[Acute organophosphate insecticide poisonings in the province of Almería. A study of 187 cases]. / Intoxicaciones agudas por insecticidas organofosforados en la provincia de Almería. Estudio de 187 casos.

BACKGROUND: The aim of the present study was to analyze the epidemiological and clinical characteristics of poisoning by organophosphorus insecticides in the province of Almería. METHODS: One hundred eighty-seven patients diagnosed with organophosphorus insecticide poisoning were included from 1981-1986. In all the cases a previously established clinic and therapeutic protocol was applied. RESULTS: Eighty-six percent of the patients were males with a mean age of 31 years. The poisoning was accidental in 62% of the cases and attempted suicide in 38%. The via of absorption was cutaneous-respiratory in 57% and digestive in 43% of the patients. All the patients presented florid initial cholinergic symptomatology. The presence of bronchorrhea, tremor-fasciculations, respiratory depression and diminution in the level of conscience was associated with severe intoxication. The quantification of acetylcolinesterase was useful as a diagnostic parameter. Global mortality was 4%. Ten percent of the patients developed delayed signs of neurotoxicity. CONCLUSIONS: The high hospital demand for poisoning by organophosphorus insecticide is of note. Hospital mortality is low. The severity of intoxication is related with attempts of autolysis, digestive absorption, appearance of respiratory manifestations and of the central nervous system and the development of complications.

Acute intoxication by endosulfan.

The authors report six patients with acute endosulfan intoxication. The symptoms of nausea, vomiting, headache, and dizziness began 2.7 +/- 0.5 h after ingestion; in four cases the patients had been hospitalized but were asymptomatic. All had severe metabolic acidosis with high anion gap and hyperglycemia; five of six had decreased blood platelets. Three patients had pulmonary aspiration, and five required mechanical ventilation. The one fatality followed acute renal failure, disseminated intravascular coagulation, thrombi in the pulmonary arteries and aorta, and cardiogenic shock. In this patient the blood endosulfan was 2.85 mg/L versus a mean of 0.48 mg/L in the survivors.