Subjective Symptoms of Male Workers Linked to Occupational Pesticide Exposure on Coffee Plantations in the Jarabacoa Region, Dominican Republic.

Acute and sub-acute effects of pesticide use in coffee farmers have rarely been investigated. In the present field study, self-reported health symptoms from 38 male pesticide users were compared to those of 33 organic farmers. Results of cytological findings have been reported in an accompanying paper in this issue. The present second part of the study comprises a questionnaire based survey for various, potentially pesticide related symptoms among the coffee farmers. Symptom rates were generally higher in exposed workers, reaching significance in nine out of 19 assessed symptoms. Significantly increased symptom frequencies were related to neurotoxicity, parasympathic effects and acetylcholine esterase inhibition, with the highest differences found for excessive salivation, dizziness and stomach ache. We revealed a lack of precautionary measures in the majority of farmers. Better education, regulations, and safety equipment are urgently needed.

Non-healing verrucous plaque over upper limb for 1 year in a tea garden worker.

A 55-year-old tea garden worker presented with a slowly growing verrucous plaque on the right arm. The diagnosis of chromomycosis was confirmed by the identification of brown sclerotic bodies in a skin biopsy.

Airborne contact dermatitis induced by parthenium: a study of 50 cases in South India.

Airborne contact dermatitis (ABCD) is a commonly occurring form of allergic contact dermatitis with varied aetiology, often posing a diagnostic challenge in management. A study was carried out on patients with a clinical picture and history consistent with ABCD due to exposure to Parthenium hysterophorus (parthenium weed), who were patch tested. There were 50 patients with parthenium-induced ABCD (36 men and 14 women; age range 24-75 years). The majority (90%) of the patients were farmers and most of the patients (74.5%) had exacerbations during summer. The most common type of dermatitis was the classic pattern (46%) followed by the mixed pattern (30%), erythroderma (14%) and chronic actinic dermatitis (10%). Of the 40 cases patch tested with the Indian standard series of antigens, 36 (90%) cases had patch-test results positive for parthenium.

Self-treatment with bleach by a Latino farmworker.

Skin disease is common among migrant Latino farmworkers. These workers rarely use formal health care services but commonly engage in self-treatment of their skin disease. We present a patient with dermatitis who self-treated with bleach. This patient illustrates a common practice that exacerbates skin disease and sheds light on social and cultural factors of which health care providers serving this community should be aware.

A case of lymphangitic sporotrichosis occurring on both forearms with a published work review of cases of bilateral sporotrichosis in Japan.

The patient, 56-year-old man who was working as a clerk and a farmer, presented with nodules that had appeared on the dorsa of both his hands 3 months earlier. At the first examination, there were multiple dark-red nodules scattered on the fingers, dorsa and wrists of both hands. The nodules were up to 3 cm in diameter and had crusts in the incenters. The patient was suspected to suffer from prurigo and was subsequently treated with topical steroid, but the nodules did not respond. Therefore, a skin biopsy and fungal culture were performed, and the patient was finally diagnosed as having bilateral multiple sporotrichosis. He was then successfully treated with local thermotherapy and oral potassium iodide. Bilaterally-distributed lymphangitic sporotrichosis is very rare and often difficult to diagnose. Careful attention is required to avoid misdiagnosis.

Fatal cardiac arrhythmia in a patient with interstitial myocarditis related to chronic arsenic poisoning.

We have reported the case of a 42-year-old man exposed to arsenic at least three times over a ten-month period from an agricultural source. He showed classical symptoms and signs of arsenic poisoning. During chelation therapy and apparent recovery from the poisoning, he suddenly and unexpectedly died; postmortem examination revealed a myocarditis similar to that reported previously. The case demonstrates the need for electrocardiographic monitoring of all patients with arsenic poisoning, during both the initial phase of the illness and convalescence.