10A NCAC 41F .0103. METHOD OF REPORTING

(a)  A report of a pesticide-related illness or injury shall be submitted to the Occupational and Environmental Epidemiology Branch on a form provided by or approved by the Branch according to these Rules. The form shall include the following information:

(1)           The name, address, telephone number, date of birth, race, ethnicity, gender, and occupation of the affected person;

(2)           The physical location of the affected person at the time of exposure to the pesticide, if known (be as specific as possible and include address and telephone number);

(3)           The name of the pesticide, if known; and

(4)           The name, address, and telephone number of the physician or medical facility.

(b)  To minimize cost and to avoid duplicate reporting, the physician is not required to report a case of a pesticide-related illness or injury to the Occupational and Environmental Epidemiology Branch if the physician has already reported that case to the state poison control center.  The state poison control center shall report all such cases to the Occupational and Environmental Epidemiology Branch.

(c)  Reporting forms are available at the Occupational and Environmental Epidemiology Branch, Division of Public Health, 1931 Mail Service Center, Raleigh, NC 27699-1931 or at http://www.epi.state.nc.us/epi/oii.html.

 

History Note:        Authority G.S. 130A-5(2);

Eff. April 1, 2006.