Pesticide poisoning exposure

Enquiries to the New Zealand National Poisons Information Centre concerning pesticide poisoning exposures accounted for 15% of total telephone enquiries for the year ended June 1993 (see Table 27.1). The breakdown of enquiries with respect to type of agricultural agent is shown in Table 27.2 [10]. 

Unlike the prevalence of drug poisoning exposures in most Western countries, pesticide poisoning exposures are numerous in Taiwan. Epidemiological. studies of the... 

It is difficult to obtain figures that accurately reflect the incidence of pesticide poisoning, and the number of documented cases of direct human poisoning in the USA varies from source to source. It was estimated that there are 100,000 nonfatal cases of human poisoning each year from pesticide exposure (7). In 1973 there were 1,A7A cases of occupational illness associated with pesticide exposure in California (8). Organophosphate insecticides are a major cause of occupational poisoning. 

Acute symptoms of pesticide poisoning include headaches, vomiting, tremors, lack of coordination, difficulty breathing or respiratory depression, loss of consciousness, seizures and death. Chronic effects of long-term pesticide exposure include impaired memory and concentration, disorientation, severe depression and confusion. 

Agricultural workers often experience long-term low level pesticide exposures. In a study of 175 farm workers so exposed, it was found that chronic exposure (over many years) to low levels of pesticides produced neurological impairments similar to those observed in acute organophosphate pesticide poisonings. ... 

With an excessive, single exposure, the result will be either a systemic pesticide poisoning or a topical lesion frequently observed on the skin or in the eyes. Since most acute intoxications are from the carbamate and organoposphate insecticides, the systemic manifestations are cholinergic and are due to the inhibition of acetyl cholinesterase and the resultant accumulation of the neurotransmitter acetylcholine, at the synapse. Topical effects, in contrast, either are the result of the irritant properties of the chemicals in the formulation or have an allergenic basis for their occurrence (3). However, topical effects are not necessarily exclusively the result of exposure to the active ingredient in the formulation but may result from a reaction to one or more inerts as well. 

Harmon GE, Reigart JR, Sandifer SH Long-term follow-up of survivors of acute pesticide poisoning. JSC Med Assoc 71 253-257,1976 Hayes WJ Jr, Dixon EM, Batchelor GS, et al Exposure to organic phosphorus sprays and occurrence of selected symptoms. Public Health Rep 72 787-794, 1957 Holmes JH, Kinzer EJ, Hibbert RW Parathion poisoning case report. Rocky Mountain Medical Journal 54 1022-1031,1957... 

Another area that would be of direct benefit to the medical personnel responsible for treating pesticide exposure in humans is the development of antidotal and symptomatic treatment for the various classes of pesticides. Although we have more specific antidotes available to treat pesticide poisoning than for any other single class of acute poisons, the number of antidotes is small for non-insecticidal pesticides and these cases must be treated symptomatically. The current acute toxicity protocols do not currently provide the kind of clinical information that is needed in such cases. 

It is estimated that there are 3.8 million cases of occupational diseases due to exposure to chemicals in the world each year. Of these, acute pesticide poisoning accounts for about 3 million cases. About 220,ci00 of these are fatal. Over 90 % of exposure incidents and about 99% of deaths take place in the third world countries [13]. German Development expert reports on the careless use of pesticides, in Sri Lanka — there they spread DDT with bare hands, people are powdered white , On the Antilles island of Trinidad a total... 

In Sri Lanka, 700,(XX) kg a of pesticides ate imported to be used in food production. In 1986, pesticide poisoning was the 6th leading cause of mortality in major hospitals and accounted for 57% of hospital admissions [3]. Approximately 13,(XX) people a" present to government hospitals for treatment of pesticide poisoning (the number of deaths is around 1(X)0 a ). Among these, nearly 25% are occupational (V unintentional exposures. 

National Poi.son Center in Taiwan indicate that the fatality rate is much higher in Taiwan than in most Western countries, with 5.65% of all poisoning exposure.s resulting in death. There were 6872 cases of pesticide intoxication among 223,436 total cases of various intoxications from 1985 to 1993 (Tabic 6>, and these accounted for approximately 22-30% of the total incidences, from 1991 to 1996. The incidence of pesticide poisoning gradually declined during this time. 

Insecticides (5217 patients, 46.3%) accounted for nearly half of the poisoning exposures. In Taiwan, 11,269 patients were intoxicated with acute pesticide poisoning, and male patients (63.9%) outnumber female patients. After adjusting for measured baseline characteristics, gender is not associated with the risk of death among patients with acute pesticide poisoning. OPs were more toxic than CMs. 

Suicide (7511 patients, 66.7%) was the most common intent of exposure. The oral route (8930 patients, 79.2%) was the most common route of exposure. Table 8 shows increased age. suicide attempt, oral exposure, and concurrent exposure with a higher risk of fatality. In terms of age differences, people 19-39 years old comprised the largest number of injured patients. Acute pesticide poisoning mainly involved adults, and the mean age of patients was 43,3 18.9 years. Acute pesticide poisoning was associated with a very high case fatality rate (14.5%), and there was a wide range of differences in clinical severity among various pesticides. 

TABLE.9 The most common of pesticides related in human poison exposure categorized by major group classification... 

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