational assistance by E-mail in the assessment
of human exposure to pesticides
Coordinated by the Association of Occupational and Environmental Clinics
to provide regional academically based free consultation for health care
providers
Consumer information documents
• Household pest control
• Alternatives to chemical pesticides
• How to choose pestiCides
• How to use, store, and dispose of them safely
• How to prevent pesticide poisoning
• How to choose a pest-control company
Recommended safest approaches and examples of programs
Information on IPM approaches for common home and garden pests
www.aoec.orglPEHSU,htm; toll-free telephone number (888)
347-AOEC (extension 2632)
0."
a~
1:
s
o
§'~
Resources for safer approaches to pest control
US EPA
Citizens Guide to Pest Control and Pesticide Safety
www.epa.gov/oppfead1/Publications/Cit_Guide/citguide.pdf
fr-
III
g.
ContrOlling pests
The University of California Integrative Pest Management
Program
Other resources
National research programs addressing children'S health
and pesticides
US EPA
The National Library of Medicine "Tox Town"
&.
.~
'"
'"
www.epa.gov/pesticides/controlling/index.htm
www.ipm.ucdavis.edu
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• NIEHS/EPA Centers for Children'S Environmental Health
&
Disease Prevention
Research
• The National Children's Study
Pesticide product labels
Section on pesticides that includes a comprehensive and well-organized list of
web link resources on pesticides
www.niehs.nih.govlresearch/supported/centers/prevention
www.nationalchildrensstudy.gov/Pages/default.aspx
www.epa.gov/pesti~ides/regulating/labels/product-Iabels.
g
o
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htrn#projects
http://toxtown.nlm.nih.govltext_version/
chemlcals.php?id~23
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play a role in promotion of develop­
ment of model programs and practices
in the communities and schools of
their patients.
RECOMMENDATIONS
Three overarching principles can be
identified: (1) pesticide exposures are
common and cause both acute and
chronic effects; (2) pediatricians need
to be knowledgeable in pesticide iden­
tification, counseling, and management;
and (3) governmental actions to improve
pesticide safety are needed. Whenever
neW public policy is developed or ex­
isting policy is revised, the wide range of
consequences of pesticide use on chil­
dren and their families should be con­
sidered. The American Academy of
Pediatrics, through its chapters, com­
mittees, councils, sections, and staff. can
provide information and support for
public policy advocacy efforts. See http://
www.aap.org/advocaCy.htmlfor addi­
tional information or contact chapter
leadership.
Recommendations to Pediatricians
help determine the need for provid­
ing targeted anticipatory guidance.
Recommend use of minimal-risk
products, safe storage practices,
and application of IPM (least toxic
methods), whenever possible.
S. Advocacy: work wtth schools and
governmental agencies to advocate
for application of least toxic pesti­
cides by using IPM principles. Pro­
mote community right-to-know
procedures when pesticide spray­
ing occurs in public areas.
Recommendations to Government
5. Exportation: aid in identification of
least toxic alternatives to pesticide
use internationally, and unless
safer alternatives are not available
or are impossible to implement,
ban export of products that are
banned or restricted for toxicity
concerns in the United States.
S. Safety: continue to evaluate pesti­
cide safety. Enforce community
right-to~know
procedures when pes­
ticide spraying occurs in public
areas. Develop, strengthen, and en­
force standards of removal of con­
cerning products for home or child
product use. Require development
of a human biomarker, such as
a urinary or blood measure, that
can be used to identify exposure
and/or early health implications
with new pesticide chemical regis­
tration or reregistration of existing
products. Developmental toxicity,
including endocrine disruption,
should be a priority when evaluat­
ing new chemicals for licensing or
reregistration of existing products.
7. Advance less toxic pestiCide alter­
natives: increase economic incen­
tives for growers who adopt IPM,
including less toxic pesticides. Sup­
port research to expand and im­
prove IPM in agriculture and
nonagricultural pest control.
8. Research: support toxicologic and
epidemiologic research to better
identify and understand health risks
associated with children's exposure
to pesticides. Gonsider supporting
another national study of pesticide
use in the home and garden setting
of US households as a targeted ini­
tiative or through cooperation with
existing research opportunities (eg,
National Children's Study, NHANES).
9. Health provider education and sup­
port: support educational efforts
to increase the capacity of pediatric
health care providers to diag­
nose and manage acute pesticide
1. Marketing: ensure that pesticide
products as marketed are not at­
tractive to children.
2. labeling: include chemical ingredi­
ent identity on the label and/or the
manufacturer's Web site for all
product constituents, including inert
ingredients, carriers, and solvents.
Include a label section specific to
"Risks to children," which informs
users whether there is evidence
that the active or inert ingredients
have any known chronic or develop­
mental health concerns for children.
Enforce labeling practices that en­
sure users have adequate informa­
tion on product contents, acute and
chronic toxicITy potential, and emer­
gency information. Consider printing
or making available labels in Span­
ish in addition to English.
3. Exposure reduction: set goal to re­
duce exposure overall. Promote appli­
cation methods and practices that
minimize children's exposure, such
as using batt stations and gels, advis­
ing against overuse of pediculicides.
Promote education regarding proper
storage of product.
4. Reporting: make pesticide-related
suspected pOisoning universally re­
portable and support a systematic
central repository of such inci­
dents to optimize national surveil­
lance.
1. Acute exposures: become familiar
with the clinical signs and symp­
toms of acute intoxication from
the major types of pesticides. Be
able to translate clinical knowledge
about pesticide hazards into an
appropriate exposure history for
pestiCide poisoning.
2. Chronic exposures: become familiar
wtth the subclinical effects of chronic
exposures and routes of exposures
from the major types of pesticides.
3. Resource identification: know lo­
cally available resources for acute
toxiCity management and chronic
low-dose exposure (see Table 3).
4. Pesticide labeling knowledge: Under­
stand the usefulness and limitations
of pesticide chemical informati()n on
pesticide product labels.
5. Counseling: Ask parents about pes­
ticide use in or around the home to
PEDIATRICS Volume 130, Number 6, December 2012
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ellS1
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poisoning and reduce pesticide ex­
posure and potential chronic pesti­
cide effects in children. Provide
support to systems such as Poison
Control Centers to provide timely,
expert advice on exposures. Require
the development of diagnostic tests
to assist providers with diagnosing
(and ruling out) pesticide poisoning.
LEAD
AUTHORS
James R. Roberts, MD. MPH
Catherine J. Karr.MD, PhD
COUNCIL ON ENVIRONMENTAL HEALTH
EXECUTIVE COMMITTEE, 2012-2013
Jerome A Paulson, MD. Chairperson
Alice C. Brock-Utne, MD
Heather
L.
Brumberg, MD, MPH
Carla C. Campbell, MD
Bruce
P.
Lanphear, MD, MPH
Kevin C. Osterhoudt. MD, MSCE
Megan
T.
Sandel, MD
Leonardo Trasande, MD, MPP
Robert
O.
Wright, MD, MPH
James
R.
Roberts, MD, MPH
Catherine J. Karr, MD, PhD
Joel
A.
Forman, MD
James M. Seltzer. MD
LIAISONS
Mary Mortensen, MD -
Centers for Disease
Control and Prevention/National Center for
Environmental Health
Walter J. Rogan. MD -
National Institute of
Environmental Health Sciences
Sharon Savage, MD
National Cancer Institute
FORMER EXECUTIVE COMMITTEE
MEMBERS
Helen J. Binns, MD. MPH
STAFF
Paul Spire
REFERENCES
1.
Roberts JR. Karr CK; American Academy of
Pediatrics. Council on Environmental
Health. Technical report-pesticide expo­
sure in children.
Pediatrics. 2012:130(6)
pesticide pathway.
Environ Health Per­
exposures, risks, and prevention.
Environ
spect. 2006;114(7):999-1006
Health Perspect.
1999;107(suppl 3):431-437
'9. Lu C, Fenske
RA.
Simcox NJ, Kalman D.
Pesticide exposure of children in an agri­
cultural community: evidence of househOld
proximity to farmland and take home ex­
posure pathways.
Environ Res. 2000;84(3):
29{)-302
10. Lu C, Toepel K, Irish R. Fenske RA. Barr DB,
Bravo
R.
Organic diets significantly lower
children's dietary exposure to organo­
phosphorus pesticides.
Environ Health
Perspect. 2006;114(2):260-263
11. Curl CL Fenske RA. Kissel JC,
at
al. Evalu­
ation of take-home organophosphorus
pesticide exposure among agricultural
workers and their children.
Environ Health
Perspect.
2002;110(12):A787-A792
12. Curwin BD. Hein MJ, Sanderson
wr.
et aL .
Pesticide contamination inside farm and
nonfarm homes.
J
Occup Environ
Hyg.
2005;
2(7) :357-367
13.
Shipp EM, Cooper SP, del Junco OJ, Bolin
17.
Reigart JR, Roberts JR.
Recognition and
Management ofPesticide Poisoning,
5th ed.
Washington, DC: US Environmental Pro­
tection Agency; 1999
18. American Academy of Pediatrics. Commit­
tee on Environmental Health. Taking an
environmental history and giving antiCipa­
tory guidance. In: Etzel
RA.
Balk SJ, eds.
Pediatric Environmental Health.
2nd ed. Elk
Grove Village, Il: American Academy of Pe­
di atrics; 2003:39-56
19. Sofer S, Tal
A.
Shahak
E.
Carbamate and
organophosphate poisoning in early child­
hood.
Pediatr Emerg Care. 1989;5(4):222-225
2. Katz
TM. Miller JH. Hebert
AA.
Insect
repellents: historical perspectives and new
developments.
J
Am Acad Dermatol.
200B;
58(5)
:865-871
3. Lewis RG, Fortune CR, Blanchard
FT.
Camann DE. Movement and deposition of
two organophosphorus pesticides within
a residence after interior and exterior
applications.
J
Air Waste Manag Assoc.
2001 ;51(3):339-351
4. Hare
p.
Robson M, Freeman
N.
et al.
Chlorpyrifos accumulation patterns for
child·accessible surfaces and objects and
urinary metabolite excretion by children
for
2
weeks after crack-and-crevice appli­
cation.
Environ Health Perspect. 2005;113
(2):211-219
5.
Gurunathan S. Robson M. Freeman N,
et
at
Accumulation of chlorpyrifos on residential
surfaces and toys accessible to children.
Environ Health Perspect. 1998;106(1):9-16
6.
Fenske RA, Black KG, Elkner KP. Lee CL,
Methner MM, Soto
R.
Potential exposure
and health risks of infants following indoor
residential pesticide applications.
Am J
Public Health.
1990;80(6)
:689-893
7. Nishioka MG, Lewis RG. Brinkman MC,
Burkholder HM, Hines CE, Menkedick JR.
Distribution of 2,4-0 in air and on surfaces
inside residences after lawn applications:
comparing exposure estimates from vari­
ous media for young children.
Environ
Health Perspect 2001;109(11):1185-1191
8. Coronado GO, Vigoren EM, Thompson B,
Griffith WC, Faustman EM. Organophos­
phate pesticide exposure and work in
pome fruit: evidence for the take-home
20. Zwiener RJ. Ginscurg CM. Organophos­
phate and carbamate poisoning in infants
and children.
Pediatrics. 1988;81(1):121­
126
JN, Whitworth RE, Cooper CJ. Pesticide
safety training among adolescent farm­
workers from Starr County, Texas.
J Agric
Sa' Health. 2007;13(3):311-321
14. Gam lin J, Diaz Romo P. Hesketh
T.
Exposure
of young children working on Mexican to­
cacco plantations to organophosphorous
and carcamic pesticides. indicated by cho­
linesterase depression.
Child Care Health
Dev. 2007;33(3):246-248
21.
Lifshitz M, Shahak E, Safer S. Carbamate
and organophosphate poisoning in young
children.
Pediatr Emerg Care. 1999;15(2):
102-103
22. Balbus JM, Harvey CEo McCurdy LE. Educa­
tional needs assessment for pediatric
health care providers on pesticide toxicity.
J
Agromeci 2006;11(1):27-38
23. Kilpatrick
N,
Frumkin H, Trowbridge J, et al.
The environmental history in pediatric
practice: a study of pediatricians' attitudes.
beliefs, and practices.
Environ Health Per­
spect.
2002;110(8)
:823-871
15. Eckerman Dt>., Gimenes
LA.
de Souza RC,
24. Trasande l, Schapiro ML, Falk R. et al. Pe­
Lopes Gaivao PR, Sarcinelli PN, Chrisman
diatrician attitudes, clinical activities, and
JR. Age related effects of pestiCide expo­
knowledge of environmental health in
sure on neurobehavioral performance of
Wisconsin.
WMJ 2006;105(2):45-49
adolescent farm workers in Brazil.
Neuro­
25.
Karr C, Murphy H, Glew G, Keifer MC, Fenske
toxicol Teratol. 2007;29(1):164-175
RA Pacific Northwest health professionals
16.
Landrigan PJ, Claudio L, Markowitz SB.
et al. Pesticides and inner-city children:
survey on pestiCides and children.
J
Agromeci
2006;11(3-4) :113-120
81762
FROM THE AMERICAN ACADEMY OF PEDIATRICS
Downloaded from pediatrics.aappublications.org by guest on October 23,2014
 PDF to HTML - Convert PDF files to HTML files
26. Roberts JR, Balk
SJ,
Forman J, Shannon M.
Teaching about pediatric environmental
heaIth.
Acad Pediatr.
2009;9 (2) :129-130
27. Bronstein AC, Spyker DA, Cantilena LR Jr,
Green JL, Rumack BH, Dart RC. 2010 Annual
Report of the American Association of
Poison Control Centers' National Poison
Data System (NPDS): 26th Annual Report
Clin
Toxieol.2011;49(10):910-941
2B. Baker
EL
Sentinel Event Notification System
for Occupational Risks (SENSOR): the con­
cept.
Am
J
Public Health.
1989;79(suppl):
18-20
29. Whitmore RW, Kelly JE, Reading PL,
et
al.
Pesticides in urban environments.
ACS
Symp Ser. 1993;522(3):18-36
30. US Environmental Protection Agency. Pes­
ticide product labels. Available at: www.
epa.gov/pesticides/regulating/labels/product­
labels.htm#projects. Accessed October 15, 2012
31. US Environmental Protection Agency. Illegal
pesticide products. Available
at
www.epa.gov/
oppOOOO1/health/iliegalproducts. Accessed Oc­
tober 15, 2012
32. Kimmel CA, Coliman GW, Fields N, Eskenazi
B. Lessons learned for the National Children's
Study from the National Institute of En­
vironmental Health Sciences/U.S. Envi­
ronmental Protection Agency Centers
for Children's Environmental Health and
Disease Prevention Research.
Environ
Health Perspect. 2005;113(10):1414­
141 B
33. US General Accounting Office. Agricultural
pesticides: Management improvements
needed to further promote integrated pest
management. Available at: www.gao.gov/
new.items/d01815.pdf. Accessed October
15,2012
PEDIATRICS Volume 130, Number 6, December 2012
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e1763
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ERRATA
Spooner. We Are Still Waiting for Fully Supportive Electronic Health Records in
Pediatrics.
Pediatrics.
2012;130(6):e1674-e1676.
An error occurred in this article by Spooner, titled "We Are Still Waiting for Fully
Supportive Electronic Health Records in Pediatrics" published in the December
2012 issue of
Pediatrics
(2012;130[6]:e1674--e1676; originally published online
November 19, 2012; doi:10.1542/peds.2012-2724). On page e1674, on line 33, this
reads: 'The alarming result from the survey was that only 3% of MP Fellows
reported that they had a system that provided all of the items listed by Leu and
colleagues." This should have read: "The alarming result from the survey was
that only 9.6% of MP Fellows reported that they had or planned to adopt within
12 months a system that provided all of the five "pediatric-supportive" items
listed by Leu and colleagues."
dOi:l0.1542/peds1013-0134
Auger et al. Medical Home Quality and Readmission Risk for Children
Hospitalized With Asthma Exacerbations.
Pediatrics.2013;13H1):64-70
An error occurred in this article by Auger
et
ai, titled "Medical Home Quality and
Readmission Risk for Children Hospitalized With Asthma Exacerbations" pub­
lished in the January 2013 issue of
Pediatrics
(2013;131[1]:64-70; dOi:1O.1542/
2012-1055). On page 69, in Table 2 under the heading Adjusted HR, on the line
Medicaid, this reads: "0.28 (0.51-1.34)." This should have read: "0.82 (0.51-1.34)."
doi:l0.1542/peds.2013-0187
Council on Environmental Health. Policy Statement: Pesticide Exposure in
Children.
Pediatrics.
2012;130(6):e1757-e1763
Acouple of errors occurred in this MP Policy Statement titled "Pesticide. Exposure
in Children" published in the December 2Q12 issue of
Pediatrics (2012;130[6]:
e1757-e1763; originally published online November 26, 2012; doi:10.1542/
peds.2012-2757). In Table 2, in the second and third columns where glyphosate
is discussed, the words "organic solvent" should be replaced with the word
"surfactant." On page e1758, in the first paragraph of the left-hand column, im­
mediately beneath Table 1, the first full sentence should be amended to read: "For
many children, diet may be the most influential source, as illustrated by an in­
tervention study that placed children on an organiC diet (produced without most
conventional pesticides) and observed drastic and immediate decrease in uri­
nary excretion of organophosphate pesticide metabolites."
doi:l0.1542/peds.2013-0576
Robert JR, Karr Cd; Council on Environmental Health. Technical Report:
Pesticide Exposure in Children. Pediatrics.2012;130(6):e1765-e1788
Several inaccuracies occurred in this MP Technical Report titled "Pesticide Ex­
posure in Children" published in the Decemoer 2012 issue of
Pediatrics (2012;130
[6]:e1765-e1788; originally published online November 26, 2012; dOi:10.1542/
peds.2012-2758). On page e1773 and in Tables 1 and 2 where the phosphonate
herbicide glyphosate is discussed, changes should be noted. In the first para­
graph of the first column on page el773 about acute glyphosate poisoning, the
word "intentional" should be substituted for the word "unintentional.
u
In this
same paragraph as well as in Tables 1 and 2, the word "surfactant" should re­
place- the words "hydrocarbon solvent" and "organic solvent, respectively." The
PEDIATRICS Volume 131, Number 5, May 2013
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Pesticide Exposure
in
Children
COUNCIL ON ENVIRONMENTAL HEALTH
Pediatrics
2012;130;e1757; originally published online November 26,2012;
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Review
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Neurobehavioural effects of developmental toxicity
.
CtouMlri::
Philippe
Grandjean,
Philip
J
Landrigan
UmcttNeurol2014;
13:
330-38
Pub~shed
Online
Febroa!}' 15, 2014
http://dx.doi.org/10.1016/
51474-4422(13)70278·3
Department of Environmental
Medicine, Uni"""ity
of
Southern Denmar!c. Odens.,
Donm.rIc (P Grand)ean MO);
Department of Environmental
Health, Harvard School of
Public Health, Boston, MA, USA
(P
Grandjean);
and
Icahn School
of Medicine at Mount Sinai,
NewYor!c.NY,USA
(P
J
Landrigan
MO)
Neurodevelopmental disabilities, including autism. attention-deficit hyperactivity disorder. dyslexia. and other
cognitive impairments.
affect
millions ofchildren worldwide. and some diagnoses seem to be increasing in frequency.
Industrial chemicals that injure the developing brain are among the known causes for
this
rise
in
prevalence. In 2006,
we
did a systematic review and identified five industrial chemicals as developmental neurotoxicants: lead,
methylmercury. polychlorinated biphenyls. arsenic. and toluene. Since 2006. epidemiological studies have documented
six additional developmental neurotoxicants-manganese, fiw)Iide, chIorpyrifos, dichlorodiphenyltrichloroethane.
tetrachloroethylene, and the polybrominated diphenyl ethers. We postulate that even more neurotoxicants remain
undiscovered. To control the pandemic of developmental neurotoxicity, we propose a global prevention strategy.
Untested chemicals should not
be
presumed to be safe to brain development, and chemicals in
existing
use and all
new chemicals must therefore be tested for developmental neurotoxicity. To coordinate these
efforts
and to accelerate
translation ofscience into prevention, we propose the urgent formation ofa new international clearinghouse.
to the nervous system in adults, mostly in connection
Disorders of neurobehavioural development
affect
10-15% with occupational exposures, poisoning incidents. or
Correspondence
to:
of
all
births,' and prevalence rates of autism spectnnn suicide attempts. Additionally, more than 1000 chemicals
Dr Philippe
Grandj.an,
have been reported to be neurotoxic in animals in
Environmental and Ocrupational
disorder and attention-deficit hyperactivity disorder seem
Medicine and Epidemiology,
to be increasing worldwide.
l
Subclinical decrements in
laboratory studies.
Harvard
School of Public Health,
We noted that recognition of the risks of industrial
brain function are even more common
than
these
401 Park Dri... E·110, Boston,
chemicals to brain development has historically needed
MA
02215,
USA
neurobehavioural developmental disorders. All these
decades of research and scrutiny, as shown in the cases
pgrand@hsph.h.rvard.edu
disabilities can have severe consequences'-they diminish
quality of life. reduce academic achievement. and disturb of lead and methylmercury.I.W In most cases, discovery
behaviour. with profound consequences for the welfare began with clinical diagnosis of poisoning in workers
and episodes of h4:h-dose exposure. More sophisticated
and productivity ofentire societies"
The root causes of the present global pandemic of epidemiological studies typically began only much later.
neurodevelopmental disorders are only partly Results from such studies documented developmental
understood. Although genetic factors have a role.' they neurotoxicity at much lower exposure levels than had
cannot explain recent increases in reported preValence. previously been thought to be safe. Thus, recognition of
and none of the genes discovered so far seem to be widespread subclinical toxicity often did not occur until
responsible for more than a small proportion of cases.' decades after the initial evidence of neurotoxicity. A
Overall. genetic factors seem to account for no more
than
recurring theme was that early warnings of subclinical
perhaps
30-40%
of
all
cases of neurodevelopmental neurotoxicity were often ignored or even dismissed."
disorders. Thus. non-genetic. environmental exposures David P
Rall.
former Director ofthe US National Institute
are involved in causation. in some cases probably by of Environmental Health Sciences, once noted that
kif
interacting with genetically inherited predispositions.
thalidomide had caused a ten-point loss of intelligence
Strong evidence exists that industrial chemicals widely quotient (IQ) instead of obvious birth defects of the
disseminated in the environment are important limbs, it would probably still be on the market".ll Many
contributors to what we have called the global. silent industrial chemicals marketed at present probably cause
pandemic of neurodevelopmental toxicity.'" The IQ deficits offar fewer than ten points and have therefore
developing human brain is uniquely vulnerable to toxic eluded detection so far. but their combined effects could
chemical exposures. and major windows of have enormous consequences .
. developmental vulnerability occur in utero and during
In our
2006
review; we expressed concern that
infancy and early childhood.' During these sensitive life additional developmental neurotoxicants might lurk
stages, chemicals can cause permanent brain injury at undiscovered among the 201 chemicals then known to be
low levels ofexposure that would have little or no adverse neurotoxic to adult human beings and among the many
effect in an adult
thousands of pesticides. solvents. and other industrial
In 2006. we did a systematic review of the published chemicals in widespread use that had never been tested
clinical and epidemiological studies into the neurotoxicity for neurodevelopmental toxicity. Since our previous
of industrial chemicals, with a focus on deVelopmental review, new
data
have emerged about the vulnerability of
neurotoxicity; We identified five industrial chemicals the developing brain and the neurotoxicity of industrial
that could be reliably classified as developmental chemicals. Particularly important new evidence derives
neurotoxicants: lead, methylmercury. arsenic, poly­ from prospective epidemiological birth cohort studies.
chlorinated biphenyls. and toluene. We also noted
In
this
Review, we consider recent information about
201 chemicals that had been reported to cause injury the developmental neurotoxicity of industrial chemicals
www:thela:ncet.(om/~mloov
Introduction
Vol,
~
March 7n1.4
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Review
I
to update our previous report.' Additionally, we propose
strategies to counter this pandemic and to prevent the
spread of neurological disease and disability in children
worldwide.
Unique vulnerability ofthe developing brain
The fetus is not well protected
against