Aldicarb poisoning

ABSTRACT

Aldicarb, 2-methyl-2 (methylthio) propanal o-[(methylamino)-carbonyl] oxime is a pesticide manufactured since 1965. This carbamate ester is sold under the tradename Temik and is used as an insecticide and nematicide. The Environmental Protection Agency has classified aldicarb in the highest toxicity category and has defined a strict control for its delivery and use. In Brazil and the Caribbean island of Guadeloupe, aldicarb is illegally used as a household rodenticide with a widespread risk of poisoning. Our study presents the first review of aldicarb poisoning with clinical and analytical findings and oxime treatment is discussed. Eighteen patients with cholinergic symptoms admitted to the Emergency Unit and two with a history of aldicarb poisoning who died were included in the study. As agricultural workers, only two of them could legally use Temik. Seventy percent of the patients were managed by the Emergency Mobile Unit. Serum cholinesterase activity was always < 30 percent of the normal range and aldicarb was identified by ultraviolet spectra and retention time after liquid chromatography separation. The most common muscarinic effect was diarrhoea (98 percent), the main nicotinic sign was fasciculation (78 percent) and 44 percent of the poisoned patients had central nervous system depression (Glasgow Coma Score < 8). Four patients had serious abnormalities and two of them died. These results suggest that aldicarb intoxication is always severe. Oxime treatment did not produce side effects and should be recommended whenever the pesticide involved is unknown. Effective measures should be implemented to stamp out the illicit use of aldicarb.(Au)