Organophosphorus Intoxication During the Control of Pine Gall Midge / 대한내과학회지

ABSTRACT

OBJECTIVES: Organophosphates make their clinical effects after absorbed through gastrointestinal tract, lungs and skin. We commonly see the gastrointestinal tract and lung as routes of organophosphates (OP) intoxication, but there have been few reports that said the skin as a route OP intoxication. We have experienced many patients that showed OP intoxication symptoms during or after the control of pine gall midge. So we analyzed the clinical characteristics of the patients and evaluated the route of OP intoxication. METHODS: We analyzed retrospectively 26 cases who were diagnosed as 'OP intoxication after control of pine gall midge' from June 1 1995 to July 31 1996. RESULTS: 1) The mean age of the cases, mean duration of work and mean initial cholinesterase level were 52 years, 11.9 days, 318.2U/L respectively. And the over all ratio of male to female was 1115. 2) All cases were engaged in drug injection and 7 cases (32%) weared mask. Face and upper body were excluded from protective clothings. 3) The cardinal symptoms were diarrhea and dizziness followed by nausea, vomiting, headache, anorexia, paralysis in order of frequency. 4 Directly contributing factors to symptom onset were rain, excessive sweating due to hot weather and direct contact. 5) Most of cases (92%) were recovered completely. 2 cases died during hospitalization due to acute respiratory failure and sepsis. Mechanical ventilation were applied in 4 cases for mean 12 days. In 2 cases, there were neurobehavioral changes as delayed neurologic sequelae. CONCLUSION: We have concluded that the route of organophosporus intoxication after the control of pine gall midge was skin (transdermal absorption). Sufficient education and protective measures should be done for preventing organophosporus intoxication in the control of pine gall midge.