Simultaneous quantification of carbamate insecticides in human plasma by liquid chromatography/tandem mass spectrometry

Carbofuran self-poisoning: forensic and analytic investigations in twins and literature review

Carbofuran is a pesticide widely used in agricultural context to kill insects, mites, and flies by ingestion or contact. Along with literature review, we aimed to (i) present the clinical, autopsy, and toxicological findings of carbofuran self-poisonings in two 69-year-old twins, resulting in the death of one of them and (ii) assess carbofuran metabolite distribution using molecular networking. Quantitative analysis of carbofuran and its main metabolites (3-hydroxycarbofuran and 3-ketocarbofuran) was carried out using an original liquid chromatography-tandem mass spectrometry method on biological samples (cardiac or peripheral blood, urine, bile, and gastric contents). Toxicological analysis of post-mortem samples (twin 1) highlighted high concentrations of carbofuran and its metabolites in cardiac blood, bile, and gastric contents. These compounds were also quantified in blood and/or urine samples of the living brother (twin 2), confirming poisoning. Using molecular networking approach to facilitate visualization of mass spectrometry datasets and sample-to-sample comparisons, we detected two more metabolites (7-phenol-carbofuran and 3-hydroxycarbofuran glucuronide) in bile (twin 1) and urine (twin 2). These results highlight the value of (i) these compounds as carbofuran consumption markers and (ii) bile samples in post-mortem analysis to confirm poisoning. From an analytical point of view, molecular networking allowed the detection and interpretation of carbofuran metabolite ammonium adducts which helped to confirm their identification annotations, as well as their structural data. From a clinical point of view, the different outcomes between the two brothers are discussed. Overall, these cases provide novel information regarding the distribution of carbofuran and its metabolites in poisoning context.

Fast and simultaneous analysis of carbamate pesticides and anticoagulant rodenticides used in suspected cases of animal poisoning

Carbamate pesticides (CBs) are reported as one of the main causes of intentional or accidental poisoning of animals. Anticoagulant rodenticides (ARs) form the main class of poisons implicated in analyzed poisoned baits. These two groups of pesticide compounds include multiple substances, and thus, the development of a simple and rapid multiclass/multiresidue analytical method for simultaneous identification of both toxicant classes should be a useful strategy for analytical laboratories to reduce analysis time and cost. The present study aimed to elaborate and validate a rapid method to simultaneously determine 11 CBs and 8 ARs in samples of real matrices (bait, stomach content, and liver) from suspected animal poisoning cases. QuEChERS sample treatment and liquid chromatography coupled to hybrid high resolution mass spectrometry were used. The method resulted in good linearity (R2 ≥ 0.98) for all compounds, recovery was between 70% and 120% for CBs and 40-90% for ARs, and precision was ≤ 20% for all compounds. The method was successfully applied to the analysis of 871 real samples originating from suspected cases of animal poisoning, collected from April 2019 to October 2020. Furthermore, full scan dependent data acquisition allowed qualitative retrospective data analysis of an additional 15 compounds outside the scope of the method to be performed; these compounds could potentially be involved in unresolved poisoning cases.

Carbofuran induces increased anxiety-like behaviors in female zebrafish (Danio rerio) through disturbing dopaminergic/norepinephrinergic system

Carbofuran, a carbamate pesticide, is widely used in developing countries to manage insect pests. Studies have found that carbofuran posed potential risks for the neurotransmitter systems of non-target species, we speculated that these disruptive effects on the neurotransmitter systems could trigger anxiety-like behaviors. In this study, female zebrafish were exposed to environmental levels (5, 50, and 500 μg/L) of carbofuran for 48 h to evaluate the effects of carbofuran on anxiety-like behaviors. Results showed that zebrafish exhibited more anxiety-like behaviors which proved by the observed higher bottom trend and more erratic movements in the novel tank after carbofuran treatment. In order to elucidate the underlying molecular mechanisms of carbofuran-induced anxiety-promoting effects, we measured the levels of neurotransmitters, precursors, and major metabolites, along with the level of gene expression and the enzyme activities involved in neurotransmitter synthesis and metabolism. The results demonstrated that acute carbofuran exposure stimulated the mRNA expression and enzyme activity of tyrosine hydroxylase, which sequentially induced the increased levels of dopamine and norepinephrine. Tyrosine hydroxylase inhibitor relieved the anxiety-related changes induced by carbofuran, confirming the overactive tyrosine hydroxylase-mediated accumulation of dopamine and norepinephrine in the brain was one of the main reasons for carbofuran-induced anxiety-like behaviors in the female zebrafish. Overall, our study indicated the environmental health risks of carbamate pesticide in inducing neurobehavioral disorders and provided novel insights into the investigation of the relevant underlying mechanisms.

Synthesis and Application of Novel Molecularly Imprinted Solid Phase Extraction Materials Based on Carbon Nanotubes for Determination of Carbofuran in Human Serum by High Performance Liquid Chromatography

Novel molecularly imprinted polymers (MIPs) based on multiwalled carbon nanotubes (MWNTs) were synthesized using carbofuran as template, methacrylic acid as functional monomer, and trimethylolpropane trimethacrylate as cross-liking agent, respectively. Characterization results showed that the carbofuran MIPs have been successfully grafted onto the surface of MWNTs as a thin layer with high stability. The results of adsorption dynamics indicated that the synthesized MWNT-MIPs displayed a biphase adsorption profile and good selective recognition to carbofuran with equilibrium adsorption of 106.2 mg/g. The MWNTs-MIPs synthesized were further applied as the adsorbent material of solid-phase extraction (SPE) for the pretreatment of carbofuran in human serum, analyzed using high performance liquid chromatograph (HPLC). The recoveries obtained ranged from 89.0 ± 4.8 to 93.6 ± 3.2, showing that the MWNTs-MIPs-SPE system developed have specific recognition toward carbofuran. Results above indicated that the proposed system filled with synthesized MWNTs-MIPs provided a fast and selective extraction of carbofuran in serum.

High lethality and minimal variation after acute self-poisoning with carbamate insecticides in Sri Lanka - implications for global suicide prevention

Background: Highly hazardous organophosphorus (OP) insecticides are responsible for most pesticide poisoning deaths. As they are removed from agricultural practice, they are often replaced by carbamate insecticides of perceived lower toxicity. However, relatively little is known about poisoning with these insecticides.

Methods: We prospectively studied 1288 patients self-poisoned with carbamate insecticides admitted to six Sri Lankan hospitals. Clinical outcomes were recorded for each patient and plasma carbamate concentration measured in a sample to confirm the carbamate ingested.

Findings: Patients had ingested 3% carbofuran powder (719), carbosulfan EC25 liquid (25% w/v, 389), or fenobucarb EC50 liquid (50% w/v, 127) formulations, carbamate insecticides of WHO Toxicity Classes Ib, II, and II, respectively. Intubation and ventilation was required for 183 (14.2%) patients while 71 (5.5%) died. Compared with carbofuran, poisoning with carbosulfan or fenobucarb was associated with significantly higher risk of death [carbofuran 2.2%; carbosulfan 11.1%, OR 5.5 (95% CI 3.0–9.8); fenobucarb 6.3%, OR 3.0 (1.2–7.1)] and intubation [carbofuran 6.1%; carbosulfan 27.0%, OR 5.7 (3.9–8.3); fenobucarb 18.9%, OR 3.6 (2.1–6.1)]. The clinical presentation and cause of death did not differ markedly between carbamates. Median time to death was similar: carbofuran 42.3 h (IQR 5.5–67.3), carbosulfan 21.3 h (11.5–71.3), and fenobucarb 25.3 h (17.3–72.1) (p = 0.99); no patients showed delayed onset of toxicity akin to the intermediate syndrome seen after OP insecticide poisoning. For survivors, median duration of intubation was 67.8 h (IQR 27.5–118.8) with no difference in duration between carbamates. Reduced GCS at presentation was associated with worse outcome although some patients with carbosulfan died after presentation with normal GCS.

Conclusions: We did not find carbamate insecticide self-poisoning to vary markedly according to the carbamate ingested although the case fatality varied according to the concentration and formulation of the insecticide. Carbamate poisoning did not appear to be much less toxic than poisoning with some liquid OP insecticide formulations, e.g., chlorpyrifos EC40, that we have previously noted in these same hospitals (Lancet 2005, 366:1452–1459; QJM 2006, 99:513–522). Replacement of WHO Class II Toxicity OP insecticides in agriculture with high-strength liquid carbamate formulations may not substantially reduce case fatality after pesticide poisoning and, therefore, global suicide rates.