Prospective study of spectrum, clinico-epidemiology, profile complication and outcome of pesticide poisoning in children

Authors

  • K. Visweswara Rao Department of Paediatrics, Konaseema Institute of Medical Science, Amalapuram, Andhra Pradesh, India
  • G. Ramesh Department of Paediatrics, Konaseema Institute of Medical Science, Amalapuram, Andhra Pradesh, India
  • Anand Acharya Department of Pharmacology, Konaseema Institute of Medical Science, Amalapuram, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20190680

Keywords:

Children, Clinical profile, Complication, Pesticide poisoning

Abstract

Background: Konaseema region of Andhra Pradesh is a rural area having well irrigated lands and rice fields. Agriculture is the major some of income, and pesticide use is high.  As per one report of deccan chronicle (a daily newspaper) Andhra Pradesh and Telangana accounts for 24% share of pesticide consumption in the country. Pediatric pesticide poisoning is under reported in India as well. In this background resent study has been designed to study clinic-epidemiology, profile, complication and treatment outcome of pesticide poisoning in Konaseema region of Andhra Pradesh.

Methods: In present study clinico-epidemiology, clinical profile, complication and outcome of the patient admitted in the Department of Emergency medicine and Paediatric were evaluated over a period of 12years.

Results: Most of the children were above 5years of age that is 74.0% (n=40), rest were below 5years of age. Male children out numbered female children and accounted for 77.78% (n=42). Accidental poisoning was more than suicidal poisoning that is 94.59% of the patients. 9.35% patient (n=5) developed respiratory failure and required ventilator support. Non-carcinogenic pulmonary edema was present in 8 (14.81%) patients. Four patients have atropine toxicity, electrolyte in balance was found in 7.4% (n=4) patients. Acute kidney injury was present in two patients, 5.5% (n=3) patients developed cardiac arrhythmia.

Conclusions: Chlorpyrifos was common agent which is responsible for poisoning most common complication in our patients were respiratory complications which required ventilatory support. Lack of information, improper disposal of container, non-existence of training and regulation is supported to the cause of accidental exposure of pesticide to paediatric patients.

References

Thundiyil JG, Stober J, Besbelli N, Pronczuk J. Acute pesticide poisoning: a proposed classification tool. Bulletin World Health Organization. 2008;86:205-9.

Jeyaratnam J. Acute pesticide poisoning: a major global health problem. World Health Stat Q 1990; 43:139-44.

Dr Lynn Goldman WHO, Mr. Bill Murray, FAO, Dr. Bo Wahlström, UNEP Childhood pesticide poisoning: Information for advocacy and action, the Chemicals Programme of the United Nations Environment Programme (UNEP Chemicals) May 2004.

Food and Agriculture Organization of the United Nations, The Future of Food and Agriculture: Trends and challenges, FAO, Rome, 2017, p. x, Available at: .

Sabina Hyseni, Understanding the Impacts of Pesticides on Children: A discussion paper, United Nations Children’s Fund (UNICEF) January 2018. Available at: https://www.unicef.org/csr/files/Understanding_the_impact_of_pesticides_on_children-_Jan_2018.pdf.

Gautami S, Sudershan RV, Bhat RV, Suhasini G, Bharati M, Gandhi KP. Chemical poisoning in three Telengana districts of Andhra Pradesh. Forensic Sci Int. 2001;122(2-3):167-71.

Srinivas Rao Ch, Venkateswarlu V, Surender T, Eddleston M, Buckley NA. Pesticide poisoning in south India: opportunities for prevention and improved medical management. Trop Med Int Health. 2005;10(6):581-8.

Dayasiri KC, Jayamanne SF, Jayasinghe CY. Patterns of acute poisoning with pesticides in the paediatric age group. Int J Emergency Med. 2017;10(1):22.

nMaster 2.0 sample size software. Available at: https://www.cmc-biostatistics.ac.in/nmaster.

Roberts JR, Karr CJ, Council on environmental Health. Pesticide exposure in children. Pediatr. 2012;130(6):e1765-88.

Lu C, Fenske RA, Simcox NJ, Kalman D. Pesticide exposure of children in an agricultural community: evidence of household proximity to farmland and take-home exposure pathways. Environ Res. 2000;84(3):290-302.

Lekei E, Ngowi AV, London L. Acute pesticide poisoning in children: hospital review in selected hospitals of Tanzania. J Toxicol. 2017;2017.

Zwiener RJ, Ginsburg CM. Organophosphate and carbamate poisoning in infants and children. Pediatr. 1988;81(1):121-6.

El-Naggar AE, Abdalla MS, El-Sebaey AS, Badawy SM. Clinical findings and cholinesterase levels in children of organophosphates and carbamates poisoning. European J Pediatr. 2009;168(8):951.

Nehal M Shah, Shashikumar H Mundhra, Clinical profile of organophosphate poisoning at a tertiary-care center. Int J Med Sci Public Health. 2016;5(8): 1621-5.

Peter JV, Jerobin J, Nair A, Bennett A, Samuel P, Chrispal A et al,Clinical profile and outcome of patients hospitalized with dimethyl and diethyl organophosphate poisoning. Clinical toxicol. 2010;48(9):916-23.

Chintale KN, Patne SV, Chavan SS. Clinical profile of organophosphorus poisoning patients at rural tertiary health care centre. Int J Advances Med. 2017;3(2):268-74.

Edwin J George, Jayaraj K, John J Manjaly, Raghunath M. Clinical profile and outcome of organophosphate poisoning in south Kerala, Int J Recent Trends Sci Technol. 2015;14(2):338-43.

Eddleston M, Mohamed F, Davies JO, Eyer P, Worek F, Sheriff MR, et al. Respiratory failure in acute organophosphorus pesticide self-poisoning. J Assoc Physic. 2006;99(8):513-22.

Faiz MS, Mughal S, Memon AQ. Acute and late complications of organophosphate poisoning. J Coll Physicians Surg Pak. 2011;21(5):288-90.

Saadeh AM, Farsakh NA, al-Ali MK. Cardiac manifestations of acute carbamate and organophosphate poisoning. Heart. 1997;77(5):461-4.

Laudari S, Patowary BS, Sharma SK, Dhungel S, Subedi K, Bhattacharya R, et al. Cardiovascular effects of acute organophosphate poisoning. Asia Pacific J Med Toxicol.2014;3(2):64-7.

Detweiler MB. Organophosphate intermediate syndrome with neurological complications of extrapyramidal symptoms in clinical practice. J Neuro Sci Rural Pract. 2014;5:298-301.

Downloads

Published

2019-02-23

Issue

Section

Original Research Articles