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Work-Related Risk Factors by Severity for Acute Pesticide Poisoning Among Male Farmers in South Korea  [PDF]
Ji-Hyun Kim,Jaeyoung Kim,Eun Shil Cha,Yousun Ko,Doo Hwan Kim,Won Jin Lee
International Journal of Environmental Research and Public Health , 2013, DOI: 10.3390/ijerph10031100
Abstract: The objective of this study was to explore work-related risk factors of acute occupational pesticide poisoning among male farmers according to the severity of the poisoning. A nationwide sampling survey of male farmers was conducted in South Korea in 2011. A total of 1,958 male farmers were interviewed. Severity of occupational pesticide poisoning in 2010 was evaluated according to symptoms, types of treatment, and number of pesticide poisoning incidents per individual. A multinomial logistic regression model was used to estimate the odds ratio with 95% confidence intervals for risk factors of acute occupational pesticide poisoning. We found that the risk of acute occupational pesticide poisoning increased with lifetime days of pesticide application (OR = 1.74; 95% CI = 1.32–2.29), working a farm of three or more acres in size (OR = 1.49), not wearing personal protective equipment such as gloves (OR = 1.29) or masks (OR = 1.39). Those who engaged in inappropriate work behaviors such as not following pesticide label instructions (OR = 1.61), applying the pesticide in full sun (OR = 1.48), and applying the pesticide upwind (OR = 1.54) had a significantly increased risk of pesticide poisoning. There was no significant risk difference by type of farming. In addition, the magnitude of these risk factors did not differ significantly by severity of acute pesticide poisoning. In fact, our findings suggest that work-related risk factors contributed to the development of acute occupational pesticide poisoning without relation to its severity. Therefore, prevention strategies for reducing occupational pesticide poisoning, regardless of severity, should be recommended to all types of farming and the level of poisoning severity.
Pesticide Poisoning
Neva Sataloglu,Berna Aydin,Ahmet Turla
TAF Preventive Medicine Bulletin , 2007,
Abstract: In this study, it is aimed that examining the socio-demographic characteristics of the pesticide poisoning cases in Samsun region where the economy mainly relies on agriculture and comparing it to similar studies; thus contributing the country s data and the possible measures. 60 pesticide poisoning cases consulted OMU Faculty of Medicine between 01.01.2004 and 31.12.2004 are examined and achieved data are analyzed and presented. Of the 60 cases, 35 (58.3%) are females and 25 (41.7) are males and the average age is 21.93 ±17.56 (1-63) years. Pesticide poisoning is most common in summer (55.0%) and spring (25.0%). It is stated either by the person himself/herself or by his/her relatives that the intake of the toxic substance is accidental in 36 cases (60.0%) and suicidal in 24 cases (40.0%). 25 cases (41.7%) are poisoned with organic phosphorus pesticides and 12 cases (20.0%) with carbamat-pesticides. Consequently, in order to prevent accidental pesticide poisoning, it is necessary to be very careful with pesticide application especially in rural areas. Substances that are least toxic to human and environment, and are licenced and most effective to pests must be used, spraying period must be short, sensitive people, especially children, must be kept away, personal precautions must be taken for the spraying person and pesticides must be kept away from the reach of children and people at risk. [TAF Prev Med Bull. 2007; 6(3): 169-174]
Presentations of patients of poisoning and predictors of poisoning-related fatality: Findings from a hospital-based prospective study
Hsin-Ling Lee, Hung-Jung Lin, Steve Yeh, Chih-Hsien Chi, How-Ran Guo
BMC Public Health , 2008, DOI: 10.1186/1471-2458-8-7
Abstract: Between January 2001 and December 2002 we prospectively recruited poisoning patients through the EDs of two medical centers in southwest Taiwan. Interviews were conducted with patients within 24 hours after admission to collect relevant information. We made comparisons between survival and fatality cases, and used logistic regressions to identify predictors of fatality.A total of 1512 poisoning cases were recorded at the EDs during the study period, corresponding to an average of 4.2 poisonings per 1000 ED visits. These cases involved 828 women and 684 men with a mean age of 38.8 years, although most patients were between 19 and 50 years old (66.8%), and 29.4% were 19 to 30 years. Drugs were the dominant poisoning agents involved (49.9%), followed by pesticides (14.5%). Of the 1512 patients, 63 fatalities (4.2%) occurred. Paraquat exposure was associated with an extremely high fatality rate (72.1%). The significant predictors for fatality included age over 61 years, insufficient respiration, shock status, abnormal heart rate, abnormal body temperature, suicidal intent and paraquat exposure.In addition to well-recognized risk factors for fatality in clinical settings, such as old age and abnormal vital signs, we found that suicidal intent and ingestion of paraquat were significant predictors of poisoning-related fatality. Identification of these predictors may help risk stratification and the development of preventive interventions.Poisoning is a public health problem worldwide [1-9] and is one of the most common reasons for attendance at hospital emergency departments (EDs) [6,10-12]. Although the incidence of poisoning is difficult to estimate accurately, the wide availability and accessibility of chemicals and their extensive use in a variety of applications including medicine, agriculture and industry has increased the risk of poisoning [1,2,13].Knowledge of the epidemiology of poisoning and its changes is important to both emergency physicians and public health
Acute Poisoning by Drug and Pesticide
Azad Reza Mansourian,Akhtar Saifi,Abdoljalal Marjani,Ezzetollah Ghaemi
Journal of Biological Sciences , 2007,
Abstract: The concept behind this study is to find out the prevalence and reasons for acute poisoning in the emergency unit of 5th Azar hospital in Gorgan which is the main department in the town. This study was a cross-sectional descriptive study, the sample population were all the patients with acute poisoning either intentionally or accidentally whom admitted to the emergency unit of the hospital during period of one year. This research was implemented using a questionnaires which was filled either by the patients themselves or by those accompany them. The collected data were analyzed using the proper statistical tests. We conclude that the pre-university students are the main age group, drugs and pesticides are major types for either accidental or acute deliberate self-poising.
Abamectin: an uncommon but potentially fatal cause of pesticide poisoning  [cached]
Y. V. Bansod,Sandeep V. Kharkar,Arshish Raut,Piyush Choudalwar
International Journal of Research in Medical Sciences , 2013, DOI: 10.5455/2320-6012.ijrms20130826
Abstract: Human intoxication with abamectin is not frequently reported. It is an uncommon but potentially fatal cause of pesticide poisoning. In contrast to common organophosphate poisoning the toxic effects of avermectin in humans are not clearly defined. Ingestion of a large dose of avermectin may be associated with life-threatening complications. The therapy for avermectin poisoning is mainly symptomatic and supportive. The prognosis of patients with avermectin poisoning is likely to be favorable unless they are complicated by severe hypotension or aspiration. We hereby report a case with abamectin poisoning with neurological toxicity and respiratory failure which responded to supportive line of therapy. [Int J Res Med Sci 2013; 1(3.000): 285-286]
Intoxicaciones agudas por plaguicidas consultadas al Centro Nacional de Toxicología durante el bienio 2007-2008 Acute pesticide poisoning assited at the National Toxicology Centre from 2007-2008
Sonia Pérez Rodríguez,Maylén álvarez Delgado,Marlene David Baldo,Belina Capote Marrero
Revista Cubana de Medicina Militar , 2012,
Abstract: Las intoxicaciones agudas por plaguicidas ocupan un lugar importante, precedidas solo por las reportadas por alimentos y medicamentos. El objetivo de este trabajo es caracterizar las intoxicaciones por plaguicidas consultadas al Centro Nacional de Toxicología en La Habana. Es un informe sobre los resultados de las 627 consultas atendidas a través del servicio de urgencia del centro durante el período 2007-2008. Se tuvieron en cuenta factores clínico epidemiológicos, como edad, sexo, circunstancias del evento, provincia de procedencia, fecha de ocurrencia y tipo de agente involucrado en el evento. Predominaron los intoxicados adultos, hombres y de circunstancia intencional, comúnmente por insecticidas organofosforados en las provincias La Habana y Holguín, con notificación uniforme de casos durante el período excepto en Holguín en abril por intoxicación masiva ocurrida en ese territorio. Acute pesticide poisonings have an important place, preceded only by food and medicine reported. The objective of this work is to characterize pesticide poisoning assisted at the National Poison Control Center in Havana. This is a report on the study results of 627 cases treated at the emergency service center from 2007-2008. Clinical epidemiological factors were considered, such as age, sex, circumstances of the event, province of origin, date of occurrence and type of agent involved in the event. Intoxicated male adults predominated, as well as intentional circumstances by organophosphate insecticides poisoning in Havana and Holguin provinces. Uniform reporting of cases during the period was performed except in Holguín in April due to mass poisoning occurred in that territory.
Causes of Death and Treatment of Organophosphorus Pesticide Poisoning  [cached]
Nalan Kozac?,Ay?a A??kal?n Akp?nar,Salim Satar,Ferhat ??me
Journal of Academic Emergency Medicine , 2012,
Abstract: Toxication caused by pesticides is a serious health problem in our country. Organophosphates are the leading cause of pesticide toxications in our country, as they are worldwide. These compounds lead to acetylcholine deposition by blocking acetylcholine esterase enzyme, causing muscarinic, nicotinic and central nervous symptoms due to continuous stimulation of the receptors. Mortality occurs in the early period due to acute cholinergic crisis or later in patients with intermediate syndrome. Death is caused by heart conduction disturbances and respiratory failure during the acute cholinergic crisis period, whereas it is due to respiratory failure in patients with an intermediate syndrome. Management of patients with pesticide poisoning should start by providing adequate respiratory and circulatory support followed by antidotes and other medical therapies. In this review, we have aimed to explain the properties and mechanisms of action of organophosphate compounds;with causes of mortality in the poisoning of these compounds and recent approaches for management of toxication.
Acute pesticide poisoning: a proposed classification tool
Thundiyil,Josef G; Stober,Judy; Besbelli,Nida; Pronczuk,Jenny;
Bulletin of the World Health Organization , 2008, DOI: 10.1590/S0042-96862008000300013
Abstract: cases of acute pesticide poisoning (app) account for significant morbidity and mortality worldwide. developing countries are particularly susceptible due to poorer regulation, lack of surveillance systems, less enforcement, lack of training and inadequate access to information systems. previous research has demonstrated wide variability in incidence rates for app. this is possibly due to inconsistent reporting methodology and exclusion of occupational and non-intentional poisonings. the purpose of this document is to create a standard case definition to facilitate the identification and diagnosis of all causes of app, especially at the field level, rural clinics and primary health-care systems. this document is a synthesis of existing literature and case definitions that have been previously proposed by other authors around the world. it provides a standardized case definition and classification scheme for app into categories of probable, possible and unlikely/unknown cases. its use is intended to be applicable worldwide to contribute to identification of the scope of existing problems and thus promote action for improved management and prevention. by enabling a field diagnosis for app, this standardized case definition may facilitate immediate medical management of pesticide poisoning and aid in estimating its incidence.
Management of severe organophosphorus pesticide poisoning
Michael Eddleston, Darren Roberts, Nick Buckley
Critical Care , 2002, DOI: 10.1186/cc1499
Abstract: We cannot understand their assessment of risk—benefit in the use of atropine. Their regimen of 0.02—0.08 mg/kg atropine as an infusion over 1 hour would provide a maximum of 5.6 mg atropine in a 70 kg person. Stopping atropine therapy '24 hours after atropinization' may cause problems with the continued release of fat-soluble OPs, such as fenthion, from the fat depot. Those authors also do not state the time it took for atropinization to be achieved; however, if patients received atropine for a mean of '3.4 ± 2.1 days', then the mean time to atropinization was 2.4 ± 2.1 days. This appears far too long. Few clinical toxicologists would disagree that full and early atropinization with 2 mg atropine stat followed by 2 mg every 5—15 min has few risks and obvious benefits [3].Their use of intravenous diltiazem or propranolol for tachydysrhythmias associated with OP poisoning is troubling. Hypotension and cardiac dysrhythmias are significant problems in OP poisoning [3]. Do the authors have any evidence that the benefits of these negative inotropic drugs outweigh the risks in such patients?The authors state that only one randomized controlled trial (RCT) has been carried out that assessed the efficacy of pralidoxime in OP poisoning. Unfortunately, the cited paper was a retrospective case series that compared the case fatality rate during a time when pralidoxime was not available in Sri Lanka with the rate at a time when it was, and as such is not a RCT [4].We recently completed a systematic review of RCTs of pralidoxime that identified two small RCTs and two very small prospective studies [4]. The RCTs were carried out in Vellore, India, and assessed the value of 12 g pralidoxime given in an infusion over 3—4 days versus a 1 g bolus or placebo. The trials failed to show any benefit. However, recent World Health Organization guidelines [5] recommend far higher doses — at least 30 mg/kg bolus followed by an infusion of 8 mg/kg per hour. In practice, this becomes 2 g stat fo
The global distribution of fatal pesticide self-poisoning: Systematic review
David Gunnell, Michael Eddleston, Michael R Phillips, Flemming Konradsen
BMC Public Health , 2007, DOI: 10.1186/1471-2458-7-357
Abstract: We have systematically reviewed the worldwide literature to estimate the number of pesticide suicides in each of the World Health Organisation's six regions and the global burden of fatal self-poisoning with pesticides. We used the following data sources: Medline, EMBASE and psycINFO (1990–2007), papers cited in publications retrieved, the worldwide web (using Google) and our personal collections of papers and books. Our aim was to identify papers enabling us to estimate the proportion of a country's suicides due to pesticide self-poisoning.We conservatively estimate that there are 258,234 (plausible range 233,997 to 325,907) deaths from pesticide self-poisoning worldwide each year, accounting for 30% (range 27% to 37%) of suicides globally. Official data from India probably underestimate the incidence of suicides; applying evidence-based corrections to India's official data, our estimate for world suicides using pesticides increases to 371,594 (range 347,357 to 439,267). The proportion of all suicides using pesticides varies from 4% in the European Region to over 50% in the Western Pacific Region but this proportion is not concordant with the volume of pesticides sold in each region; it is the pattern of pesticide use and the toxicity of the products, not the quantity used, that influences the likelihood they will be used in acts of fatal self-harm.Pesticide self-poisoning accounts for about one-third of the world's suicides. Epidemiological and toxicological data suggest that many of these deaths might be prevented if (a) the use of pesticides most toxic to humans was restricted, (b) pesticides could be safely stored in rural communities, and (c) the accessibility and quality of care for poisoning could be improved.The World Health Organisation (WHO) estimated that there were 873,000 suicides worldwide in 2002[1] which makes suicide a major cause of premature mortality globally. A central component of suicide prevention strategies is restricting access to lethal m
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