Acute Illnesses and Injuries Related to Total Release Foggers — 10 States, 2007–2015

Ruiling Liu,Ketki Patel,John Beckman,Joanne B Prado,Lucia S Graham,Kathleen G Aubin,Karen R Cummings,Geoffrey M Calvert,Prakash Mulay,Abby Schwartz,Sheila A Higgins,Derry Stover,Justin Waltz,Walter A Alarcon

doi:10.15585/mmwr.mm6704a4

Abstract

Total release foggers (TRFs) (also known as "bug bombs") are pesticide products often used indoors to kill insects. After an earlier report found that TRFs pose a risk for acute illness (1), the Environmental Protection Agency required improved labels on TRFs manufactured after September 2012 (2). To examine the early impact of relabeling, the magnitude and characteristics of acute TRF-related illness were evaluated for the period 2007-2015. A total of 3,222 TRF-related illnesses were identified in 10 participating states, based on three data sources: Sentinel Event Notification System for Occupational Risk-Pesticides (SENSOR) programs, the California Department of Pesticide Regulation (CDPR) program, and poison control centers (PCCs) in Florida, Texas, and Washington. No statistically significant decline in the overall TRF-illness incidence rate was found. Failure to vacate treated premises during application was the most commonly reported cause of exposure. To reduce TRF-related illness, integrated pest management strategies (3) need to be adopted, as well as better communication about the hazards and proper uses of TRFs. Redesigning TRFs to prevent sudden, unexpected activation might also be useful.

Highlights

This study identified 3,222 cases in 10 states during 2007–2015, with an average annual incidence rate of 27 per 10 million population
This increase likely resulted from including all poison control centers (PCCs) cases from Florida, Texas, and Washington and conducting a more comprehensive search for Total release foggers (TRFs)-related cases in the Sentinel Event Notification System for Occupational Risk (SENSOR) database
The increase might partly result from increased TRF use and improved case ascertainment in recent years

Summary

Introduction

A previous study identified 466 acute TRF-related illnesses in eight states during 2001–2006 (1) for a crude average annual incidence rate of seven cases per 10 million population. Exposure narratives from case reports suggested that many users did not follow or read label instructions.

Results

Conclusion