Deliberate self-poisoning with older pesticides such as organophosphorus compounds are commonly fatal and a serious public health problem in the developing world. The clinical consequences of self-poisoning with newer pesticides are not well described. Such information may help to improve clinical management and inform pesticide regulators of their relative toxicity. This study reports the clinical outcomes and toxicokinetics of the neonicotinoid insecticide imidacloprid following acute self-poisoning in humans.
Methodology/Principal Findings
Demographic and clinical data were prospectively recorded in patients with imidacloprid exposure in three hospitals in Sri Lanka. Blood samples were collected when possible for quantification of imidacloprid concentration. There were 68 patients (61 self-ingestions and 7 dermal exposures) with exposure to imidacloprid. Of the self-poisoning patients, the median time to presentation was 4 hours (IQR 2.3–6.0) and median amount ingested was 15 mL (IQR 10–50 mL). Most patients only developed mild symptoms such as nausea, vomiting, headache and diarrhoea. One patient developed respiratory failure needing mechanical ventilation while another was admitted to intensive care due to prolonged sedation. There were no deaths. Median admission imidacloprid concentration was 10.58 ng/L; IQR: 3.84–15.58 ng/L, Range: 0.02–51.25 ng/L. Changes in the concentration of imidacloprid in serial blood samples were consistent with prolonged absorption and/or saturable elimination.
Conclusions
Imidacloprid generally demonstrates low human lethality even in large ingestions. Respiratory failure and reduced level of consciousness were the most serious complications, but these were uncommon. Substitution of imidacloprid for organophosphorus compounds in areas where the incidence of self-poisoning is high may help reduce deaths from self-poisoning.
Information obtained : http://www.plosone.org/article/
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Sengaja diri keracunan dengan racun perosak lebih tua seperti sebatian organophosphorus biasanya maut dan masalah kesihatan awam yang serius di dunia membangun. Akibat klinikal keracunan diri dengan racun perosak baru tidak juga diterangkan. Maklumat tersebut boleh membantu meningkatkan pengurusan klinikal dan memberitahu pengawal selia racun ketoksikan relatif mereka. Kajian ini melaporkan hasil klinikal dan toxicokinetics daripada serangga imidacloprid neonicotinoid berikut akut diri keracunan pada manusia.
Kaedah / Pengetua Penemuan
Data demografi dan klinikal telah direkodkan secara prospektif pada pesakit dengan pendedahan imidacloprid di tiga hospital di Sri Lanka. Sampel darah diambil apabila mungkin untuk kuantifikasi kepekatan imidacloprid. Terdapat 68 pesakit (61 ingestions diri dan 7 pendedahan kulit) dengan pendedahan kepada imidacloprid. Daripada pesakit diri keracunan, masa median untuk pembentangan adalah 4 jam (IQR 2,3-6,0) dan jumlah median dimakan adalah 15 mL (IQR 10-50 mL). Kebanyakan pesakit hanya dibangunkan gejala ringan seperti loya, muntah-muntah, sakit kepala dan cirit-birit. Satu pesakit maju kegagalan pernafasan yang memerlukan pengudaraan mekanikal manakala seorang lagi dimasukkan ke unit rawatan rapi kerana ubat pelali yang berpanjangan. Tidak ada kematian. Median kemasukan tumpuan imidacloprid adalah 10.58 ng / L; IQR: 3,84-15,58 ng / L, Range: 0,02-51,25 ng / L. Perubahan dalam kepekatan imidacloprid dalam sampel darah bersiri adalah selaras dengan penyerapan yang berpanjangan dan / atau penghapusan saturable.
kesimpulan
Imidacloprid umumnya menunjukkan lethality manusia rendah walaupun dalam ingestions besar. Kegagalan pernafasan dan tahap dikurangkan kesedaran adalah komplikasi yang paling serius, tetapi ini adalah luar biasa. Penggantian imidacloprid kompaun organophosphorus di kawasan di mana kejadian diri keracunan yang tinggi boleh membantu mengurangkan kematian akibat diri keracunan.
Maklumat diperolehi : http://www.plosone.org/article/
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