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2.
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
3.
Rev Bras Epidemiol ; 23: e200022, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32401913

RESUMO

OBJECTIVE: To update findings of observational analytical studies on the association between occupational exposure to organophosphates and hematologic malignancies. METHODOLOGY: Systematic literature review, including cohort and case-control studies, without limitation of publication time, in Portuguese and English. The articles were traced from June 2017 to July 2019 in PubMed, MEDLINE, LILACS, Web of Science, and Scopus databases. The qualitative bias risk assessment was performed using the Newcastle-Ottawa Scale and the Downs and Black Checklist. Results were presented according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). RESULTS: Seventeen studies evaluated as good/high methodological quality were eligible. Exposure to diazinon (1 cohort), phonophos (1 cohort), dichlorvos, crotoxiphos and famphur (1 case control) was associated with leukemia, while exposure to organophosphate was associated to lymphomas (6 case control); the risk of non-Hodgkin's lymphoma was higher in those exposed to diazinon (1 control case) and malathion (3 control case) than non-exposed ones. Multiple myeloma occurred more commonly in organophosphate exposed than in non-exposed individuals (1 case-control). CONCLUSION: Occupational exposure to organophosphates increases the risk of hematologic malignancies, especially among individuals with longer exposure periods. Worker monitoring and exposure control measures are recommended.


Assuntos
Neoplasias Hematológicas/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Intoxicação por Organofosfatos/complicações , Praguicidas/envenenamento , Humanos , Medição de Risco , Fatores de Risco , Fatores de Tempo
4.
Rev Bras Epidemiol ; 23: e200027, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32401918

RESUMO

OBJECTIVE: To estimate the prevalence of pesticide exposure and associated factors among rural residents. METHODS: A population-based, cross-sectional study conducted with 1,518 individuals in 2016. We randomly selected 24 census tracts from the eight rural districts of the city of Pelotas, RS. All individuals aged 18 years or older, living in the randomly selected households were eligible. A descriptive analysis was performed and the prevalence of contact with pesticides was presented. The association between outcome and independent variables was analyzed using Poisson regression according to the hierarchical model. The variables were all adjusted to the same level, including those at the previous level and those with p<0.20 were kept in the model. RESULTS: The prevalence of contact with pesticides in the past year was 23.7% and among the participants, 5.9% reported having pesticide poisoning at some time in their lives. The probability of contact with pesticides in the past year was higher among men (PR=2,00; 95%CI 1.56 - 2.56), among those aged 40-49 years (PR = 2.00; 95%CI 1.12 - 1.80), among individuals with lower levels of education (PR = 2.06; 95%CI 1.39 - 3.10), in those who performed rural work (PR = 2.87; 95%CI 1.39 - 3.10) and in those who had lived in rural areas all their lives (PR = 1.28 95%CI 1.00 - 1.66). CONCLUSIONS: Approximately one in four adults in rural Pelotas had come into contact with pesticides in the year before the study. The findings show the existence of social inequalities related to exposure to pesticides and provide information for action aimed at reducing exposure and poisoning from these products.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Praguicidas/envenenamento , População Rural/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Brasil/epidemiologia , Estudos Transversais , Fazendeiros/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Prevalência , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
5.
Rev Bras Epidemiol ; 23: e200024, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32401920

RESUMO

BACKGROUND: Pesticide poisoning causes high morbidity and mortality. Surveillance is required for post-marketing monitoring of these products. AIM: To assess poisonings and associated factors with lethality by pesticides. METHOD: This is a case-control study based on the cases of pesticide poisoning assisted in 2017 by Brazilian Poison Control Centers. Patients who died were the cases and the survivors, the control. The odds ratio (OR) of death and 95% confidence interval (CI) were calculated. From the regression model, a predictive model of death was developed, stratified by age, gender and occupational context to investigate the risk of agricultural workers poisoned by extremely hazardous agents. RESULTS: 3,826 patients poisoned by pesticides were identified, of which 146 died. Older people (OR = 4.94; 95%CI 2.49 - 9.80), males (OR = 1.68; 95%CI 1.15 - 2.46), agricultural workers (OR = 2.20; 95%CI 1.15 - 4.24), suicide attempts (OR = 13.27; 95%CI 6.48 - 27.19) and exposure to extremely hazardous products (OR = 2.77; 95%CI 1.84 - 4.16) odds of death from pesticide poisoning. CONCLUSION: Out of 100 pesticides poisoning, four died. Elderly, males, working in the agricultural sector, suicide attempts and extremely hazardous products had a higher risk of death.


Assuntos
Praguicidas/envenenamento , Envenenamento/mortalidade , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Doenças dos Trabalhadores Agrícolas/mortalidade , Brasil/epidemiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Fazendeiros/estatística & dados numéricos , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Tentativa de Suicídio/estatística & dados numéricos , Adulto Jovem
6.
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
7.
Epidemiol Psychiatr Sci ; 29: e114, 2020 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-32299524

RESUMO

AIMS: The 2014 World Health Organization report on global suicide identified large differences in the male-to-female ratio of suicide rates between countries: most high-income countries (HICs) report ratios of 3:1 or higher while many low- and middle-income countries (LMICs) - including China and India - report ratios of less than 1.5:1. Most authors suggest that gender-based social-cultural factors lead to higher rates of suicidal behaviour among women in LMICs and, thus, to relatively high female suicide rates. We aim to test an alternative hypothesis: differences in the method and case-fatality of suicidal behaviour - not differences in the rates of suicidal behaviour - are the main determinants of higher female suicide rates in LMICs. METHODS: A prospective registry of suicide attempts treated in all 14 general hospitals in a rural county in China was established and data from the registry were integrated with population and mortality data from the same county from 2009 to 2014. RESULTS: There were 160 suicides and 1010 medically-treated suicidal attempts in the county; 84% of female suicides and 58% of male suicides ingested pesticides while 73% of female attempted suicides and 72% of male attempted suicides ingested pesticides. The suicide rate (per 100 000 person-years of exposure) was 8.4 in females and 9.1 in males (M:F ratio = 1.08:1) while the incidence of 'serious suicidal acts' (i.e. those that result in death or received treatment in a hospital) was 81.5 in females and 47.7 in males (M:F ratio = 0.59:1). The case-fatality of serious suicidal acts was higher in males than in females (19 v. 10%), increased with age, was highest for violent methods (92%), intermediate for pesticide ingestion (13%) and lowest for other methods (5%). CONCLUSIONS: The incidence of medically serious suicidal behaviour among females in rural China was similar to that reported in HICs, but the case-fatality was much higher, primarily because most suicidal acts involved the ingestion of pesticides, which had a higher case-fatality than methods commonly used by women in HICs. These findings do not support sociological explanations for the relatively high female suicide rate in China but, rather, suggest that gender-specific method choice and the case-fatality of different methods are more important determinants of the demographic profile of suicide rates. Further research that involves ongoing monitoring of the changing incidence, demographic profile and case-fatality of different suicidal methods in urban and rural parts of both LMICs and HICs is needed to confirm this hypothesis.


Assuntos
Praguicidas/envenenamento , Sistema de Registros/estatística & dados numéricos , População Rural , Ideação Suicida , Tentativa de Suicídio/estatística & dados numéricos , Suicídio/psicologia , Adolescente , Adulto , Idoso , Criança , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Mortalidade , Estudos Prospectivos , Distribuição por Sexo , Fatores Sexuais , Fatores Socioeconômicos , Suicídio/etnologia , Suicídio/estatística & dados numéricos , Adulto Jovem
8.
BMC Public Health ; 20(1): 303, 2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32156268

RESUMO

BACKGROUND: Acute pesticide poisoning (APP) is reported to affect community health worldwide but its burden in Tanzania is unknown particularly in women. This study examines APP involving adult females and adolescent girls 10 to 19 years in 3 regions of Tanzania which are famous for coffee and vegetable production. METHODS: Over the period of 12 months, health facility-based surveillance for cases of APP was implemented in 10 Tanzanian healthcare facilities in 2006. RESULTS: The study identified 108 APP cases of whom 31 (28.7%) occurred amongst adolescent girls. Suicide was the leading poisoning circumstances (60.2%) and the most vulnerable women were 20-29 years old who comprised 38.4% of all cases with suicide as circumstance. Organophosphates (OPs), zinc phosphide, paraquat and endosulfan were common amongst known reported poisoning agents. The annual APP incidence, mortality and Case Fatality Rate for women were 5.1/100,000, 0.2/100,000 and 3.7/100, respectively. CONCLUSION: APP amongst women in Tanzania is common and this call for diverse preventive interventions to reduce poisoning incidents.


Assuntos
Praguicidas/envenenamento , Adolescente , Adulto , Criança , Endossulfano/envenenamento , Feminino , Humanos , Incidência , Intoxicação por Organofosfatos/epidemiologia , Paraquat/envenenamento , Fosfinas/envenenamento , Suicídio/estatística & dados numéricos , Tanzânia/epidemiologia , Adulto Jovem , Compostos de Zinco/envenenamento
9.
BMC Public Health ; 20(1): 251, 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32075613

RESUMO

BACKGROUND: Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides from agricultural use has been successful in reducing total suicide numbers in several South Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of highly hazardous pesticides and explore how they might relate to suicide rates across India. METHODS: Information on pesticide regulation was collated from agriculture departments of the central government and all 29 state governments (excluding union territories). National and state-level data on suicides from 1995 to 2015 were obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate the trends in suicide rates nationally and in Kerala, in view of the robust measures Kerala has taken to restrict a number of HHPs, to identify any effect on suicides. RESULTS: As of October 2019, 318 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization toxicity criteria. Despite many highly hazardous pesticides still being available, several bans have been implemented during the period studied. In our quantitative analyses we focused on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995 to 2015, 90.3% of which occurred in 11 of the 29 states. There was statistical evidence of lower than expected rates of pesticide suicides (rate ratio [RR] 0.52, 95% CI 0.49-0.54) and total suicides nationally by 2014 (0.90, 0.87-0.93) after the 2011 endosulfan ban. In Kerala, there was a lower than expected rate of pesticide suicides (0.45, 0.42-0.49), but no change to the already decreasing trend in total suicides (1.02, 1.00-1.05) after the 2011 ban of 14 pesticides. The 2005 ban on endosulfan showed a similar effect - lower than expected pesticide suicides (0.79, 0.64-0.99), but no change to the decreasing trend of total suicides (0.97, 0.93-1.02) in 2010. There was no evidence of a decline in agricultural outputs following the bans. CONCLUSION: Highly hazardous pesticides continue to be used in India and pesticide suicide remains a serious public health problem. However, some pesticide bans do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of highly hazardous pesticides could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.


Assuntos
Agricultura/legislação & jurisprudência , Regulamentação Governamental , Praguicidas/envenenamento , Suicídio/tendências , Humanos , Índia , Governo Estadual
10.
Artigo em Inglês | MEDLINE | ID: mdl-32033179

RESUMO

The flower industry in East Africa has grown in recent years, especially in the production and export of roses. The aim of this study was to assess pesticide use on selected flower farms in Ethiopia. Serum cholinesterase levels in workers were used as a marker of pesticide exposure. This study was a cross-sectional study involving 588 workers from 15 different flower farms. It had a response rate of 95.5%. The participants included 277 males (mean age 26 years; 148 pesticide sprayers and 129 non-sprayers) and 311 females (mean age 25 years; 156 working in greenhouses and 155 working outside the greenhouses). The researchers undertook structured interviews, blood sampling, and walkthrough surveys. Descriptive statistics and Poisson regression were used in the statistical analyses. A total of 154 different trade names of pesticides were found. Of them, 31 (27%) were classified as moderately hazardous by the WHO, and 9% were organophosphates. Serum levels of cholinesterase deviating from 50-140 Michel units were considered abnormal. Abnormal serum cholinesterase levels (above 140 Michel units) were found in 97 participants (16.5%, 95% confidence interval 13.7-19.7%). There were no differences between the four job groups regarding cholinesterase levels. The high prevalence of abnormal serum cholinesterase levels might indicate the presence of pesticide intoxication. Thus, there is a need for routine monitoring of all workers exposed to pesticides, not only sprayers.


Assuntos
Acetilcolinesterase/sangue , Doenças dos Trabalhadores Agrícolas/sangue , Exposição Ocupacional/análise , Praguicidas , Adolescente , Adulto , Doenças dos Trabalhadores Agrícolas/epidemiologia , Monitoramento Biológico , Estudos Transversais , Etiópia/epidemiologia , Fazendeiros , Fazendas , Feminino , Flores , Humanos , Masculino , Organofosfatos , Praguicidas/envenenamento , Adulto Jovem
11.
BMC Health Serv Res ; 20(1): 30, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31918695

RESUMO

BACKGROUND: Pesticides are responsible for a significant percentage of deaths globally with majority occurring in sub-Saharan Africa. Deaths due to pesticide poisoning can be reduced if poisoning cases are managed optimally. However, the quality of care given to pesticide poisoning patients is still insufficient especially in sub-Saharan Africa. This study was aimed at exploring doctors' experiences on quality of care for pesticide poisoning cases in hospitals in Kampala, Uganda. METHODS: Fifteen (15) in-depth interviews were conducted with doctors who were directly involved in management of pesticide poisoning patients in the accident and emergency, Medicine, Pediatrics and Intensive Care Unit wards in 5 hospitals in Kampala, Uganda. All interviews were transcribed and subjected to directed content analysis with the guidance of the Donabedian model of quality of care which emphasizes structure, process and outcome measures as pertinent to ensuring quality of care. RESULTS: Doctors reported structural, process and outcome facets that support diagnosis and treatment of pesticide poisoning cases that improved the quality of care they provided. Among the structures includes hospital units such as Intensive Care Unit (ICU), pediatrics and internal medicine; equipment and clinical guidelines such as airway, breathing and consciousness (ABC) protocol; and doctors' knowledge and experiences. Doctors relied on history, and signs and symptoms to establish the cause and severity of pesticide poisoning. However, some patients and caretakers provided inaccurate pesticide poisoning history. Due to its availability in hospitals, doctors largely relied on atropine to manage pesticide poisoning cases whether or not relevant to treat the actual pesticide active ingredient responsible for the poisoning. Although majority of the cases treated recovered, those due to suicide were further referred to the hospital psychiatrist. Sharing experiences of managing pesticide poisoning patients among health workers and engaging in sensitization outreaches against pesticide poisoning were reported as potential activities to improve quality of care for pesticide poisoning patients. CONCLUSION: Doctors reflected on the structure, process and outcome measures of quality of care given to pesticide poisoning patients. The implications of hospital structures and clinical process to the quality of the outcomes of care demonstrates their importance in improving management of pesticide poisoning cases in hospitals in Kampala, Uganda.


Assuntos
Atitude do Pessoal de Saúde , Corpo Clínico Hospitalar/psicologia , Praguicidas/envenenamento , Envenenamento/terapia , Qualidade da Assistência à Saúde , Feminino , Hospitais , Humanos , Masculino , Corpo Clínico Hospitalar/estatística & dados numéricos , Avaliação de Processos e Resultados em Cuidados de Saúde , Pesquisa Qualitativa , Resultado do Tratamento , Uganda
12.
J Fluoresc ; 29(6): 1475-1485, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31792741

RESUMO

The combined use of 3D-fluorescence spectroscopy and independent component analysis using a differential fingerprinting approach has been applied with success to detect physiological effects of dimethoate in honeybees. Biochemical determinations combined with the identification of fluorescence zones that may correspond to proteins, NADH or neurotransmitters/neurohormones (octopamine, dopamine and serotonin) related to the physiological stress caused by the pesticide enabled phenomenological modeling of the physiological response in the honeybee using a simple and rapid method. The signals associated with the fluorophores involved in the response to stress were extracted from the fluorescence spectra using an unsupervised algorithm such as independent component analysis. The signals of different neurotransmitters were isolated on separated factorial components, thus facilitating their biochemical interpretation.


Assuntos
Abelhas/efeitos dos fármacos , Dimetoato/análise , Fluorescência , Praguicidas/análise , Acetilcolinesterase/metabolismo , Animais , Biomarcadores/metabolismo , Dimetoato/metabolismo , Dimetoato/farmacologia , Praguicidas/envenenamento , Espectrometria de Fluorescência
13.
Artigo em Inglês | MEDLINE | ID: mdl-31816899

RESUMO

Suicide is a major public health concern in South Korea, and self-poisoning by pesticides is one of the common methods of suicide. Pesticide ban policies have been successful for suicide prevention; however, no studies have shown their effect according to occupational groups. The present study analyzed suicide and suicide by pesticide rates among South Korean workers aged 15-64 in 2003-2017, their associations with occupational groups, and the impact of three major economic indices on these factors. Workers in the agriculture, forestry, and fishery industries had relative risks of 5.62 (95% CI: 5.54-5.69) for suicide overall and 25.49 (95% CI: 24.46-26.57) for suicide by pesticide. The real gross domestic product had a positive association with suicide overall only in the last five-year period investigated in this study, and the unemployment rate consistently had a positive association. The economic status and policy for suicide prevention affected suicide and suicide by pesticide rates differently among occupational groups and different time periods. Policy addressing suicidal risk for different occupational groups should be of concern in South Korea.


Assuntos
Ocupações/estatística & dados numéricos , Praguicidas/envenenamento , Suicídio/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Adolescente , Adulto , Agricultura , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Desemprego/psicologia , Adulto Jovem
14.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi ; 37(11): 877-880, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31838827

RESUMO

Aluminum phosphide (ALP) is frequently used for grain conservation despite its high toxicity. In some developing countries increased utilization of ALP has resulted in increment of ALP-attributed poisoning numbers. The mortality of ALP poisoning is extremely high and no effective antidote is available so far. However, the astute survey of potential misconceptions in the course of acute toxicity has led some scientists to introduce novel therapeutic approaches. Meanwhile, some new antioxidants were discovered and expected to be used in the management of ALP poisoning. In addition, the progress in intensive care has promoted technologies such as CRRT, IABP and ECMO for the treatment of ALP poisoning with reported success in alleviating severe toxicity. Recent studies on the therapy of ALP poisoning are reviewed in this article.


Assuntos
Compostos de Alumínio/envenenamento , Praguicidas/envenenamento , Fosfinas/envenenamento , Envenenamento/terapia , Antioxidantes/uso terapêutico , Humanos
15.
Glob Health Action ; 12(1): 1692616, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31775583

RESUMO

Background: Pesticide self-poisoning as a method of suicide is a major global health problem.Objectives: To estimate the cost and per patient cost of treating pesticide self-poisoning at different hospital levels in a Sri Lankan district, and to examine the distribution of cost components. Another objective was to investigate changes in total cost of treatment of pesticide poisoning for all causes at different administrative levels in Sri Lanka in 2005 and 2015.Methods: The economic framework was a costing analysis, adopting a government perspective. Cost data were collected prospectively over a 4-month period in 2016 for patients admitted for pesticide self-poisoning to six hospitals in the Anuradhapura District. Assumption-based scenario analyses were run to determine changes in total pesticide poisoning treatment costs.Results: We included 67 self-poisoned patients in the study. The total cost of treatment was US$ 5,714 at an average treatment cost of US$ 85.3 (9.7-286.6) per patient (across all hospital levels). Hospital costs constituted 67% of the total cost for treating self-poisoning cases and patient-specific costs accounted for 29%. Direct cost of patient hospital transfer constituted the smallest share of costs (4%) but accounted for almost half of the total costs at primary level. The estimated total cost of treating all causes of pesticide poisoning in Sri Lanka was US$ 2.5 million or 0.19% of the total government health expenditure (GHE) in 2015.Conclusion: Our findings indicate that the average per patient cost of pesticide self-poisoning treatment has increased while the total cost of pesticide poisoning treatment as a percentage of the total GHE in Sri Lanka has declined over the past decade. A continuous focus on banning the most hazardous pesticides available would likely further drive down the cost of pesticide self-poisoning and pesticide poisoning to the government.


Assuntos
Financiamento Governamental/economia , Financiamento Governamental/estatística & dados numéricos , Custos de Cuidados de Saúde/estatística & dados numéricos , Praguicidas/economia , Praguicidas/envenenamento , Suicídio/economia , Suicídio/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sri Lanka , Adulto Jovem
16.
PLoS One ; 14(10): e0222617, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31577819

RESUMO

Despite substantial research on the economic effects of transgenic insect-resistant Bacillus thuringiensis (Bt) cotton, there is still limited work on this technology's impacts on human health. Due to the inbuilt insect resistance, Bt cotton requires fewer pesticide sprays than conventional cotton, which is not only advantageous from economic and environmental perspectives, but may also result in health benefits for farmers. Using socioeconomic and biophysical data from Pakistan, we provide the first evidence of a direct association between Bt gene expression in the plant and health benefits. A key feature of this study is that Bt cotton cultivation in Pakistan occurs in a poorly regulated market: farmers are often mistaken in their beliefs about whether they have planted Bt cotton or conventional cotton, which may affect their pesticide-use strategies and thus their pesticide exposure. We employ a cost-of-illness approach and variations in the measurement of Bt adoption to estimate the relationship between Bt cotton and farmers' health. Bt adoption based on farmers' beliefs does not reduce the pesticide-induced cost of illness. However, adoption based on measuring Bt gene expression is associated with significant health cost savings. Extrapolating the estimates for true Bt seeds to Pakistan's entire Bt cotton area results in annual health cost savings of around US$ 7 million. These findings have important implications for the regulation of seed markets in Pakistan and beyond: improved regulations that ensure claimed crop traits are really expressed can increase the benefits for farmers and society at large.


Assuntos
Fazendeiros , Gossypium/genética , Saúde , Fenômenos Biofísicos , Gastos em Saúde , Humanos , Paquistão , Praguicidas/envenenamento , Plantas Geneticamente Modificadas , Autorrelato
17.
Environ Sci Pollut Res Int ; 26(32): 33135-33145, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31520378

RESUMO

Aluminum phosphide (AlP) is considered now one of the most common causes of poisoning among agricultural pesticides. Poisoning with AlP is extremely toxic to humans with high mortality rate. The aim of this work was to evaluate the prognostic factors and outcome of acute aluminum phosphide poisoning in Alexandria Main University Hospital during a period of 6 months from 1 November 2017 until the end of April 2018, highlighting the role of SOFA score and echocardiography in predicting the mortality. The prospective study was conducted on all patients admitted with acute AlP poisoning to Alexandria Main University Hospital for those 6 months. Patients' data were collected in a special sheet and included biosocial data, medical history, poisoning history, complete medical examination, investigations, duration of hospital stay, and the outcome. All patients were assessed according to SOFA score on admission. Thirty patients were admitted during the period of the current study. Females outnumbered males in all age groups with a sex ratio of 2.75:1. The mean age of patients was 22.77 ± 12.79 years. 96.6% of patients came from rural areas. 93.3% of the cases were exposed to poisoning at home, where suicidal poisoning accounted for (86.7%) of cases. 43.3% of patients died (n = 13), and the median value of SOFA score among non-survivors was 10, versus 1 among survivors. The median value of ejection fraction among non-survivors (25%) was half its value in survivors (50%). Although there were many predictors of severity of AlP poisoning, SOFA score was the most predictive factor of mortality detected by multivariate analysis.


Assuntos
Compostos de Alumínio/envenenamento , Praguicidas/envenenamento , Fosfinas/envenenamento , Envenenamento/diagnóstico , Adolescente , Adulto , Criança , Ecocardiografia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Envenenamento/epidemiologia , Envenenamento/etiologia , Estudos Prospectivos , Adulto Jovem
19.
Ann Saudi Med ; 39(4): 229-235, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31381368

RESUMO

BACKGROUND: Poisoning among the pediatric population is an important public health concern that is responsible for frequent pediatric emergency department visits and hospital admissions. Surveillance of poisoning cases is essential for designing and implementing effective preventive strategies. OBJECTIVE: Describe the characteristics of acute poison exposure and related therapeutic interventions in children aged 12 years and younger. DESIGN: Prospective, descriptive cross-sectional study. SETTING: Two pediatric emergency departments in Riyadh. PATIENTS AND METHODS: We prospectively reviewed pediatric poisonings that presented to emergency departments over a period of two years. MAIN OUTCOME MEASURES: Epidemiological aspects of pediatric poisoning Riyadh. SAMPLE SIZE: 1035 patients. RESULTS: The median (IQR) age at the time of exposure was 27 (23-42) months. The most frequently involved substance class was toxic household products in children younger than 6 years and pesticides in children 6 years or older. A frequently involved single agent was paracetamol in younger and older children. The majority of patients (78.7%) were completely asymptomatic at the time of presentation and during the observation period. Almost half of the exposure incidents (47.8%) needed no intervention. Most exposure incidents (95%) did not require any pharmacological support and most (87%) did not require nonpharmacological intervention. Eight (0.7%) patients required intubation and mechanical ventilation. Activated charcoal was administered for 27% of cases. Gastric lavage, whole bowel irrigation, and ipecac were used in a few cases (1%, 0.3%, and 0.1%, respectively). Enhanced elimination interventions were performed for only 0.5% of exposure cases. Only two patients died. CONCLUSIONS: Household products were the commonest reason for pediatric poisonings in Saudi Arabia and most of them were asymptomatic. Our results suggest a need for strategic plans for prevention and care. LIMITATIONS: May not be representative of the experiences and practices of smaller hospitals in remote regions of the country. CONFLICT OF INTEREST: None.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Produtos Domésticos/envenenamento , Praguicidas/envenenamento , Envenenamento/epidemiologia , Fatores Etários , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Envenenamento/terapia , Estudos Prospectivos , Arábia Saudita/epidemiologia
20.
Artigo em Inglês | MEDLINE | ID: mdl-31331061

RESUMO

BACKGROUND: Pesticide poisoning is an important issue in rural China, and is also a major public health problem that affects the health of farmers. The purpose of this paper is to explore the epidemiology of pesticide poisoning in Jiangsu Province, and to put forward the relevant suggestions on the logical and discerning utilization of the pesticides. METHODS: According to the data of the pesticide poisoning report card established by the health hazard detection information system, the cases of pesticide poisoning in Jiangsu Province from 2006 to 2018 were exported to Excel, and the database of pesticide poisoning was established. Furthermore, the imported data was screened and collected. A descriptive statistical analysis had been employed on this data utilizing SPSS 20.0. RESULTS: Between the years 2006 and 2018, 38,513 pesticide poisoning cases were registered in Jiangsu Province, with a downward trend. Meanwhile, 77.83% of poisoning cases involved insecticide poisoning, followed by herbicide and rodenticide. The greater part of the diverse sorts of studied insecticide poisoning cases involved people aged between 30 and 59 years (57.51%). Poisoning cases caused by rodenticide accounted for a large proportion of people aged between 0 and 14 years (23.72%) in non-occupational pesticide poisoning. Regarding seasons, it was distinguished that more insecticide cases were reported in autumn (46.95% of the total number of cases). Pesticide poisoning was reported in 13 cities of Jiangsu Province, and among these, insecticide poisoning was reported mainly from the northern Jiangsu area, which was the same as rodenticide and herbicide. CONCLUSIONS: Although there is a decreased risk for pesticide poisoning among farmworkers in Jiangsu Province, the number of farmworkers with pesticide poisoning is still high. Further management of the pesticide utilization is necessary, especially insecticide. More attention ought to be paid to the protection of vulnerable groups, including children and the elderly.


Assuntos
Praguicidas/envenenamento , Envenenamento/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , China/epidemiologia , Fazendeiros , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , População Rural , Estações do Ano , Adulto Jovem
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