**INCIDENT REPORTS ASSOCIATED WITH**

Tributyltin (TBT) -- containing Chemicals

(tributyltin oxide, tributyltin benzoate, and tributyltin maleate)

PC Codes: 083001, 083106, 083118

January 29, 2008

U.S. Environmental Protection Agency

Office of Pesticide Programs

Antimicrobials Division

**TABLE OF CONTENTS**

[0.0 INTRODUCTION 1](#introduction)

[1.0 INCIDENT REPORT DATA ASSOCIATED WITH HEALTH EFFECTS
1](#incident-report-data-associated-with-health-effects)

[1.1 OPP's Incident Data System (IDS) 2](#opps-incident-data-system-ids)

[**Summary of the Incident Reports due to Exposure to Tributyltin
maleate** 2](#OLE_LINK2)

[**Summary of the Incident Reports due to Exposure to Tributyltin
oxide** 2](#__RefHeading___Toc189407202)

[1.2 **Poison Control Center (1993 -- 2003)**
3](#poison-control-center-1993-2003)

[**1.3** **California Data - 1982 through 2003**
3](#__RefHeading___Toc189407204)

> [**Incidences due to exposure to TBT (alone or in combination)**
> 3](#__RefHeading___Toc189407205)
>
> [**Incidences due to exposure to tributyltin oxide**
> 5](#__RefHeading___Toc189407206)
>
> [**Incidences due to exposure to tributyltin Maleate**
> 6](#__RefHeading___Toc189407207)
>
> [**Incidences due to exposure to tributyltin neodecanoate**
> 7](#__RefHeading___Toc189407208)

[1.4 National Pesticide Telecommunications Network (NPTN)
8](#national-pesticide-telecommunications-network-nptn)

[1.5 Epidemiological Studies Published in Scientific Literature
8](#epidemiological-studies-published-in-scientific-literature)

[2.0 SUMMARY AND CONCLUSION 8](#summary-and-conclusion)

[3.0 REFERENCES 9](#references)

# 0.0 INTRODUCTION

The purpose of this chapter is to review the evidence of health effects
in humans resulting from exposure to tributyltin (TBT) -- containing
Chemicals (tributyltin oxide, tributyltin maleate and tributyltin
benzoate).

Two approaches are used in this section:

1.  The potential health effects of TBT in humans, reported as incident
    reports from different sources, are summarized.

2.  A literature search of health effects associated with TBT exposure,
    including results of epidemiological studies, is summarized.

# 1.0 INCIDENT REPORT DATA ASSOCIATED WITH HEALTH EFFECTS 

The following databases have been consulted for incident data:

**[OPP Incident Data System (IDS)]{.underline}** - The Incident Data
System of The Office of Pesticide Programs (OPP) of the Environmental
Protection Agency (EPA) contains reports of incidents from various
sources, including registrants, other federal and state health and
environmental agencies and individual consumers, submitted to OPP since
1992. Reports submitted to the Incident Data System represent anecdotal
reports or allegations only, unless otherwise stated. Typically no
conclusions can be drawn implicating the pesticide as a cause of any of
the reported health effects. Nevertheless, sometimes with enough cases
and/or enough documentation risk mitigation measures may be suggested.

**[Poison Control Centers]{.underline}** - as the result of a data
purchase by EPA, OPP received Poison Control Center data covering the
years 1993 through 1998 for all pesticides. Most of the national Poison
Control Centers (PCCs) participate in a national data collection system,
the Toxic Exposure Surveillance System, which obtains data from about
65-70 centers at hospitals and universities. PCCs provide telephone
consultation for individuals and health care providers on suspected
poisonings involving drugs, household products, pesticides, etc.

**[California Department of Pesticide Regulation]{.underline}** -
California has collected uniform data on suspected pesticide poisonings
since 1982. Physicians are required, by statute, to report to their
local health officer all occurrences of illness suspected of being
related to exposure to pesticides. The majority of the incidents involve
workers. Information on exposure (worker activity), type of illness
(systemic, eye, skin, eye/skin and respiratory), likelihood of a causal
relationship, and number of days off work and in the hospital are
provided.

**[National Pesticide Telecommunications Network (NPTN)]{.underline}** -
NPTN is a toll-free information service supported by OPP. A ranking of
the top 200 active ingredients for which telephone calls were received
during calendar years 1984-1991, inclusive, has been prepared. The total
number of calls was tabulated for the categories of human incidents,
animal incidents, calls for information, and others.

**[Published Incident Reports]{.underline}** - Some incident reports
associated with TBT-related human health hazards are published in the
scientific literature.

## [OPP's Incident Data System (IDS)]{.underline}

[]{#OLE_LINK2 .anchor}

**[Summary of the Incident Reports due to Exposure to Tributyltin
maleate]{.underline}**

An incident in which a woman was exposed to pillows treated with
Ultrafresh DM 50, containing tributyltin maleate, developed swollen
mouth, cheeks, neck, lips and a swollen throat (that inhibited her from
talking), irritation of the eyes and mouth, quivering of the jaws and
lack of concentration. Exposures to tributyltin maleate occurred via the
dermal and the ocular routes.

[]{#__RefHeading___Toc189407202 .anchor}**[Summary of the Incident
Reports due to Exposure to Tributyltin oxide]{.underline}**

A total of 3 incidents were reported due to residential uses of
tributyltin oxide either for painting the wall or handling the wooden
joists to control a mildew problem. Inhalation of tributyltin oxide in
combination with other chemicals was considered to be the primary route
of exposure. One of the incidents took place when a couple painted the
interior of their sail boat with a chemical containing tributyltin
oxide. The husband suffered from muscle weakness, muscle fasciculation,
tremors and weakness in his shoulders, and was diagnosed with Lou
Gehrig's disease; while the wife experienced muscle fatigue and numbness
in her extremities. The second incident occurred in Barclay square
apartments and Park lane apartments, where the residents complained of
offensive odors, eye irritations, and respiratory distress. In the third
incident, the building workers experienced poor co-ordination and
unsteadiness 3 days after handling treated wooden joists. The route of
exposure could not be determined from the information provided in the
incident report.

A total of 11 incidents were reported from the use of tributyltin oxide,
in combination with other chemicals, in wood preservative stain. Dermal
exposure to wood preservative stain (indoor/outdoor/deck painting) led
to 9 incidents of rash, hives/welts, itching, blisters, color
alteration, ocular irritation, headache, nausea, and dizziness/vertigo.
Inhalation of the chemical vapors resulted in chest pain and one
incident of seizures.

Although these incidents have been reported for exposure to tributyltin
oxide, there is no one reported incident involving tributyltin oxide as
an individual chemical exposure, only in combination with other
chemicals.

## 1.2 [Poison Control Center (1993 -- 2003)]{.underline}

There is no reported TBT specific incident in the PCC' s database.

[]{#__RefHeading___Toc189407204 .anchor}**1.3 [California Data - 1982
through 2003]{.underline}**

The incidences associated with tributyl tin and individual compounds
were presented separately in this section,

[]{#__RefHeading___Toc189407205 .anchor}**[Incidences due to exposure to
TBT (alone or in combination)]{.underline}**

There are 10 incidences that have been reported in the California
Pesticide Surveillance Program Database (1982-1998) as definitely or
probably related to tributyltin compounds alone or in combination. As
summarized in Table 1, symptoms associated with eyes are the primary
reported illness in all the associated incidences. Nausea, dizziness,
headache, and sore throat are the primary systemic effects that have
been reported. The primary dermal effects that have been reported are
rash, burning sensation, itching.

As summarized in Table 2, although there are some people who were unable
to work after exposure for a certain period of time, no one was
hospitalized.

**Table 1. Cases Due to TBT compounds Exposure in California Reported by
Type of Illness and Year, 1982-1998**

  -----------------------------------------------------------------------------
  Year        Illness                                                  
              Type                                                     
  ----------- ----------- ------- -------- ------------- ------------- --------
              Systemic    Eye     Skin ^b^ Respiratory   Combination   Total
              ^a^                                        ^c^           

  1982                                                                 

  1984                                                                 

  1987                    1                                            1

  1988                                                                 

  1989                                                                 

  1990                                                                 

  1991                    1                                            1

  1992        1                   1                                    2

  1995                            1                                    1

  1997                    1                                            1

  1998        2           2                1             1             4

  Total       3           5       2        1             1             10
  -----------------------------------------------------------------------------

^a^ Category include cases where nausea, sore throat, dizziness,
headache and other systemic effects occurred.

^b^ Category includes burning sensation, dry scaling irritation,
cracking and thickened skin, itching, and blisters and rash on hands.

^c^ Category includes combined effects to eye, skin, respiratory and/or
systemic effects.

**Table 2. Number of days lost from work or Hospitalized for Indicated
Number of Days after being Exposed to Tributyltin compounds in
California, 1982-1998.**

  ------------------------ ------------------------ ----------------------
                           **Number of Days lost    **Number of Persons
                           from work**              Hospitalized**

  **One day**              1                        \-

  **Two days**             \-                       \-

  **3-5 days**             2                        \-

  **6-10 days**            \-                       \-

  **11-16 days**           \-                       \-

  **Indefinite ^a^**       \-                       \-

  **Unknown^b^**           \-                       \-
  ------------------------ ------------------------ ----------------------

Note:

\(a\) An entry of indefinite indicates the event occurred, but the time
period is not known.

(b).An entry of unknown indicates no information was provided.

[]{#__RefHeading___Toc189407206 .anchor}**[Incidences due to exposure to
tributyltin oxide]{.underline}**

There are 7 incidences that have been reported in the California
Pesticide Surveillance Program Database (1982-1998) as definitely or
probably related to tributyltin compounds alone or in combination. As
summarized in Table 1, symptoms associated with eyes including burning
irritation are the primary reported illness in all the associated
incidences. Nausea, dizziness, headache, and sore throat are the primary
systemic effects that have been reported. The primary dermal effects
that have been reported are rash, burning sensation, itching.

As summarized in Table 4, although there are some people who were unable
to work after exposure for a certain period of time, no one was
hospitalized.

**Table 3. Cases Due to Tributyltin oxide Exposure in California
Reported by Type of Illness and Year, 1982-1998**

  -----------------------------------------------------------------------------
  Year        Illness                                                  
              Type                                                     
  ----------- ----------- ------- -------- ------------- ------------- --------
              Systemic    Eye     Skin ^b^ Respiratory   Combination   Total
              ^a^                                        ^c^           

  1982                                                                 

  1984                                                                 

  1987                    1                                            1

  1988                                                                 

  1989                                                                 

  1990                                                                 

  1992                            1                                    1

  1995                            1                                    1

  1997                    1                                            1

  1998        1           2                                            3

  Total       1           4       2                                    7
  -----------------------------------------------------------------------------

^a^ Category include cases where nausea, sore throat, dizziness,
headache and other systemic effects occurred.

^b^ Category includes burning sensation, dry scaling irritation,
cracking and thickened skin, itching, and blisters and rash on hands.

^c^ Category includes combined effects to eye, skin, respiratory and/or
systemic effects.

**Table 4. Number of days lost from work or Hospitalized for Indicated
Number of Days after being Exposed to Tributyltin Oxide in California,
1982-1998.**

  ------------------------ ------------------------ ----------------------
                           **Number of Days lost    **Number of Persons
                           from work**              Hospitalized**

  **One day**              1                        \-

  **Two days**             \-                       \-

  **3-5 days**             1                        \-

  **6-10 days**            \-                       \-

  **11-16 days**           \-                       \-

  **Indefinite ^a^**       \-                       \-

  **Unknown^b^**           \-                       \-
  ------------------------ ------------------------ ----------------------

Note:

\(a\) An entry of indefinite indicates the event occurred, but the time
period is not known.

(b).An entry of unknown indicates no information was provided.

[]{#__RefHeading___Toc189407207 .anchor}**[Incidences due to exposure to
tributyltin Maleate]{.underline}**

There are 2 incidences that have been reported in the California
Pesticide Surveillance Program Database (1982-1998) as definitely or
probably related to tributyltin compounds alone or in combination. As
summarized in Table 1, symptoms associated with eyes are the primary
reported illness in all the associated incidences. Nausea, dizziness,
headache, and sore throat are the primary systemic effects that have
been reported. The primary dermal effects that have been reported are
rash, burning sensation, itching. None of the people were either
hospitalized or lost days from work.

**Table 5. Cases Due to Tributyltin maleate Exposure in California
Reported by Type of Illness and Year, 1982-1998**

  -----------------------------------------------------------------------------
  Year        Illness                                                  
              Type                                                     
  ----------- ----------- ------- -------- ------------- ------------- --------
              Systemic    Eye     Skin ^b^ Respiratory   Combination   Total
              ^a^                                        ^c^           

  1989                                                                 

  1998        1                            1                           2

  Total       1                            1                           2
  -----------------------------------------------------------------------------

^a^ Category include cases where nausea, sore throat, dizziness,
headache and other systemic effects occurred.

^b^ Category includes burning sensation, dry scaling irritation,
cracking and thickened skin, itching, and blisters and rash on hands.

^c^ Category includes combined effects to eye, skin, respiratory and/or
systemic effects.

[]{#__RefHeading___Toc189407208 .anchor}**[Incidences due to exposure to
tributyltin neodecanoate]{.underline}**

There are 2 incidences that have been reported in the California
Pesticide Surveillance Program Database (1982-1998) as definitely or
probably related to tributyltin neodecanoate alone or in combination. As
summarized in Table 6, symptoms associated with eyes are the primary
reported illness in all the associated incidences. Nausea, dizziness,
headache, and sore throat are the primary systemic effects that have
been reported. The primary dermal effects that have been reported are
rash, burning sensation, itching. As summarized in Table 8, although
there are some people who were unable to work after exposure for a
certain period of time, no one was hospitalized.

**Table 6. Cases Due to Tributyltin Neodecanoate Exposure in California
Reported by Type of Illness and Year, 1988-1992**

  -----------------------------------------------------------------------------
  Year        Illness                                                  
              Type                                                     
  ----------- ----------- ------- -------- ------------- ------------- --------
              Systemic    Eye     Skin ^b^ Respiratory   Combination   Total
              ^a^                                        ^c^           

  1988                                                                 

  1989                                                                 

  1991                    1                                            1

  1992        1                                                        1

  Total       1           1                                            2
  -----------------------------------------------------------------------------

^a^ Category include cases where nausea, sore throat, dizziness,
headache and other systemic effects occurred.

^b^ Category includes burning sensation, dry scaling irritation,
cracking and thickened skin, itching, and blisters and rash on hands.

^c^ Category includes combined effects to eye, skin, respiratory and/or
systemic effects.

**Table 7. Number of days lost from work or Hospitalized for Indicated
Number of Days after being Exposed to Tributyltin Neodecanoate in
California, 1988-1992.**

  ------------------------ ------------------------ ----------------------
                           **Number of Days lost    **Number of Persons
                           from work**              Hospitalized**

  **One day**              \-                       \-

  **Two days**             \-                       \-

  **3-5 days**             1                        \-

  **6-10 days**            \-                       \-

  **11-16 days**           \-                       \-

  **Indefinite ^a^**       \-                       \-

  **Unknown^b^**           \-                       \-
  ------------------------ ------------------------ ----------------------

Note:

\(a\) An entry of indefinite indicates the event occurred, but the time
period is not known.

(b).An entry of unknown indicates no information was provided.

## 1.4 [National Pesticide Telecommunications Network (NPTN)]{.underline}

There is no incident reported in the NPTN database related to TBT
exposure..

## 1.5 [Epidemiological Studies Published in Scientific Literature]{.underline}

No information was located regarding toxicity of tributyltin oxide in
humans following oral exposure. Human data summarized by Boyer (1989)
suggest that tributyltin oxide is a potent non-allergenic dermal
irritant. There are several case reports claiming irritation of the
respiratory tract following acute inhalation exposure of people to
tributyltin oxide (Anon., 1991; Hay and Singer, 1991; and Shelton et
al., 1992). None of these reports, however, contains sufficient
information to characterize the exposure-response relationship for the
reported effects. There is no epidemiological study can be located
associated with TBT exposure.

# 2.0 SUMMARY AND CONCLUSION 

There are some incident reports associated with exposure to tributyl tin
compounds. Nausea, dizziness, headache, and sore throat are the primary
systemic effects that have been reported. The primary dermal effects
that have been reported are rash, burning sensation, itching. There are
several case reports claiming irritation of the respiratory tract
following acute inhalation exposure of people to TBT.

# 3.0 REFERENCES 

> Case Reports Received by the California Pesticide Illness Surveillance
> Program, 1982 -- 2005, Generated November 27, 2007 by Louise Mehler
> Department of Pesticide Regulation, CalEPA.
>
> Anon. 1991. Acute effect of indoor exposure to paint containing
> bis(tributyltin)oxide \--Wisconsin, 1991. Morb. Mortal. Wkly. Rep.
> 40:280-281
>
> Boyer, I.J. 1989. Toxicity of dibutyltin, tributyltin and other
> organotin compounds to humans and to experimental animals. Toxicology
> 55:253-298.
>
> Hay, A., and C. R. Singer. 1991. Wood preservatives, solvents, and
> thrombocytopenic purpura (letter). Lancet. 338:766.
>
> Shelton, D., B. Urch, and S. M. Tarlo. 1992. Occupational asthma
> induced by a carpet fungicide \-- tributyltin oxide. J. Allergy Clin.
> Immunol. 90:274-275.