II. ACTION REQUESTED 

This review is intended to fulfill our requirement to docket summaries of incident data that were 

reported to the Agency, as well as to ensure human incident data and the Agricultural Health 

Study (AHS) are part of the problem formulation phase of Registration Review. Reports of 

adverse health effects allegedly due to a specific pesticide exposure (i.e., an “incident”) are 

largely self-reported and therefore, generally speaking, neither exposure to a pesticide or 

reported symptom (or the connection between the two) is validated. Typically, causation cannot 

be determined based on incident data. However, incident information can be an important source 

of feedback to the Agency – incidents of severe outcome, or a suggested pattern or trend among 

less severe incidents, can signal the Agency to further investigate a particular chemical or 

product. Observational epidemiology studies relate the risk of disease, e.g., cancer, and exposure 

to an agent such as a pesticide product in the general population or specific sub-groups like 

pesticide applicators. 

III. BACKGROUND 

For this evaluation, the OPP Incident Data System (IDS) was utilized for pesticide incident data 

on the active ingredient pyrethrins (PC Code 069001). The purpose of the database search is to 

identify potential patterns on the frequency and severity of the health effects attributed to 

pyrethrins exposure. The IDS includes reports of alleged human health incidents from various 

sources, including mandatory Federal Insecticide, Fungicide and Rodenticide Act (FIFRA) 

Section 6(a)(2) reports from registrants, other federal and state health and environmental 

agencies and individual consumers. Since 1992, OPP compiles these reports in IDS. IDS 

contains reports from across the U.S. and most incidents have all relevant product information 

recorded. Reports submitted to the IDS represent anecdotal reports or allegations only, unless 

otherwise stated in the report. The AHS is a high quality, prospective epidemiology study 

evaluating the link between pesticide use and various health outcomes including cancer. The 

AHS includes private and commercial pesticide applicators and their spouses. If there are AHS 

findings relevant to a particular pesticide going through registration review, the Agency will 

ensure they are considered in the problem formulation/scoping phase of the process and, if 

appropriate, fully reviewed in the risk assessment phase of the process. The AHS includes 

information on use of 50 different pesticide active ingredients commonly used in agriculture. 

IV. RESULTS/DISCUSSION 

Incidents resulting in higher severity outcomes reported by registrants and incidents reported 

directly to the Agency by non-registrants are recorded in an IDS module called the Main IDS 

module. This system stores incident data for death, major and moderate incidents (and some 

minor or no effects incidents that are reported as unique cases to the Agency), and it includes 

more details about the location, date and nature of the incident. Main IDS incidents involving 

only one pesticide are considered to provide more certain information about the potential effects 

of exposure from the pesticide. When an incident involves more than one pesticide, it is difficult 

to determine which effects are attributed to the pesticide being considered. The less severe 

human incidents (minor, unknown, or no effects outcomes) are reported by registrants as counts 

called aggregate summaries and are recorded in a separate module called Aggregate IDS. 

Page 2 of 8 
In Aggregate IDS, which contains exposures classified as minor, unknown, or no effects 

outcomes, from January 1, 2006 to June 6, 2011, there are 4,375 exposures involving pyrethrins 

resulting in these low severity outcomes (664 of the exposures are classified as an unknown/no 

effects outcome, 3,711 of the exposures are classified as resulting in a minor outcome). As 

discussed, there are relatively few details provided on the incidents in the Aggregate IDS module 

and these incidents are low severity; regardless, the relatively high frequency of exposures 

(relative to other pesticides in IDS) reported involving pyrethrins indicates high potential for 

exposure. 

 

For the Main IDS, from January 1, 2006 to June 6, 2011, there are 13 exposures reported for 

single chemical only in the database (one exposure classified as resulting in a minor outcome and 

12 classified as moderate)1

, and 803 additional exposures that involved more than one chemical. 

During the scoping phase of Registration Review, the higher severity exposures (those resulting 

in fatal or major outcomes) are considered in more detail. Additionally, as described above, 

incidents involving one pesticide are typically focused on because they are considered to provide 

more certain information about the potential effects of the particular pesticide. However, because 

pyrethrins are usually co-formulated with other active ingredients, and because there is about a 

50-fold difference between the frequency of incidents involving pyrethrins alone versus 

pyrethrins and other chemicals, it is important to attend to the incidents involving multiple 

chemicals in this case. Subsequently, the higher severity exposures (those resulting in fatal or 

major outcomes) that involve pyrethrins and other chemicals are described in Table 1 (30 major 

outcomes and one fatality). Similar to the Aggregate IDS module, the relatively high frequency 

of exposures indicates a high potential for exposure. 

Pyrethrins is not included in the AHS, and therefore does not provide information for this report. 

In general, both the Aggregate and Main IDS modules result in relatively high frequency of 

pyrethrins exposures. Although most of these exposures resulted in low severity outcomes, high 

severity outcomes did occur. Subsequently, based on the frequency of exposures and the 

potential for exposures to result in high severity outcomes, these incident data warrant further 

analysis in the preliminary risk assessment phase of Registration Review.2

 

1

 Note: when conducting the query in IDS, an incident classified as HB was identified, however, upon further review 

it did not occur in the relevant time period, and therefore is not included in this review. 

2

 Note: during the Reregistration of pyrethrins, EPA required the Pyrethrins Joint Venture (PJV), an industry task 

force, to institute a product stewardship program involving a prospective in-depth follow-up of reported pyrethrins 

incidents to clarify any possible correlation between pyrethrins product use and adverse health consequences. The 

product stewardship program also requires outreach to physicians and Poison Control Centers, and provides them 

with better guidance and diagnostic standards. The program has been initiated; however, the results are not 

available. During the preliminary risk assessment phase of Registration Review, it will be important to consider this 

information, as well as a previous Agency review of pyrethrins conducted in 2009 

(Hhttp://www.epa.gov/oppsrrd1/reevaluation/pyrethrins-pyrethroids-asthma-allergy-9-18-09.pdfH) 

Page 3 of 8 
Table 1: Main IDS high severity incidents involving pyrethrins and other substances 

Chemical: Pyrethrins PC code: 

069001 

Human 

Incidents 

 

Incident 

Number 

Incident 

Date 

Product 

Name 

Registration 

Number City State 

Exposure 

Type* 

Incident Description 

018339 - 

00001 1/1/2007 

565 Plus Xlo 

Pressurized 

Contact 

Insecticide 000499-00310 Denver CO HA 

A 43 year old male used product off 

and on, and died. Existing conditions 

included alcoholism, liver failure and 

HIV positive. 

018344 - 

00002 1/12/2007 

Adams Room 

Fogger With 

Sykillstop 

011715-00313-

004758 MI HB 

A female child crawled on floor 

where product was used one or two 

weeks ago. She experienced 

twitching, jerking, body shudders and 

decreased muscle tone. Subsequently, 

doctor thought it may be a rare viral 

disease. 

018502 - 

00013 4/29/2007 Drione 1 Lb 000432-00992 Rexford NY HB 

A 49 year old male was using a 

spreader to apply product on lawn, 

and experienced agonal (abnormal) 

breathing and cardiac arrest. He was 

transported to the Emergency Room. 

He recovered. A third party involved 

reported the cardiac arrest was related 

to a cardiac event. 

018517 - 

00005 3/25/2007 

Raid Ant Killer 

16-17.5 Oz 004822-00473 Bellevue WA HB 

A 56 year old female sprayed product 

on floor, and 10 minutes later slipped 

on treated area and broke her hip. 

Recovery (to walk again) is expected 

to take 6-8 weeks. 

018799 - 

00016 12/1/2006 

Hot Shot 

Kitchen Bug 

Killer 

009688-00114-

008845 

Niagara 

Falls NY HB 

A 52 year old female’s landlord uses 

product in her apartment when food is 

out. Subsequently, she reports 

exposure to product via her diet, and 

has experienced abdominal pain, 

nausea, an inflamed stomach, a bad 

taste in her mouth and throat 

irritation. Both exposure and 

symptoms have gone on for 7-8 

months. She is medicated for 

hypertension. 

018932 - 

00006 7/20/2007 

Raid Flea Killer 

Plus Carpet And 

Room Spray 16 

Oz 004822-00273 

Centennial CO 

HB 

A 58 year old female used both 

products. Two days later she 

experienced abdominal pain, blood in 

stool and was hospitalized for three 

days. Then she experienced skin 

irritation (bite/sting feeling) which 

persists; a doctor provided topical 

steroids and oral antihistamine. 

Raid Flea Killer 

16 Oz 004822-00073 HB 

019154 - 

00006 10/9/2007 

Zodiac Flea & 

Tick Powder For 

Dogs, Puppies, 

Cats & Kittens 002724-00627 IL HB 

An adult male (18-64 years old) was 

chronically exposed to product at the 

workplace. He experienced dry skin, 

anemia and deterioration of the heart 

muscle. 

Page 4 of 8 
Chemical: Pyrethrins PC code: 

069001 

Human 

Incidents 

 

Incident 

Number 

Incident 

Date 

Product 

Name 

Registration 

Number City State 

Exposure Incident Description 

Type* 

019721 - 

00002 8/15/2006 

Raid Deep 

Reach Fogger 004822-00387 Columbus OH HB 

A 29 year old male was exposed to 

product when it was activated in his 

home. Later he began seeing sparks 

when he closed his eyes, and the next 

morning he experienced bloatedness, 

numbness, and difficulty thinking. He 

sought medical help, which said he 

was seriously poisoned and referred 

him to Emergency Room (ER). He 

declined to go to the ER. Within a 

week he could think clearly, although 

numbness remained and he 

experienced impotency. 

019849 - 

00001 5/1/2008 

Ultracide 

Pressurized Igr 

& Adulticide 000499-00404 NC HB 

An adult male (18-64 years old) used 

product at work and was exposed via 

the dermal and inhalation routes. 

Soon after exposure a rash on most of 

his body, that persisted despite 

treatment from healthcare 

practitioner. Then he experienced 

mobility problems and was diagnosed 

with a mild stroke. 

019950 - 

00001 6/29/2008 

Tat Roach & 

Ant Killer 000506-00166 Memphis TN HB 

A 29 year old male used product 

indoors for several days. 

Subsequently, he experienced 

lacrimation, tongue numbness, and 

paralysis of the left side of his face. 

020344 - 

00002 

11/10/200

8 

Ultraguard Flea 

& Tick Dip For 

Dogs & Cats 

Concentrate 002596-00086 GA HB 

A two year old male ingested gulp of 

product, and vomited 3-4 times per 

day for 6-7 days and also experienced 

diarrhea. Previously he had been 

diagnosed with a 24-hour stomach 

flu. Medical treatment was sought, as 

the diarrhea and vomiting persisted, 

and he then begin having difficulty 

walking. 

020416 - 

00002 1/1/2008 

Garden Safe 

Brand 

Houseplant & 

Garden Insect 

Spray 

067702-00006-

039609 Runnemede NJ HB 

A 60 year old female has used 

product for a year and a half (4 

bottles in the last year). Over the last 

18 months she experienced health 

problems, including her heart 

skipping beats and breathing 

difficulties. 

020597 - 

00002 1/1/2009 

Advanced Care 

3 In 1 Carpet 

Powder 

004758-00175-

002596 CO HB 

A 73 year old female used half the 

container of product over the last 

month without vacuuming. She was 

recently hospitalized with dementia 

and is unable to walk. She was 

diagnosed with a neurological 

disorder. 

Page 5 of 8 
Chemical: Pyrethrins PC code: 

069001 

Human 

Incidents 

 

Incident 

Number 

Incident 

Date 

Product 

Name 

Registration 

Number City State 

Exposure Incident Description 

Type* 

020671 - 

00006 9/20/2008 

Adams Flea And 

Tick Mist 000270-00343 La Fayette GA HB 

An adult female used product and 

noticed odor. The next day the skin 

around her nose, cheekbones and 

throat were red, and she could not 

speak and had trouble swallowing. 

She was hospitalized for two weeks, 

given IV antibiotics and a feeding 

tube. 

020861 - 

00001 10/5/2008 

Knock Out 

Room & Area 

Fogger/ Zema 

Igr Total 

Release Fogger 002382-00184 

Black 

River Falls WI HB 

A 20-month old male was 

hospitalized for seizures, chewing 

face and irritability after application 

of product in home. Environmental 

samples confirmed presence of 

multiple pesticides in his home. 

021037 - 

00001 7/9/2009 

Walgreens 

Roach & Flea 

Fogger 

000498-00146-

043428 

Chicago 

(Berwyn?) IL 

HB 

A 60 year old male used product and 

his apartment exploded. He was 

transported to the hospital in an 

ambulance. He was treated for 

hearing loss. There was damage to 

the apartment. The incident included 

a complaint that the instructions were 

too small a font size to read. 

HB 

An adult female (wife of adult male 

described above) was in apartment 

where product was used. She was 

transported to hospital in an 

ambulance and treated for head 

injuries. 

021066 - 

00009 7/9/2009 

Ultraguard Rid 

Flea & Tick 

Shampoo For 

Dogs Clean 

Fresh Scent 002596-00022 MO HB 

A five year old male ingested product 

(about 45 ounces), and about two 

weeks later sought medical attention 

for renal failure. A biopsy of kidneys 

indicated failure may be due to 

phosphorus. 

021149 - 

00001 7/16/2009 

Flysect Super-7 

Repellent Spray 000270-00300 VA HB 

A 54 year old female got product 

(about 1 teaspoon) on hand while 

transferring product to spray bottle. 

She hosed off hand immediately. 

Shortly thereafter she experienced 

skin irritation (felt like “thousands of 

bugs under her skin”) and swelling. 

She passed out and vomited. An 

ambulance transported her to the 

hospital and was administered an EpiPen en route. At the hospital, her 

blood pressure was low and she was 

give IV steroids. Upon discharge, she 

was instructed to take Zantac 2x/day 

and Benadryl 3x/day 

021542 - 

00007 1/1/2009 

Zodiac Fleatrol 

Flea & Tick 

Spray/Dogs, 

Cats, Puppies & 

Kittens 002724-00404 WI HB 

A 14 year old male developed new 

seizure activity after product was 

used on dog (for the past two 

months). He is on medication that has 

seizure activity as a possible side 

effect. 

Page 6 of 8 
Chemical: Pyrethrins PC code: 

069001 

Human 

Incidents 

 

Incident 

Number 

Incident 

Date 

Product 

Name 

Registration 

Number City State 

Exposure Incident Description 

Type* 

021605 - 

00009 

11/30/200

9 Tri-Die Silica 000499-00385 San Diego CA HB 

An 82 year old male was hospitalized 

for five days, and experienced skin 

and sinus problems, and renal failure. 

The adjacent rooms in the extended 

stay hotel he was living in were 

treated with product 10 days prior to 

his hospitalization. 

022178 - 

00009 8/19/2009 

Knockout Extra 

Strength Area 

Treatment 16 Oz 

000499-00404-

002382 Biscoe NC HB 

An adult female (18-64 years old) 

used product and inhaled some. 

Shortly thereafter she felt lousy, and 

the following day she developed 

black stools, lethargy, and an odor 

that persist. About a week after 

exposure, she was admitted to the 

hospital and given blood. 

022379 - 

00011 9/13/2010 

Ultraguard Plus 

Flea & Tick 

Carpet Powder 2 

002724-00777-

002596 OH HB 

A 43 year old female used product 

and inhaled some. Shortly thereafter, 

she developed respiratory distress and 

shortness of breath. She was brought 

to the hospital and put on ventilator, 

given antibiotics and diagnosed with 

Acute Respiratory Distress 

Syndrome. About two weeks after 

exposure, she had a tracheotomy. She 

is an asthmatic and smoker. 

022469 - 

00006 

10/21/201

0 

Hot Shot 

Bedbug & Flea 

Killer 

009688-00150-

008845 

Lexington KY 

HB 

A 22 year old male had seizures 4-10 

days after product was used in his 

home. He has epilepsy. 

Hot Shot 

Bedbug And 

Flea Fogger 

001021-01674-

008845 HB 

022514 - 

00001 

10/19/201

0 

Ultraguard Plus 

Flea & Tick 

Carpet Powder 2 

002724-00777-

002596 

Boston MA 

HB 

A female child (6-12 years old) 

experienced respiratory issues the day 

after the product was used in her 

home. She was hospitalized and 

almost put on the respirator, but she 

improved with antibiotics, prednisone 

and fluids. 

Ultraguard Plus 

Flea & Tick 

Fogger 

001021-01623-

002596 HB 

022851 - 

00004 7/18/2010 

Advanced Care 

3 In 1 Carpet 

Powder 

002724-00777-

002596 Tiffin OH HB 

And adult female (18-64 years old) 

used product in two rooms. The day 

after she experienced burning eyes, 

face and throat irritation. Symptoms 

persisted and worsened over 8 

months, and now she has lost weight, 

and is experiencing joint pain and 

headaches. She has consulted doctors, 

and they have ruled out lupus. 

Page 7 of 8 
Page 8 of 8 

Chemical: Pyrethrins PC code: 

069001 

Human 

Incidents 

 

Incident 

Number 

Incident 

Date 

Product 

Name 

Registration 

Number City State 

Exposure 

Type* 

Incident Description 

HB 

The daughter (13 years old) of the 

adult female described above also 

experienced similar symptoms, in 

addition to nausea, abdominal pain, 

numbness in her limbs and twitching 

of her legs and arm. She was treated 

for pink eye for two months before 

medical professionals realized it was 

an incorrect diagnosis. 

HB 

The husband (adult male 18-64 years 

old) of the adult female described 

above and father of youth female 

described above experienced 

diarrhea, joint pain, facial swelling, 

throat and eye irritation and burning 

eyes two months after the product 

was applied in the home. 

* Severity Categories 

H-A Human Fatality Death (if the person died) 

H-B Human Major Major (if the person alleged or exhibited symptoms which may have been life-threatening, or resulted in adverse

reproductive effects or in residual disability) 

H-C Human Moderate Moderate (if the person alleged or exhibited symptoms more pronounced, more prolonged or of a more systemic 

nature than minor symptoms; and involved some form of treatment, even though symptoms were not life 

threatening and the person returned to his/her pre-exposure state of health with no additional residual disability) 

H-D Human Minor Minor (if the person alleged or exhibited some symptoms, but they were minimally traumatic; the symptoms 

resolved rapidly and usually involve skin, eye or respiratory irritation) 

H-E Human Unspecified Unspecified (if symptoms are unknown, unspecified or are alleged to be of a delayed or chronic nature that may 

appear in the future) 

H Human Undetermined (an undetermined severity) 

from 40 CFR § 159.184 

**Incidents that are involved in lawsuits and incidents that occur outside of the U.S. are excluded