Pesticide poisoning

Pesticides are chemicals designed to protect crops from various pests and diseases. But are they so safe for humans? Practice shows that the danger of pesticide poisoning does exist, and intoxication can be quite strong, and the consequences - serious. So how harmful are pesticides, and what to do in case of poisoning by these chemicals?

Epidemiology

The use of toxic chemicals in agriculture has declined somewhat over the past decade, but pesticide poisoning still ranks among the leading chemical intoxications. Mass pesticide poisoning is the most frequently registered, which is especially relevant for developing countries. For example, in Nicaragua, 80% of pesticide poisonings are of mass occupational nature.

On average, pesticide intoxication accounts for about 12% of all intoxications, and this is not insignificant. Poisonings are recorded mainly in rural areas. [1]

Causes of the pesticide poisoning

Pesticide poisonings are divided into occupational and household poisonings depending on the causes.

• Occupational poisonings include those that occur among those who work in pesticide manufacturing, seed dressing, or field and horticultural operations. Poisoning can occur during maintenance of processing equipment, accidental release of pesticides, or ingestion of food or water with traces of a toxic substance. Intoxication can also develop when working with treated plants - for example, if a gardener is pruning, weeding, etc. However, most patients with occupational pesticide poisoning are caused by non-compliance with safety rules - for example, if the work is performed without the use of personal protective equipment. The rules of transportation and storage of chemical reagents are often violated, and the time limits for visiting treated gardens and fields are not observed.
• Domestic intoxications are typical among people who have no professional contact with pesticides. For example, many dacha dwellers improperly store chemicals in their dwellings, where they can be easily confused with something else and misused. In addition, it is not uncommon to use pesticide containers to store food products, which is categorically unacceptable. And some gardeners cultivate their land without observing safety rules. All this can lead to severe pesticide poisoning. [2]

Risk factors

The populations most susceptible to pesticide poisoning are:

• Workers in the chemical and agricultural industries;
• Gardeners, gardeners, gardeners;
• Children and the elderly.

Poisoning is most often accidental rather than intentional. Factors that exacerbate the clinical picture include:

• Chronic illnesses, recent surgeries;
• The young age of the victim;
• Alcoholism;
• Frequent stress, malnutrition, mental illness. [3]

Pathogenesis

Pesticide is a collective term for a variety of chemical compounds capable of protecting crops and animals from diseases and pests. The use of such substances is technically simple, inexpensive and quite effective, so they are often used both by professional agrarian and agricultural organizations and ordinary amateur gardeners.

Pesticides are many chemical compounds that differ in structure and action. To date, several classifications are known:

• Insectoacaricides - agents that affect harmful insects;
• Nematicides - pesticides to kill worms;
• Rodenticides - agents directed against rodents;
• Herbicides - weed killers, etc.

According to their chemical structure, pesticides can be organochlorine, mercury-containing, arsenic-containing, phenol-containing, organophosphorus-containing and so on.

The usual dilutions of preparations recommended for treatment are considered to be low-toxic, low-strength, and have no cumulative properties. Nevertheless, acute, subacute or chronic poisoning may develop in case of direct contact of pesticides with the human body. At the same time, any dose of pesticides is characterized by xenobiotoxic properties and can cause certain disorders in the organism.

The main mechanism of toxic effect is the reaction of stimulation of free radical processes, which are regulated by the system of antioxidants. Stability of functional and structural indicators of biological membranes is disturbed, which leads to disruption of structural and functional organization of cells. In general, such changes cause a failure in the systemic work of the body, in the course of adaptation and defense reactions, which entails the development of immunodeficiency states. [4]

Symptoms of the pesticide poisoning

Signs of acute pesticide poisoning in the mild form are manifested by headache, dizziness, feeling of weakness in arms and legs, sharp deterioration of vision, dyspepsia, increased salivation. Patients are usually restless and anxious. On examination, pupil constriction, insufficient response to light stimulus, increasing spasm of accommodation, worsening adaptation to darkness are observed. There is nystagmus at extreme eyeball retraction, facial puffiness, hyperhidrosis.

The first signs do not occur immediately, as pesticide poisoning manifests itself in certain stages:

• The latent stage, which lasts from the moment of intoxication until the first visible symptoms, and can last either a couple of hours or several days;
• Precursor stage - characterized by signs of nonspecific poisoning (nausea, periodic vomiting, state of weakness and fatigue, headache);
• Intoxication build-up stage (specific signs of pesticide poisoning appear).

The subacute pathologic state is typified by a weak reaction of the organism to toxic effects and a more prolonged intoxication process. Although in children and weakened patients sensitivity to toxic substances may be higher.

Chronic poisoning is characterized by persistent pain in the head (more often in the temples), general heaviness, dizziness, memory impairment, sleep and appetite disorders, nausea, loss of efficiency. Often recorded bradycardia, a decrease in blood pressure. Some patients are found to have disorders of the biliary system, gastric secretion is disturbed, allergic reactions in the form of dermatitis and bronchitis often occur. [5]

Complications and consequences

The consequences of intoxication depend on many factors:

• From the amount of poison ingested;
• The degree of fullness of the stomach (if the pesticide has been swallowed);
• On how quickly first aid is administered to the victim.

In general, the consequences can be as follows:

• Visual impairment, optic nerve damage;
• Paresis, paralysis of arms and legs;
• Stomach ulcer;
• Toxic liver damage;
• Acute pancreatitis;
• Development of psychosis, other disorders of the nervous system;
• Acute respiratory failure;
• Heart failure;
• Acute renal failure;
• Encephalopathy;
• Comatose;
• The patient's death.

Severe pesticide poisoning is accompanied by coma. In deep coma, the victim loses sensation, loss of tendon reflexes, hypotonia of muscles, drop in blood pressure. If no assistance is rendered, the person may die. [6]

Diagnostics of the pesticide poisoning

All patients brought to the hospital for pesticide poisoning are given a general clinical examination, which includes:

• Blood and urine tests, blood chemistry;
• Electrocardiography, ultrasound examination of abdominal and chest organs;
• Chest X-ray;
• Electroencephalography.

General clinical biochemical diagnostics consists in the assessment of renal and liver functional capacity according to standard accepted methods.

Auscultation of respiratory organs allows you to listen to stiff breathing, dry rales. The cardiovascular system demonstrates tachycardia changing to bradycardia. Heart tones are muffled, the electrocardiogram shows prolongation of the P-Q interval, decreased P and T teeth, indicating initial suppression of the sinus node. Changes on the electrocardiogram are present within a week from the moment of pesticide poisoning.

Electroencephalography allows detection of moderately altered background activity, which is manifested by disruption of the organization of baseline brain activity.

In the laboratory, the blood shows a decrease in oxygen concentration, a deviation towards acidosis, potassium deficiency, symptoms of increased blood clotting are present, and cholinesterase activity is decreased.

Differential diagnosis

Differential diagnosis is appropriate with other anticholinesterase intoxications - first of all, poisoning by medications is considered: Proserine, Pilocarpine, Galantomine. When differentiating, it should be taken into account that the voiced drugs transiently inhibit cholinesterase, so their activity is easily inhibited with atropine. In pesticide poisoning, the effect of poisons is present for a long time, and atropine acts only after several cholinolytic injections.

In addition, intoxication is differentiated with pulmonary edema, acute appendicitis and peritonitis, acute circulatory failure in the brain. [7]

Treatment of the pesticide poisoning

In case of pesticide poisoning in the first 1-2 hours from the moment of intoxication onset, it is necessary to provide nonspecific detoxification therapy, including abundant shower with detergent, use of saline laxatives, gastric lavage followed by sorbent preparation. It is recommended to drink a large volume of alkaline water (up to two or three liters per day): at the same time take diuretics, infusion of reopolyglucin (or reosorbilact, up to 400 ml per day), carry out symptomatic treatment.

In severe poisoning during the first 48 hours, sorbitol solution or sulfuric magnesia (25 g per glass of water three times a day) is administered, which leads to the development of osmolar diarrhea.

In acute pesticide poisoning the antidote is 0.1%atropine sulfate, which is administered in the amount of 1-2 ml. It is possible repeated administration of antidote with a half-hour interval until disappearance of signs of cholinergic syndrome.

Severe poisoning requires additional administration of cholinesterase reactivators:

• 15% dipyroxime bromide 1 ml intravenously or intramuscularly up to three times daily with a minimum interval of 1 hour;
• 10% diethixim 1-2 ml for the first two days.

Emergency drug administration is usually not accompanied by clinically significant adverse events. However, the possibility of an allergic reaction cannot be excluded. If this happens, urgent measures are taken to replace the drug with another pharmacological analog.

On the second day, additional diagnostics for violations of basic body functions are performed.

First aid in case of pesticide poisoning

First aid is started with emergency blocking of toxic substance entry into the body. If necessary, use a respirator or gas mask, remove the victim from the zone of action of the toxic chemical. Clothing is removed, open areas of the body are treated with 5% ammonia solution or ordinary water.

If the pesticide solution has been swallowed, the stomach and intestines should be cleaned as a matter of urgency:

• Induce vomiting by first drinking several cups of water and one cup of water with a small amount of soap dissolved;
• Give the victim a laxative drug (any, except castor oil).

After cleansing the stomach and intestines should give the patient a glass of milk or decoction of oatmeal, provide lying down and rest. If the victim complains of weakness, you can offer him a cup of strong coffee without sugar.

An ambulance must be called or the person must be transported to a hospital emergency room. [8]

Prevention

Preventive measures to avoid pesticide poisoning include these recommendations:

• If professional activity is connected with production, packing or transportation of pesticides, it is necessary to use all necessary personal protective equipment, wash hands and face frequently, rinse mouth, avoid direct contact with chemical substances.
• It is important to take care of proper storage of pesticides - in tightly sealed containers, with signed labels, in places inaccessible to children, the elderly and mentally unstable people, away from residential areas. The storage area should be well ventilated and free of potential ignition sources.
• When handling or diluting pesticides, make sure that there are no people - especially children - around. Do not forget about safety regulations.
• In case of any suspicion of pesticide poisoning, it is necessary to seek medical help as soon as possible - to a toxicologist, epidemiologist, infectious disease specialist.

Forecast

Pesticides are quite dangerous poisonous substances. However, in agriculture and agrarian sector it is quite difficult to grow a good crop without them. Therefore, if all safety measures are observed, these chemicals do not pose a danger to humans. Nevertheless, pesticide poisoning is quite common. This is a painful condition caused by ingestion of pesticides. Most often, acute poisoning requiring emergency medical intervention is recorded.

Before the arrival of doctors, first aid should be provided by the victim's immediate environment. The prognosis for the patient's life and health largely depends on this. If help was provided in a timely and complete manner, pesticide poisoning can be cured without any negative consequences for the body.