Death by Copper Ammonium Complex-Containing Fungicide.

ABSTRACT: There is a paucity of published reports of copper ammonium complex ingestion, as most published data describe overdoses of copper sulfate formulations. We report a case of suicide by ingestion of copper ammonium complex-containing fungicide with an elevated postmortem copper level. A 77-year-old woman was found dead at home by her relative after ingesting a fungicide containing 8% copper ammonium complex solution. Turquoise emesis was found at the scene, and on autopsy, turquoise material was found throughout the gastrointestinal tract. Postmortem central blood copper level was 500 µg/dL. Cause of death was determined to be acute copper toxicity.

Childhood pesticide poisoning in Zhejiang, China: a retrospective analysis from 2006 to 2015.

BACKGROUND: Pesticide poisoning in children has been a serious public health issue around the world, especially in the developing countries where agriculture is still one of the largest economic sectors. The purpose of this study was to analyze epidemiological characteristics of acute pesticide poisoning in children from Zhejiang province, China. METHODS: The pesticide poisoning cases for children were retrieved from Occupational Disease Surveillance and Reporting System, Zhejiang Provincial Center for Disease Control and Prevention, China. The incident cases, deaths, and fatality rate of child pesticide poisoning from 2006 through 2015 were calculated. RESULTS: During the study period, totally 2952 children were poisoned by pesticides, with 66 deaths, resulting in a fatality rate of 2.24%. Among them, there were 1607 male cases with 28 deaths, and 1345 female cases with 38 deaths. Most of the cases occurred in preschool children (1349) and adolescent age group (1269). Organophosphate and carbamate insecticides were the cause of most poisonings (1130), leading to 34 deaths. The highest fatality rate (3.13%) was due to poisoning by herbicides and fungicides, causing 14 deaths out of 448 cases. Poisoning occurred mostly in rural areas (78%). And most pesticide poisoning occurred in the summer (896) and fall (811), while fewest poisoning cases in the winter (483) but with the highest fatality rate (3.52%). CONCLUSIONS: This study shows that pesticide poisoning of children is a major health problem in Zhejiang, suggesting preventive strategies should be conducted to control childhood pesticide poisoning.

Chorea as unusual complication of fungicide poisoning.

Chorea is a rare manifestation of poisoning. We report an index case of a young woman who developed generalized chorea following propiconazole toxin ingestion. As large series on neurological complications of toxic compounds are difficult to be compiled, it is of interest to report our experience. This report adds one more compound to the increasing list of toxic chorea.

Occupational exposure to pesticides and endotoxin and Parkinson disease in the Netherlands.

OBJECTIVES: Previous research has indicated that occupational exposure to pesticides and possibly airborne endotoxin may increase the risk of developing Parkinson disease (PD). We studied the associations of PD with occupational exposure to pesticides, specifically to the functional subclasses insecticides, herbicides and fungicides, and to airborne endotoxin. In addition we evaluated specific pesticides (active ingredients) previously associated with PD. METHODS: We used data from a hospital-based case-control study, including 444 patients with PD and 876 age and sex matched controls. Exposures to pesticides from application and re-entry work were estimated with the ALOHA+job-exposure matrix and with an exposure algorithm based on self-reported information on pesticide use. To assess exposure to specific active ingredients a crop-exposure matrix was developed. Endotoxin exposure was estimated with the DOM job-exposure matrix. RESULTS: The results showed almost no significant associations. However, ORs were elevated in the higher exposure categories for pesticides in general, insecticides, herbicides and fungicides, and below unity for endotoxin exposure. The analyses on specific active ingredients showed a significant association of PD risk with the fungicide benomyl. CONCLUSIONS: This study did not provide evidence for a relation between pesticide exposure and PD. However, the consistently elevated ORs in the higher exposure categories suggest that a positive association may exist. The possible association with the active ingredient benomyl requires follow-up in other studies. This study did not provide support for a possible association between endotoxin exposure and PD.

Therapeutic effects of olive leaves extract on rats treated with a sublethal concentration of carbendazim.

OBJECTIVES: The present study was carried out to establish the possible protective effects of administration of olive leaves extract on carbendazim induced physiological and histopathological alterations in male rats. MATERIALS AND METHODS: The experimental rats were divided randomly into five groups and kept at ten rats per group. The first group was untreated and served as a control. The second group was orally administered with carbendazim (200 mg/kg) for one month. The third group was supplemented with olive leaves extract and exposed to carbendazim at the same dose given to the second group. Rats of the fourth group were supplemented with olive leaves extract at the same dose given to the third group. Rats of the fifth group were supplemented with only corn oil. RESULTS: Carbendazim induced statistically declines in the values of red blood corpuscles (RBC) count, hemoglobin (Hb) concentration, hematocrit (Hct) and the level of plasma and liver total protein, while the value of white blood cells (WBC) count, the levels of plasma glucose, triglycerides, cholesterol, creatinine, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver glycogen and total lipid were elevated. Moreover, after one month of carbendazim exposure, there were severe changes in the structures of liver, kidney and testis. Pretreatment of carbendazim-exposed rats with olive leaves extract showed marked improvement in both physiological and histopathological alterations. CONCLUSIONS: We conclude that olive leaves extract is a promising chemotherapeutic agent for reducing the toxicity of carbendazim and may be for other pesticides and toxicants.

Acute pesticide poisoning associated with pyraclostrobin fungicide--Iowa, 2007.

Pyraclostrobin is an agricultural pesticide product used to kill fungi (e.g., blights, mildews, molds, and rusts). Hazards to humans from pyraclostrobin exposure include eye injury and skin irritation. In July 2007, the Iowa Department of Public Health (IDPH) received reports of five events involving pyraclostrobin that sickened 33 persons, including 27 migrant workers who were exposed in a single incident during aerial application (i.e., crop dusting). This report describes those five events and provides recommendations for preventing additional illnesses associated with exposure to pyraclostrobin.

Immune effects and exposure to ethylenebisdithiocarbamate pesticides in re-entry workers in the Netherlands.

Ethylenebisdithiocarbamates are widely used as fungicides in agriculture. Although EBDC's have a low acute toxicity, they are suspected to have immune effects at low doses. However, little human studies on these effects have been published. In the Netherlands, a study was conducted among pesticide exposed workers aimed at evaluating the short-term and long-term immune effects of exposure and the relation between ethylenebisdithiocarbamate and immune effects. Forty-one re-entry workers and 40 nonexposed controls were medically examined; furthermore, immune parameters were determined in blood, and all participants filled in a questionnaire regarding exposure and outcome parameters. The level of ethylenethiourea in urine was determined as indicator of exposure. No relevant adverse immune effects were found in the pesticide exposed workers compared with the nonexposed controls. Also no exposure response relationship between immune effects and ethylenebisdithiocarbamate in urine was found. This finding might be due to very low exposure levels of the re-entry work but might also be due to a lack of immunotoxicity of ethylenebisdithiocarbamate at normal exposure levels.

Asthmatic symptoms after exposure to ethylenebisdithiocarbamates and other pesticides in the Europit field studies.

We conducted a multicenter prospective study to assess the effects of occupational exposure to ethylenebisdithiocarbamate fungicides and/or other pesticides on self-reported asthma and asthmatic symptoms. This multicenter study was conducted among 248 workers exposed to pesticides and 231 non-exposed workers from five field studies. The five field studies were carried out in The Netherlands, Italy, Finland, and two studies in Bulgaria. Subjects constituting this cohort completed a self-administered questionnaire at baseline (before the start of exposure). Ethylenethiourea in urine was determined to assess exposure to ethylenebisdithiocarbamates. In multivariate analyses adjusted for all potential confounders (age, education, residence, smoking, gender, and field study), we found inverse associations, all not statistically significant, between occupational exposure to pesticides and asthma diagnosis (OR 0.41; 95% CI 0.15-1.11), complains of chest tightness (OR 0.60; 95% CI 0.36-1.02), wheeze (OR 0.56; 95% CI 0.32-0.98), asthma attack (OR 0.52; 95% CI 0.12-2.25), and asthma medication (OR 0.79; 95% CI 0.25-2.53). Furthermore, we reported null associations for multivariate analysis using ethylenethiourea as determinant for exposure. Although exposure to pesticides remains a potential health risk, our results do not suggest an association between exposure to ethylenebisdithiocarbamates and/or other pesticides used in our study on asthma and asthmatic symptoms.

Pediatric fatality following ingestion of dinitrophenol: postmortem identification of a "dietary supplement".

Dinitrophenol, a chemical currently used as an insecticide, is known to uncouple mitochondrial oxidative phosphorylation. A component of explosives, it has also been used in the past as a food coloring and clothing dye. In the 1930s, physicians prescribed it for weight loss, but this practice was discontinued when reports of cataracts, deaths, and other adverse outcomes came to light. We describe in our report the overdose and fatality of a teenager who purchased the product as a weight loss dietary supplement by mail order. We also describe a laboratory method that allowed postmortem determination of the dinitrophenol concentration in the victim's serum. Her death, despite prompt medical treatment, underscores the danger of dinitrophenol. The easy accessibility and apparent resurgent interest in dinitrophenol as a weight loss agent is extremely timely and troubling.

Acute effect of indoor exposure to paint containing bis(tributyltin) oxide--Wisconsin, 1991.

In January 1991, a woman in Wisconsin contacted her local public health department to report that she and her two children had become ill after her landlord painted the walls and ceilings of two rooms of her apartment. Reported symptoms included a burning sensation in the nose and forehead, headache, nose bleed, cough, loss of appetite, nausea, and vomiting. The woman, who was in the third trimester of pregnancy, also complained of a persistent odor from the paint and provided an empty bottle of a paint additive used for mildew control. The label indicated that this product contained 25% bis(tributyltin) oxide (TBTO) as its only active ingredient.

Mechanisms of hypotension in iminoctadine poisoning: pharmacological analysis in rats.

Iminoctadine, a fungicide used widely in fruit culture, causes hypotension in human acute oral poisoning. In an attempt to elucidate this mechanism, we investigated the effects of iminoctadine on the cardiovascular system of rats. In anesthetized rats, intravenously administered iminoctadine produced hypotension and tachycardia. In isolated right atria beating spontaneously in Krebs-Ringer's solution, iminoctadine produced an increase in heart rate. It also produced a positive inotropic response in electrically driven left atria. These responses were partially diminished by atenolol, a beta 1-adrenoceptor antagonist, and also partially diminished to a similar degree in atria of reserpinized rats. Therefore, the positive inotropic and chronotropic effects of iminoctadine were partially mediated via the release of norepinephrine from sympathetic nerve terminals. In aortic ring segments, iminoctadine caused a rightward shift of the concentration-contractile response curve for phenylephrine but did not affect those for prostaglandin F2 alpha or KCl. Iminoctadine produced a potent vasodilation in aortic segments precontracted with phenylephrine. Removal of the aortic endothelium produced a rightward shift of the concentration-response curve for iminoctadine. When the aortic ring preparations were precontracted with prostaglandin F2 alpha or KCl, iminoctadine produced only slight vasodilation. Therefore, the vasodilation caused by iminoctadine is due mostly to its alpha 1-adrenoceptor antagonizing action, and partly to endothelium-dependent mechanisms our data suggest that the hypotension induced by iminoctadine is due to its vasodilator effects.

Acute non-occupational intoxications with pesticides in Romania: a comparative study from 1988 to 1993.

Cases of non-occupational intoxications with pesticides registered in 26 counties of Romania between 1988 and 1993 are reported. From the total number the accidental cases represent high values (53%-73%) in this period, showing an elevated death rate of 10.1%-26.4%. Products or active substances which contributed to intoxications were identified only in approximately 30% of cases. Therefore, a more careful analysis of cases with intoxications and a more rigorous control by law of pesticide use is recommended.

Cytogenetic biomonitoring of an Italian population exposed to pesticides: chromosome aberration and sister-chromatid exchange analysis in peripheral blood lymphocytes.

Chromosome aberrations (CA) and sister-chromatid exchanges (SCE) were measured in lymphocytes of (A) 32 healthy individuals working in the flower industry and exposed to pesticides, (B) 32 individuals exposed as above and hospitalized for bladder cancer, and (C) 31 controls. Compounds to which floriculturists were exposed included 18 nitro-organic herbicides and fungicides, 9 nitro-organic fungicides, 12 organophosphate and organothiophosphate insecticides, 4 hydrocarbon derivative herbicides and 5 inorganic fungicides and insecticides. 150 and 70 metaphases per individual were scored for CA and SCE, respectively. A significant increase in the incidence of CA and SCE was observed in both exposed groups. Cancer patients showed the presence of rare rearrangements (dicentrics, rings and quadriradials) that were not observed in controls and were present at a lower frequency in healthy exposed people. Hyperdiploid and polyploid metaphases were also significantly increased in the 2 exposed groups compared to controls. Stratifying for age or smoking habits, although affecting the significance of individual data, did not change the substance of the results.

Investigation of deaths in an area of groundnut plantations in Casamance, South of Senegal after exposure to Carbofuran, Thiram and Benomyl.

Between May and October 2000, the Regional Health Office of Kolda Region in the south of Senegal, West Africa, reported an epidemic of an unknown illness characterized by thoracic pain, dyspnea and edemas of limb and face. The epidemic covered a radius of approximately 40 km (24 miles) between the districts of Kolda and Sedhiou in Kolda Region. Cases were mostly men whose age ranged between 12 and 60 years old. Investigation revealed that they had been exposed to pesticides distributed by the government to groundnut farmers. The signs and symptoms suggested intoxication with carbamates, carbofurans, and possibly thiram, contained in the pesticides distributed with the groundnut seeds. Government distribution created an excessive use of pesticides in the farms, and consequently an overexposure of the subjects who handled the seeders, especially young males but also a small proportion of women who worked in the groundnut fields. Many of these subjects, not accustomed to handle pesticides, came to overestimate the quantity of product to fill the seeder. It should be noted that the policy of distribution of pesticides in Senegal, which presents risk of poisoning, was not systematically accompanied by sufficient information on the danger of the products and of certain precautions that should be taken during their use.

Use of chlorophenols as fungicides in sawmills.

Several commercial formulations of chlorophenols used as fungicides in sawmills were found to contain impurities, some of which are known to be much more toxic than the main products. The most frequent impurities were chlorinated phenoxyphenols, chlorinated diphenyl ethers, chlorinated dibenzofurans, and chlorinated dibenzodioxins. Samples of wood dust from several positions in two Swedish sawmills were analyzed. The results suggest that the impurities in the chlorophenol formulations are enriched in the work environment in relation to the chlorophenols themselves, probably because of the low volatility and high chemical stability of the impurities. The effect of various methods of fungicide application on the work environment is discussed.

A fatal forensic intoxication with fenarimol: analysis by HPLC/DAD/MSD.

Fenarimol (Rubigan) is a pyrimidine ergosterol biosynthesis inhibitor used as a systemic fungicide. The authors present a fatal fenarimol intoxication case analysed in the Forensic Toxicology Service of the National Institute of Legal Medicine. The results were used to compare two different HPLC techniques, regarding selectivity and sensitivity: an HPLC system with a diode array detector (DAD) and an HPLC system with a DAD and a mass spectrometry detector (MSD) with an electrospray interface. All biological samples were submitted to a solid-phase extraction procedure. The detection and quantification limits of fenarimol, linearity, precision and accuracy were evaluated. The fenarimol concentration levels determined were of 89.0 mg/ml in gastric contents, 1.9 mg/g in liver and 0.4 mg/g in kidney. Blood was not available at autopsy. No published data related to fenarimol self-poisoning were found, so it was not possible to interpret the results obtained by comparison with toxic/lethal levels.

Morphology and histochemistry of the thalamus in the course of intoxication by ethyl-mercury-p-toluenesulphanilide (EMTS).

Organic Mercury compounds are known for their neurotoxicity. From our previous studies it appeared that a variable degree of damage is brought about in the individual structures of the CNS by ingestion of organic mercurials. A detailed study was undertaken on the histotopography of pathological changes occurring in the thalamus - the major integrator of various cerebral functions - following intragastric administration of EMTS, a fungicide widely applied in agriculture. Rats served as the experimental animals. They were treated intragastrically with a daily dose of 15 mg of EMTS over a period of 10 days ( the per os DL50 for rats is 100 mg/kg of body weight). The results of our study have revealed that chronic ingestion of large doses of EMTS brings about a considerable inhibition of the activities of AChE, BuTJ, acP and ATPase in many thalamic nuclei with a concomitant elevation of TPPase and NsE activities. There was considerable variation as to the degree of histoenzymatic changes in the individual thalamic nuclei. The accompanying glial reaction was evaluated aw well. An interpretation of the findings made in this study has been undertaken.