Effect of prohibiting the use of Paraquat on pesticide-associated mortality

Structure-to-process design framework for developing safer pesticides

Rational design of pesticides with tunable degradation properties and minimal ecotoxicity is among the grand challenges of green chemistry. While computational approaches have gained traction in predictive toxicology, current methods lack the necessary multifaceted approach and design-vectoring tools needed for system-based chemical development. Here, we report a tiered computational framework, which integrates kinetics and thermodynamics of indirect photodegradation with predictions of ecotoxicity and performance, based on cutoff values in mechanistically derived physicochemical properties and electronic parameters. Extensively validated against experimental data and applied to 700 pesticides on the U.S. Environmental Protection Agency's registry, our simple yet powerful approach can be used to screen existing molecules to identify application-ready candidates with desirable characteristics. By linking structural attributes to process-based outcomes and by quantifying trade-offs in safety, depletion, and performance, our method offers a user-friendly roadmap to rational design of novel pesticides.

Thunbergia laurifolia aqueous leaf extract ameliorates paraquat-induced kidney injury by regulating NADPH oxidase in rats

We aim to study the antioxidant ability of Thunbergia laurifolia (TL) aqueous leaf extract against PQ-induced kidney injury. Rats were divided into four groups (n = 4 per group): control group, the rats received subcutaneous injection of 1 ml/kg body weight (BW) normal saline; PQ group, the rats received subcutaneous injection of 18 mg/kg BW paraquat dichloride; PQ + TL-low dose (LD) group, the rats received subcutaneous injection of 18 mg/kg BW paraquat dichloride and were orally gavaged with TL leaf extract (100 mg/kg BW); and PQ + TL-high dose (HD) group, the rats received subcutaneous injection of 18 mg/kg BW paraquat dichloride and were orally gavaged with TL leaf extract (200 mg/kg BW). This study analyzed blood urea nitrogen (BUN) and creatinine levels, renal malondialdehyde (MDA) levels, kidney histopathology, mRNA expressions of renal NADPH oxidase (NOX) and protein expressions of renal NOX-1 and NOX-4 using immunohistochemistry. The PQ group showed a significant increase in BUN and creatinine levels, renal MDA level, and a upregulation of the mRNA expression of renal NOX compared with the control group. It also demonstrated mild hydropic degeneration of the tubules. Immunohistochemistry displayed a significant increase in the protein expressions of renal NOX-1 and NOX-4 compared with the control group. TL aqueous leaf extract especially in the high dose group significantly reduced the BUN and creatinine levels, the renal MDA level, and downregulated the mRNA expression of renal NOX and protein expressions of renal NOX-1 and NOX-4 compared with the PQ group. Furthermore, it can improve PQ-induced kidney injury. TL aqueous leaf extract can ameliorate PQ-induced kidney injury by regulating oxidative stress through inhibiting NOX, especially NOX-1 and NOX-4 expressions.

Design and synthesis of amphiphilic carboxyl-functionalized magnetic polymer microspheres for fast determination of paraquat and its four metabolites in human urine samples prior to ultra-high performance liquid chromatography-high resolution mass spectrometry

In cases of low concentration paraquat (PQ) poisoning, as the disease progresses over a long period of time, the prototype PQ may not be detected in the urine, which has a significant negative impact on the precise treatment of the poisoning. But PQ poisoning can also be confirmed by the detection of specific metabolites of PQ in the urine samples. In the present study, core-shell amphiphilic carboxyl-functionalized magnetic polymer microsphere (Amphiphilic-MPs-COOH) was prepared, and the as-prepared Amphiphilic-MPs-COOH was characterized by transmission electron microscope (TEM), scanning electron microscope (SEM), Fourier-transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and thermogravimetry and differential thermogravimetry analyses (TG-DTG). Then, the Amphiphilic-MPs-COOH was employed as a magnetic solid-phase extraction (MSPE) adsorbent for pretreatment and rapid determination of PQ and its four metabolites from urine samples prior to ultra-high performance liquid chromatography-high resolution mass spectrometry (UPLC-HRMS). The extraction-elution conditions of Amphiphilic-MPs-COOH towards PQ and its metabolites were optimized in spiking urine samples to obtain the best MSPE efficiency. The adsorption mechanism of PQ and its metabolites by Amphiphilic-MPs-COOH involves electrostatic attraction and π-π stacking interactions. Moreover, the effect of different ratios of hydrophilic monomer NVP and functional monomer 4-VBA on the extraction and purification performance of PQ and its metabolites in urine samples. And the results revealed that both hydrophilic monomer and functional monomer were important for the adsorption of PQ and its metabolites, and the addition of the appropriate amount of the hydrophilic monomer NVP can improve the compatibility of the adsorbent with the urine substrate. In addition, this study compared the matrix effect of the Amphiphilic-MPs-COOH based MSPE method and the commercial Waters Oasis WCX SPE method. The results showed that the Amphiphilic-MPs-COOH based MSPE method developed in this paper had better resistance to matrix interference. Under optimal conditions, the recoveries of PQ and its metabolites were ranging from 84.5 to 103%, with relative standard deviations (RSDs) of 1.1-6.3%. While the limits of detection (LODs, S/N ≥ 3) and limits of quantification (LOQs, S/N ≥ 9) of the method were in range of 0.1-1.6 μg/L and 0.3-4.8 μg/L, respectively. Finally, the established MSPE-UPLC-HRMS method in this study was used to confirm PQ poisoning not only based on detecting PQ prototype, but also on its four metabolites, providing strong technical support for clinical precision treatment.

Silymarin protects the rats against paraquat-induced acute kidney injury via Nrf2

BACKGROUND

Paraquat (PQ) poisoning induces severe acute kidney injury and causes extremely high rate of death. In this study, we aimed to investigate the protective effects of silymarin on PQ-induced acute kidney injury and explore the underlying mechanisms.

METHODS

A rat model was established through intraperitoneal injection of PQ. Rats were administrated with saline or silymarin for 3 days. Then, survival rate, physiological parameters, and renal injury score were evaluated. The apoptosis and oxidative stress in kidney tissues were determined through hematoxylin and eosin staining, quantitative reverse transcription polymerase chain reaction, Western blot, and enzyme-linked immunosorbent assays.

RESULTS

Silymarin administration could significantly increase the survival rate of PQ-poisoned rats. It was found that silymarin treatment improved renal function, decreased injury score in kidney tissues, and inhibited the apoptosis and oxidative stress in PQ-induced acute kidney injury through the activating the signaling pathway of Nrf2 and promoting its nuclear translocation.

CONCLUSION

Silymarin exhibited a protective effect against PQ-induced kidney injury, suggesting that treatment with this flavonoid could be a potential therapeutic agent for the treatment of acute kidney injury.

Association Between Means Restriction of Poison and Method-Specific Suicide Rates

Question

Findings

Meaning

Importance

Objective

Evidence Review

Findings

Conclusions and Relevance

Pectin/chitosan/tripolyphosphate encapsulation protects the rat lung from fibrosis and apoptosis induced by paraquat inhalation

BACKGROUND

Paraquat poisoning leads to lung injury and pulmonary fibrosis. The effect of paraquat encapsulation by previously described Pectin/Chitosan/Tripolyphosphate nanoparticles on its pulmonary toxicity was investigated in present study in a rat model of poison inhalation.

MATERIAL AND METHOD

The rats inhaled nebulized different formulation of paraquat (n = 5) for 30 min in various experimental groups. Lung injury and fibrosis scores, Lung tissue enzymatic activities, apoptosis markers were determined compared among groups.

RESULTS

Encapsulation of paraquat significantly rescued both lung injury and fibrosis scores. Lung MDA level was reduced by encapsulation. Paraquat poisoning led to lung tissue apoptosis as was evidenced by higher Caspase-3 and Bax/Bcl2 expressions in rats subjected to paraquat inhalation instead of normal saline or free nanoparticles. Again, nanoencapsulation reduced these apoptosis markers significantly. Alpha-SMA expression was also reduced by encapsulation. Nanoparticles per se have no or little toxicity as was evidenced by inflammatory and apoptotic markers and histological scores.

CONCLUSION

In a rat model of inhalation toxicity of paraquat, loading of this herbicide on PEC/CS/TPP nanoparticles reduced acute lung injury and fibrosis. The encapsulation also led to lower apoptosis, oxidative stress and alpha-SMA expression in the lung tissue.

The acute paraquat poisoning mortality (APPM) score to predict the risk of death in paraquat-poisoned patients

CONTEXT

Mortality prediction in paraquat poisoning is a major issue since most prediction rules are inapplicable if the exact ingestion time cannot be determined and/or the serum paraquat concentration is not readily available, as in most countries. Therefore, we aimed to develop and validate a new prediction rule not requiring these two parameters.

METHODS

We designed a 10-year observational cohort study including all consecutive paraquat-poisoned patients managed in two Taiwanese hospitals. We built one cohort to define and one cohort to validate this prediction rule. Parameters independently related to mortality determined using a multivariate analysis were used to formulate the Acute Paraquat Poisoning Mortality (APPM) score.

RESULTS

Overall, 321 paraquat-poisoned patients were included, 156 in the derivation and 165 in the validation cohort. Mortality rates in the derivation and validation cohorts were 73% and 81%, respectively (p = 0.20). The three parameters chosen of 28-day mortality at presentation were urine paraquat level >10 ppm (using a colorimetric sodium dithionite-based test; odds ratio (OR), 12.70; 95% confidence interval (CI), 2.64-61.24), white blood cells >13.0 G/L (OR, 5.50; CI, 1.41-21.48) and blood glucose >140 mg/dL [7.8 mmol/L] (OR, 7.45; CI, 1.70-32.86). In the derivation cohort, the area under the ROC curve (AUC-ROC) of the APPM score did not significantly differ from AUC-ROCs of serum paraquat (0.95, p = 0.25) and the Severity Index of Paraquat Poisoning (0.95, p = 0.33). AUC-ROCs of the APPM score in the derivation and validation cohorts were 0.91 and 0.94, respectively.

CONCLUSION

We built and validated a reliable score to predict 28-day mortality in paraquat-poisoned patients at presentation, independently from the ingestion time and serum paraquat measurement.

A novel flowchart to predict mortality and analyse effectiveness of routinely used pharmacological regimens in paraquat poisoning

Paraquat is responsible for an extremely high case-fatality rate poisoning. Mortality prediction remains a major issue since evidence to support benefits of routinely used treatments is lacking. We aimed to develop an easy-to-use prediction flowchart not requiring the ingestion time, for which accuracy is frequently questionable, and to evaluate the effectiveness of routinely used pharmacological therapies on mortality. We designed a two-centre cohort study including consecutive paraquat-poisoned adults with confirmed diagnosis based on serum/urine paraquat measurement. We built a flowchart using a multivariate analysis of death predictors and analysed the outcome according to the administered therapies. Overall, 256 patients were enrolled. Mortality rate was 75%. Independent death predictors on admission were serum creatinine (odds ratio [OR], 5.07; 95% confidence interval [CI], 1.97-13.05) and serum paraquat concentration (OR, 2.26; CI, 1.66-3.09). The area-under-the flowchart curve was 0.91. Overall sensitivity and specificity were 81.5% and 94.8%, respectively. More survivors than non-survivors of severe poisoning received methylprednisolone (P = 0.04). While not significantly differing in severity, methylprednisolone-treated patients had better survival (P = 0.04). To conclude, we defined an efficient flowchart to predict mortality in paraquat poisoning at presentation, even if ingestion time is undetermined. Methylprednisolone seems effective to improve the outcome, especially in the most severe cases.

Assessment of glufosinate-containing herbicide exposure: A multi-center retrospective study

BACKGROUND

Exposure to glufosinate ammonium, an herbicide used worldwide, can cause CNS and respiratory toxicities. This study aimed to analyze acute human glufosinate ammonium poisoning.

MATERIALS AND METHODS

This multicenter retrospective cohort study involved five medical institutes affiliated with the Chang Gung Memorial Hospital system. Patients with glufosinate ammonium exposure visiting the emergency department (ED) between January 2008 and December 2020 were included.

RESULTS

In total, 95 patients were enrolled. Compared to exposure via the non-oral route, patients exposed orally (n = 61) had lower GCS scores, higher mortality rates, and longer hospital lengths of stay (P-value: <0.001, 0.002, and < 0.001, respectively). In the subgroup analysis among oral exposure patients, the survival group had a lower amount of estimated glufosinate ingestion than the non-survival group (10.5 [3.4-27] vs. 40.5 [27-47.3] g, P-value: 0.022), lower rate of substance co-exposure (9 [19.6%] vs. 10 [66.7%] P-value: 0.001), and lower rate of paraquat co-exposure (0 [0%] vs. 7 [46.7%] P < 0.001) compared with the mortality group. In the orally-exposed and non-paraquat co-exposure patients (n = 54), age > 70 years and GCS score < 9 at triage presented a high sensitivity (100.00%, 95% CI: 63.06-100.00%) and medium specificity (58.70%, 95% CI: 43.23-73.00%) in predicting mortality.

CONCLUSION

Old age, change in consciousness, and paraquat co-exposure were associated with higher mortality in human glufosinate poisoning. Age > 70 years and GCS score < 9 at triage could be predictors of mortality in patients with acute oral glufosinate poisoning.

The global distribution of acute unintentional pesticide poisoning: estimations based on a systematic review

BACKGROUND

Human poisoning by pesticides has long been seen as a severe public health problem. As early as 1990, a task force of the World Health Organization (WHO) estimated that about one million unintentional pesticide poisonings occur annually, leading to approximately 20,000 deaths. Thirty years on there is no up-to-date picture of global pesticide poisoning despite an increase in global pesticide use. Our aim was to systematically review the prevalence of unintentional, acute pesticide poisoning (UAPP), and to estimate the annual global number of UAPP.

METHODS

We carried out a systematic review of the scientific literature published between 2006 and 2018, supplemented by mortality data from WHO. We extracted data from 157 publications and the WHO cause-of-death database, then performed country-wise synopses, and arrived at annual numbers of national UAPP. World-wide UAPP was estimated based on national figures and population data for regions defined by the Food and Agriculture Organization (FAO).

RESULTS

In total 141 countries were covered, including 58 by the 157 articles and an additional 83 by data from the WHO Mortality Database. Approximately 740,000 annual cases of UAPP were reported by the extracted publications resulting from 7446 fatalities and 733,921 non-fatal cases. On this basis, we estimate that about 385 million cases of UAPP occur annually world-wide including around 11,000 fatalities. Based on a worldwide farming population of approximately 860 million this means that about 44% of farmers are poisoned by pesticides every year. The greatest estimated number of UAPP cases is in southern Asia, followed by south-eastern Asia and east Africa with regards to non-fatal UAPP.

CONCLUSIONS

Our study updates outdated figures on world-wide UAPP. Along with other estimates, robust evidence is presented that acute pesticide poisoning is an ongoing major global public health challenge. There is a need to recognize the high burden of non-fatal UAPP, particularly on farmers and farmworkers, and that the current focus solely on fatalities hampers international efforts in risk assessment and prevention of poisoning. Implementation of the international recommendations to phase out highly hazardous pesticides by the FAO Council could significantly reduce the burden of UAPP.

Autophagy and Redox Homeostasis in Parkinson's: A Crucial Balancing Act

Reactive oxygen species (ROS) and reactive nitrogen species (RNS) are generated primarily from endogenous biochemical reactions in mitochondria, endoplasmic reticulum (ER), and peroxisomes. Typically, ROS/RNS correlate with oxidative damage and cell death; however, free radicals are also crucial for normal cellular functions, including supporting neuronal homeostasis. ROS/RNS levels influence and are influenced by antioxidant systems, including the catabolic autophagy pathways. Autophagy is an intracellular lysosomal degradation process by which invasive, damaged, or redundant cytoplasmic components, including microorganisms and defunct organelles, are removed to maintain cellular homeostasis. This process is particularly important in neurons that are required to cope with prolonged and sustained operational stress. Consequently, autophagy is a primary line of protection against neurodegenerative diseases. Parkinson's is caused by the loss of midbrain dopaminergic neurons (mDANs), resulting in progressive disruption of the nigrostriatal pathway, leading to motor, behavioural, and cognitive impairments. Mitochondrial dysfunction, with associated increases in oxidative stress, and declining proteostasis control, are key contributors during mDAN demise in Parkinson's. In this review, we analyse the crosstalk between autophagy and redoxtasis, including the molecular mechanisms involved and the detrimental effect of an imbalance in the pathogenesis of Parkinson's.

The Characteristics of Elderly Individuals Who Attempted Suicide by Poisoning: a Nationwide Cross-sectional Study in Korea

BACKGROUND

Suicide among the elderly is a public health concern, as life expectancy is increasing rapidly and suicide rates increase with age. In Korea, self-poisoning is the most common method of attempted suicide. This study aimed to evaluate the characteristics of attempted suicide by self-poisoning among the elderly and to identify risk factors related to the suicide attempts.

METHODS

A cross-sectional observational study was conducted using the Emergency Department-based Injury In-depth Surveillance database in Korea. We included all adult patients visiting the emergency department (ED) who attempted suicide by poisoning between January 2011 and December 2017 and stratified according to age: the elderly (≥ 65 years old) and the younger group. Characteristics and risk factors for attempted suicide by poisoning among the elderly were evaluated using stepwise regression analysis.

RESULTS

Among 25,904 adult patients, 5,164 (19.9%) were classified as elderly. The elderly were more likely to be admitted to hospital and intensive care units, the average ED length of stay was longer, and total mortality was higher than that of the younger group. Male sex, low socioeconomic status, poor physical health, pesticide use, lower alcohol consumption, and fewer prior suicide attempts were found to be risk factors for suicide among the elderly.

CONCLUSION

Self-poisoning among the elderly is associated with poorer clinical outcomes than in younger adult patients. Suicide among the elderly is a potentially preventable public health problem, and with proper identification of the associated risk factors, appropriate multidisciplinary intervention strategies can be implemented.

Pesticides in aquatic environments and their removal by adsorption methods

Although pesticides are widely used in agriculture, industry and households, they pose a risk to human health and ecosystems. Based on target organisms, the main types of pesticides are herbicides, insecticides and fungicides, of which herbicides accounted for 46% of the total pesticide usage worldwide. The movement of pesticides into water bodies occurs through run-off, spray drift, leaching, and sub-surface drainage, all of which have negative impacts on aquatic environments and humans. We sought to define the critical factors affecting the fluxes of contaminants into receiving waters. We also aimed to specify the feasibility of using sorbents to remove pesticides from waterways. In Karun River in Iran (1.21 × 10⁵ ng/L), pesticide concentrations are above regulatory limits. The concentration of pesticides in fish can reach 26.1 × 10³ μg/kg, specifically methoxychlor herbicide in Perca fluviatilis in Lithuania. During the last years, research has focused on elimination of organic pollutants, such as pesticides, from aqueous solution. Pesticide adsorption onto low-cost materials can effectively remediate contaminated waters. In particular, nanoparticle adsorbents and carbon-based adsorbents exhibit high performance (nearly 100%) in removing pesticides from water bodies.

Oxidative stress delays development and alters gene expression in the agricultural pest moth, Helicoverpa armigera

Stress is a widespread phenomenon that all organisms must endure. Common in nature is oxidative stress, which can interrupt cell homeostasis to cause cell damage and may be derived from respiration or from environmental exposure through diet. As a result of the routine exposure from respiration, many organisms can mitigate the effects of oxidative stress, but less is known about responses to oxidative stress from other sources. Helicoverpa armigera is a major agricultural pest moth that causes significant damage to crops worldwide. Here, we examined the effects of oxidative stress on H. armigera by chronically exposing individuals to paraquat-a free radical producer-and measuring changes in development (weight, developmental rate, lifespan), and gene expression. We found that oxidative stress strongly affected development in H. armigera, with stressed samples spending more time as caterpillars than control samples (>24 vs. ~15 days, respectively) and therefore living longer overall. We found 1,618 up- and 761 down-regulated genes, respectively, in stressed versus control samples. In the up-regulated gene set, was an over-representation of biological processes related to cuticle and chitin development, glycine metabolism, and oxidation-reduction. Oxidative stress clearly impacts physiology and biochemistry in H. armigera and the interesting finding of an extended lifespan in stressed individuals could demonstrate hormesis, the phenomenon whereby toxic compounds can actually be beneficial at low doses. Collectively, our findings provide new insights into physiological and gene expression responses to oxidative stress in invertebrates.

Clinical Features, Treatment, Prognosis, and Mortality in Paraquat Poisonings: A Hospital-Based Study in Iran

Objective:

The aim of the present study was to evaluate the demographics, clinical characteristics, fatal dose, the efficacy of treatments, and prognosis in paraquat (PQ) poisoning in the Kerman Province of Iran.

Methods:

This analytical cross-sectional study was conducted on 126 PQ poisoned patients who were referred to Afzalipour Hospital during 2006–2015. Demographic variables such as age and gender, signs and symptoms of poisoning, the estimated ingested dosage of PQ, and clinical outcome were extracted from medical records. Patients were compared and categorized into two groups considering the outcome: survivors and nonsurvivors. Patients with nonoral exposures, combined drug exposures, PQ exposures more than 24 h before the presentation, and critical underlying diseases were not included in the study.

Findings:

Our results indicated that the mean dose of PQ used by all patients was 2358 mg, which was reported as 1846 and 2812 mg in females and males, respectively. Moreover, the results showed that the highest mortality rate was in patients with respiratory distress, followed by oral ulceration and excess salivation. In all PQ-poisoned patients, the dose of greater than approximately 2250 mg predicted death with 86.2% specificity and 75.7% sensitivity.

Conclusion:

Based on the results of the present study, the mortality rate in PQ-poisoned patients depended on the dose of poison, blood sugar level, and aspartate transaminase levels. Our results suggest that these parameters have excellent prognostic value for the prediction of mortality.

Comparison of four pharmacological strategies aimed to prevent the lung inflammation and paraquat-induced alveolar damage

Objective

The aim of this study was to compare in vivo effect of five pharmacological options on inflammation and pulmonary fibrosis induced by paraquat.

Methods

54 Wistar SPF rats were used. After 2 h post-intoxication with paraquat ion, groups of 9 animals were randomly assigned to (1) cyclophosphamide plus dexamethasone (2) low molecular weight heparin (3) unfractionated heparin (4) vitamin C every 24 h, (5) atorvastatin or (6) placebo with intraperitoneal saline. Lung inflammation, alveolar injury, hepatocyte damage, hepatic regeneration, acute tubular necrosis and kidney congestion were evaluated.

Results

In the control group 100% of animals presented moderate and severe lung inflammation, while in the groups with atorvastatin and intratracheal heparin this proportion was lower (55.5%; CI 26.6–81.3%) (p = 0.025). A lower degree of moderate or severe hepatic regeneration was evident in the treatment groups with atorvastatin (p = 0.009). In this study was demonstrated that statins and heparin might have a protective effect in the paraquat-induced destructive phase. More evidence is needed to evaluated of dose–response effects of these drugs before to study in clinical trials.

Retrospective study of clinical features and prognosis of edaravone in the treatment of paraquat poisoning

To observe whether edaravone can protect organs and inhibit pulmonary fibrosis in patients with paraquat poisoning and to provide a method for clinical intervention for paraquat poisoning.Forty-four cases of paraquat poisoning were collected from March 2011 to December 2017 in our hospital. Eighteen cases from March 2011 to November 2013 did not receive edaravone treatment and were considered the control group, and 26 cases from January 2014 to December 2017 were treated with edaravone and were considered the observation group. Injuries to the central nervous system, heart, liver, kidney, and digestive system were evaluated on at 24 hours, 3 days, and 7 days after hospitalization. The expression of serum inflammatory factors (interleukin [IL]-6, IL-10, tumor necrosis factor-α [TNF-α]) and oxidative stress correlation (superoxide dismutase [SOD] and malondialdehyde [MDA]) were assayed at 24 hours, 3 days, and 7 days after being hospitalized. After 7, 14, and 30 days, the changes in pathological lung characteristics in the 2 groups were assessed, and survival rates were calculated.Edaravone significantly increased the serum levels of SOD and obviously markedly reduce the serum levels of IL-6, IL-10, TNF-α, and MDA in patients poisoned with paraquat (P < .05). Edaravone significantly protected the liver (P = .021), cardiovascular (P = .031), and renal (P = .028) organs of patients from paraquat poisoning-induced injury after 7 days but had no significant protection or improvement on respiratory and digestive tract damage. Edaravone delayed the occurrence of pulmonary fibrosis and increase the survival time of patients at 7 and 14 days (P < .05). However, the 1-month follow-up found that edaravone did not reduce pulmonary fibrosis (77.8% vs 73.1%, P = .615) and did not increase the survival rate of the patients (61.1% vs 65.3%, P = .853).Edaravone is beneficial for protecting the kidneys and liver from paraquat poisoning through reducing oxidative stress and inhibiting inflammatory response. It can also inhibit the pulmonary fibrosis process and prolong the survival time of the patients. However, no significant improvements were seen in the probability of pulmonary fibrosis and the survival rate.

Burden of paraquat poisoning in the department of Antioquia, Colombia

Background

Paraquat (PQ) poisoning is a public health problem in many regions of Colombia. This study aimed to estimate the burden of PQ poisoning in the Department of Antioquia, Colombia.

Methods

Disability-adjusted life year (DALYs) were calculated as the sum of years of life lost (YLL) and years of life lived with disability (YLD) due to paraquat poisoning in Antioquia; a bootstrapped method with 1000 iterations was used to estimate each statistical parameter using the package DALY calculator in R. For this instance, the annual incidence of paraquat poisoning was obtained from the reported surveillance data according to regional Government.

Results

From 2010 to 2016, 3299 DALYs were estimated in the department of Antioquia for PQ intoxication, with a rate of 53.4 DALYs per 100,000 inhabitants. The majority of the DALYs (2852 DALYs) were generated for men ranging from 15 to 44 years old.

Conclusion

The rate of DALYs reported here is higher than that reported by all chemical poisonings. Better strategies to regulate and restrict the market of this dangerous products are required in Colombia.