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1.
Medicine (Baltimore) ; 100(27): e26444, 2021 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-34232177

RESUMO

ABSTRACT: To studied epidemiological characteristics of 493 cases of acute poisoning in Nantong city, Jiangsu province.Based on the analysis platform of poisoning treatment, adopted single center and prospective investigation method, analyzed data of acute poisoning patients from May 2015 to December 2018 in the second affiliated hospital of Nantong University.Among 493 patients with acute poisoning, men 227 (46.04%), women 266 (53.96%). Age ranged from 12 to 89 years old, average age 41.6 years. In the occupational distribution, farmers were 30.02%; 351 cases (71.20%) visited the hospital within 6 hours after exposure. Oral exposure poisoning 415 cases (84.18%). Pesticide poisoning accounted for 45.45% of deaths.Using the poisoning treatment platform to analyze the clinical characteristic had accurately and reliably in Nantong. The fatality rate of pesticide poisoning in cases of acute poisoning is high. Management of highly toxic pesticides should be continued and effective health education on pesticide use should be carried out.


Assuntos
Gerenciamento Clínico , Exposição Ocupacional/efeitos adversos , Praguicidas/envenenamento , Envenenamento/epidemiologia , Estações do Ano , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Envenenamento/terapia , Estudos Prospectivos , Adulto Jovem
2.
Lancet Glob Health ; 9(6): e854-e862, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33901424

RESUMO

BACKGROUND: Pesticide poisoning is among the most common means of suicide globally, but can be prevented with regulation of the most hazardous agents. We aimed to compare the lethality of pesticides ingested by our cohort, seek evidence on variation between human and regulatory animal toxicity, and establish change over time in the case fatality of individual pesticides in Sri Lanka. METHODS: We examined the case fatality of agricultural pesticides in a prospective cohort in nine hospitals serving rural populations in Sri Lanka. We included all patients (>11 years) who had presented to a South Asian Clinical Toxicology Research Collaboration study hospital during the study period. Patients were enrolled by clinical research assistants and were regularly reviewed. Identification of the ingested pesticide was generally on the basis of history or positive identification of the container, supported by nested blood analysis. FINDINGS: From March 31, 2002, to Dec 31, 2019, 34 902 patients (median age 29 years [IQR 21-40]; 23 060 [66·1%] male) presented with a possible or known pesticide self-poisoning. We identified 23 139 specific pesticides that were ingested. Poisoning was fatal in 2299 (6·6%) patients. Case fatality varied greatly from 0·0% (several substances) to 41·8% (paraquat). The three most toxic agents (ie, paraquat, dimethoate, and fenthion) were banned between 2008 and 2011. Since 2013, the five agents causing the most deaths (ie, profenofos, propanil, fenobucarb, carbosulfan, and quinalphos) had a case fatality of 7·2-8·6%. A steady decline was seen in overall case fatality of pesticide poisoning (10·5% for 2002-06 to 3·7% for 2013-19), largely attributable to pesticide bans. A modest fall in case fatality for non-banned pesticides was also seen. INTERPRETATION: Declines seen in case fatalities of poisonings with non-banned pesticides suggest that medical management improved over time. The human data for acute toxicity of pesticides should drive hazard classifications and regulation. We believe that a global benchmark for registration of pesticides should include a less than 5% case fatality after self-poisoning, which could prevent many deaths and have a substantial effect on global suicide rates. FUNDING: The Wellcome Trust and the National Health and Medical Research Council of Australia. TRANSLATIONS: For the Sinhala and Tamil translations of the abstract see Supplementary Materials section.


Assuntos
Praguicidas/envenenamento , Suicídio Consumado/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Estudos Prospectivos , Sri Lanka/epidemiologia , Adulto Jovem
3.
Pan Afr Med J ; 38: 42, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33854671

RESUMO

Introduction: intentional poisoning is a major public health problem in both developed and developing countries. The purpose of this study is to describe the epidemiological features of criminal intoxication in Morocco. Method: we conducted a retrospective study of all cases of criminal intoxication identified by the Morocco Poison Control and Pharmacovigilance Centre (MPCPC) between 1980 and 2014. Results: during the study period, 611 cases of criminal poisoning were recorded, reflecting a rate of 2.1% of all intentional poisoning reported during the same period. The average age of intoxicated patients was 26.4±14.3 years. More than a quarter of the subjects were children under the age of 15 (28.6%). According to the study results, 55.9% were male, with a sex-ratio (M/F) of 1.3. The majority of cases (89.4%) occurred in urban areas. Collective intoxications were reported in 24.4% of cases. The most frequently used products were pesticides (19.1%) and plants (19%). Patients developed different symptoms based on the toxic substances used, the amount ingested and the time elapsed before treatment. A range of digestive, neurological, respiratory and cardiovascular disorders were reported. Out of 440 patients with outcome data available, 27 died. The remainder of patients survived with or without sequelae. Conclusion: criminal poisoning is a major issue. The number of cases is probably underestimated due to a large number of undiagnosed or unreported cases.


Assuntos
Crime , Farmacovigilância , Envenenamento/epidemiologia , Venenos/administração & dosagem , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Praguicidas/envenenamento , Intoxicação por Plantas/epidemiologia , Centros de Controle de Intoxicações/estatística & dados numéricos , Estudos Retrospectivos , Adulto Jovem
4.
Forensic Sci Rev ; 33(1): 67-78, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33518515

RESUMO

Pesticides are chemical or biological agents used to repel or kill pests. Pesticides are potent and lethal toxic substances that are also being infamously used for homicidal purposes due to their easy availability and rapid action. In this review, we look at 21 articles related to homicidal pesticide poisoning in the literature with an emphasis on fatal doses, routes of administration, and profiles of victims and perpetrators. Organophosphates and rodenticides were the most commonly used classes of pesticides, and ingestion was the most common route of administration; however, other modes of administration, such as through intraperitoneal injection, were also reported. Interestingly, we have noticed that victims involved in homicidal poisoning were mostly in close relationships with perpetrators. Most perpetrators were either spouses or other immediate family members. Abiding by the regulations that govern the production, sale, and use of pesticides and proper documentation of the related trail can help control the prevalence of homicidal pesticide poisoning. Recognition of the distinct morbid anatomy of the poisoning cases, alongside a high index of suspicion in cases that fit the profile, is essential for forensic analysis.


Assuntos
Praguicidas/envenenamento , Rodenticidas/envenenamento , Medicina Legal , Humanos , Organofosfatos
5.
Med. oral patol. oral cir. bucal (Internet) ; 26(1): e56-e63, ene. 2021. tab, graf
Artigo em Inglês | IBECS | ID: ibc-200539

RESUMO

BACKGROUND: Tobacco, alcohol consumption, and HPV infection are the most common risk factors for head and neck cancer (HNC). Despite of this, recent evidences are growing on the association between long-term exposure to pesticides and the risk of chronic diseases, including different types of cancer. The present review evaluated in current literature evidence of an association between exposure to pesticides and the occurrence of HNCs. MATERIAL AND METHODS: A literature search of the case-control studies was conducted in the PubMed, Web of science and Cochrane databases. Methodological quality of each study was rated with the Scottish Intercollegiate Guidelines Network (SIGN 50) checklist. RESULTS: One thousand and thirty-five studies were identified and twelve met all criteria and, therefore, considered for quality assessment and data extraction. According to SIGN 50 criteria, six studies received an overall high-quality. All the studies considered of high quality found a positive association between exposure to pesticides and different HNC sites, including larynx, pharynx and nasal cavity. In addition, the increased risk was associated with the frequency of exposure. CONCLUSIONS: Finally, improving pesticide users' awareness of their risks and proper handling, as well as adopting protective measures such as the use of personal protective equipment, appear to be effective in reducing human health damage


No disponible


Assuntos
Humanos , Neoplasias de Cabeça e Pescoço/etiologia , Exposição a Praguicidas , Praguicidas/envenenamento , Estudos de Casos e Controles , Fatores de Risco , Medição de Risco
6.
Forensic Sci Int ; 318: 110558, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33208234

RESUMO

Poisoning is an increasing and significant burden that causes morbidity and mortality worldwide. In this retrospective study, poisoning-related cases that occurred in 19 cities and prefectures in Sichuan, Southwest China, between 2010 and 2018 were collected from the West China Forensic Medical Center of Sichuan and Public Security Bureaus. A total of 782 poisoning-related deaths were recorded, and their demographic characteristics, season of death, type of poison, and manner and cause of death were analysed. Of these cases, the victims were predominantly male (65.3%), and the 21∼50-year-old age group included the most victims (63.2%). The rural incidence was 71%. The most common poisoning agent was pesticide (40%), followed by toxic gases (32%), and there were cases of poisoning by poisonous animals and plants that are not common in other regions of China. The predominant manner of poisoning death was accident (50%), followed by suicide (38.3%) and homicide (5.0%). In this study, relevant information on poisoning-related cases was collected and compared with the poisoning data from other areas of China and foreign countries to provide guidance for the formulation of public health policies in Sichuan, Southwest China.


Assuntos
Envenenamento/mortalidade , Acidentes/mortalidade , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Animais , Animais Venenosos , Criança , Pré-Escolar , China/epidemiologia , Feminino , Intoxicação por Gás/mortalidade , Intoxicação por Metais Pesados/mortalidade , Homicídio/estatística & dados numéricos , Humanos , Drogas Ilícitas/envenenamento , Lactente , Masculino , Pessoa de Meia-Idade , Praguicidas/envenenamento , Plantas Tóxicas , Estudos Retrospectivos , Distribuição por Sexo , Suicídio Consumado/estatística & dados numéricos , Adulto Jovem
7.
Lancet Glob Health ; 9(3): e291-e300, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33341152

RESUMO

BACKGROUND: Reducing suicides is a key Sustainable Development Goal target for improving global health. Highly hazardous pesticides are among the leading causes of death by suicide in low-income and middle-income countries. National bans of acutely toxic highly hazardous pesticides have led to substantial reductions in pesticide-attributable suicides across several countries. This study evaluated the cost-effectiveness of implementing national bans of highly hazardous pesticides to reduce the burden of pesticide suicides. METHODS: A Markov model was developed to examine the costs and health effects of implementing a national ban of highly hazardous pesticides to prevent suicides due to pesticide self-poisoning, compared with a null comparator. We used WHO cost-effectiveness and strategic planning (WHO-CHOICE) methods to estimate pesticide-attributable suicide rates for 100 years from 2017. Country-specific costs were obtained from the WHO-CHOICE database and denominated in 2017 international dollars (I$), discounted at a 3% annual rate, and health effects were measured in healthy life-years gained (HLYGs). We used a demographic projection model beginning with the country population in the baseline year (2017), split by 1-year age group and sex. Country-specific data on overall suicide rates were obtained for 2017 by age and sex from the Global Burden of Disease Study 2017 Data Resources. The analysis involved 14 countries spanning low-income to high-income settings, and cost-effectiveness ratios were analysed at the country-specific level and aggregated according to country income group and the proportion of suicides due to pesticides. FINDINGS: Banning highly hazardous pesticides across the 14 countries studied could result in about 28 000 (95% uncertainty interval [UI] 24 000-32 000) fewer suicide deaths each year at an annual cost of I$0·007 per capita (95% UI 0·006-0·008). In the population-standardised results for the base case analysis, national bans produced cost-effectiveness ratios of $94 per HLYG (95% UI 73-123) across low-income and lower-middle-income countries and $237 per HLYG (95% UI 191-303) across upper-middle-income and high-income countries. Bans were more cost-effective in countries where a high proportion of suicides are attributable to pesticide self-poisoning, reaching a cost-effectiveness ratio of $75 per HLYG (95% UI 58-99) in two countries with proportions of more than 30%. INTERPRETATION: National bans of highly hazardous pesticides are a potentially cost-effective and affordable intervention for reducing suicide deaths in countries with a high burden of suicides attributable to pesticides. However, our study findings are limited by imperfect data and assumptions that could be improved upon by future studies. FUNDING: WHO.


Assuntos
Países em Desenvolvimento , Regulamentação Governamental , Praguicidas/envenenamento , Suicídio/prevenção & controle , Fatores Etários , Análise Custo-Benefício , Saúde Global , Humanos , Cadeias de Markov , Modelos Econômicos , Fatores Sexuais , Fatores Socioeconômicos
8.
BMC Public Health ; 20(1): 1875, 2020 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-33287770

RESUMO

BACKGROUND: Human poisoning by pesticides has long been seen as a severe public health problem. As early as 1990, a task force of the World Health Organization (WHO) estimated that about one million unintentional pesticide poisonings occur annually, leading to approximately 20,000 deaths. Thirty years on there is no up-to-date picture of global pesticide poisoning despite an increase in global pesticide use. Our aim was to systematically review the prevalence of unintentional, acute pesticide poisoning (UAPP), and to estimate the annual global number of UAPP. METHODS: We carried out a systematic review of the scientific literature published between 2006 and 2018, supplemented by mortality data from WHO. We extracted data from 157 publications and the WHO cause-of-death database, then performed country-wise synopses, and arrived at annual numbers of national UAPP. World-wide UAPP was estimated based on national figures and population data for regions defined by the Food and Agriculture Organization (FAO). RESULTS: In total 141 countries were covered, including 58 by the 157 articles and an additional 83 by data from the WHO Mortality Database. Approximately 740,000 annual cases of UAPP were reported by the extracted publications resulting from 7446 fatalities and 733,921 non-fatal cases. On this basis, we estimate that about 385 million cases of UAPP occur annually world-wide including around 11,000 fatalities. Based on a worldwide farming population of approximately 860 million this means that about 44% of farmers are poisoned by pesticides every year. The greatest estimated number of UAPP cases is in southern Asia, followed by south-eastern Asia and east Africa with regards to non-fatal UAPP. CONCLUSIONS: Our study updates outdated figures on world-wide UAPP. Along with other estimates, robust evidence is presented that acute pesticide poisoning is an ongoing major global public health challenge. There is a need to recognize the high burden of non-fatal UAPP, particularly on farmers and farmworkers, and that the current focus solely on fatalities hampers international efforts in risk assessment and prevention of poisoning. Implementation of the international recommendations to phase out highly hazardous pesticides by the FAO Council could significantly reduce the burden of UAPP.


Assuntos
Praguicidas , Envenenamento , África Oriental , Agricultura , Ásia , Fazendeiros , Humanos , Praguicidas/envenenamento , Envenenamento/epidemiologia , Envenenamento/mortalidade
9.
Rev Saude Publica ; 54: 133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33331527

RESUMO

OBJECTIVE: To explore the association of occupational pesticide exposure with acute and mental health symptoms. METHODS: Cross-sectional survey carried out with 78 Brazilian family farmers, who were pesticide applicators and helpers conveniently selected. Symptoms and exposure data were collected by interviews, and mental health outcomes by the Self-Reporting Questionnaire. Blood samples were analyzed to assess cholinesterase levels. Exposure indicators and symptoms were compared between applicators and helpers, and Poisson regression was performed to estimate prevalence ratios. RESULTS: Farmers reported exposure to multiple pesticides from early ages; they worked without safety training, technical support, and full protective equipment, and they had a high prevalence of acute and mental health symptoms (e.g., headache, mucosal irritation, tachycardia, and depressive signs). Applicators had more cholinesterase changes than helpers, but less symptoms. Helpers used less personal protection and had significantly higher prevalence ratio of headache, dyspnea, wheezing, cough, poor digestion, tiredness, and feeling worthless, after adjustment. CONCLUSIONS: Acute and mental health symptoms were observed, both among farmers and helpers. Thus, surveillance actions must be reinforced in Brazil, technical support and safety training improved, focused on applicators and helpers, who are occupationally and environmentally exposed to pesticides. Agricultural practices of these groups with less pesticide use should receive incentive.


Assuntos
Depressão/induzido quimicamente , Fazendeiros , Cefaleia/induzido quimicamente , Exposição Ocupacional/estatística & dados numéricos , Praguicidas/envenenamento , Praguicidas/toxicidade , Envenenamento/epidemiologia , Doenças Respiratórias/induzido quimicamente , Taquicardia/induzido quimicamente , Adolescente , Adulto , Agricultura , Brasil/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Família , Feminino , Cefaleia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Prevalência , Doenças Respiratórias/diagnóstico , Doenças Respiratórias/epidemiologia , Taquicardia/epidemiologia , Adulto Jovem
10.
PLoS One ; 15(12): e0243922, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33373373

RESUMO

Habits such as smoking and alcohol drinking and existing esophageal malfunction are considered the main risk factors for esophageal carcinogenesis. Caustic ingestion of acidic or alkaline agents or strong irritants can induce severe esophageal corrosive injury and increase esophageal cancer risk. We studied the relationship between esophageal carcinoma and acute detergent or pesticide poisoning by using nationwide health insurance data. Methodology/Principle findings: We compared a pesticide/detergent intoxication cohort (N = 21,840) and an age- and gender-matched control cohort (N = 21,840) identified from the National Health Insurance Research Database between 2000 and 2011. We used the multivariable Cox proportional model to determine esophageal carcinoma risk. The overall incidence density of esophageal cancer was 1.66 per 10,000 person-years in the comparison cohort and 4.36 per 10,000 person-years in the pesticide/detergent intoxication cohort. The corresponding adjusted hazard ratio (HR) for esophageal cancer was 2.33 (95% confidence interval [CI] = 1.41-3.86) in the pesticide/detergent intoxication cohort compared with the control cohort. Patients with corrosive and detergent intoxication did not have a higher risk of esophageal cancer (adjusted HR = 0.98, 95% CI = 0.29-3.33) than those without pesticide/detergent intoxication. However, patients with pesticide intoxication had a significantly higher risk of esophageal cancer (adjusted HR = 2.52, 95% CI = 1.52-4.18) than those without pesticide/detergent intoxication. Conclusion: In the present study, after adjusting for conventional risk factors, we observed that pesticide intoxication could exert substantial effects through increased esophageal cancer risk. However, patients with detergent intoxication may not have an increased risk of esophageal cancer.


Assuntos
Carcinoma/epidemiologia , Cáusticos/envenenamento , Neoplasias Esofágicas/epidemiologia , Praguicidas/envenenamento , Adulto , Idoso , Carcinoma/induzido quimicamente , Carcinoma/patologia , Estudos de Coortes , Detergentes/envenenamento , Ingestão de Alimentos/efeitos dos fármacos , Neoplasias Esofágicas/induzido quimicamente , Neoplasias Esofágicas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco
11.
Med Lav ; 111(4): 296-305, 2020 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-32869766

RESUMO

BACKGROUND: Occupational pesticide poisoning is an important public health concern worldwide, especially in developing countries. OBJECTIVES: This study was aimed at determining the prevalence and risk factors of acute pesticide poisoning (APP) among the vegetable and fruit farmers in Karacabey District in northwest Turkey. METHODS: The study group consisted of 565 farmers. The dependent variable of the study is APP defined according to the World Health Organization's APP case definition matrix. The study's independent variables are the farmers' sociodemographic characteristics and the preventive measures they use when they are applying pesticides. The chi-square and logistic regression analysis analyzed the relationship between the dependent and independent variables. RESULTS: A total of 64 (11.3%) farmers reported APP and 75% of them presented to a health institution due to symptoms. The factors associated with increased risk of APP were: illiteracy (odds ratio (OR)=2.5), 14 years and less farming experience (OR=3.3), not reading the pesticide labels (OR=6.4), and contact with liquid pesticides (OR=2.3). -Conclusions: The study shows that approximately one out of ten farmers experience APP. Training programs should be planned and monitored to improve farmers' awareness of the dangers of pesticides, and they should be encouraged to adopt and implement protective measures.


Assuntos
Agricultura , Exposição Ocupacional , Praguicidas , Estudos Transversais , Fazendeiros , Frutas , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Praguicidas/envenenamento , Autorrelato , Turquia , Verduras
13.
J Forensic Leg Med ; 75: 102050, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32905870

RESUMO

Therapeutic artefacts are a challenge for forensic pathologists for correct interpretation at autopsy. A 23-year-old female was found unconscious at home and immediately admitted to an emergency of a tertiary care hospital where resuscitative measures were taken. However, she died after 4 h of hospitalization. The injuries (abrasions, subcutaneous bruising and haemorrhage in the deep structures of the neck) discovered at autopsy simulated the findings of throttling and aroused the suspicion of homicide. Later, enquiry revealed that it happened due to mal-positioned central line in the carotid artery during internal jugular vein access to provide fluid as the patient was in shock due to aluminium phosphide (Celphos)poisoning. The bleeding diatheses in Celphos poisoning might have precipitated the extensive neck haemorrhage in this case.


Assuntos
Compostos de Alumínio/envenenamento , Artefatos , Cateterismo Venoso Central/efeitos adversos , Lesões do Pescoço/patologia , Praguicidas/envenenamento , Fosfinas/envenenamento , Ressuscitação/efeitos adversos , Choque/terapia , Adulto , Lesões das Artérias Carótidas/etiologia , Contusões/etiologia , Contusões/patologia , Feminino , Hemorragia/etiologia , Hemorragia/patologia , Humanos , Veias Jugulares , Lesões do Pescoço/etiologia , Choque/etiologia , Suicídio Consumado
14.
Environ Toxicol Pharmacol ; 80: 103471, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32818631

RESUMO

Animal poisoning by chemicals (pesticides and household products) and drugs is a frequent occurrence and special attention should be paid to this phenomenon to improve prevention and treatment strategies and because of the fundamental role that animals may play as bioindicators. From January 2017 to March 2019 the Poison Control Centre of Milan (CAV) in collaboration with the University of Milan, collected and analyzed epidemiological data on animal poisoning. During this period, the CAV received a total of 442 enquiries on domestic animal poisoning episodes and, among these, 80.3 % were related to chemicals and drugs. Pesticides and drugs were the two major causes of poisoning (34.1 % and 33.5 %, respectively), followed by household products (29.3 %) and other causative agents (3.1 %, n = 11). In conclusion, these findings can provide useful information for the identification and monitoring of known and emerging toxicants, with positive repercussions on human, animal and environmental health.


Assuntos
Animais Domésticos , Produtos Domésticos/envenenamento , Praguicidas/envenenamento , Envenenamento/epidemiologia , Envenenamento/veterinária , Animais , Itália/epidemiologia , Centros de Controle de Intoxicações
15.
Artigo em Inglês | MEDLINE | ID: mdl-32603923

RESUMO

Organophosphate, carbamate and pyrethroid pesticides are the most common insecticides used worldwide. They may cause chronic poisoning in farmers and acute poisoning in homicidal or suicidal cases. The determination of trace levels of these pesticides in human blood and urine is very challenging. This study focuses on a simultaneous quantitation method that was developed and validated for multi-class nine pesticides belonging to organophosphate, carbamate and pyrethroid classes in human blood and urine. Target pesticides were extracted from blood and urine using a modified QuEChERS (Quick, Easy, Cheap, Effective, Rugged and Safe) extraction method. Capillary column DB-35 ms (15 m × 0.25 mm, 0.25 µm) was used for chromatography with a 0.079 ml/min flow rate of carrier gas at constant pressure mode. Quantitation of sulfotep, phorate, carbofuran, chlorpyriphos, profenophos, triazophos, pyriproxyfen, lambda-cyhalothrin and permethrin was performed by mass spectrometer equipped with electron impact ionization source using selected ion monitoring (SIM) mode. The lower and upper limits of quantitation for all nine pesticides were 0.01 mg/L and 2.0 mg/dL respectively. The proposed method was proved to be simple, fast, sensitive, and robust. It has been applied to the analysis of 9 pesticides samples.


Assuntos
Cromatografia Gasosa-Espectrometria de Massas/métodos , Resíduos de Praguicidas/sangue , Resíduos de Praguicidas/urina , Conteúdo Gastrointestinal/química , Humanos , Limite de Detecção , Modelos Lineares , Extração Líquido-Líquido/métodos , Resíduos de Praguicidas/química , Resíduos de Praguicidas/isolamento & purificação , Praguicidas/análise , Praguicidas/envenenamento , Reprodutibilidade dos Testes
16.
Trop Med Int Health ; 25(10): 1205-1213, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32687625

RESUMO

OBJECTIVES: Suicide by pesticide self-poisoning is a major public health challenge in low- and middle-income countries. While effectiveness studies are required to test alternative prevention approaches, economic evidence is lacking to inform decision-making in research priority setting. Therefore, this study aimed to estimate the costs of a shop-based gatekeeper training programme for pesticide vendors seeking to prevent pesticide self-poisoning in rural Sri Lanka and assess its potential for cost-effectiveness. METHODS: Ex-ante cost and cost-effectiveness threshold (CET) analyses were performed from a governmental perspective based on a three-year analytic horizon, using 'no programme' as a comparator. A programme model targeting all 535 pesticide shops in the North Central Province and border areas was applied. Total programme costs (TPC) were estimated in 2019 USD using an ingredients approach and 3% annual discounting. The Sri Lankan gross domestic product per capita and life years saved were used as CET and effectiveness measure, respectively. Sensitivity analyses were performed. RESULTS: TPC were estimated at 31 603.03 USD. TPC were sensitive to cost changes of training material and equipment and the programme lifetime. The programme needs to prevent an estimated 0.23 fatal pesticide self-poisoning cases over three years to be considered cost-effective. In the sensitivity analyses, the highest number of fatal cases needed to be prevented to obtain cost-effectiveness was 4.55 over three years. CONCLUSIONS: From an economic perspective, the programme has a very high potential to be cost-effective. Research assessing its effectiveness should therefore be completed, and research analysing its transferability to other settings prioritised.


Assuntos
Comércio , Educação/economia , Controle de Acesso/economia , Praguicidas/envenenamento , Tentativa de Suicídio/prevenção & controle , Análise Custo-Benefício , Humanos , Praguicidas/economia , População Rural , Sri Lanka
17.
JNMA J Nepal Med Assoc ; 58(225): 338-340, 2020 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-32538930

RESUMO

Amitraz is a formamidine group of compounds used in many parts of the world as an agricultural pesticide and an ectoparasiticide. Amitraz intoxication secondary to the oral, dermal or inhalational routes, both accidental and suicidal, has been encountered in humans leading to severe life-threatening side effects. Only very few cases of amitraz toxicity have been reported to date. This emphasizes the importance to ascertain amitraz intoxication from more commonly encountered pesticides like organophosphorus poisoning to avoid erroneous management of the patient. We report a case of a twenty-seven-year-old man who presented to the emergency room following suicidal ingestion of amitraz with the clinical manifestations of vomiting, altered sensorium, bradycardia and hypotension and complete recovery following supportive management.


Assuntos
Intoxicação por Organofosfatos , Praguicidas/envenenamento , Toluidinas/envenenamento , Adulto , Humanos , Masculino , Intoxicação por Organofosfatos/diagnóstico
18.
Rev. cuba. med. mil ; 49(2): e482, abr.-jun. 2020. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1149906

RESUMO

Introducción: El Centro Nacional de Toxicología de Cuba, supervisa y controla la información de eventos atribuibles a la inmunización, vacunación e intoxicaciones con medicamentos y plaguicidas. Los casos que llegan al centro, se justifican mayormente por el uso de plaguicidas que tienen un alto nivel de toxicidad y riesgo de muerte. Los especialistas en toxicología, requieren facilidad para revisar las hojas de seguridad, el listado oficial de plaguicidas autorizados en Cuba y los casos anteriores. Esto permite analizar y emitir un diagnóstico, que salve la vida del afectado. Objetivo: Presentar un sistema para la gestión y el análisis de los casos intoxicados por plaguicidas. Métodos: El desarrollo se sustentó en la metodología de software Extreme Programming, modelado con la herramienta CASE Visual Paradigm 8.0 y lenguaje UML 2.0. Se utilizó Java con NetBeans 8.0.2 y como gestor de base de datos PostgreSQL 9.3. Resultados: Se desarrolló una herramienta de gestión de la información toxicológica, así como una base de casos de los síntomas, plaguicidas y diagnóstico por plaguicida. Los especialistas en toxicología cuentan con una herramienta de apoyo a la toma de decisiones, que reduce la ocurrencia de errores humanos(AU)


Introduction: The Cuban National Toxicology Center supervises and controls the information of events attributable to immunization, vaccination and poisonings with medications and pesticides. The cases that arrive at the center are mainly justified by the use of pesticides that have a high level of toxicity and risk of death. Specialists in toxicology require ease to review the safety sheets, the official list of authorized pesticides in Cuba and the above cases. This allows analyzing and issuing a diagnosis that saves the life of the affected person. Objective: To present a system for the management and analysis of cases poisoned by pesticides. Methods: The development was based on the Extreme Programming software methodology, modeled with the CASE Visual Paradigm 8.0 tool and the UML 2.0 language. Java was used with NetBeans 8.0.2 and as PostgreSQL 9.3 database manager. Results: A toxicological information management tool was developed, as well as a case database of symptoms, pesticides and pesticide diagnosis. Toxicology specialists have a decision support tool that reduces the occurrence of human errors(AU)


Assuntos
Humanos , Praguicidas/efeitos adversos , Praguicidas/envenenamento , Software/normas , Cuba
19.
Artigo em Chinês | MEDLINE | ID: mdl-32447883

RESUMO

Objective: To investigate the value of high-sensitivity cardiac troponin I (hs-cTnI) and soluble suppression of tumorigenicity 2 (sST2) in predicting cardiac complications of severe acute organophosphorus pesticide poisoning (SAOPP) . Methods: All 274 SAOPP patients from September 2014 to February 2019 were selected. According to the results of hs-cTnI detection, the patients were divided into non-elevated troponin group (78 cases) and troponin elevation group (196 cases) at 1 hour after admission. 3 days after admission, there were 109 cases of complication and 165 cases of non-complication according to the presence or absence of cardiac complications. The changes of hs-cTnI, sST2, N-terminal B-type brain natriuretic peptide (NT proBNP) , acute physiology and chronic health (APACHE-Ⅱ) , cholinesterase activity, left ventricular ejection fraction (LVEF) , short axis shortening rate (FS) were observed and analyzed. The predictive value of hs-cTnI and sST2 were evaluated by receiver operating characteristic curve (ROC) analysis. Results: The sST2 level in patients with troponin elevation group was significantly higher than that in non-elevated troponin group (P<0.05) . Compared with the non-complication and non-elevated troponin group, the patients with non-complication and troponin elevation group had elevated hs-cTnI, sST2 and decreased cholinesterase (P<0.05) . Compared with other groups, the hs-cTnI, sST2, NT-proBNP, and APACHE-Ⅱ scores in the complication and troponin elevation group were significantly increased, and cholinesterase was significantly reduced (P<0.05) . In the non-complication group, LVEF and FS were in the normal range, and there was no significant difference between the groups (P>0.05) . Compared with other groups, the LVEF and FS of patients with elevated troponin in the complications group were significantly decreased (P<0.05) . Correlation analysis showed that hs-cTnI and sST2 were positively correlated in patients with SAOPP complications (r=0.725, P<0.01) . hs-cTnI, sST2 and APACHE-Ⅱ scores were positively correlated in the complications group (r=0.846, 0.885, P<0.01) . ROC results showed that the areas under the curve for predicting SAOPP secondary heart damage of hs-cTnI (1 hour after admission) and sST2 (3 days after admission) were 0.945 and 0.833, respectively. Conclusion: hs-cTnI and sST2 may have important clinical value in the early diagnosis and prognosis evaluation of patients with SAOPP secondary cardiac damage.


Assuntos
Coração/efeitos dos fármacos , Proteína 1 Semelhante a Receptor de Interleucina-1/sangue , Intoxicação por Organofosfatos/diagnóstico , Praguicidas/envenenamento , Troponina I/sangue , Biomarcadores/sangue , Diagnóstico Precoce , Humanos , Miocárdio/patologia , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Valor Preditivo dos Testes , Volume Sistólico , Função Ventricular Esquerda
20.
BMC Public Health ; 20(1): 780, 2020 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-32450831

RESUMO

BACKGROUND: Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data for further pesticide regulation. METHODS: We performed a secondary analysis of data collected prospectively during a cluster randomized controlled trial in the Anuradhapura district of Sri Lanka from 2011 to 16. The identity of pesticides responsible for suicides were sought from medical or judicial medical notes, coroners' records, and the person's family. Trend analysis was done using a regression analysis with curve estimation to identify relative importance of key pesticides. RESULTS: We identified 337 suicidal deaths. Among them, the majority 193 (57.3%) were due to ingestion of pesticides while 82 (24.3%) were due to hanging. A specific pesticide was identified in 105 (54.4%) of the pesticide suicides. Ingestion of carbosulfan or profenofos was responsible for 59 (56.2%) of the suicides with a known pesticide and 17.5% of all suicides. The increasing trend of suicides due to carbosulfan and profenofos over time was statistically significant (R square 0.846, F 16.541, p 0.027). CONCLUSION: Ingestion of pesticides remains the most important means of suicides in rural Sri Lanka. The pesticides that were once responsible for most pesticide suicides have now been replaced by carbosulfan and profenofos. Their regulation and replacement in agriculture with less hazardous pesticides will further reduce the incidence of both pesticide and overall suicides in rural Sri Lanka.


Assuntos
Agricultura/legislação & jurisprudência , Praguicidas/envenenamento , População Rural , Suicídio/estatística & dados numéricos , Carbamatos/envenenamento , Ingestão de Alimentos , Regulamentação Governamental , Humanos , Organotiofosfatos/toxicidade , Estudos Prospectivos , Sri Lanka/epidemiologia
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