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State of California Department of Pesticide Regulation - page 76 / 132





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Emergency Medical Care. Employers must make advance emergency medical care arrangements for employees who handle pesticides. They must inform employees of the name and location of the facility where they have arranged for this care. In addition, the name, address, and telephone number of this facility (whether it is a clinic or a hospital emergency room) must be conspicuously posted at the work site, or in the work vehicle if there is no designated work site. If the emergency facility is not reasonably accessible from the work location, the employer must post the procedures employees should follow to obtain emergency medical care.

Employers must ensure that an employee is taken immediately to a physician when there are reasonable grounds to suspect that the employee has a pesticide illness or injury. Reasonable grounds to suspect a possibility of a pesticide illness or injury include the presence of symp- toms or indications such as

  • headache

  • weakness

  • dizziness

  • blurred vision

  • nausea

  • abdominal cramps

  • sweating

  • tightness of the chest

  • when exposure to a pesticide has occurred that might reasonably be expected to lead to an illness or injury

Medical Supervision. Employers must maintain use records that identify the employee, the name of the pesti- cide, and the date of handling when- ever an employee handles a pesticide

  • that carries the signal word Danger or Warning

  • that contains an organophosphate or carbamate


  • that is used for the commercial or research production of an agricul- tural plant commodity


Employers who have employees who regularly handle (see Glossary) organo- phosphate or carbamate pesticides that carry the signal word Danger or Warning and that are used for the commercial or research production of an agricultural plant commodity must have a signed written agreement with a doctor. The agreement must include the names and addresses of both the doctor who will provide medical supervision and the employer respon- sible for the employees. Employers must give a copy of this agreement to the county agricultural commissioner before an employee begins to regularly handle these pesticides. The designated doctor must possess and be familiar with the publication Medical Supervi- sion of Pesticide Workers—Guidelines for Physicians, which is available from the California Department of Health Services.

Cholinesterase Determinations. Employees who regularly handle organophosphate or carbamate pesti- cides that carry the signal word Danger or Warning, and that are used for the commercial or research production of an agricultural plant commodity are required to have baseline red cell and plasma cholinesterase determinations. These determinations must be verified every two years. For new employees, the medical supervisor may accept previously established baseline values if these values

  • were obtained according to the regulations

  • were obtained by the same labora- tory methodology that the new laboratory uses

  • are acceptable to the new labora- tory that will analyze the employee’s blood samples

Employers are responsible to make sure that employees who were not under medical supervision as their employees in the past obtain red cell and plasma cholinesterase determinations. They must do this within three working days after the end of each 30-day period

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