title: Acute Illness Associated with Exposure to a New Soil Fumigant Containing Dimethyl Disulfide-Hillsborough County, Florida, 2014.
abstract: Dimethyl disulfide (DMDS) is a new soil fumigant that is considered a replacement for methyl bromide. In 2014, the Florida Department of Health (FDOH) received several complaints of illness following a strong DMDS odor in Hillsborough County. Public health investigation of DMDS-related illness was conducted to assess illness and identify areas to target for prevention activities. This investigation included surveillance, interviews, review of medical records, review of supporting documentation, and determination of pesticide-related illness and injury case status. FDOH interviewed 66 people complaining of illness related to DMDS. Thirty-two were classified as possible and 11 as suspicious cases of DMDS-related illness. Among cases, the mean age was 48 years (range: 3-71 years). The majority were non-Hispanic (n = 43, 100%), white (n = 40, 93%), and female (n = 23, 53.5%). The most common signs and symptoms reported by exposed people included eye pain, throat irritation, nausea, dizziness, headache, and fatigue. There were 88% of cases classified as having low severity of illness and 12% classified as having moderate severity. The average distance from an application site among individuals who reported being exposed at or near their home was 0.74 miles for those classified as cases (n = 36) and 2.84 miles for those not classified as cases (n = 21, P < .05). This is the first known comprehensive report of DMDS-related illness in humans. Even though illnesses associated with DMDS in this investigation were generally of low severity, it is important to identify better ways to prevent off-target movement of DMDS and to improve notification to communities when nearby DMDS applications are planned.
authors.affiliation: a Division of Disease Control and Health Protection , Florida Department of Health , Tallahassee , Florida , USA.
authors.forename: Prakash R
authors.initials: PR
authors.lastname: Mulay
authors.affiliation: a Division of Disease Control and Health Protection , Florida Department of Health , Tallahassee , Florida , USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Cavicchia
authors.affiliation: a Division of Disease Control and Health Protection , Florida Department of Health , Tallahassee , Florida , USA.|b Pennsylvania Department of Health , Harrisburg , Pennsylvania , USA.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Watkins
authors.affiliation: a Division of Disease Control and Health Protection , Florida Department of Health , Tallahassee , Florida , USA.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tovar-Aguilar
authors.affiliation: c Florida Department of Health in Hillsborough County , Tampa , Florida , USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Wiese
authors.affiliation: d Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health , Centers for Disease Control and Prevention , Cincinnati , Ohio , USA.
authors.forename: Geoffrey M
authors.initials: GM
authors.lastname: Calvert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004220:Disulfides / Q000633:toxicity*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005431:Florida; D005651:Fumigation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009812:Odorants; D055815:Young Adult
chemical_list: D004220:Disulfides; C021181:dimethyl disulfide
keywords: Acute poisonings; Paladin; dimethyl disulfide; pesticides; soil fumigant; surveillance