INCIDENT
REPORT
February
2,
2004
Jonathan
Chen,
Ph.
D.
U.
S.
Environmental
Protection
Agency
Office
of
Pesticide
Programs
Antimicrobials
Division
TABLE
OF
CONTENTS
INTRODUCTION
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3
1.0
INCIDENT
REPORT
DATA
ASSOCIATED
WITH
HEALTH
EFFECTS
OF
CCA
EXPOSURE
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3
1.1
OPP's
Incident
Data
System
(
IDS)
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4
1.2
Poison
Control
Center
(
PCC)
Data
­
1993
through
1996
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5
1.3
California
Data
­
1982
through
1996
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5
1.4
Incident
Reports
Published
in
Scientific
Literature.
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7
2.0
REFERENCES
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9
Page
3
of
9
INTRODUCTION
The
purpose
of
this
chapter
is
to
review
the
evidence
of
health
effects
in
humans
resulting
from
exposure
to
chromated
copper
arsenate
(
CCA).
In
particular,
the
acute
and
chronic
toxicity,
teratogenic/
reproductive
effects,
and
carcinogenicity
are
discussed.

A
critical
evaluation
of
the
health
effects
of
CCA
is
made
difficult
by
the
fact
that
few
studies
have
been
conducted
wherein
the
specific
exposure
of
interest
was
the
mixture
of
chromated
copper
arsenate
.
For
a
substance
that
has
been
widely
used
for
many
years
by
a
large
number
of
people
in
many
geographical
areas,
it
is
reasonable
to
expect
that
much
information
would
be
written
about
the
substance.
Indeed,
ample
information
is
available
on
physical
and
chemical
properties
and
on
usage
of
materials
treated
with
CCA.
However,
there
is
a
true
paucity
of
structured
studies
with
credible
exposure
assessments
and
appropriate
controls
available
for
review.
A
few
reports
are
available
on
populations
exposed
to
multiple
wood
preservatives,
including
CCA.
In
contrast,
a
large
body
of
literature
exists
on
the
health
effects
(
acute
and
chronic)
in
humans
of
exposure
to
the
components
in
CCA,
most
particularly
arsenic
and
to
a
lesser
degree,
chromium
and
copper.
Nevertheless,
considerable
attention
was
given
to
presenting
the
information
collected
during
the
review
in
as
logical
a
format
as
possible.
In
this
section
the
potential
acute
health
effects
of
CCA
in
humans,
reported
as
incident
reports
from
different
sources,
are
summarized.

1.0
INCIDENT
REPORT
DATA
ASSOCIATED
WITH
HEALTH
EFFECTS
OF
CCA
EXPOSURE
There
are
many
incident
report
data
associated
with
the
individual
components
of
CCA.
However,
in
view
of
evaluating
the
health
effects
of
CCA
exposure,
in
this
section,
only
incidents
associated
with
direct
CCA
or
CCA­
treated
wood
exposure
are
evaluated.
The
following
data
bases
have
been
consulted:

1.
OPP
Incident
Data
System
(
IDS)
­
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.

2.
Poison
Control
Centers
­
as
the
result
of
a
data
purchase
by
EPA,
OPP
received
Poison
Control
Center
data
covering
the
years
1993
through
1996
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.
Page
4
of
9
3.
California
Department
of
Pesticide
Regulation
­
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.

4.
Literature
Published
Incident
Reports
­
Some
incident
reports
associated
with
CCA
related
human
health
hazard
are
published
in
the
scientific
literature.

1.1
OPP's
Incident
Data
System
(
IDS)

Please
note
that
the
following
cases
from
the
IDS
do
not
have
documentation
confirming
exposure
or
health
effects.
.
Registrants
are
not
required
to
report
incidents
involving
exposure
to
previously
treated
wood,
only
direct
exposure
to
CCA
itself.
Therefore,
it
is
possible
that
serious
adverse
effects
involving
exposures
to
treated
wood
have
been
missed
by
this
review.
Legal
claims
of
severe
damage
to
eyes
and
skin
including
infections
requiring
amputation
have
been
reported
but
only
in
a
cursory
way
and
without
enough
documentation
to
be
included
in
this
review.

Incident
#
I001618­
001
In
an
incident
report
received
8/
1/
91,
a
Florida
man
handling
arsenic
treated
lumber,
which
was
not
properly
marked
with
warnings,
reported
severe
injury.
He
experienced
itching,
burning
rashes,
neurological
symptoms,
and
breathing
problems.

Incident
#
I002606­
001
In
an
incident
report
received
9/
10/
95,
a
woman
and
her
child
were
exposed
to
treated
wood
in
their
condominium
stairs.
The
child
developed
a
film
on
their
teeth
and
the
woman
developed
dermatitis.
Reported
as
a
potential
source
of
inhalation
and
dermal
exposure
was
sap
draining
from
the
wood.

Incident
#
I003604­
010
In
Virginia,
multiple
chlorine
and
wood
preservative
spills
result
in
high
numbers
of
fish­
kills
reported
4/
15/
92.

Incident#
I006508­
001
In
a
report
dated
1/
1/
94,
a
construction
supervisor
reported
"
ruined"
nerves
in
feet
and
legs.
Believes
saw
dust
and
fumes
from
cutting
and
routing
much
CCA­
treated
lumber
are
responsible.
Page
5
of
9
Incident
#
I007587­
033
Washington
State
Department
of
Health
1997
annual
report
includes
219
incidents
involving
CCA
that
were
investigated
by
the
Washington
Department
of
Agriculture
and
the
Washington
State
Departments
of
Labor
and
Health
in
1996.

Incident#
I002365­
001
On
01/
01/
91
an
incident
was
reported
in
which
pressurized
timber
was
used
as
a
wall
around
a
vegetable
garden.
Persons
who
ate
the
vegetables
became
ill.
Arsenic
was
detected
in
soil
and
potato
samples.

Incident
I007824­
001
In
an
incident
report
dated
01/
01/
95,
pressure
treated
wood
caused
a
chronic
rash
that
persisted
for
three
years.
The
rash
was
subsiding
when,
in
9/
98,
the
person
cut
some
pieces
of
CCA­
treated
wood
and
the
rash
returned.

Incident
I008468­
001
On
5/
16/
95
a
person
received
a
splinter
from
CCA­
treated
wood
which
then
developed
into
a
severe
infection
requiring
surgery.
Dorsal
cellulitis,
ascending
limphangitis,
and
acute
tenosynovitis
were
reported.

1.2
Poison
Control
Center
(
PCC)
Data
­
1993
through
1996
No
information
available.

1.3
California
Data
­
1982
through
1996
Detailed
descriptions
of
nine
cases
submitted
to
the
California
Pesticide
Illness
Surveillance
Program
(
1982­
1996)
were
reviewed.
A
brief
summary
of
each
of
these
reported
incidences
are
listed
below.
Table
4­
1
presents
the
types
of
illnesses
reported
by
year.
The
first
four
number
of
the
incident
Case
ID
is
the
year
the
incident
was
happened.

Incident
#
1987­
866.
Sawdust
from
CCA­
treated
wood
blew
into
a
clerk's
eye.
The
eye
became
swollen
and
irritated.
The
report
indicated
that
the
clerk
had
previously
been
sawing
the
wood
and
had
worn
safety
goggles.

Incident#
1987­
1009.
Two
workers
were
exposed
while
working
with
CCA­
treated
wood.
Dust
masks
were
worn.
Symptoms
reported
included
headache,
nausea,
shakiness,
and
thirst.

Incident
#
1987­
1576
A
worker
not
wearing
protective
gloves
was
handling
CCA­
treated
wood
and
wiped
his
eye
with
his
contaminated
hand.
Eye
swelling
and
redness
was
reported.
Page
6
of
9
Incident#
1989­
1496
A
lumber
yard
worker
scraped
his
back
on
a
pile
of
wood.
It
was
unknown
if
the
wood
was
treated
with
CCA.
He
was
wearing
proper
clothing
but
developed
a
large
rash
around
the
initial
scratch.
Diagnosis
of
contact
dermatitis
was
made.

Incident#
1991­
3071
A
worker
developed
a
rash
on
both
forearms
after
handling
CCA­
treated
lumber.
No
gloves
or
arm
protection
was
worn.

Incident#
1992­
1484
A
lumber
yard
worker
developed
contact
dermatitis
on
both
palms
and
fingers
after
handling
CCA­
treated
wood.

Incident#
1995­
1057
A
lumber
mill
worker
reported
nausea
and
headache
radiating
down
to
shoulders
after
boring
holes
in
wood
to
check
penetration
of
CCA
treatment.

Incident#
1996­
301
A
wood
treatment
facility
worker
experienced
eye
irritation
after
CCA
from
freshly­
treated
lumber
splashed
into
his
eye.

Table
4­
1.
Cases
Due
to
CCA
Exposure
in
California
Reported
by
Type
of
Illness
and
Year,
1982­
1996
Year
Illness
Type
Systemica
Eye
Skin
Total
1987
2
2
­
4
1989
­
­
1
1
1991
­
­
1
1
1992­
96
1
1
1
3
Total
4
3
3
9
a
Category
includes
cases
where
skin,
eye,
or
respiratory
effects
were
also
reported.
Page
7
of
9
1.4
Incident
Reports
Published
in
Scientific
Literature.

As
reported
by
Hay,
et
al
(
2000),
a
33­
year­
old
man
attempted
suicide
by
ingesting
an
unknown
liquid,
later
identified
as
a
CCA
preservative,
75
minutes
before
his
arrival
in
the
emergency
department.
He
was
in
severe
respiratory
distress,
drooling,
tachycardia,
and
hypotensive.
There
was
an
orange
color
on
the
palms
of
both
hands.
Severe
green
colored
burns
of
the
buccal
mucosa
were
observed.
The
larynx
was
edematous.
Blood
tests
revealed
partially
compensated
metabolic
acidosis.
The
patient
deteriorated
rapidly;
the
systolic
blood
pressure
dropped
to
70
mmHg,
and
he
passed
bloody
diarrhea.
The
patient
died
2.5
hours
after
his
arrival
to
the
hospital.

According
to
Geschke,
et
al.
(
1996)
a
middle­
age
man,
his
wife,
and
his
father
experienced
severe
abdominal
pain,
vomiting,
and
diarrhea
one
to
two
hours
after
a
barbeque.
A
dog
present
at
the
barbeque
also
seemed
unwell.
The
man's
vomiting
and
diarrhea
subsided
after
two
days
but
was
followed
by
tingling
of
the
fingers,
facial
numbness,
and
cramps
down
the
left
side
of
his
torso.
Within
the
same
week
he
experienced
exfoliation
of
the
skin
on
both
hands.
The
fuel
for
the
barbeque
was
timber
offcuts
from
a
nearby
construction
site.
3
days
following
the
incident
urinary
arsenic
levels
was
4.9
µ
mol/
L.
Food
poisoning
was
ruled
out.

All
eight
members
of
a
rural
Wisconsin
family
experienced
a
three­
year
period
of
sensory
hyperesthesias,
muscle
cramps,
recurrent
pruitic
conjunctivitis,
earaches,
and
otis
media,
sinusitus,
bronchitis,
pneumonia,
nose
bleeds,
easy
bruising,
and
seasonal
alopecia
ranging
from
thinning
hair
to
complete
baldness.
A
four­
week
old
neonate
with
recurring
viral
pneumonia
and
respiratory
exacerbations
was
treated
with
a
permanent
tracheotomy.
All
children
exhibited
recurrent
"
measle­
like"
rashes.
The
children
who
went
barefoot
experienced
reddened,
thickened
skin
on
the
soles
of
the
feet
and
babies
who
crawled
on
the
floor
showed
rashes
on
the
legs,
arms,
and
diaper
and
stomach
area
which
later
became
desquamated.
The
youngest
child
developed
a
thrombosed
penile
artery.
All
family
members
experienced
malaise,
easy
fatigue,
and
lack
of
sensation
in
the
arms,
hands,
feet,
and
legs.
Severe
muscle
cramps
were
reported
in
the
evening
hours.
Frequent
headaches
developed
and
the
two
parents
reported
"
black­
outs"
sometimes
lasting
for
two
hours
in
duration.
The
two
youngest
children
had
multiple
grand
mal
seizures
from
birth
to
one
year
of
age.
One
child
was
diagnosed
by
a
physician
as
having
idopathic
thrombocytopenic
pupua.
The
mother's
fifth
pregnancy
resulted
in
a
premature
birth
with
placenta
previa
or
abruptio
placenta.
It
was
determined
that
the
cause
of
the
disorders
was
due
to
the
use
of
CCA­
treated
marine
wood
and
plywood
scraps
in
a
wood
stove
used
inside
the
home
for
heating
in
winter
months.
Reported
exposure
occurred
through
ingestion,
inhalation,
and
direct
contact
with
ashes,
vapors,
and
unburned
wood
(
Peters,
et
al.,
1984).

In
1993,
a
36­
year­
old
construction
worker
with
a
history
of
peptic
ulcer
disease
was
admitted
to
a
hospital
for
severe
abdominal
pain
localized
to
the
epigastric
region,
lower
left
quadrant,
or
sometimes
everywhere.
The
pain
was
accompanied
with
nausea
but
no
vomiting.
An
extensive
laboratory
work­
up
was
negative
for
ulcers
upon
admission.
Additionally,
the
patient
had
a
negative
colonoscopy,
nerve
conduction
test,
and
electromylegram.
The
man
received
Demerol,
Dilaudid,
Darvocet,
Percocet,
and
a
low­
dose
morphine
pump
but
the
abdominal
pain
was
still
severe.
A
urinalysis
performed
showed
urinary
arsenic
levels
of
865
mcg/
L
(
normal
less
than
100
mcg/
L)
and
the
patient
was
treated
for
arsenic
toxicity.
The
patient
indicated
a
definite
exposure
Page
8
of
9
to
CCA­
treated
wood
for
the
past
several
years
in
his
occupation
(
Nakawatase
and
Nakatsuka,
1993).

In
1976
Aitken
reported
on
a
35­
year­
old
self­
employed
carpenter
who
was
admitted
to
a
Health
Center
with
reports
of
the
skin
of
his
whole
body
feeling
cold.
He
had
been
working
with
CCAtreated
wood
and
for
the
past
four
months
had
been
using
scraps
of
the
wood
as
fuel
for
cooking
food.
A
urinalysis
showed
arsenic
levels
of
230
mcg/
L
(
normal
less
than
100
mcg/
L).
He
was
treated
for
arsenic
exposure.

In
1998,
seven
cows
out
of
a
herd
of
37
became
ill
with
diarrhea,
weakness,
stumbling,
and
prostration.
Four
of
the
seven
cows
died
within
48
hours
of
onset
of
symptoms.
All
cows
in
the
herd
were
in
otherwise
good
health
and
feed
and
water
was
negative
for
any
causative
agent.
A
burnsite
in
the
pasture
was
found
to
contain
ashes
and
incompletely
burned
CCA­
treated
fence
posts
with
an
arsenic
concentration
of
1850
ppm.
Upon
autopsy
the
four
deceased
cows
had
multifocal
abomasal
hemorrhage,
severe
hyperemia
of
the
small
intestine,
and
arsenic
concentrations
in
the
liver,
abomasal
contents,
and
rumen
contents
of
4.2,
42,
and
105
ppm,
respectively
(
Hullinger,
et
al.
1998).

Reported
in
1980,
seven
Californian
construction
workers
developed
symptoms
of
arsenic
poisoning
while
building
a
pier
using
woods
treated
with
a
combination
of
ammonium,
copper
and
arsenic
(
ACA).
Workers
urinary
arsenic
levels
were
elevated.
This
incident
led
to
a
study
conducted
at
3
Californian
wood
treatment
plants
with
varying
levels
of
worker
exposure.
A
study
of
the
urinary
arsenic
levels
of
workers
illustrates
a
dose­
response
relationship
with
high
exposure
resulting
in
high
urinary
arsenic
levels
(
Rosenburg,
et
al.
1980).
Page
9
of
9
2.0
REFERENCES
Aitken,
I.
Arsenic
Poisoning
Associated
with
the
Burning
of
Arsenic­
Treated
Timber.
Papua
New
Guinea
Medical
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1976
June;
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2):
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104.

Geschecke,
A.,
Lynch,
V.,
Rouch,
G.,
and
Golec,
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1996
Sep;
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Hay,
E.,
Derazon,
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2000)
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19
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2)
159­
163.

Hullinger,
G.,
Sangster,
L,
Colvin,
B.,
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Chrome­
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1998
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1984
May;
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