Pesticide poisoning

Pesticides are chemical agents designed to protect crops from various pests and diseases. But are they safe for humans? Practice shows that the danger of pesticide poisoning really exists, and intoxication can be quite strong, and the consequences can be serious. So just how harmful are pesticides, and what to do if you get poisoned by these chemicals?

Epidemiology

Over the past ten years, the use of toxic chemicals in agriculture has somewhat decreased, but pesticide poisoning still occupies one of the leading places among all chemical intoxications. Most often, mass pesticide poisoning is recorded, which is especially important for developing countries. For example, in Nicaragua, 80% of pesticide poisonings are of mass occupational nature.

On average, among all intoxications, pesticide damage is approximately 12% and this is a lot. Poisonings are recorded mainly in rural areas. [1]

Causes of the pesticide poisoning

Pesticide poisoning, depending on the causes, is divided into professional and domestic.

• Occupational poisonings include those that are noted among those who work in enterprises for the manufacture of pesticides, seed dressing or processing fields and horticultural farms. Poisoning can occur during the maintenance of processing equipment, by accidental release of pesticides, by ingestion of food or water with traces of a toxic substance. Intoxication can also develop when working with treated plants - for example, if the gardener is pruning, weeding, etc. However, in most patients with occupational pesticide poisoning, the cause is non-compliance with safety rules - for example, if the work is performed without the use of personal protective equipment. The rules for the transportation and storage of chemical reagents are often violated, the deadlines for visiting treated gardens and fields are not observed.
• Household intoxications are typical among people who do not have professional contact with pesticides. For example, many summer residents store chemicals incorrectly in residential areas, where they can be easily confused with something and used for other purposes. In addition, cases of using pesticide containers for food storage are not uncommon, which is categorically unacceptable. And some gardeners cultivate their land holdings without observing safety regulations. All this can lead to severe pesticide poisoning. [2]

Risk factors

The following population groups are most susceptible to pesticide poisoning:

• workers in the chemical and agricultural industries;
• summer residents, gardeners, gardeners;
• children and the elderly.

Poisonings are most often accidental rather than intentional. The following factors exacerbate the clinical picture:

• chronic diseases, recent surgeries;
• young age of the victim;
• alcoholism;
• frequent stress, malnutrition, mental illness. [3]

Pathogenesis

Pesticides is a collective term for chemical compounds of different composition that can protect cultivated plants and animals from diseases and pests. The use of such substances is technically simple, they are inexpensive and quite effective, so they are often used by both professional agrarian and agricultural organizations and ordinary amateur gardeners.

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

• insectoacaricides - agents that act on harmful insects;
• nematicides - pesticides to kill worms;
• rodenticides - means directed against rodents;
• herbicides - means that destroy weeds, etc.

According to the chemical structure, pesticides can be organochlorine, mercury-containing, arsenic, phenol-containing, organophosphorus, etc.

The usual dilutions of drugs recommended for processing are considered to be of low toxicity, low persistence, and do not have cumulative properties. However, with direct contact with pesticides in the human body, acute, subacute or chronic poisoning can develop. At the same time, any dose of pesticides is distinguished by xenobiotic properties and can cause certain disorders in the body.

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

Symptoms of the pesticide poisoning

Signs of acute pesticide poisoning in a mild form are manifested by pain in the head, dizziness, a feeling of weakness in the arms and legs, a sharp deterioration in vision, dyspepsia, and increased salivation. Patients are usually restless and anxious. On examination, there is a narrowing of the pupils, an insufficient reaction to a light stimulus, an increase in spasm of accommodation, a deterioration in adaptation in the dark. There is nystagmus with extreme abduction of the eyeballs, puffiness of the face, hyperhidrosis.

The first signs do not appear immediately, since pesticide poisoning manifests itself in certain stages:

• a hidden stage that lasts from the moment of intoxication to the first visible symptoms, and can last either a couple of hours or several days;
• the precursor stage - characterized by signs of non-specific poisoning (nausea, periodic vomiting, weakness and fatigue, headache);
• stage of increasing intoxication (specific signs of pesticide poisoning appear).

For a subacute pathological condition, a weak reaction of the body to toxic effects and a longer intoxication process are typical. Although children and debilitated patients may be more sensitive to toxic substances.

Chronic poisoning is characterized by persistent pain in the head (often in the temples), general heaviness, dizziness, memory impairment, sleep and appetite disorders, nausea, and a drop in efficiency. Often fixed bradycardia, lowering blood pressure. In some patients, disorders of the biliary system are found, the secretion of the stomach is disturbed, allergic reactions often occur in the form of dermatitis and bronchitis. [5]

Complications and consequences

The consequences of intoxication depend on many factors:

• on the amount of poison that has entered the body;
• on the degree of fullness of the stomach (if the pesticide was swallowed);
• on how quickly first aid was provided to the victim.

In general, the consequences can be as follows:

• blurred vision, damage to the optic nerve;
• paresis, paralysis of arms and legs;
• stomach ulcer;
• toxic damage to the liver;
• acute pancreatitis;
• the development of psychosis, other disorders of the nervous system;
• acute insufficiency of the respiratory system;
• insufficiency of cardiac activity;
• acute renal failure;
• encephalopathy;
• coma;
• death of the patient.

Severe pesticide poisoning is accompanied by a coma. With a deep coma, the victim loses sensitivity, there is a loss of tendon reflexes, muscle hypotension, and a drop in blood pressure. If help is not provided, a person may die. [6]

Diagnostics of the pesticide poisoning

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

• blood and urine tests, blood biochemistry;
• electrocardiography, ultrasound examination of the abdominal cavity and chest;
• chest x-ray;
• electroencephalography.

General clinical biochemical diagnostics consists in assessing the functional ability of the kidneys and liver according to standard accepted methods.

Auscultation of the respiratory organs allows you to listen to hard breathing, dry wheezing. The cardiovascular system demonstrates tachycardia, turning into bradycardia. The heart sounds are muffled, the PQ interval is noticeably lengthened on the electrocardiogram, the P and T waves are reduced, which indicates the initial depression of the sinus node. Changes on the electrocardiogram are present within a week from the moment of pesticide poisoning.

Electroencephalography allows you to detect moderately altered background activity, which manifests itself in a violation of the organization of basic brain activity.

Laboratory in the blood there is a decrease in oxygen concentration, a deviation towards acidosis, a lack of potassium, there are symptoms of increased blood coagulation, cholinesterase activity decreases.

Differential diagnosis

Differential diagnosis is appropriate with other anticholinesterase intoxications - first of all, drug poisoning is considered: Prozerin, Pilocarpine, Galantomin. When differentiating, it should be taken into account that the mentioned drugs temporarily inhibit cholinesterase, so their activity is easily inhibited by atropine. In case of pesticide poisoning, the action of poisons is present for a long time, and atropine acts only after several anticholinergic injections.

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

Treatment of the pesticide poisoning

In case of pesticide poisoning, already in the first 1-2 hours from the onset of intoxication, non-specific detoxification therapy should be provided, including a plentiful shower with detergent, the use of saline laxatives, a gastric lavage procedure, followed by taking a sorbent preparation. It is recommended to use a large volume of alkaline water (up to two or three liters per day): at the same time take diuretics, infusion of rheopolyglucin (or rheosorbilact, up to 400 ml per day), symptomatic treatment is carried out.

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

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

Severe poisoning requires additional administration of cholinesterase reactivators:

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

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

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

First aid for pesticide poisoning

First aid begins with an emergency blocking of the entry of a toxic substance into the body. If necessary, use a respirator or gas mask, remove the victim from the zone of action of the pesticide. Clothes are removed, open areas of the body are treated with a 5% ammonia solution or plain water.

If the pesticide solution has been swallowed, then the stomach and intestines should be urgently cleaned:

• induce vomiting after drinking several cups of water and one cup of water with a small amount of soap dissolved;
• give the victim a laxative (any, except castor oil).

After cleansing the stomach and intestines, the patient should be given a glass of milk or a decoction of oatmeal, ensure a supine position and rest. If the victim complains of weakness, you can offer him a cup of strong coffee without sugar.

Without fail, an ambulance is called, or a person is urgently transported to the emergency department of a hospital. [8]

Prevention

Preventive measures to prevent pesticide poisoning include the following recommendations:

• If professional activities are related to the production, packaging or transportation of pesticides, then it is necessary to use all necessary personal protective equipment, wash hands and face frequently, rinse your mouth, and avoid direct contact with chemicals.
• It is important to take care of the proper storage of pesticides - in tightly sealed containers, with signed stickers, in places inaccessible to children, the elderly and mentally unbalanced people, away from living quarters. The storage area must be well ventilated and free of potential ignition sources.
• When processing or diluting pesticides, you need to make sure that there are no people nearby - in particular children. Do not forget about the safety rules.
• 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 toxic substances. However, in agriculture and the agricultural sector, it is quite difficult to grow a good harvest without them. Therefore, subject to all safety measures, these chemicals do not pose a danger to humans. However, pesticide poisoning is quite common. We are talking about a painful condition caused by the ingestion of pesticides into the body. Most often, acute poisoning is recorded, requiring emergency medical intervention.

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