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    PESTICIDEPOISONING

    By

    Dr. R. V. Nakat

    AICRP on Biological Control of Crop Pests and Weeds

    Entomology Division, M.P.K.V. College of Agriculture, Pune

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    WHAT IS A TOXIC

    SUBSTANCE ? Any substance which is harmful to the

    environment and humans. There arenaturally occurring toxins and synthetictoxins.

    Toxic Substance

    Natural Toxins Synthetic Toxins

    Poisonous plants PesticidesSnakes Industrial chemicals

    Other poisonous animals Household products

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    WHAT IS A PESTICIDE ?

    A Pesticide is a chemical use toprevent, destroy or repel pests.Pests can be Insects, Mice, Weeds,Fungi or Microorganisms such asBacteria and Viruses.

    Pesticides - Insecticides

    WeedicidesRodenticidesFungicides

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    INSECTICIDES

    Organophosphates - Baytex EC 50,

    Harcros Demro Carbamates - Baygon Fly Bait

    Organochlorine - Aldrin

    Pyrethroids - Baygon mosquitocoil

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    WEEDICIDES

    Paraquat - Gramoxone

    Propanil - 3 4 DPA Glyphosate - Roundup Chlorophenoxy - MCPA

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    RODENTICIDES &

    FUNGICIDES Zinc phosphide - Run rat

    Coumarins - Racumin

    Brodifacoum - KleratPellets

    Sulphur - Morisal WP, Dithiocarbamate - Metaxil

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    TYPE & ROUTE OF

    POISONING

    Accidental Oral

    Suicidal Inhalation

    Homicidal Dermal

    Occupational Eye contact

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    ORGANOPHOSPHATES

    AND CARBAMATES Group of chemicals share a common

    mechanism of cholinesterase

    inhibition and hence can cause similarsymptoms. Phosphorylation of the acetylcholinesterase

    (AChE) at nerve endings.

    Loss of available AChE results accumulation ofacetylcholine at receptor sites and effectororgan to become over stimulated by the excessacetylcholine.

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    AND CARBAMATES

    Contd. Clinical Features are based onexcessive cholinergic

    stimulation. Unlikeorganophosphate poisoning,carbamate poisoning tend to be

    of shorter duration becausethe inhibition of nerve tissueAChE is reversible.

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    CLINICAL FEATURES Eye contact: Irritation or pain,lacrymation, swelling, blurring of

    vision. Inhalation: Cough, difficulty in

    breathing, bronchitis, pneumonia.

    Ingestion: Nausea, vomiting,diarrhoea, sweating, salivation, smallor pin point pupils, muscle twitching,

    fasciculation.

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    ORGANOCHLORINES Very few organochlorines are used now aspesticides. Organochlorines are very toxicif ingested or inhaled. Some are readily

    absorbed through the intact skin.

    Skin contact: Dermatitis Inhalation: Inhalation can give rise to

    irritation of eyes, nose, throat and cough. Ingestion: Nausea, vomiting, diarrhoea,abdominal pain, headache, dizziness,convulsions and coma.

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    PYRETHRINS &

    PYRETHROIDS Pyrethrum is an insecticide

    extracted from chrysanthemum

    flower. Active ingredients ofpyrethrum are known as pyrethrins.Synthetic compounds structurallyrelated to pyrethrins are known aspyrethroids.

    Inhalation: Allergic manifestationss ch as hee i

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    PYRETHRINS &

    PYRETHROIDS Contd Ingestion: After ingestion

    pyrethrums have low toxicity,

    vomiting, epigastric pain anddiarrhoea are the common features.

    Eye contact: Lacrymation, oedemaof the eyelids.

    Skin contact: Allergic dermatitis.

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    PARAQUAT Paraquat is a widely used herbicide in SriLanka. It is a safe herbicide because it isinactivated by contact with soil. Paraquatis commonly used as suicidal poison in thiscountry.

    Paraquat has life threatening effects onthe gastrointestinal tract, kidney, liverand other organs. The lung is the primarytarget organ of paraquat poisoning.

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    PARAQUATContd

    Recently a new paraquat formulation withINTEON technology (containing analginate that converts to a gel understomach acid conditions, increased levelsof emetic and purgative) was developed inorder to reduce oral toxicity. Howeveringestion of INTEON is still very likely tobe lethal.

    Skin contact: prolonged contact willproduce blistering, abrasion and ulceration.Although absorption across intact skin isslow, abraded or eroded skin allowsefficient absorption.

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    PROPANIL &CHLOROPHENOXY

    COMPOUNDS Propanil is a selective herbicide oflow toxicity. However, in selfpoisoning with large dosesmethaemogloninaemia is cause, whichcan be fatal.

    Chlorophenoxy compounds are well

    absorbed from the gastrointestinaltract. They are less well absorbedfrom the lung. Cutaneous absorptionappears to be minimal.

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    GLYPHOSATE Glyphosate is a non-selective herbicide,typically marketed as an aqueous solutionof 41% isopropylamine glyphosate, 15%

    polyoxyethyleneamine surfactant andvarious minor components including anti-foaming and colour agents, biocides andinorganic ions to produce pH adjustment.

    Ingestion of concentrated formulations

    may cause epigastric pain, dysphagia,nausea, vomiting, oral ulceration, diarrhoeaand haemetemesis in severe cases leadingto hypovolaemic shock.

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    RODENTICIDES Coumarins, indandiones andbrodifacoum are used as

    rodenticides. They are fairlysafe for human beings due to thelow concentration of the active

    ingredient. Their toxicity is dueto depression of the synthesis offactors essential for coagulation

    of blood.

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    BANNED PESTICIDES 1970 Endrin 1976 DDT

    1980 Chlordimeform

    1980 Dieldrin

    1980 Phosphamidon

    1980 Thallium sulpht.

    1984 2,4,5-T 1984 Ethyl parathion

    1984 Methyl

    parathion

    1986 - Aldrin

    1986 Lindane

    1987 HCH (mixed

    Isomers)

    1987 Mercury cpds.

    1988 Arsenic(arsenites andarsenates)

    1988 Hepatachlor

    1989 Leptophos

    Captafol

    1990 Dichloropropane

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    BANNED PESTICIDES

    Contd.. 1990 Aldicarb 1990 Quintozene (PCNB)

    1994 Pentachlorophenol 1995 Methamidophos 1995 Monocrotophos (restricted to

    coconut) 1996 Chlordane 1998 - Endosulfan

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    FIRST AIDSkin contact: Remove contaminated clothes

    carefully. Wash the skin with running water

    for at least 15 minutes.

    Do not use any local applicationwithout seeking medical advice.

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    FIRST AID Contd Wash eyes with running water for

    at least 15 minutes.

    Do not use any eye drops withoutseeking medical advice.

    If there is visual impairment seek

    medical advice from anOphthalmologist.

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    FIRST AID Contd Inhalation:Remove the patient away from the sourceand encourage deep breathing of fresh air.

    Ingestion:Do not induce emesis because somepesticides have corrosive effects andsome may contain hydrocarbons assolvents.If patient is semiconscious or unconsciouskeep the patient in Neck extendedposition.

    M t f

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    Management ofOrganophosphate and

    Carbamatepoiosning Contd Atropine:

    The following features of cholinergicsyndrome is an indication for atropinetherapy.

    Poor air entry in to the lungs due tobronchorrhoea and bronchospasm.

    Excessive sweating Bradycardia

    Hypotension

    Miosis

    M t f

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    Management ofOrganophosphate and

    Carbamatepoiosning Contd Initial dose: 1.8 3 mg, 3-5 of 0.6 mg

    vials rapidly IV into a fast flowing IV

    drip depending on the condition. After 5 min. check the five

    parameters and if there is no

    improvement double the dose.

    M t f

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    Management ofOrganophosphate and

    Carbamatepoiosning Contd Once atropinised clinical features:

    Clear lungs

    Adequate heart rate ( > than 80 beats/m.)

    Blood pressure (> 80 mmHg systolic)

    Dry skin

    Pupils no longer pinpoint

    Set up an infusion with 10-20% of total amountof atropine.

    M t f

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    Management ofOrganophosphate and

    Carbamatepoiosning Contd Target end points for atropine therapy.

    Clear chest on ausculatation with nowheeze.

    Heart rate between 80-100 beats/min.

    Pupils no longer pinpoint.

    Systolic blood pressure > 80 mmHg.

    Dry axillae.

    M t f

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    Management ofOrganophosphate and

    Carbamatepoiosning Contd Excess atropine causes confusion, urinaryretention, hyperthermia, bowel ileus andtachycardia.

    In this condition atropine should be ceasedand the patient reviewed after 30 min. tosee whether the features of toxicity havesettled.

    When atropine toxicity settles 70-80% ofthe previous rate.

    M t f

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    Management ofOrganophosphate and

    Carbamate poiosning Pralidoxime:Give 30 mg/kg loading dose of pralidoximeover 10-20 min. followed by a continuous

    infusion of 8-10 mg/kg per hour untilclinical recovery (for example 12-24 hoursafter atropine is no longer required or thepatient is extubated) or 7 days which is

    later. Less severely poisoned patients canbe given intermittent doses (1 gram 6hourly by slow IV bolus over 10 20 mins).

    Oximes are not required for carbamate

    poisoning.

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    Management of

    Organochlorine poisoning For convulsions give diazepam 5-10mg IV slowly (Paediatric dose 0.2

    mg/kg). Repeat if necessary. Up to40 mg/day can be given orally asmaintenance dose.

    Continue diazepam for 3-4 days afterconvulsions have been controlled. 10ml of 10% calcium gluconate IV canalso be used to control convulsions.

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    Management of Paraquat

    poisoning An absorbent (Fullers earth or Activatedcharcoal) should be given orally or via anasogastric tube as early as possible.

    The dose of Fullers earth is 1 litre of 15%aqueous suspension (Paediatric dose 15ml/kg body weight).

    If Fullers earth is not available giveactivated charcoal 50-100g dissolved in200 ml of water (Paediatric dose 15 ml/kgbody weight).

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    Management of Propanil

    poisoning If symptoms of methaemoglobinaemia arepresent (tachycardia, tachopnoea orconfusion) or if the levels are over 30%,

    give 1% methylene blue 0.1 ml/kg IV over5 minutes. The same dose may be repeatedwithin 1 hour if there is no improvement.

    If IV preparation is not available givemethylene bluee 300 mg daily orally. Ifmethylene blue is not available giveascorbic acid 1 g IV twice daily.

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    Management of

    Rodenticide poisoning If there has been no bleeding, but the PT isprolonged, give vitamin K1 10-50 mg orally two tofour times a day (paediatric dose 0.4mg/kg/dose).

    For prolonged PT with less severe bleeding, givevitamin K1 10 to 15 mg SC or IM (for a child 1 to 5mg).

    In severe haemorrhage with prolonged

    prothrombin time (PT) give vitamin K1(phytomenadione) 20 mg by slow IV injection (0.6mg/kg for children under 12 years).

    In severe bleeding, it may be necessary to givefresh frozen plasma or fresh blood.

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    THANK YOU