ABSTRACT
Organophosphorous [OP] pesticides are used frequently in agriculture, particularly in Asian countries over the past decades. Poisoning by these agents, either as acute or chronic in these nations, is a serious health problem. OP pesticides residue in fruits and vegetables that may not induce early clinical features, could also affect the human health. Therefore, medical and health professionals should be aware and learn more on the toxicology, prevention and proper management of OP poisoning. The well-known mechanism of OP toxicity is the inhibition of acetyl cholinesterase, resulting in an accumulation of acetylcholme and continued stimulation of acetylcholine receptors. Therefore, they are also called anticholinesterase agents. Determination of blood acetyl cholinesterase and butyryl cholinesterase activities remains a mainstay for the rapid initial screening of OP pesticides. Quantitative analysis of OP and their degradation products in plasma and urine by mass spectrometric methods is a more specific method, but is expensive and limited to specialized laboratories. Therefore, history of OP pesticides exposure and clinical manifestations of a cholinergic syndrome is sufficient for management of the exposed patients. However, electrophysiological tests may be required for the diagnosis of delayed neuropathy of OP poisoning. The standard management of OP poisoning includes decontamination, atropine sulphate with an oxime. Recent advances focus on blood alkalimsation and magnesium sulphate as promising adjunctive therapies. Preventive measures in OP exposure are of great importance in human health in developing countries. Therefore, regulations and controls on safe use of OP particularly in Asian countries are recommended
ABSTRACT
Occupational lead poisoning is a health problem in Iran. It has not previously been studied in traditional tile makers. To determine the prevalence of lead poisoning and its complications in traditional tile workers in Mashhad, Northwest of Iran, We visited workers in two traditional tile factories and collected data by direct history taking and physical examination. Blood and urine lead concentrations were measured by heated graphite atomization technique. Overall, 108 men with mean +/- SD age of 37 +/- 7.8 years were studied. The mean +/- SD length of daily lead exposure was 9.8 +/- 6 years. The mean +/- SD blood lead concentration was 520.5 +/- 323, 2 M9/L. The main objective clinical findings were the presence of lead line [64.8%], peripheral neuropathy of the upper extremities [37%], depressed deep tendon reflexes in the upper extremities [25.7%], tremor [23.3%], peripheral neuropathy of the lower extremities [17%] and abdominal tenderness [15.1%]. The subjective findings were mainly attributed to the central nervous system and included loss of memory [57%], moodiness [56.1%], agitation [47.7%], drowsiness [36.4%] and headache [29.9%]. There was no statistically significant correlation between the blood lead concentration and glomerular filtration rate. However, there were significant correlations between the blood lead concentration and each of the urine lead concentration [p<0.001], diastolic blood pressure [p=0.04], serum triglyceride level [p=0.043], high density lipoprotein level [p=0.012], and basophilic stippling [p=0.048]. Blood lead level, however, did not have any significant correlation with the presence of lead line. In traditional tile workers, lead toxicity is not uncommon and the toxic effects of lead were found more often on the teeth [bone], central and peripheral nervous system, hematological and lipid profiles than on the renal function