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BACKGROUND: In August 2014, employees of a food distributor in central North Carolina (NC) released several brands of pesticide foggers inside the facility’s warehouse. The warehouse was sealed for the weekend and ventilated briefly before employees returned to work. On Monday, 17 employees and one police officer became ill and were evaluated in the local emergency department; four (24%) of the employees were admitted to the hospital overnight. The most common symptoms reported were nausea, vomiting, and shortness of breath. The local health director declared the building an imminent public health hazard and barred employees from entering the facility until sampling was performed and the building deemed safe for re-entry. The NC Department of Agriculture and Consumer Services (NC DACS) embargoed all food products in the facility.
METHODS: Staff from NC’s Pesticide Incident Surveillance Program interviewed 12 (67%) of the 18 symptomatic individuals through a translator using a standard telephone questionnaire. The questionnaire included demographic information, exposure history, and symptoms. State health officials collaborated with local health officials, first responders, NC DACS, NC Department of Labor, US Environmental Protection Agency, and US Consumer Product Safety Commission. Investigation activities included identifying the released pesticides, reviewing the cleanup contractor’s plan for air and surface sampling inside the facility, and determining when re-entry was appropriate.
RESULTS: Authorities determined that two of the released pesticides were labeled for residential use only, and the third was not registered in the US. The interviewed employees revealed that similar pesticide incidents had occurred at the facility in the past. Employees were hesitant to discuss the incident and expressed concerns about losing their jobs and being able to pay their medical bills. Reviewing the sampling plan, collecting and analyzing samples, and interpreting the results took several weeks. Air and surface sampling showed acceptable chemical levels throughout the facility, and cleanup was not required. Local health officials permitted employees to re-enter the facility and resume business operations 22 days after employees became ill.
CONCLUSIONS: Off-label use of pesticides in a food distribution warehouse sickened 18 people and triggered a public health investigation that required the collaboration of multiple local, state and federal agencies. Conducting air and surface sampling was vital to ensure the safety of the employees and the food products. The NC Structural Pest Control Committee fined the company $10,000 for numerous violations related to this incident, and the NC Occupational Safety & Health Administration is currently investigating.