Spatial and temporal variations of currently used pesticides (CUPs) concentrations in ambient air in Wallonia, Belgium.

Pesticides are among the most widely used chemicals thus contributing to a global contamination of the environment. Studies in North America and Europe have reported ambient air concentrations of Currently Used Pesticides in rural and urban locations as well as in remote areas. Monitoring pesticides in air is required for a better understanding of human exposure through inhalation and to assess potential health effects related to this exposure pathway. In this study, 46 pesticides were analyzed in ambient air in sampling stations distributed over Wallonia during a year, from May 2015 to May 2016. Different typologies were defined for sampling sites (remote areas, urban sites, agricultural sites, livestock area, and sites with other professional uses). Ambient air was sampled for 14 days with an active air sampler at a flow rate of 4 m³/h. Quartz filters and PUF/XAD-2/PUF cartridges were used to sample both gas and particulate phase pesticides. On the 46 pesticides studied, 6 insecticides, 18 herbicides and 18 fungicides were detected. Herbicides were measured in 68.3% of samples throughout the year, whereas fungicides and insecticides were measured in 62.6% and 13.2% of the samples, respectively. The highest mean concentrations for all pesticides were measured in spring-summer, whereas few pesticides were measured at low concentrations in winter. Six pesticides were measured in the remote sampling station at lower concentrations than in all other sites highlighting volatility of these pesticides. The highest number of different pesticides and the highest concentrations were measured in agricultural stations, where uses of plant protection products are higher. Finally, less volatile pesticides were only detected near application areas and at low concentrations. Together, these results provide better insight on the spatial and temporal variations of pesticides concentrations in ambient air, which were related to pesticides uses as well to atmospheric volatility and persistence.

Mixed amlodipine/valsartan overdose treated by the molecular adsorbent recirculating system (MARS™).

CASE REPORT: We describe the case of a 58-year-old woman who developed a severe distributive shock following the intentional ingestion of a large overdose of amlodipine (480 mg) combined with valsartan (3680 mg). Extreme vasoplegia remained refractory to maximal standard therapy including fluid resuscitation, intravenous calcium, vasopressors at very high doses, hyperinsulinemia-euglycemia therapy, lipid emulsion, and methylene blue administration. Besides, the patient exhibited hyperglycemia refractory to very high doses of insulin. Due to its theoretical ability to effectively remove protein-bound drugs such as amlodipine from the circulation, albumin dialysis with the molecular adsorbent recirculating system (MARS™) was performed during two consecutive sessions. Blood was drawn for toxicokinetic calculations. Amlodipine elimination half-life during the first MARS™ session was calculated at 7.6 h. In addition, there was a rapid fall in blood glucose, requiring the introduction of a continuous infusion of glucose in order to achieve euglycemia. Moreover, a few hours after the initiation of the MARS™ therapy, the hemodynamic status was not significantly modified but a significant tapering of epinephrine infusion was possible, together with a progressive decrease of blood lactate level. However, the need for vasopressors in decreasing doses was present until day 5 post-ingestion. Eventually, the patient fully recovered and was discharged home 8 days after admission. DISCUSSION: The role of the MARS™ in the treatment of severe poisoning of calcium channel blockers is still to be defined. We were able to demonstrate a relatively short elimination half-life of amlodipine. A decreased insulin resistance and a reduction of epinephrine infusion were also observed.

Dimethylformamide metabolism following self-harm using a veterinary euthanasia product.

BACKGROUND: A veterinary euthanasia drug containing embutramide, mebezonium, tetracaine, and dimethylformamide (DMF; T-61® or Tanax®) may cause serious manifestations or even fatalities after self-poisoning. Immediate toxicity is mainly due to a general anesthetic and due to a neuromuscular blocking agent, while delayed hepatotoxicity seems related to the solvent DMF. The protective role of N-acetylcysteine (NAC) administration remains debatable. MATERIAL AND METHODS: Two male veterinarians (50- and 44-year-old) attempted suicide by injecting T-61 in the precordial area for the first one, and by ingesting 50 mL for the second. Both received NAC (for 14 days in the first case and only for 20 h in the second). Urine was collected for the serial determination of DMF, N-methylformamide (NMF), and N-acetyl-S-(N-methylcarbamoyl)cysteine (AMCC). RESULTS: Both patients developed only mild signs of liver injury. The metabolite of DMF, NMF, appeared rapidly in the urine, while a further delay was necessary for AMCC excretion. The kinetics of elimination of DMF and DMF metabolites were slightly slower than those reported in exposed workers. CONCLUSIONS: While both patients had a favorable outcome, there is no clear evidence that NAC could directly influence NMF and AMCC excretion. Further investigations of NMF and AMCC excretion, with and without NAC, would be indicated.