 Attachment to the Amendment to the Metaldehyde RED

Requirements for Call Centers Identified on Metaldehyde Product Labels

The Agency’s has several objectives for the metaldehyde poisoning
hotlines:

1.  To provide callers  with prompt, helpful, and appropriate
information for responding to human or domestic animal poisoning
incidents in order to minimize the adverse effects of exposure.  These
calls may come from the general public or from health or veterinary care
providers.

Callers from the general public will be advised to contact and go to a
doctor, emergency room, veterinarian, or veterinary emergency room, as
appropriate.   If a health or veterinary care provider is not available
or if the caller indicates that he or she will not take the affected
individual or animal to a provider, the caller should be referred to an
entity qualified to provide emergency care information (such as a local
poison control center or the Animal Poison Control Center), as needed.

2.  To collect information on these poisoning incidents, in a manner
consistent with the process outlined in this attachment, so that
statistics on incidents are comparable and can be compiled with those
reported by other metaldehyde poisoning hotline services.

3.   To respond to callers who are not reporting a pesticide poisoning
emergency with the information they seek or to refer them to entities
that can do so.  Examples of inquiries that might be expected include
requests for interpreting label directions, for information on how long
after a metaldehyde is applied pets can be allowed to return to the
treated area, and for information on how to remediate treated areas so
that the hazard to potentially exposed animals is minimized.  NPIC is
one source for such information.

Process for Handling Hotline Calls 

In order to address these objectives, the Agency is requiring that the
poisoning reports required to be submitted by the registrant come from
call centers using a protocol substantially similar to the one used by
NPIC and the certified poison control centers.  The required elements of
this protocol are listed below.  They cover both the disposition of the
call by the call center and data collection from the caller.

Disposition

1.	Each call must be assigned a unique identifier (ex., log or case
number).  The date and time of call must be recorded.

2.	If the call is about an exposure to a person or domestic animal via
ingestion, the call center must advise the caller that such exposures
can be quite serious, and strongly encourage the caller to take the
exposed individual or animal to a hospital emergency room or medical or
veterinary care clinic as soon as possible.

3.	If the call center believes that such a caller does not have access
to a hospital emergency room or medical or veterinary care clinic, or
believes that the caller should utilize such a service but will not do
so, the caller should be transferred or referred to the Animal Poison
Control Center or a certified Poison Control Center as he or she allows.

4.	As part of the record of the call, the call center must include
information on how the call was handled (answered questions directly,
advised medical care, referred elsewhere, etc.).

Data collection

The technician or operator from the hotline service must attempt to get
information from the caller and record responses for the following
prompts and questions:

(Note:  People calling about situations they consider to be emergencies
may not wish to stay on the phone for very long.  Assume the caller is
willing to give no more than 3-5 minutes for answering these questions.)

1.	Product of concern (Registration Number and/or Product Name, if
possible)

2	Is the caller a member of the general public, a veterinary care
provider, or other?

3.	Formulation of metaldehyde product of concern (ex., liquid, granular,
dust)

4.	Where did the application or exposure take place (State, county,
city)?

5.	In what area did the application or exposure occur (ex., yard, park,
storage shed)?

6.	Type of Question (ex., seeking treatment advice, remediation of
treated area) 

If the call relates to a possible exposure, the caller should be asked:

7.	What are the exposed individual’s age, weight, and gender? OR

	What are the exposed animal’s species and breed, age, weight, and
gender?

8.	What was the likely route of exposure (ex., oral, inhalation, dermal,
ocular)?

9.	What symptoms have been observed?

10.	When did the exposure occur?

11.	How long did animal have access to the treated area or material in
question? OR	How much was person exposed to?

12.	How long after the exposure did symptoms develop (if known)?

13.	How was the pesticide of concern applied?  How much was applied? OR

	How was the individual or animal otherwise exposed (ex., torn bag)?

14.	If an animal was exposed via an open or torn bag, where was that bag
located at 

	the time of the exposure (ex., garage floor, unlocked shed, high or low
shelf)?

Any additional narrative explanation of the incident provided by caller
should be recorded as it may be informative. 

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