Caracterización de las exposiciones a plaguicidas entre los años 2006 y 2013 reportadas al Centro de Información Toxicológica de la Pontificia Universidad Católica de Chile / Characterization of pesticide exposures reported between 2006 and 2013 to a poison information center in Chile

Background: Pesticides are widely used to increase crop yields and vector control. However, both acute and chronic exposure have health consequences. There is paucity of information about the global occurrence of pesticide poisonings. Aim: To characterize the reports of pesticide exposures received by a University Poison Information Center. Material and Methods: All pesticide exposures reported in Chile between 2006 and 2013 were analyzed. A data-collection sheet provided by the International Programme on Chemical Safety of the World Health Organization, was used to collect information. Results: In the study period, 13,181 reports were analyzed. The main age groups exposed were preschoolers and adults. Sixty one percent of exposures occurred accidentally and 24.8% were suicide attempts. Exposures to acetylcholinesterase inhibitors was reported in 29.3% of cases, to superwarfarin rodenticides in 28.5% and to pyrethroids in 24.0%. An increased risk of suicide attempts with pesticides was observed among women, when compared with men (odds ratio: 1.5; 95% confidence intervals: 1.4-1.6; p < 0.001). The risk was higher among teenage girls. Conclusions: The amount of cases under acetyl cholinesterase inhibitor exposure, the most toxic pesticides currently in use should be highlighted. Workers should be educated and all cases should be reported to take actions aiming at reducing these events.

An Outbreak of Food Borne Illness Due to Methomyl Pesticide Intoxication in Korea

On February 21, 2013, 6 elderly people collapsed abruptly after eating bean sprout bibimbab (boiled rice mixed with bean sprouts and seasoned with soybean sauce) at a countryside restaurant in the Chungbuk Province, Korea. Minutes after eating the meal, all of the patients lapsed into a state of stupor. Respiratory arrest developed in 2 patients; and one of two patients died of cardiac arrest. The autopsy identified methomyl and methanol in the deceased patient's gastric contents and in the remaining soybeanbean sauce seasoning. Five of the 6 patients ingested one spoonful of the soybeanbean sauce seasoning and survived, while one patient who died of cardiac arrest, ingested approximately two spoons. Symptoms of toxicity presented quickly in the subjects and progressed rapidly, including chest tightness, an unusual sensation in the pit of the stomach, dizziness, ataxia, and finally, collapse. Three patients who drank ethanol with the meal experienced only mild toxic symptoms. Our analysis of the clinical observations in these cases suggests that ingestion of methomyl pesticide and the additive toxicity of methanol may have been responsible for the intoxication.

Intermediate syndrome in organophosphorous poisoning--a case report.

A case of organophosphorous poisoning in a 29 year old male who developed intermediate syndrome manifested by features of respiratory depression as evidenced by marked weakness of the respiratory muscles, tachypnoea, and drop in oxygen saturation despite reversal of nicotinic and muscarinic effects of organophosphorous poisoning. The case highlights its early recognition and prompt institution of mechanical ventilation with continuation of anticholinergic drugs. The mechanical ventilation had to be continued for 9 days with successful outcome.

Neurological syndromes following organophosphate poisoning.

Organophosphorous compounds, the anticholinesterases, produce significant morbidity and mortality in India. Although exact estimates are not available, hospital based statistics suggest that nearly half of the admissions to emergency with acute poisoning are due to organophosphates. Following accidental or suicidal exposure, these anticholinesterases lead to three well defined neurological syndromes i.e. initial life threatening acute cholinergic crisis which often requires management in intensive care unit, intermediate syndrome in which cranial nerve palsies, proximal muscle weakness and respiratory muscle weakness are common and patients often require respiratory support and delayed organophosphate induced polyneuropathy. In addition to these three classical neurological syndromes following acute exposure and in some following low dose chronic exposure, several neurobehavioural changes have been observed and these have been termed together as 'chronic organophosphate induced neuropsychiatric disorders' (COPIND). Organo-phosphate compounds produce significant pesticide related illness in developing countries. There is, thus, a need to determine exact extent of the problem and to develop appropriate strategies to manage these cases with available resources in these countries.

Intoxicación aguda por paratión-metílico con manifestaciones extrapiramidales antes no informadas / Acute poisoning by methyl parathion with previously unreported extrapyramidal manifestations

Femenina de 14 años de edad que intenta suicidio mediante la ingestión de insecticida paratión-metílico concentrado, quien presentó intoxicación aguda grave con manifestaciones muscarínicas, nicotínicas y neurológicas, así como descenso de 88 por ciento de la actividad de la colinesterasa. Al noveno día de su evolución, súbitamente presentó síntomas extrapiramidales, crisis oculógiras y bucolinguales, distonía de torsión de cuello y tronco, hipertonía y temblores digitales; mismos que mejoraron con la administración endovenosa de difenhidramina. Se descartó la administración de neurolépticos, la exposición a otros tóxicos capaces de originar esta sintomatología y la posibilidad de un síndrome intermedio por orgánico-fosforados. Se especula, dadas las propiedades bioquímicas del insecticida, que pudiera causar esta sintomatología al inhibir los receptores dopaminérgicos de la sustancia nigra y de los ganglios basales

Intoxicaçöes humanas agudas por agrotóxicos inibidores da acetilcolinesterase / Human intoxications by agrotoxics inhibitors of the acetylcholinesterase

Trata de intoxicaçöes agudas causadas por produtos organofosforados e carbamatos, nos aspectos de incidência, manifestaçöes clínicas e tratamento.