Intoxicaciones masivas con plaguicidas en Colombia / Large-scale pesticides poisoning in Colombia

Este artículo resume los hechos de las tres intoxicaciones masivas con plaguicidas ocurridas en Colombia hasta 1998. La primera ocurrió en Chiquinquirá (Boyacá) en 1967 e involucró a más de 500 personas, de los cuales 165 requirieron tratamiento hospitalario y 63 murieron. La segunda ocurrió en Puerto López (Meta) en 1970 y tuvo 190 intoxicados, de los cuales 157 requirieron tratamiento médico y 7 murieron. El tercer caso ocurrió en Pasto (Nariño) en 1977 y tuvo como consecuencia más de 300 intoxicados, con 120 hospitalizados y 15 muertos. En los casos de Chiquinquira y Pasto los plaguicidas que provocaron la intoxicación fueron metil-paratión y paratión respectivamente, mientras que en el caso de Puerto López solo se conoce que fue un plaguicida organofosforado. Los 3 casos de intoxicación masiva ocurrieron por consumo de alimentos contamidados. Estos casos se analizaron y se compararon con las principales intoxicaciones ocurridas en el mundo. Se propone una discusión en torno a las consecuencias que tuvieron estos hechos en las políticas de salud pública nacionales, la capacidad de hacer frente a situaciones de este tipo en el país, la capacitación de personal para la prevención y manejo de estas situaciones y la educación de los profesionales de la salud en epidemiología, toxicologia y otras disciplinas involucradas en el campo de la salud ambiental

Type II paralysis or intermediate syndrome following organophosphorous poisoning.

Three cases of type II paralysis or intermediate syndrome following organophosphorous poisoning are reported. Two patients had an initial improvement followed by development of paralysis of neck flexors, cranial nerves, proximal muscles of the limbs and respiratory muscles, which occurred 48 to 96 hours after the poisoning. All the patients recovered completely.

Serum and red cell cholinesterase activity in people exposed to organophosphate insecticides.

Serum and red cell cholinesterase activities were determined in 2 groups of subjects namely:-I) a group of 10 patients who took organophosphate insecticide and were admitted into the hospital for treatment and II) a group of 65 workers from an organophosphate insecticide factory. Serum cholinesterase levels were considerably depressed in all patients in group I and one patient died. The low serum cholinesterase activities increased very slowly and were still very low on day 4 of admission. Serum cholinesterase level in 65 workers were significantly lower than that of the normal subjects. The exposed subjects had still further lower serum cholinesterase activity than those of the non-exposed subjects. There was no significant difference between their red cell cholinesterase activities and those of the normal subjects. Serum and red cell cholinesterase levels in these workers also showed no correlation to the duration of insecticide exposure. These findings indicated that serum cholinesterase activity was a good diagnostic aid in acute exposure because it responded more rapidly than red cell cholinesterase level but it was not sensitive for follow up of the treatment since its recovery rate was too slow. Findings of low serum cholinesterase with normal red cell cholinesterase levels without signs or symptoms of toxicity indicated that these workers had been exposed to some degree of organophosphate insecticides.