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Mohan MK, Thorat K, Puthiyapurayil TP, Sunnapu O, Chandrashekharappa S, Ravula V, Khader R, Sankaranarayanan A, Muhammad H, Vemula PK. Oxime-functionalized anti-insecticide fabric reduces insecticide exposure through dermal and nasal routes, and prevents insecticide-induced neuromuscular-dysfunction and mortality. Nat Commun 2024; 15:4844. [PMID: 38844466 PMCID: PMC11156901 DOI: 10.1038/s41467-024-49167-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/23/2024] [Indexed: 06/09/2024] Open
Abstract
Farmers from South Asian countries spray insecticides without protective gear, which leads to insecticide exposure through dermal and nasal routes. Acetylcholinesterase plays a crucial role in controlling neuromuscular function. Organophosphate and carbamate insecticides inhibit acetylcholinesterase, which leads to severe neuronal/cognitive dysfunction, breathing disorders, loss of endurance, and death. To address this issue, an Oxime-fabric is developed by covalently attaching silyl-pralidoxime to the cellulose of the fabric. The Oxime-fabric, when stitched as a bodysuit and facemask, efficiently deactivates insecticides (organophosphates and carbamates) upon contact, preventing exposure. The Oxime-fabric prevents insecticide-induced neuronal damage, neuro-muscular dysfunction, and loss of endurance. Furthermore, we observe a 100% survival rate in rats when repeatedly exposed to organophosphate-insecticide through the Oxime-fabric, while no survival is seen when organophosphate-insecticide applied directly or through normal fabric. The Oxime-fabric is washable and reusable for at least 50 cycles, providing an affordable solution to prevent insecticide-induced toxicity and lethality among farmers.
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Affiliation(s)
- Mahendra K Mohan
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Ketan Thorat
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Theja Parassini Puthiyapurayil
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | | | - Sandeep Chandrashekharappa
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Venkatesh Ravula
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Rajamohammed Khader
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Aravind Sankaranarayanan
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
- Tata Institute for Genetics and Society (TIGS), inStem, GKVK Post, Bellary Road, Bangalore, 560065, India
| | - Hadi Muhammad
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India
| | - Praveen Kumar Vemula
- Institute for Stem Cell Science and Regenerative Medicine (DBT-inStem), GKVK Post, Bellary Road, Bangalore, 560065, Karnataka, India.
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Kumar A, Ojha PK, Roy K. The first report on the assessment of maximum acceptable daily intake (MADI) of pesticides for humans using intelligent consensus predictions. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2024; 26:870-881. [PMID: 38652036 DOI: 10.1039/d4em00059e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Direct or indirect consumption of pesticides and their related products by humans and other living organisms without safe dosing may pose a health risk. The risk may arise after a short/long time which depends on the nature and amount of chemicals consumed. Therefore, the maximum acceptable daily intake of chemicals must be calculated to prevent these risks. In the present work, regression-based quantitative structure-activity relationship (QSAR) models were developed using 39 pesticides with maximum acceptable daily intake (MADI) for humans as the endpoint. From the statistical results (R2 = 0.674-0.712, QLOO2 = 0.553-0.580, Q(F1)2 = 0.544-0.611, and Q(F2)2 = 0.531-0.599), it can be inferred that the developed models were robust, reliable, reproducible, accurate, and predictive. Intelligent Consensus Prediction (ICP) was employed to improve the external predictivity (Q(F1)2 =0.579-0.657 and Q(F2)2 = 0.563-0.647) of the models. Some of the chemical markers responsible for toxicity enhancement are the presence of unsaturated bonds, lipophilicity, presence of C< (double bond-single bond-single bonded carbon), and the presence of sulphur and phosphate bonds at the topological distances 1 and 6, while the presence of hydrophilic groups and short chain fragments reduces the toxicity. The Pesticide Properties Database (PPDB) (1694 pesticides) was also screened with the developed models. Hence, this research work will be helpful for the toxicity assessment of pesticides before their synthesis, the development of eco-friendly and safer pesticides, and data-gap filling reducing the time, cost, and animal experimentation. Thus, this study might hold promise for future potential MADI assessment of pesticides and provide a meaningful contribution to the field of risk assessment.
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Affiliation(s)
- Ankur Kumar
- Drug Discovery and Development Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, India.
| | - Probir Kumar Ojha
- Drug Discovery and Development Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, India.
| | - Kunal Roy
- Drug Theoretics and Cheminformatics (DTC) Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata 700032, India.
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Zein-Elabdeen SMM, Hassan NA, El-Ebiary AA, Hafez ASAF, Hodeib AA. Albuterol as an adjuvant in acute anticholinesterase pesticide poisoning: a randomized, placebo-controlled clinical trial. Toxicol Res (Camb) 2024; 13:tfae048. [PMID: 38559756 PMCID: PMC10980788 DOI: 10.1093/toxres/tfae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/05/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Acute anticholinesterase pesticide poisoning is a serious clinical problem, particularly in developing countries. Atropine is the most acceptable treatment for acute anticholinesterase poisoning. However, it only stops fluid production. Albuterol is a beta-2 receptor agonist that can increase fluid removal and speed the return of effective oxygen exchange. This study aims to evaluate the safety and efficacy of nebulized albuterol as an adjuvant therapy in patients with acute anticholinesterase poisoning. This stratified block randomized, single-blinded, placebo-controlled, parallel-group clinical trial was conducted between November 2020 and October 2021. It enrolled 80 patients with acute anticholinesterase pesticide poisoning who were admitted to Tanta University Poison Control Center. Patients were allocated into two groups (40 patients each). The strata were based on the severity of poisoning (moderate and severe). Patients in group I received 10 mg of nebulized albuterol. Group II received an equivalent volume of nebulized normal saline. Additionally, standard treatment was provided to both groups. Outcomes included oxygenation, mortality, need for endotracheal intubation and mechanical ventilation, hospital stay duration, time to atropinization, and total doses of atropine and oxime. We found insignificant differences in sociodemographics, exposure characteristics, clinical manifestations, or routine laboratory tests between the studied groups. The median values of oxygen saturation by pulse oximetry were 99% in the albuterol moderate toxicity group and 98% in the control moderate toxicity group. Albuterol significantly improved oxygen saturation in moderate intoxicated patients (P = 0.039). Therefore, nebulized albuterol is a safe drug. Moreover, it may improve oxygenation in acute anticholinesterase pesticide poisoning.
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Affiliation(s)
- Samar M M Zein-Elabdeen
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Neven A Hassan
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Ahmad A El-Ebiary
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Amal S A F Hafez
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Aliaa A Hodeib
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
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Kovarik Z, Moshitzky G, Maček Hrvat N, Soreq H. Recent advances in cholinergic mechanisms as reactions to toxicity, stress, and neuroimmune insults. J Neurochem 2024; 168:355-369. [PMID: 37429600 DOI: 10.1111/jnc.15887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 07/12/2023]
Abstract
This review presents recent studies of the chemical and molecular regulators of acetylcholine (ACh) signaling and the complexity of the small molecule and RNA regulators of those mechanisms that control cholinergic functioning in health and disease. The underlying structural, neurochemical, and transcriptomic concepts, including basic and translational research and clinical studies, shed new light on how these processes inter-change under acute states, age, sex, and COVID-19 infection; all of which modulate ACh-mediated processes and inflammation in women and men and under diverse stresses. The aspect of organophosphorus (OP) compound toxicity is discussed based on the view that despite numerous studies, acetylcholinesterase (AChE) is still a vulnerable target in OP poisoning because of a lack of efficient treatment and the limitations of oxime-assisted reactivation of inhibited AChE. The over-arching purpose of this review is thus to discuss mechanisms of cholinergic signaling dysfunction caused by OP pesticides, OP nerve agents, and anti-cholinergic medications; and to highlight new therapeutic strategies to combat both the acute and chronic effects of these chemicals on the cholinergic and neuroimmune systems. Furthermore, OP toxicity was examined in view of cholinesterase inhibition and beyond in order to highlight improved small molecules and RNA therapeutic strategies and assess their predicted pitfalls to reverse the acute toxicity and long-term deleterious effects of OPs.
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Affiliation(s)
- Zrinka Kovarik
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Gilli Moshitzky
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Alexander Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Hermona Soreq
- The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
- The Alexander Silberman Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
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De Santi O, Orellana MJ, Di Niro CA, Lashin HI, Greco V. The adjuvant effect of oil-based gastric lavage on the outcome of acute Aluminum phosphide poisoning: a systematic review and meta-analysis. Toxicol Res (Camb) 2024; 13:tfae029. [PMID: 38496382 PMCID: PMC10939350 DOI: 10.1093/toxres/tfae029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/04/2024] [Accepted: 02/16/2024] [Indexed: 03/19/2024] Open
Abstract
Introduction Aluminum Phosphide (AlP) poisoning constituted the most common cause of poisoning death in some low- and middle-income countries (LMICs). This study aimed to evaluate the safety and efficacy of oil-based gastric lavage (GL) compared with standard therapy for the treatment of AlP poisoning. Materials and methods. This systematic review complied with "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) Protocols. A comprehensive search was carried out, identifying randomized controlled trials (RCTs), including anyone presenting within 6 h of exposure to AlP, and the administration of GL with oils, including liquid paraffin or coconut oil. Results We identified 7 RCTs. The evidence from 4 RCTs indicates that GL with paraffin oil is an effective treatment for acute AlP poisoning, decreasing the mortality rate (RR = 0.62; 95% CI = 0.48 to 0.81; participants = 226; I 2 = 10%; low-quality evidence). We estimate the Number Needed to Treat of 4. Likewise, this intervention reduces the need for intubation and mechanical ventilation (RR = 0.62; 95% CI = 0.40 to 0.79; I2 = 0%; low-quality evidence). Regarding GL with coconut oil, the evidence from 4 RCTs, indicates a slight reduction in mortality (RR = 0.82; 95% CI = 0.69 to 0.98; participants = 112; I2 = 0%; very low-quality evidence). Conclusions Limited evidence suggests that GL with paraffin oil is effective in reducing the mortality rate. Likewise, limited evidence showed in favor of paraffin oil concerning the need for intubation and mechanical ventilation. Very limited evidence suggests that GL with coconut oil could reduce mortality. Both interventions would have a benign safety profile.
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Affiliation(s)
- Omar De Santi
- Toxicology, Hospital Nacional Professor Alejandro Posadas, Centro Nacional de Intoxicaciones (CNI), Buenos Aires, Arturo U. Illia Av. (w/o number) and Marconi Morón 386, B1684, El Palomar, Buenos Aires, Argentina
| | - Marcelo J Orellana
- Toxicology, Hospital Nacional Professor Alejandro Posadas, Centro Nacional de Intoxicaciones (CNI), Buenos Aires, Arturo U. Illia Av. (w/o number) and Marconi Morón 386, B1684, El Palomar, Buenos Aires, Argentina
| | - Cecilia A Di Niro
- Cardiology, Hospital Municipal Central de San Isidro “Melchor A. Posse”, Buenos Aires, Argentina. Av. Sta Fe 431, B1641 Acassuso, Provincia de Buenos Aires, Argentina
| | - Heba I Lashin
- Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Tanta University Toxicologist. Tanta University, Poison Control Center (TUPCC), Tanta, Gharbia 31111, 31527, Egypt
| | - Vanina Greco
- Toxicology, Hospital Nacional Professor Alejandro Posadas, Centro Nacional de Intoxicaciones (CNI), Buenos Aires, Arturo U. Illia Av. (w/o number) and Marconi Morón 386, B1684, El Palomar, Buenos Aires, Argentina
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See WZC, Naidu R, Tang KS. Paraquat and Parkinson's Disease: The Molecular Crosstalk of Upstream Signal Transduction Pathways Leading to Apoptosis. Curr Neuropharmacol 2024; 22:140-151. [PMID: 36703582 DOI: 10.2174/1570159x21666230126161524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 01/28/2023] Open
Abstract
Parkinson's disease (PD) is a heterogeneous disease involving a complex interaction between genes and the environment that affects various cellular pathways and neural networks. Several studies have suggested that environmental factors such as exposure to herbicides, pesticides, heavy metals, and other organic pollutants are significant risk factors for the development of PD. Among the herbicides, paraquat has been commonly used, although it has been banned in many countries due to its acute toxicity. Although the direct causational relationship between paraquat exposure and PD has not been established, paraquat has been demonstrated to cause the degeneration of dopaminergic neurons in the substantia nigra pars compacta. The underlying mechanisms of the dopaminergic lesion are primarily driven by the generation of reactive oxygen species, decrease in antioxidant enzyme levels, neuroinflammation, mitochondrial dysfunction, and ER stress, leading to a cascade of molecular crosstalks that result in the initiation of apoptosis. This review critically analyses the crucial upstream molecular pathways of the apoptotic cascade involved in paraquat neurotoxicity, including mitogenactivated protein kinase (MAPK), phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K)/AKT, mammalian target of rapamycin (mTOR), and Wnt/β-catenin signaling pathways.
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Affiliation(s)
- Wesley Zhi Chung See
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Bandar Sunway, Selangor, Malaysia
| | - Rakesh Naidu
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Bandar Sunway, Selangor, Malaysia
| | - Kim San Tang
- School of Pharmacy, Monash University Malaysia, 47500 Bandar Sunway, Selangor, Malaysia
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Zhong C, Li S, Yin N, Zhang L, Jiang J, Wang X, Li P. Single extraction and integrated non-target data acquisition with data mining workflow for analysis of hazardous substances in agricultural plant products. Food Chem 2023; 429:136899. [PMID: 37478607 DOI: 10.1016/j.foodchem.2023.136899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/28/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
Identifying contaminants in agricultural plant food products (APFPs) is a major problem. In this study, we developed a single-step extraction and integrated non-target data acquisition (INDA) workflow for increasing hazardous substances coverage. D-optimal experimental designs were applied to optimize filter plate extraction (FPE) for one-single extraction of multipolar hazardous substances. The vDIA mode was used to collect all precursor ion fragments within the range to supplement data loss caused by DDA mode. The underlying principle of vDIA is to increase the utilization rate of MS2 spectra that are likely to identify a maximum number and minimum amounts of hazardous substances. Compared with traditional DDA mode alone, a combination of the two modes increased the rate of identification of hazardous substances by 18.5%. The molecular network of hazardous substance provided by GNPS could enable some metabolites and structure-related products to discover potentially hazardous substance.
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Affiliation(s)
- Cheng Zhong
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China; National Reference Laboratory for Agricultural Testing, Wuhan 430062, China; Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Laboratory of Quality and Safety Risk Assessment for Oilseed Products (Wuhan), Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Key Laboratory of Detection for Mycotoxins, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China
| | - Songhe Li
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China; National Reference Laboratory for Agricultural Testing, Wuhan 430062, China; Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Laboratory of Quality and Safety Risk Assessment for Oilseed Products (Wuhan), Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Key Laboratory of Detection for Mycotoxins, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China
| | - Nanri Yin
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China; National Reference Laboratory for Agricultural Testing, Wuhan 430062, China; Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Laboratory of Quality and Safety Risk Assessment for Oilseed Products (Wuhan), Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Key Laboratory of Detection for Mycotoxins, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China
| | - Liangxiao Zhang
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China; National Reference Laboratory for Agricultural Testing, Wuhan 430062, China; Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Laboratory of Quality and Safety Risk Assessment for Oilseed Products (Wuhan), Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Key Laboratory of Detection for Mycotoxins, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China
| | - Jun Jiang
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China; National Reference Laboratory for Agricultural Testing, Wuhan 430062, China; Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Laboratory of Quality and Safety Risk Assessment for Oilseed Products (Wuhan), Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Key Laboratory of Detection for Mycotoxins, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China
| | - Xiupin Wang
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China; National Reference Laboratory for Agricultural Testing, Wuhan 430062, China; Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Laboratory of Quality and Safety Risk Assessment for Oilseed Products (Wuhan), Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Key Laboratory of Detection for Mycotoxins, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China.
| | - Peiwu Li
- Key Laboratory of Biology and Genetic Improvement of Oil Crops, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Oil Crops Research Institute, Chinese Academy of Agricultural Sciences, Wuhan 430062, China; National Reference Laboratory for Agricultural Testing, Wuhan 430062, China; Quality Inspection and Test Center for Oilseed Products, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Laboratory of Quality and Safety Risk Assessment for Oilseed Products (Wuhan), Ministry of Agriculture and Rural Affairs, Wuhan 430062, China; Key Laboratory of Detection for Mycotoxins, Ministry of Agriculture and Rural Affairs, Wuhan 430062, China
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Asaduzzaman M, Roy S, Das Pew N, Roy AD, Kibria S, Roy RK, Alam MJ, Chakraborty SR. Paraquat induced acute kidney and lung injury with a dramatic response to methylprednisolone: A case report. Toxicol Rep 2023; 11:350-354. [PMID: 37868809 PMCID: PMC10585619 DOI: 10.1016/j.toxrep.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/24/2023] [Accepted: 10/13/2023] [Indexed: 10/24/2023] Open
Abstract
Background Paraquat poisoning is one of the leading causes of fatal poisoning in many parts of the world, especially in agricultural countries. Its high toxicity even in small amounts causes rapid damage to multiple organs, especially the kidneys, lungs, and liver, mainly through free radical-mediated injury. As no specific antidote is yet available, early diagnosis and the importance of supportive therapy are critical parts of management. Some evidence suggests a survival benefit from using immunosuppressive drugs. Case report This case presentation concerns a 15-year-old boy from a village with a history of herbicide poisoning, later confirmed to be paraquat. Despite supportive therapy her condition continued to deteriorate with features of kidney and lung damage. The patient was then treated with methylprednisolone 500 mg daily for 5 days, along with other supportive care, and has made a remarkable recovery. Conclusions High efficacy as an herbicide, availability and low cost make paraquat an easy-to-encounter poison for suicidal or accidental use. Its high fatality calls for urgent and effective strategies to save lives. Methylprednisolone may play a role in its treatment.
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Affiliation(s)
- Md Asaduzzaman
- Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet 3100, Bangladesh
| | - Soumitra Roy
- Department of Medicine, Sylhet MAG Osmani Medical College, Sylhet 3100, Bangladesh
| | - Nibedita Das Pew
- Department of Pathology, Sylhet MAG Osmani Medical College, Sylhet 3100, Bangladesh
| | - Anindya Deb Roy
- Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet 3100, Bangladesh
| | - Shahrin Kibria
- Department of Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet 3100, Bangladesh
| | - Ranjon Kumer Roy
- Department of Medicine, Sylhet MAG Osmani Medical College, Sylhet 3100, Bangladesh
| | - M.M. Jahangir Alam
- Department of Medicine, Sylhet MAG Osmani Medical College, Sylhet 3100, Bangladesh
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Khatun P, Islam A, Sachi S, Islam MZ, Islam P. Pesticides in vegetable production in Bangladesh: A systemic review of contamination levels and associated health risks in the last decade. Toxicol Rep 2023; 11:199-211. [PMID: 37711360 PMCID: PMC10497734 DOI: 10.1016/j.toxrep.2023.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/26/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023] Open
Abstract
This paper reviewed the published data on the levels of different pesticide residues in vegetables (tomato, eggplant, beans, gourds, cauliflower, cabbage, cucumber, potato, carrot, onion, red chilli, red amaranth, lady's finger, spinach, coriander, and lettuce) from Bangladesh in the last decade. Vegetable production in Bangladesh has increased tremendously (37.63%) compared to the last decades, along with its pesticide use. The most observed pesticide groups used in vegetable production were organophosphorus, pyrethroids, carbamate, organochlorine, nereistoxin analogue group, and neonicotinoids. More specifically, chlorpyrifos, dimethoate, diazinon, and malathion were the most used pesticides. More than 29% of the vegetable samples (1577) were contaminated with pesticide residue; among the contaminated samples (458), most cases (73%) exceeded the maximum residue limits (MRLs). The pesticide-contaminated vegetables were cucumber (51%), tomato (41%), cauliflower (31%), miscellaneous vegetables (36%), eggplant (29%), beans (23%), cabbage (18%), and gourds (16%). Among the pesticide-contaminated samples, vegetables with above MRL were gourds (100%), beans (92), tomato (78%), eggplant (73%), miscellaneous vegetables (69%), cucumber (62%), cabbage (50%), cauliflower (50%) (p < 0.05). It was also observed that a single vegetable was often contaminated with multiple pesticides, and farmers did not follow a proper withdrawal period while using pesticides. Hazard quotation (HQ>1) was observed in adolescents and adults in tomato, eggplant, beans, cauliflower, cabbage, cucumber, lady's finger, lettuce, and coriander. There was no health risk observed (HQ<1) in gourds, potato, carrot, onion, red chilli, red amaranth, spinach, and okra. The highest acute and chronic HQ (aHQ, cHQ) was observed for cypermethrin (bean) in adolescents (aHQ=255, cHQ= 510) and adults (aHQ=131, cHQ=263). It was also observed that these pesticides harmed air, soil, water, and non-target organisms. Nevertheless, the review will help the government develop policies that reduce pesticide use and raise people's awareness of its harmful effects.
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Affiliation(s)
- Popy Khatun
- Department of Pharmacology, Faculty of Veterinary Science, Bangladesh Agricultural University, Bangladesh
| | - Arup Islam
- Department of Microbiology, Mymensingh Medical College, Bangladesh
| | - Sabbya Sachi
- Department of Pharmacology, Faculty of Veterinary Science, Bangladesh Agricultural University, Bangladesh
| | - Md. Zahorul Islam
- Department of Pharmacology, Faculty of Veterinary Science, Bangladesh Agricultural University, Bangladesh
| | - Purba Islam
- Department of Pharmacology, Faculty of Veterinary Science, Bangladesh Agricultural University, Bangladesh
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Nepali P, Adhikari S, Aryal S, Gyawali P, Pathak R, Upreti A, Koirala S, Upadhayaya A, Ghimire B, Bhatta LR. Acute oral poisoning due to pretilachlor herbicide - a rare case report from Nepal. Ann Med Surg (Lond) 2023; 85:6227-6230. [PMID: 38098598 PMCID: PMC10718366 DOI: 10.1097/ms9.0000000000001417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/09/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Acute oral intoxication of pretilachlor, a synthetic chloroacetanilide herbicide, can present similar clinical manifestations of organophosphorus toxicity in humans. Case presentation A 15-year-old male was admitted after suicidal ingestion of pretilachlor poison, with decreased consciousness and blood-mixed vomiting. Discussion Pretilachlor is a colorless and odorless liquid that can cause neurotoxicity and carcinogenicity due to its prolonged exposure. The effects of acute oral exposure are mild and may differ from chronic exposure. Individuals exposed to chloroacetanilides may not show symptoms or experience vomiting and neurological issues. Clinical manifestations such as vomiting, excessive lacrimation, bowel and bladder incontinence, bradycardia, and hypotension can be observed in both organophosphate poisoning and pretilachlor poisoning, making accurate diagnosis challenging, particularly in resource-limited settings like ours. There is no specific antidote for pretilachlor poisoning. Treatment focuses on symptomatic care and monitoring the patient's hemodynamics as per standard protocol. Conclusion This case underscores the need for prompt stabilization, vigilant monitoring, and supportive care to ensure timely recovery in pretilachlor poisoning cases despite similarities with organophosphate poisoning. It emphasizes the importance of educating and raising awareness among physicians about potential mimickers like organophosphates.
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Affiliation(s)
| | | | - Suraj Aryal
- Tribhuvan University, Institute of Medicine, Maharajgunj
| | | | - Roshan Pathak
- Tribhuvan University, Institute of Medicine, Maharajgunj
| | - Apil Upreti
- Tribhuvan University, Institute of Medicine, Maharajgunj
| | - Saru Koirala
- Gandaki Medical College and Teaching Hospital, Pokhara
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11
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Wu YJ, Chang SS, Chen HY, Tsai KF, Lee WC, Wang IK, Lee CH, Chen CY, Liu SH, Weng CH, Huang WH, Hsu CW, Yen TH. Human Poisoning with Chlorpyrifos and Cypermethrin Pesticide Mixture: Assessment of Clinical Outcome of Cases Admitted in a Tertiary Care Hospital in Taiwan. Int J Gen Med 2023; 16:4795-4804. [PMID: 37908758 PMCID: PMC10614644 DOI: 10.2147/ijgm.s432861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 10/12/2023] [Indexed: 11/02/2023] Open
Abstract
Background and Purpose There is an overall paucity of data regarding the human toxicity of chlorpyrifos and cypermethrin pesticide mixture. Both organophosphate and pyrethroid insecticides are metabolized by carboxylesterases. Thus, its pesticide combination, organophosphates may boost the toxicity of pyrethroids via inhibited its detoxification by carboxylesterases. This study examined the clinical course, laboratory tests, and outcomes of patients with chlorpyrifos, cypermethrin or their pesticide mixture poisoning, and to determine what association, if any, might exist between these findings. Patients and Methods Between 2000 and 2021, 121 patients poisoned with chlorpyrifos, cypermethrin, or their pesticide mixture were treated at Chang Gung Memorial Hospital. Patients were categorized as chlorpyrifos (n=82), cypermethrin (n=27) or chlorpyrifos and cypermethrin (n=12) groups. Demographic, clinical, laboratory and mortality data were collected for analysis. Results The patients experienced a broad range of clinical symptoms, including aspiration pneumonia (44.6%), salivation (42.5%), acute respiratory failure (41.3%), acute kidney injury (13.9%), seizures (7.5%), hypotension (2.6%), etc. Leukocytosis (12,700±6600 /uL) and elevated serum C-reactive protein level (36.8±50.4 mg/L) were common. The acute respiratory failure rate was 41.3%, comprising 48.8% in chlorpyrifos, 11.1% in cypermethrin as well as 58.3% in chlorpyrifos and cypermethrin poisoning. Patients with chlorpyrifos and cypermethrin pesticide mixture poisoning suffered higher rates of acute respiratory failure (P=0.001) and salivation (P=0.001), but lower Glasgow Coma Scale score (P=0.011) and serum cholinesterase level (P<0.001) than other groups. A total of 17 (14.0%) patients expired. The mortality rate was 14.0%, including 17.1% in chlorpyrifos, 3.7% in cypermethrin as well as 16.7% in chlorpyrifos and cypermethrin poisoning. No significant differences in mortality rate were noted (P=0.214). Conclusion Chlorpyrifos pesticide accounted for the major toxicity of the pesticide mixture. While the data show a higher rate of respiratory failure in the chlorpyrifos and cypermethrin pesticide mixture group than others, other measures of toxicity such as mortality and length of stay were not increased.
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Affiliation(s)
- Yi-Jan Wu
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, Department of Public Health, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Hsien-Yi Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
| | - Kai-Fan Tsai
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung City, Taiwan
| | - Wen-Chin Lee
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung City, Taiwan
| | - I-Kuan Wang
- Department of Nephrology, China Medical University Hospital, Taichung City, Taiwan
- College of Medicine, China Medical University, Taichung City, Taiwan
| | - Chern-Horng Lee
- Division of General Internal Medicine and Geriatrics, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
| | - Chao-Yu Chen
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Shou-Hsuan Liu
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Cheng-Hao Weng
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Wen-Hung Huang
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Ching-Wei Hsu
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology, Clinical Poison Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
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12
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Stephenson L, Van Den Heuvel C, Humphries M, Nash C, Byard RW. Features of fatal pesticide ingestion in South Australia. MEDICINE, SCIENCE, AND THE LAW 2023:258024231197914. [PMID: 37661826 DOI: 10.1177/00258024231197914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
Pesticides are used to kill, repel or control any animal or plant species which are considered pests, but have also been associated with intentional and unintentional human fatalities. A rapid increase in pesticide suicides was observed during 'The Green Revolution' after pesticides were introduced into low- and middle-income rural households without appropriate guidelines for safe use and storage. While national pesticide bans have contributed to a significant decrease in pesticide-related suicides, such cases still comprise a large proportion of all suicides around the world. The aim of the current study was to provide a profile of pesticide suicides in a high-income country as a point of comparison against studies from low- and middle-income countries. Statistical analyses were performed using R (version 4.2.3). Over the 20-year study period, there were a low, yet consistent number of pesticide suicides which were most common among males over the age of 40. Paraquat and methomyl pesticides collectively contributed to almost half (48.8%) of all fatalities. Consistent with the literature, such cases often occurred with little premeditation in response to an acute emotional crisis. While interpretation of autopsy findings was mostly limited, there were some pesticides that demonstrated findings consisted with previously reported characteristics (e.g., gastroesophageal erosions with paraquat). Given the high proportion of cases where paraquat and methomyl pesticides were implicated, it may be appropriate to review the availability and accessibility of such compounds to reduce the occurrence of pesticide suicides in South Australia and potentially the wider Australian population.
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Affiliation(s)
- Lilli Stephenson
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Melissa Humphries
- School of Mathematical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Christine Nash
- Toxicology Group, Forensic Science SA (FSSA), Adelaide, South Australia, Australia
| | - Roger W Byard
- Pathology Group, Forensic Science SA (FSSA), Adelaide, South Australia, Australia
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Grau D, Grau N, Paroissin C, Gascuel Q, Di Cristofaro J. Underestimation of glyphosate intake by the methods currently used by regulatory agencies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:100626-100637. [PMID: 37639106 DOI: 10.1007/s11356-023-29463-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/18/2023] [Indexed: 08/29/2023]
Abstract
The acceptable daily intake (ADI) is an estimate of the amount of a substance in food or beverages that can be consumed daily over a lifetime without presenting an appreciable risk to health. To assess the risk of ingesting glyphosate, regulatory agencies compare glyphosate daily intake to ADI. Based on published data on urine glyphosate levels measured according to known quantities of ingested glyphosate, our objectives were to test the robustness of the mathematical model currently used to calculate glyphosate daily intake, and to propose alternative models based on urinary excretion kinetics. Our results support that the quantity of ingested glyphosate is systematically underestimated by the model currently used by regulatory agencies, whereas the other models evaluated showed better estimations, with differences according to gender. Our results also show a great variability between individuals, leading to some uncertainties notably with regards to the ADI, and further support that glyphosate excretion varies significantly among individuals who follow a similar dosing regimen. In conclusion, our study highlights the lack of reliability of assessment processes carried out by regulatory agencies for glyphosate in particular, and pesticides in general, and questions the relevance of such processes supposed to safeguard human health and the environment.
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Affiliation(s)
- Daniel Grau
- Association Campagne Glyphosate, Foix, France
| | - Nicole Grau
- Association Campagne Glyphosate, Foix, France
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14
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Souza MCO, Cruz JC, Cesila CA, Gonzalez N, Rocha BA, Adeyemi JA, Nadal M, Domingo JL, Barbosa F. Recent trends in pesticides in crops: A critical review of the duality of risks-benefits and the Brazilian legislation issue. ENVIRONMENTAL RESEARCH 2023; 228:115811. [PMID: 37030406 DOI: 10.1016/j.envres.2023.115811] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 05/16/2023]
Abstract
Due to the increasing population worldwide, in recent years, an exponential increase in agricultural practices has occurred in order to attend to the growing demand for food. Unfortunately, this increase is not associated with the supply of foodstuffs free of environmental pollutants. In Brazil, agriculture is one of the most important economic pillars, making the country one of the largest consumers of pesticides around the world. The intense use of pesticides, mainly glyphosate, 2,4-D, and atrazine, constitutes an essential factor in the viability of this great agricultural productivity. Sugarcane, corn, soybean, and citrus crops consume around 66% of the total pesticides worldwide, representing 76% of the planted area. Pesticide residues have been frequently detected in food and the environment, becoming a significant concern for human health. Monitoring programs for pesticide use are essential to reduce the potential negative impacts on the environment and improve the overall efficiency and sustainability of their use. However, in Brazil, the approval status of pesticide-active ingredients is very discrepant compared to other agricultural countries. Moreover, the duality of benefits and risks of pesticide application creates an economic and toxicological conflict. In this paper, we have critically reviewed the duality of risks-benefits of the use of pesticides in agriculture and the current Brazilian legislation issues. We have also compared this flawed legislation with other countries with high economic potential. Due to the negative environmental impacts on soil and water by the high levels of pesticides, remediation techniques, sustainable agriculture, and the development of new technologies can be considered some viable alternatives to reduce the levels in these compartments. Besides, this paper includes some recommendations that can be included in the coming years.
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Affiliation(s)
- Marília Cristina Oliveira Souza
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology and Food Sciences. Analytical and System Toxicology Laboratory, Avenida do Cafe s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil.
| | - Jonas Carneiro Cruz
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology and Food Sciences. Analytical and System Toxicology Laboratory, Avenida do Cafe s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil
| | - Cibele Aparecida Cesila
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology and Food Sciences. Analytical and System Toxicology Laboratory, Avenida do Cafe s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil
| | - Neus Gonzalez
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology and Food Sciences. Analytical and System Toxicology Laboratory, Avenida do Cafe s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil; Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, Sant Llorenç 21, 43201 Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Catalonia, Spain
| | - Bruno Alves Rocha
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology and Food Sciences. Analytical and System Toxicology Laboratory, Avenida do Cafe s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil
| | - Joseph A Adeyemi
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology and Food Sciences. Analytical and System Toxicology Laboratory, Avenida do Cafe s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil; Department of Biology, School of Sciences, Federal University of Technology, Akure, Ondo State, Nigeria
| | - Marti Nadal
- Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, Sant Llorenç 21, 43201 Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Catalonia, Spain
| | - José L Domingo
- Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, Sant Llorenç 21, 43201 Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Catalonia, Spain
| | - Fernando Barbosa
- University of Sao Paulo, School of Pharmaceutical Sciences of Ribeirao Preto, Department of Clinical Analyses, Toxicology and Food Sciences. Analytical and System Toxicology Laboratory, Avenida do Cafe s/n°, 14040-903, Ribeirao Preto, Sao Paulo, Brazil
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Zaman T, Fahad TM, Rana M, Hossain MS, Mamun A, Haque MA, Sarker A, Islam MS, Haque MMUL, Naz T, Manik MIN, Ali H, Yamasu K, Khan A. Endosulfan affects embryonic development synergistically under elevated ambient temperature. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-27665-z. [PMID: 37188935 DOI: 10.1007/s11356-023-27665-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 05/11/2023] [Indexed: 05/17/2023]
Abstract
In the present study, we determined the developmental toxicity of endosulfan at an elevated ambient temperature using the zebrafish animal model. Zebrafish embryos of various developmental stages were exposed to endosulfan through E3 medium, raised under two selected temperature conditions (28.5 °C and an elevated temperature of 35 °C), and monitored under the microscope. Zebrafish embryos of very early developmental stages (cellular cleavage stages, such as the 64-cell stage) were highly sensitive to the elevated temperature as 37.5% died and 47.5% developed into amorphous type, while only 15.0% of embryos developed as normal embryos without malformation. Zebrafish embryos that were exposed concurrently to endosulfan and an elevated temperature showed stronger developmental defects (arrested epiboly progress, shortened body length, curved trunk) compared to the embryos exposed to either endosulfan or an elevated temperature. The brain structure of the embryos that concurrently were exposed to the elevated temperature and endosulfan was either incompletely developed or malformed. Furthermore, the stress-implicated genes hsp70, p16, and smp30 regulations were synergistically affected by endosulfan treatment under the elevated thermal condition. Overall, the elevated ambient temperature synergistically enhanced the developmental toxicity of endosulfan in zebrafish embryos.
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Affiliation(s)
- Tanjeena Zaman
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh
- Rajshahi Institute of Bioscience, Maskatadighi, Motihar, Rajshahi, 6212, Bangladesh
| | | | - Masud Rana
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | | | - Al Mamun
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Md Anwarul Haque
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Ashananda Sarker
- Department of Pharmacy, Jagannath University, Chittaranjan Avenue, Dhaka, 1100, Bangladesh
| | - Md Shariful Islam
- Department of Veterinary and Animal Science, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Md Minhaz-U L Haque
- Department of Applied Chemistry and Chemical Engineering, Islamic University, Kushtia, 7003, Bangladesh
| | - Tarannum Naz
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh
| | - Md Imran Nur Manik
- Department of Pharmacy, Northern University Bangladesh, Dhaka, Bangladesh
| | - Hazrat Ali
- Department of Pharmacy, International Islamic University Chittagong, Chittagong, 4318, Bangladesh
| | - Kyo Yamasu
- Division of Life Science, Graduate School of Science and Engineering, Saitama University, Saitama, 338-8570, Japan
| | - Alam Khan
- Department of Pharmacy, University of Rajshahi, Rajshahi, 6205, Bangladesh.
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16
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Dabholkar S, Pirani S, Davis M, Khan M, Eddleston M. Suicides by pesticide ingestion in Pakistan and the impact of pesticide regulation. BMC Public Health 2023; 23:676. [PMID: 37041526 PMCID: PMC10088141 DOI: 10.1186/s12889-023-15505-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 03/22/2023] [Indexed: 04/13/2023] Open
Abstract
INTRODUCTION Suicide is a major public health problem in Pakistan, accounting to approximately 19,331 deaths every year. Many are due to consumption of acutely toxic pesticides; however, there is a lack of national suicide data, limiting knowledge and potential for intervention. In this paper, we aimed to review the literature on pesticide self-poisoning in Pakistan to identify the most problematic pesticides in relation to national pesticide regulations. METHODS Information on the currently registered and banned pesticides was obtained from Ministry of National Food Security and Research while data on pesticide import and use was extracted from FAOSTAT. We searched the following sources for articles and research papers on poisoning in Pakistan: Cumulative Index to Nursing and Allied Health (CINAHL), Google Scholar, Applied Social Sciences Index and Abstracts (ASSIA), Excerpta Medica (EMBASE), National Library of Medicine's MEDLINE (PUBMED), PS102YCHINFO and Pakmedinet.com using the search terms 'self-poisoning', 'deliberate self-harm', 'suicide', 'methods and means of suicide', 'organophosphate', 'wheat pill', 'aluminium phosphide', 'acute poisoning', OR 'pesticides', AND 'Pakistan'. RESULTS As of May 2021, 382 pesticide active ingredients (substances) were registered in Pakistan, of which five were WHO hazard class Ia (extremely hazardous) and 17 WHO hazard class Ib (highly hazardous). Twenty-six pesticides, four formulations, and seven non-registered pesticides had been banned, of which two were WHO class Ia and five Ib. We identified 106 hospital-level studies of poisoning conducted in Pakistan, of which 23 did not mention self-poisoning cases and one reported no suicidal poisoning cases. We found no community or forensic medicine studies. Of 52,323 poisoning cases identified in these papers, 24,546 [47%] were due to pesticides. The most commonly identified pesticide classes were organophosphorus (OP) insecticides (13,816 cases, 56%) and the fumigant aluminium phosphide (3 g 56% tablets, often termed 'wheat pills'; 686 cases, 2.7%). Few studies identified the particular pesticides involved or the resulting case fatality. CONCLUSION We found pesticide poisoning to be a major cause of poisoning in Pakistan, with OP insecticides and the fumigant aluminium phosphide the main pesticides identified. Withdrawal of Class I pesticides (as proposed to occur nationally in 2022) and high concentration aluminium phosphide tablets should rapidly reduce suicidal deaths by reducing the case fatality for low-intention poisoning cases. National cause of death data and forensic toxicology laboratory data identifying the pesticides responsible for deaths will be important to assess impacts of the proposed national ban.
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Affiliation(s)
- Shweta Dabholkar
- Centre For Pesticide Suicide Prevention, University of Edinburgh, QMRI E3.22a, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Shahina Pirani
- Department of Psychiatry, & Brain & Mind Institute, Aga Khan University, Karachi, Pakistan
| | - Mark Davis
- Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Murad Khan
- Department of Psychiatry, & Brain & Mind Institute, Aga Khan University, Karachi, Pakistan
| | - Michael Eddleston
- Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
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Atone J, Wagner K, Koike S, Yang J, Hwang SH, Hammock BD. Inhibition of soluble epoxide hydrolase reduces paraquat neurotoxicity in rodents. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2023; 98:104070. [PMID: 36682504 PMCID: PMC9992278 DOI: 10.1016/j.etap.2023.104070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/15/2023] [Accepted: 01/18/2023] [Indexed: 06/17/2023]
Abstract
Given the paucity of research surrounding the effect of chronic paraquat on striatal neurotoxicity, there is a need for further investigation into the neurotoxic effects of paraquat in mouse striatum. Furthermore, while previous studies have shown that inhibiting soluble epoxide hydrolase mitigates MPTP-mediated endoplasmic reticulum stress in mouse striatum, its effect on paraquat toxicity is still unknown. Thus, this study attempts to observe changes in inflammatory and endoplasmic reticulum stress markers in mouse striatum following chronic paraquat administration to determine whether inhibiting soluble epoxide hydrolase mitigates paraquat-induced neurotoxicity and whether it can reduce TLR4-mediated inflammation in primary astrocytes and microglia. Our results show that while the pro-inflammatory effect of chronic paraquat is small, there is a significant induction of inflammatory and cellular stress markers, such as COX2 and CHOP, that can be mitigated through a prophylactic administration of a soluble epoxide hydrolase inhibitor.
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Affiliation(s)
- Jogen Atone
- Department of Entomology and Nematology, and UC Davis Comprehensive Cancer Center, University of California Davis, Davis, CA 95616, USA
| | - Karen Wagner
- Department of Entomology and Nematology, and UC Davis Comprehensive Cancer Center, University of California Davis, Davis, CA 95616, USA
| | - Shinichiro Koike
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA
| | - Jun Yang
- Department of Entomology and Nematology, and UC Davis Comprehensive Cancer Center, University of California Davis, Davis, CA 95616, USA
| | - Sung Hee Hwang
- Department of Entomology and Nematology, and UC Davis Comprehensive Cancer Center, University of California Davis, Davis, CA 95616, USA
| | - Bruce D Hammock
- Department of Entomology and Nematology, and UC Davis Comprehensive Cancer Center, University of California Davis, Davis, CA 95616, USA.
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18
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Li C, Wang Y, Wang Z, Li X. β-Cyclodextrin/Azobenzene Microspheres Loaded with Paraquat Are Safe and Effective. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2023; 39:638-646. [PMID: 36542801 DOI: 10.1021/acs.langmuir.2c03004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Although paraquat is a widely used herbicide, it is toxic to humans if ingested or absorbed through an open wound. To improve the safety of paraquat, a new formulation of paraquat based on photoresponsive polymers was exploited. Photoresponsive β-cyclodextrin polymer microspheres (AZO-CD) were synthesized via a host-guest interaction between β-cyclodextrin and azobenzene. AZO-CD were characterized by Fourier transform infrared spectrometry, circular dichroism, ultraviolet (UV) spectrophotometry, and thermogravimetric analysis, and their photoresponsiveness was also evaluated. AZO-CD were used to load paraquat, which yielded photoresponsive paraquat-loaded microspheres. For the paraquat-loaded microspheres, irradiation with UV light or sunlight induced the isomerization of azobenzene into the cis form. Then, the cis-azobenzene was liberated from the cavities of the β-cyclodextrin. The paraquat-loaded microspheres released paraquat continuously over time. Furthermore, under UV light, the herbicidal capacity of the paraquat-loaded microspheres against barnyard grass was comparable to that of free paraquat at the same dose. Our findings show that loading paraquat into AZO-CD provides a safe and environmentally friendly herbicide formulation.
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Affiliation(s)
- Chaonan Li
- Engineering & Technology Research Center for Bio Pesticide and Formulating Processing, College of Plant Protection, Hunan Agricultural University, Changsha410128, China
| | - Ya Wang
- Engineering & Technology Research Center for Bio Pesticide and Formulating Processing, College of Plant Protection, Hunan Agricultural University, Changsha410128, China
| | - Zihao Wang
- Engineering & Technology Research Center for Bio Pesticide and Formulating Processing, College of Plant Protection, Hunan Agricultural University, Changsha410128, China
| | - Xiaogang Li
- Engineering & Technology Research Center for Bio Pesticide and Formulating Processing, College of Plant Protection, Hunan Agricultural University, Changsha410128, China
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Multiwalled Carbon Nanotubes Embedded in a Polymeric Matrix as a New Material for Thin Film Microextraction (TFME) in Organic Pollutant Monitoring. Polymers (Basel) 2023; 15:polym15020314. [PMID: 36679194 PMCID: PMC9863860 DOI: 10.3390/polym15020314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/30/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
It is essential to monitor organic pollutants to control contamination levels in environmental water bodies. In this respect, the development of new materials based on functionalised polymeric films for the measurement of toxic compounds is of interest. In this study, we prepare new films based on polymer cellulose triacetate modified with multi-walled carbon nanotubes for the monitoring of selected compounds: a fungicide (chlorpyrifos) and two emerging contaminants, the musk tonalide and the bactericide triclosan, which are used in the formulation of personal care products. The films, upon contact with water samples and following the principles of thin film microextraction, allow the determination of organic pollutants at low concentration levels. The contact time of the film with a predetermined volume of water is fixed at 60 min, and the compounds are eluted with a small volume (1 mL) of organic solvent for GC-MS analysis. Parameters such as repeatability for different films and detection limits are found to be satisfactory. Applying the method to river water demonstrates its suitability and, in the cases of chlorpyrifos and tonalide, the absence of a significant matrix effect.
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Deuster E, Tomenson JA, Mohamed F, Gawarammana I, Buckley NA, Wilks MF, Eddleston M. Dose ingested, vomiting, and outcome in patients ingesting a standard paraquat 20SL formulation. Clin Toxicol (Phila) 2023; 61:29-38. [PMID: 36541442 DOI: 10.1080/15563650.2022.2142601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND FAO specifications for liquid paraquat dichloride SL formulations require the use of an emetic agent to stimulate vomiting within 30 min of ingestion. To date, there is no high-quality evidence of efficacy, despite use of the PP796 emetic since 1979. We first examined the validity of patients' self-reported dose of paraquat ingested by examining the relationship with blood paraquat concentration and time to death for patients ingesting the standard paraquat SL formulation in a Sri Lankan cohort. As a secondary outcome, we assessed whether ingestion resulted in vomiting within 30 min and whether vomiting was associated with good outcome. METHODS Patients presenting with paraquat SL self-poisoning were prospectively studied in ten Sri Lankan hospitals in 2003-08. Data on reported dose ingested, incidence and timing of vomiting after ingestion, treatment received, plasma paraquat concentration, and outcome were collected prospectively on presentation to hospital. Time between ingestion and blood sampling was incorporated by covariate adjustment. RESULTS 441 patients were recruited to the case series, presenting a median (IQR) of 3.0 (1.5-8.1] h post ingestion. Outcome was known for 435 patients of whom 322 (74.0%) died within 42 days, a median of 1.3 (0.6-4.4) days post ingestion. Median reported dose ingested was 15 to <30 mL. There was a highly significant linear trend between log plasma paraquat and reported dose ingested (p < .001); adjustment for the log of the time from ingestion to sampling further improved the model fit. Case fatality and median time to death also showed good agreement with estimated ingestion amount. 347/438 patients (79.2%) were stated to have vomited before reaching the study hospital with 300 (68.5%) vomiting within 30 min of ingestion; time to vomiting was unknown for a further 12 (2.7%). The proportion vomiting was strongly associated with reported dose ingested (p < .001); of note the proportion vomiting within 30 min only increased to 83.3% for the highest ingestion group. Patients vomiting within 30 min had higher plasma paraquat concentrations (p = .008), and higher hazard ratio in the adjusted Cox regression model of 2.01 (95% CI 1.45-2.77) compared to those who did not. Vomiting within 30 min was associated with a higher case fatality (241/295 [81.7%] vs 68/125 [54.4%], p < .001). Forty-three (47.3%) of the 91 patients who did not vomit before reaching hospital died (one had unknown outcome). CONCLUSION Importantly, we found good agreement between reported dose ingested and plasma paraquat concentration, case fatality, and time to death, suggesting that the reported dose is a valid marker for the dose ingested. Vomiting occurred within 30 min for 68.5% of patients, exceeding the characteristics for a purported effective emetic in the FAO specifications. However, vomiting within 30 min was associated with approximately double the risk of death compared to those who did not vomit, larger paraquat ingestions, and higher blood paraquat concentrations. In addition, death occurred in many patients who did not vomit, and the proportion vomiting within 30 min only reached 82.1% for the highest ingested dose group. Overall, we found no evidence of benefit resulting from incorporation of the emetic, suggesting that the current FAO specification is not effective at preventing deaths after ingestion of the paraquat SL formulation.
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Affiliation(s)
- Eileen Deuster
- University Hospital Frankfurt Goethe University, Frankfurt, Germany
| | | | - Fahim Mohamed
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Indika Gawarammana
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Nicholas A Buckley
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka.,Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Martin F Wilks
- Swiss Centre for Applied Human Toxicology & Dept. of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Michael Eddleston
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka.,Centre for Pesticide Suicide Prevention and Pharmacology, Toxicology and Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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21
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Fu G, Duan Y, Yi W, Zhang S, Liang W, Li H, Yan H, Wu B, Fu S, Zhang J, Zhang G, Wang G, Liu Y, Xu S. A rapid and reliable immunochromatographic strip for detecting paraquat poinsoning in domestic water and real human samples. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 315:120324. [PMID: 36191800 DOI: 10.1016/j.envpol.2022.120324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/14/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
Paraquat (PQ) is one of the most commonly used herbicides, but it has polluted the environment and threatened human health through extensive and improper usage. Here, a new naked-eye PQ immunochromatographic strip was developed to recognize PQ in domestic water and real human samples within 10 min based on a novel custom-designed anti-PQ antibody. The PQ test strip could recognize PQ at a concentration as low as 10 ng/ml, reaching the high-efficiency time-of-flight mass spectrometry detection level and identifying trace amounts of PQ in samples treated with a diquat (DQ) and PQ mixture. Notably, both the performance evaluation and clinical trial of the proposed PQ strips were validated in multiple hospitals and public health agencies. Taken together, our study firstly provide the clinical PQ-targeted colloidal gold immunochromatographic test strip designed both for environment water and human sample detection with multiple advantages, which are ready for environmental monitoring and clinical practice.
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Affiliation(s)
- Guanyan Fu
- Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing, 400060, China; National Emergency Response Team for Sudden Poisoning, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College Chongqing 400060, China
| | - Yu Duan
- Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing, 400060, China; National Emergency Response Team for Sudden Poisoning, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College Chongqing 400060, China
| | | | - Shun Zhang
- Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing, 400060, China; Zybio Inc, Chongqing, 400016, China
| | - Wenbin Liang
- Key Laboratory of Luminescence Analysis and Molecular Sensing (Southwest University), Ministry of Education, College of Chemistry and Chemical Engineering, Southwest University, Chongqing, 400715, China
| | - Huiling Li
- Department of Occupational Medicine and Clinical Toxicology, Beijing Chao-yang Hospital, Capital Medical University, Beijing, 100020, PR China
| | - Huifang Yan
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Beijing, 100050, China
| | - Banghua Wu
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, 510300, China
| | - Sheng Fu
- Hunan Prevention and Treatment Institute for Occupational Diseases, Hunan Province, 410007, China
| | - Jing Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, 610041, China
| | - Gen Zhang
- Hubei Provincial Hospital of Integrated Chinese and Western Medicine, Wuhan, 430010, China
| | - Guixue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, 400030, China
| | - Yongsheng Liu
- Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing, 400060, China; National Emergency Response Team for Sudden Poisoning, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College Chongqing 400060, China
| | - Shangcheng Xu
- Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing, 400060, China; National Emergency Response Team for Sudden Poisoning, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College Chongqing 400060, China.
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Occupational factors affecting the decline in pulmonary function among male farmers using occupational pesticide in Gyeonggi-do, South Korea. Ann Occup Environ Med 2022; 34:e42. [PMID: 36704539 PMCID: PMC9836821 DOI: 10.35371/aoem.2022.34.e42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/07/2022] [Accepted: 11/08/2022] [Indexed: 12/23/2022] Open
Abstract
Background Occupational pesticide exposure is a potential risk for respiratory health effects. Most clinical studies on pesticide exposure were related to acute exposure, and only a few studies on chronic exposure have been conducted. This study investigated the chronic respiratory health status and the chronic effects of occupational pesticide exposures of farmers in Gyeonggi-do. Methods Surveys and pulmonary function tests were conducted on 1,697 farmers in 16 regions of Gyeonggi-do. The structured questionnaire included demographic characteristics, medical history, recent respiratory symptoms and diseases, and work-related conditions, and was conducted through one-on-one interviews. The prevalence of respiratory diseases was compared by the odds ratios (ORs) at 95% confidence intervals (CIs) estimated by logistic regression analysis. Additional multivariate logistic regression analysis was also conducted. Results Pesticide work groups showed significant association with an obstructive pattern in the lung function test (unadjusted OR, 2.38; 95% CI, 1.17-5.52). Selected work-related variables of pesticide exposure were 'start age,' 'cumulative duration,' 'mixing pesticides,' and 'protection(goggle).' The obstructive pattern of lung function test showed significant associations with mixing pesticides (OR, 2.30; 95% CI,1.07-5.46), and protection (goggle) use (OR, 0.34; 95% CI, 0.12-0.79). Conclusions Mixing two or more pesticides showed a significant association. Wearing goggles can be seen as an indicator of awareness of the protective equipment and proper wearing of protective equipment, and loss of pulmonary function can be prevented when appropriate protection is worn.
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Gerlits O, Fajer M, Cheng X, Blumenthal DK, Radić Z, Kovalevsky A. Structural and dynamic effects of paraoxon binding to human acetylcholinesterase by X-ray crystallography and inelastic neutron scattering. Structure 2022; 30:1538-1549.e3. [PMID: 36265484 PMCID: PMC9637784 DOI: 10.1016/j.str.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/07/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022]
Abstract
Organophosphorus (OP) compounds, including nerve agents and some pesticides, covalently bind to the catalytic serine of human acetylcholinesterase (hAChE), thereby inhibiting acetylcholine hydrolysis necessary for efficient neurotransmission. Oxime antidotes can reactivate the OP-conjugated hAChE, but reactivation efficiency can be low for pesticides, such as paraoxon (POX). Understanding structural and dynamic determinants of OP inhibition and reactivation can provide insights to design improved reactivators. Here, X-ray structures of hAChE with unaged POX, with POX and oximes MMB4 and RS170B, and with MMB4 are reported. A significant conformational distortion of the acyl loop was observed upon POX binding, being partially restored to the native conformation by oximes. Neutron vibrational spectroscopy combined with molecular dynamics simulations showed that picosecond vibrational dynamics of the acyl loop soften in the ∼20-50 cm-1 frequency range. The acyl loop structural perturbations may be correlated with its picosecond vibrational dynamics to yield more comprehensive template for structure-based reactivator design.
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Affiliation(s)
- Oksana Gerlits
- Department of Natural Sciences, Tennessee Wesleyan University, Athens, TN 37303, USA
| | - Mikolai Fajer
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA
| | - Xiaolin Cheng
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH 43210, USA
| | - Donald K Blumenthal
- Department of Pharmacology and Toxicology, University of Utah, Salt Lake City, UT 84112, USA
| | - Zoran Radić
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla, CA 92093-0657, USA.
| | - Andrey Kovalevsky
- Neutron Scattering Division, Oak Ridge National Laboratory, Oak Ridge, TN 37831, USA.
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Brassell M, Karunarathne A, Utyasheva L, Eddleston M, Konradsen F, Rother HA. Current pesticide suicide surveillance methods used across the African continent: a scoping review protocol. BMJ Open 2022; 12:e055923. [PMID: 35981770 PMCID: PMC9394204 DOI: 10.1136/bmjopen-2021-055923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Every year, more than 800 000 people die from suicides of which an estimated 20% are from pesticide ingestion. Multiple studies have estimated that around 77%-80% of these pesticide suicides occur in low/middle-income countries. The full burden of pesticide suicides in African countries remains poorly documented, one reason being the lack of systematic data collection. It is essential to know the number of pesticide suicide cases to guide prevention of further cases occurring. This can be done by informing policy and legislation, and the implementation of targeted bans, as well as raising community awareness around the use of these pesticides, training of healthcare personnel, and influencing the type and level of clinical facility investments into this area of healthcare. The scoping review aims to investigate how pesticide suicide deaths in Africa are recorded by exploring the various surveillance systems in place, as well as highlighting key limitations and data collection barriers. METHODS AND ANALYSIS A scoping review will be carried out with the five-stage methodological frameworks set out by Arksey and O'Malley and the Joanna Briggs Institute. Studies in English that looked at pesticide suicide in African countries will be extracted and screened independently by two reviewers against the inclusion and exclusion criteria of this review. Studies' data will be extracted, and a descriptive synthesis developed of their main findings, as guided by the approach of Levac and colleagues. ETHICS AND DISSEMINATION Ethics approval is not required for this review as no human participants will be involved. The study findings will be distributed in a peer-reviewed publication. REGISTRATION DETAILS This protocol has been submitted for publication to BMJ Open.
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Affiliation(s)
- Maxine Brassell
- Division of Environmental Health, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
| | - Ayanthi Karunarathne
- Centre for Pesticide Suicide Prevention, The University of Edinburgh The Queen's Medical Research Institute, Edinburgh, UK
| | - Leah Utyasheva
- Centre for Pesticide Suicide Prevention, The University of Edinburgh The Queen's Medical Research Institute, Edinburgh, UK
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, The University of Edinburgh The Queen's Medical Research Institute, Edinburgh, UK
| | - Flemming Konradsen
- Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Hanna-Andrea Rother
- Division of Environmental Health, University of Cape Town Faculty of Health Sciences, Observatory, Western Cape, South Africa
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25
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Nendick E, Mohamed F, Raubenheimer J, Gawarammana I, Buckley NA, Eddleston M. Acute fungicide self-poisoning - a prospective case series. Clin Toxicol (Phila) 2022; 60:1106-1112. [PMID: 35950874 DOI: 10.1080/15563650.2022.2105710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Pesticide self-poisoning is a global clinical and public health problem. While self-poisoning with insecticides and herbicides has been extensively studied, there is minimal literature on acute fungicide self-poisoning. We aimed to study the clinical course and outcome of fungicide self-poisoned patients recruited to a prospective cohort in Sri Lanka. METHODS We conducted a prospective study of patients presenting with fungicide self-poisoning to nine hospitals in Sri Lanka between 2002 and 2020. Patients were enrolled by clinical research assistants, with clinical outcomes being recorded at regular review for each patient. RESULTS We identified 337 cases of self-poisoning with fungicides (alcohol as only co-ingestant), including 28 different fungicides across 5 different fungicide classes. Median time from ingestion to examination was 3.1 (1.8-5.7) h. Nearly all presented to hospital fully conscious (GCS 15, 15-15)- only 27 patients (8.0%) presented with reduced GCS (<15) and only 2 (0.6%) had GCS 3/15. Most patients (333/337, 98.8%) made a full recovery, of whom only eight (2.37%) required intubation and ventilation. Four patients died (case fatality rate: 1.2%; 95% CI 0.0-23.4) after ingestion of edifenphos (n = 2), propamocarb and pyraclostrobin. CONCLUSION Fungicide self-poisoning appears to be less hazardous than insecticide or herbicide self-poisoning, with a substantially lower case fatality in the same cohort. Edifenphos is an exception to this 'less toxic' rule; as a WHO Class Ib highly hazardous pesticide, we recommend its withdrawal from, and replacement in, global agricultural practice. Propamocarb should be listed in the WHO hazard classification as propamocarb hydrochloride to reflect the higher toxicity of the common agricultural formulation. Pyraclostrobin currently has no WHO classification; one is urgently required now that its ingestion has now been linked the death of a patient. Additional prospective clinical data on fungicide self-poisoning is required to expand knowledge on the effects of these diverse compounds.
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Affiliation(s)
- Edward Nendick
- Academic Unit of Medical Education, University of Sheffield, Sheffield, UK
| | - Fahim Mohamed
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Jacques Raubenheimer
- Pharmacology, Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Indika Gawarammana
- Faculty of Allied Health Sciences, Department of Pharmacy, University of Peradeniya, Peradeniya, Sri Lanka
| | - Nick A Buckley
- National Poison Centre, Universiti Sains Malaysia, Penang, Malaysia
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Eddleston M. Evidence for the efficacy of the emetic PP796 in paraquat SL20 formulations - a narrative review of published and unpublished evidence. Clin Toxicol (Phila) 2022; 60:1163-1175. [PMID: 35950791 DOI: 10.1080/15563650.2022.2105709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The bipyridyl herbicide paraquat was first introduced into agriculture in the 1960s by Imperial Chemical Industries. Due to issues with unintentional poisoning, the centrally acting emetic PP796 was added in 1976 to the company's 20% paraquat ion soluble liquid (SL20) formulations (Gramoxone®) at a concentration of 0.5 g/L or 0.05% (equivalent to 0.071 mg/kg in a 70 kg adult ingesting a minimum lethal dose of 10 mL) to induce early vomiting (within 30 min), reduce paraquat absorption from the gut, and prevent deaths. Its presence in paraquat products was subsequently mandated by the Food and Agriculture Organization Committee of Experts on Pesticides in Agriculture (predecessor to the current FAO/WHO Joint Meeting on Pesticide Specifications). However, no primary pre-clinical or clinical data have been published regarding the effectiveness of PP796. We reviewed the published literature and unpublished company reports for data on the effectiveness of PP796. METHODS PubMed and Google were searched for published studies on the emetic using the search terms "paraquat" and ["emetic" or "PP796"]. Company documents reporting pre-clinical and clinical studies were accessed at the website of U.S. Right to Know (https://usrtk.org/pesticides/paraquat-papers/). Primary study reports were sought as well as overviews written by company toxicologists. RESULTS Pre-clinical dog and monkey studies indicated that the PP796 EC50 dose for vomiting was around 0.5-2 mg/kg. Further increasing the PP796 concentration speeded up the time to first vomit and reduced the amount of paraquat absorbed (as assessed by the 0-24 h plasma area-under-the-curve) 100-fold compared to a control group receiving no PP796. However, the dose selected for paraquat SL20 formulations by the company (0.5 g/L or 0.05%) was based exclusively on a phase II study in the early 1970s involving five volunteers receiving 3 different doses, with only two individuals actually vomiting, supplemented by data from 37 patients taking 2 mg in clinical trials. A UK-mandated toxicovigilance study in the 1980s identified only 21 patients ingesting paraquat SL20 with PP796 for whom data on time to vomit was available; of these patients, 11 vomited within 30 min (52.4%, 95%CI 31-73.7%). No effect on mortality could be identified from any study of paraquat SL containing 0.05% PP796. A clinical study in Sri Lanka 30 years after the emetic was first introduced, of a revised formulation (Gramoxone® Inteon) containing a three-fold higher amount of PP796, as well as MgSO4 and an alginate, showed increased rates of early vomiting and modestly reduced mortality for patients ingesting up to 100 mL. CONCLUSION Pre-clinical studies showed a clear dose response for PP796 to cause early vomiting, with effective doses in the 0.5-20 mg/kg range. A too low concentration of PP796 was selected for paraquat formulations based on an inadequate phase II study. Currently, evidence that PP796 at 0.05% in paraquat SL20 causes more rapid vomiting after ingestion is weak or unpublished; no evidence of clinical benefit or fewer deaths has been identified. There is no evidence to support the FAO/WHO Joint Meeting on Pesticide Specifications mandate to include PP796 or any other emetic in paraquat products. Products with higher emetic concentrations have been developed but are not widely used; it is possible they may prevent deaths.
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Affiliation(s)
- Michael Eddleston
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Isorhapontigenin Modulates SOX9/TOLLIP Expression to Attenuate Cell Apoptosis and Oxidative Stress in Paraquat-Induced Acute Kidney Injury. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3328623. [PMID: 35720190 PMCID: PMC9203234 DOI: 10.1155/2022/3328623] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 05/07/2022] [Indexed: 11/18/2022]
Abstract
Paraquat (PQ) is a widely used herbicide but can be lethal to humans. The kidney is vital for PQ elimination; therefore, explorations for therapeutic approaches for PQ-induced acute kidney injury (AKI) are of great significance. Here, the effects of a natural bioactive polyphenol isorhapontigenin (ISO) on PQ-AKI were investigated. In vitro experiments carried out in PQ-intoxicated rat renal tubular epithelial cells (NRK-52E) showed that ISO treatment inhibited PQ-induced cell apoptosis and oxidative stress, which was evidenced by the decreased proapoptotic proteins [cleaved caspase 3/9 and poly (ADP-ribose) polymerase (PARP)], the reduced oxidative stress indicators [reactive oxygen species (ROS), malondialdehyde (MDA), and lactate dehydrogenase (LDH) leakage], and the increased antioxidants [superoxide dismutase (SOD), nuclear factor E2-related factor 2 (NRF2), and oxygenase-1 (HO-1)]. Furthermore, 50 mg/kg ISO pretreatment before PQ administration significantly attenuated PQ-AKI in rats, as manifested by the improved renal tubule damage, the reduced serum and urine markers of kidney injury, and the inhibited cell apoptosis and oxidative stress in the renal cortex. Furthermore, expression of sex-determining region Y box 9 (SOX9) and Toll-interacting protein (TOLLIP) in NRK-52E cells and the renal cortex was significantly upregulated after ISO treatment. Overexpression of SOX9 increased TOLLIP transcription and attenuated PQ-induced apoptosis and oxidative stress, whereas knockdown of SOX9 impaired the protective effects of ISO on NRK-52E cells against PQ toxicity. In conclusion, the present study demonstrated that ISO modulated SOX9/TOLLIP expression to attenuate cell apoptosis and oxidative stress in PQ-AKI, suggesting the potential of ISO in treating PQ-poisoned patients.
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Jafari Fakhrabad M, Moshiri M, Ariakia F, Askari VR, Salmasi Z, Etemad L. Effect of cyanocobalamin (vitamin B12) on paraquat-induced brain injury in mice. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2022; 25:745-754. [PMID: 35949307 PMCID: PMC9320208 DOI: 10.22038/ijbms.2022.64164.14128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/08/2022] [Indexed: 11/06/2022]
Abstract
Objectives The goal of this study was to evaluate the neuroprotective effects of vit B12 on paraquat-induced neurotoxicity. Materials and Methods Thirty-six male mice were randomly divided into six groups. Three groups were treated intraperitoneally with paraquat (10 mg/kg) twice a week (with a 3-day interval) for 3 weeks. Normal saline, vit B12 (1 mg /kg), or vit C (50 mg/kg) was injected 30 min before paraquat administration. Other groups only received normal saline (control), vit B12, or vit C in the same protocol. Motor performance and coordination were assayed by challenging beam traversal, pole, open field, and rotarod tests. The hippocampus and serum samples were isolated to evaluate the oxidative stress (GSH and ROS), apoptosis (caspase 3), and inflammatory markers (TNF-α and IL-1β). Results Administration of paraquat leads to induction of motor deficits, which were improved by treatment with vit B12. In addition, vit B12 could prevent oxidative damage, apoptosis, and inflammation caused by paraquat. Conclusion It seems that vit B12 could be a novel therapeutic agent in the management of paraquat induced-neurotoxicity.
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Affiliation(s)
- Marzieh Jafari Fakhrabad
- Department of Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Moshiri
- Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Clinical Toxicology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Ariakia
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Reza Askari
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Pharmaceutical Sciences in Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Salmasi
- Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Etemad
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran,Department of Pharmaceutical and Food Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding author: Leila Etemad. Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Pharmaceutical and Food Control, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran. Tel/ Fax: +98-5137112611;
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Eddleston M, Nagami H, Lin CY, Davis ML, Chang SS. Pesticide use, agricultural outputs, and pesticide poisoning deaths in Japan. Clin Toxicol (Phila) 2022; 60:933-941. [PMID: 35475715 DOI: 10.1080/15563650.2022.2064868] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Although pesticide poisonings occur worldwide, most high-income countries have not been severely affected. Japan is a key exception, with pesticide suicides becoming a major public health concern in the 1980s. We here report the epidemiology of lethal pesticide poisoning in Japan in relation to its pesticide regulation and agricultural output. METHODS We obtained data on pesticide registration and sales from the Japan Plant Protection Association's annual Pesticide Handbook, National Food and Agricultural Materials Inspection Center, and Food and Agriculture Organization of the United Nations. Data on deaths due to pesticide poisoning and population were obtained from Vital Statistics of Japan. We reviewed the registration status and hazard classification of pesticides in Japan and analysed the relationships between the use/sales, pesticides fatalities, and agricultural output. RESULTS Five hundred and twenty-nine pesticide active ingredients are currently registered in Japan, including four WHO hazard class IB organophosphorus and carbamate insecticides. Paraquat was registered in 1962 as a liquid SL20 formulation. In 1986, restrictions were imposed on its sale/use and a 4.3% paraquat ion/4.1% diquat ion combination product registered by ICI. There were 221 pesticide poisoning fatalities in 2019, down from 2648 in 1986, a 92% reduction over 33 years. Self-poisoning was responsible for most pesticide deaths in both 1985 (2013/2476, 81.3%) and 2019 (146/221, 66.1%). Pesticide poisoning made up 8.6% of all suicides in 1985, down to 0.7% in 2019. Unintentional pesticide poisoning deaths also all fell by 83.8%, from 463 to 75. These reductions were associated with reduced sales of both OP/carbamate insecticides and paraquat/diquat but no apparent change in agricultural output across a broad range of crops. CONCLUSIONS Reduced use of highly hazardous pesticides and lowered concentration formulations in Japan were associated with major decreases in all deaths from pesticide poisoning and the proportion of all suicides due to pesticide ingestion.
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Affiliation(s)
- Michael Eddleston
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Hiroshi Nagami
- Institute for Prevention of Pesticide Adverse Effects on Human, Yamatokohriyama, Japan
| | - Chien-Yu Lin
- Institute of Health Behaviors and Community Sciences, and Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Mark L Davis
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, and Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Tu CY, Yen TH, Chang CM, Chen HY, Yen YC, Guo MC, Lu TH, Wu CS, Chen IM, Cheng HC, Huang WL, Chen CC, Eddleston M, Chang SS. Characteristics and psychopathology of 1,086 patients who self-poisoned using pesticides in Taiwan (2012-2019): A comparison across pesticide groups. J Affect Disord 2022; 300:17-26. [PMID: 34952117 DOI: 10.1016/j.jad.2021.12.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/09/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
Background Previous studies, mainly from low- and middle-income settings, showed that pesticide self-poisonings were mostly impulsive with low levels of psychopathology. We aimed to investigate whether pesticide self-poisoning in a high-income country showed similar profiles, and whether those with certain characteristics and psychopathology were more likely to use specific pesticides. Methods Data were extracted from hospital records of pesticide self-poisoning patients treated at eight major hospitals in Taiwan between 2012 and 2019. Multinomial logistic regression was used to investigate the association of interpersonal conflicts, triggers of self-poisoning, and psychopathology with the groups of pesticides ingested. Results A total of 1,086 patients who self-poisoned using pesticides were identified; 67.0% were male and 39.8% aged 65+ years. Approximately three quarters (75.7%) of patients who received psychiatric assessment had at least one psychiatric diagnosis, and the prevalence was 48.3% in all patients. No association was found between the pesticide groups ingested and interpersonal conflicts, most of the triggers, past psychiatric service use, or having psychiatric diagnoses. Limitations Data were collected from hospital records retrospectively. Only 60.3% of the patients received a psychiatric assessment. Conclusions The majority of patients who self-poisoned using pesticides and received psychiatric assessment in Taiwan had psychiatric illness. Patients who ingested different groups of pesticides were similar in their characteristics. The choice of pesticides used in self-poisoning more likely relates to availability rather than intentional selection. Psychiatric assessment and treatment are important in patients who self-poisoned using pesticides, while restricting access to highly hazardous pesticides is likely to prevent many deaths from pesticide self-poisoning.
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Affiliation(s)
- Chao-Ying Tu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology and Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chia-Ming Chang
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hsien-Yi Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yung-Chieh Yen
- Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ming-Chao Guo
- Department of Psychiatry, Camillian Saint Mary's Hospital Luodong, Yilan, Taiwan
| | - Tsung-Hua Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University, Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hai-Ching Cheng
- Department of Psychiatry, National Taiwan University Hsin-Chu Hospital, Hsinchu, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Che Chen
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University BioMedical Park Hospital, Hsinchu, Taiwan
| | - Michael Eddleston
- Department of Psychiatry, National Taiwan University BioMedical Park Hospital, Hsinchu, Taiwan; Center for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK; Pharmacology, Toxicology and Therapeutics, University and British Heart Foundation Center for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Shu-Sen Chang
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka; Institute of Health Behaviors and Community Sciences and Global Health Program, and College of Public Health, National Taiwan University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan.
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Study of the Photocatalytic Degradation of Highly Abundant Pesticides in Agricultural Soils. Molecules 2022; 27:molecules27030634. [PMID: 35163899 PMCID: PMC8840474 DOI: 10.3390/molecules27030634] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/14/2022] [Accepted: 01/17/2022] [Indexed: 11/17/2022] Open
Abstract
Organic pesticides are major sources of soil pollution in agricultural lands. Most of these pesticides are persistent and tend to bio accumulate in humans upon consumption of contaminated plants. In this study, we investigate different natural soil samples that were collected from agricultural lands. The samples revealed the presence of 18 pesticides that belong to four different groups including organochlorines (OCP), organophosphorus (OPP), carbamates (Carb), and pyrethroids (Pyrth). The photocatalytic degradation of the five most abundant pesticides was studied in the presence and absence of 1% TiO2 or ZnO photocatalysts under UV irradiation at a wavelength of 306 nm. The five abundant pesticides were Atrazine (OCP), Chlorpyrifos methyl (OPP), Dimethoate (OPP), Heptachlor (OCP), and Methomyl (Carb). The results showed that photolysis of all pesticides was complete under UV radiation for irradiation times between 64–100 h. However, both photocatalysts enhanced photocatalytic degradation of the pesticides in comparison with photolysis. The pesticides were photocatalytically degraded completely within 20–24 h of irradiation. The TiO2 photocatalyst showed higher activity compared to ZnO. The organochlorine heptachlor, which is very toxic and persistent, was completely degraded within 30 h using TiO2 photocatalyst for the first time in soil. The mechanism of photocatalytic degradation of the pesticides was explained and the effects of different factors on the degradation process in the soil were discussed.
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Jha M, Gaur N. Paraquat poisoning with spontaneous pneumothorax in the era of online shopping. J Family Med Prim Care 2022; 11:357-359. [PMID: 35309669 PMCID: PMC8930143 DOI: 10.4103/jfmpc.jfmpc_957_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 10/06/2021] [Indexed: 11/04/2022] Open
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Pannu AK, Garg S, Bhalla A, Dhibar DP, Sharma N. Lipid emulsion for the treatment of acute organophosphate poisoning: an Open-Label randomized trial. Clin Toxicol (Phila) 2021; 60:602-608. [PMID: 34928182 DOI: 10.1080/15563650.2021.2013496] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Many organophosphate (OP) pesticides are lipid-soluble; therefore, intravenous lipid emulsion (ILE) has been evaluated as a possible treatment for acute poisoning. A single bolus dose of 100 ml of 20% ILE was found safe in a pilot observational study. This randomized trial aimed to assess the effectiveness and safety of an extended dose of ILE in acute OP poisoning. METHODS This was an investigator-initiated, parallel-group, open-label, randomized controlled trial conducted at PGIMER, Chandigarh (India), from January 2019 to June 2020, in patients aged above 13 years with acute OP poisoning. The primary efficacy outcome was to study the change in atropine dose requirement (total and over the first 24 h) for cholinergic crisis after giving an initial bolus dose of 100 ml of 20% ILE followed by an infusion of 100 ml of 20% ILE over 6 h in addition to the standard care. The secondary efficacy outcomes were to detect the effects on hemodynamic variables, length of hospital stay, and duration of mechanical ventilation required. The incidence of adverse events was evaluated. RESULTS A total of 45 patients were assigned to receive either ILE (intervention group, n = 23) or normal saline (control group, n = 22) in addition to standard treatment. Baseline variables in both groups were comparable. The median dose of atropine (in mg) in the first 24 h and at complete resolution in the ILE group were similar to the control group (124.0 versus 141.8, p-value 0.916; and 150.8 versus 175.0, p-value 0.935). Hemodynamic variables (systolic and diastolic blood pressures, mean arterial pressure, and pulse rate) over 24, 48, and 72 h of treatment, length of hospital stay, and duration of mechanical ventilation were also unaffected by ILE. Case fatality was 4 and not statistically different between intervention and control groups (1 versus 3, p-value 0.346). There was no excessive fever, dyspnea, elevation of serum amylase, or pancreatitis from ILE. CONCLUSION ILE has no apparent benefit in acute OP poisoning. However, an extended dose appears safe for the indication.
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Affiliation(s)
- Ashok Kumar Pannu
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sahil Garg
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Deba Prasad Dhibar
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Navneet Sharma
- Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Pravinson M, Pirasath S, Ghetheeswaran S, Uthayakumaran S. Acute poisoning with acetamiprid, a type of neonicotinoid insecticide causing severe lactic acidosis: A case report. SAGE Open Med Case Rep 2021; 9:2050313X211059296. [PMID: 34888052 PMCID: PMC8649425 DOI: 10.1177/2050313x211059296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 10/25/2021] [Indexed: 11/19/2022] Open
Abstract
Acetamiprid is a type of neonicotinoid that belongs to the new class of
insecticides. It is fatally toxic to insects by acting as an agonist to
nicotinic acetylcholine receptors. Cases with neonicotinoids including
acetamiprid poisoning in humans were reported around the world. Only one case
with acetamiprid poisoning associated with severe adverse effects has been
described from Sri Lanka. Serious side effects will occur if it is consumed in
excess amount. Here, we described a case of acetamiprid poisoning in a man who
developed severe lactic acidosis, myocardial suppression, hyperglycemia, and
intestinal obstruction following accidental intake of acetamiprid insecticide.
The patient was managed conservatively as there is no specific management
mentioned in the literature.
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Alleviation of Malathion Toxicity Effect by Coffea arabica L. Oil and Olea europaea L. Oil on Lipid Profile: Physiological and In Silico Study. PLANTS 2021; 10:plants10112314. [PMID: 34834675 PMCID: PMC8619699 DOI: 10.3390/plants10112314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/14/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022]
Abstract
The community health plans commonly use malathion (MAL), an organophosphate pesticide (OP), to eliminate pathogenic insects. The objective of the present research is to evaluate the consequences of Coffea arabica L. oil and Olea europaea L. oil on MAL-intoxicated male rats. Six equal groups of animals were used for conducting this study (n = 10). Animals in group one were designated as control, animals belonging to group two were exposed to MAL in the measure of hundred mg per kg BW (body weight) for forty-nine days (seven weeks), rats in the third and fourth groups were administered with 400 mg/kg BW of Coffea arabica L. and Olea europaea L. oils, respectively, and the same amount of MAL as given to the second group. Groups five and six were administered with the same amount of Coffea arabica L. oil and Olea europaea L. oil as given to group three. Exposure of rats to 100 mg/kg body weight of MAL resulted in statistical alteration of the serum lipid profile. A marked decline was noticed in the severe changes of these blood parameters when MAL-intoxicated rats were treated with Coffea arabica L. oil and Olea europaea L. oil. Two compounds from Coffea arabica L. oil (Chlorogenic acid) and Olea europaea L. oil (Oleuropein) demonstrated good interaction with xanthine oxidase (XO) and 3-hydroxy-3-methyl-glutaryl-CoA reductase (HMGR) enzymes that are associated with cholesterol production. The present study indicated that Coffea arabica L. oil and Olea europaea L. oil could be considered prospective and potential healing agents against metabolic conditions induced by MAL.
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Grundler F, Séralini GE, Mesnage R, Peynet V, Wilhelmi de Toledo F. Excretion of Heavy Metals and Glyphosate in Urine and Hair Before and After Long-Term Fasting in Humans. Front Nutr 2021; 8:708069. [PMID: 34651007 PMCID: PMC8505741 DOI: 10.3389/fnut.2021.708069] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/02/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Dietary exposure to environmental pollutants in humans is an important public health concern. While long-term fasting interrupts the dietary exposure to these substances, fat mobilization as an energy source may also release bioaccumulated substances. This was, to our knowledge, only investigated in obese people decades ago. This study explored the effects of 10-days fasting on the excretion of heavy metals and glyphosate. Methods: Urinary levels of arsenic, chromium, cobalt, lead, nickel, mercury and glyphosate were measured before and after 10 fasting days in 109 healthy subjects. Additionally, hair analysis was done before and ten weeks after fasting in 22 subjects. Results: Fasting caused a decrease in body weight, and in urinary arsenic (by 72%) and nickel (by 15%) concentrations. A decrease in lead hair concentrations (by 30%) was documented. Urinary mercury levels were unchanged for chromium, cobalt and glyphosate, which were undetectable in most of the subjects. Additionally, fatigue, sleep disorders, headache and hunger were reduced. Body discomfort symptoms diminished four weeks after food reintroduction. Conclusions: The results of this study provide the first insights into the changes in heavy metal excretion caused by long-term fasting. Further studies focusing on the kinetics of efflux between different compartments of the body are needed. Clinical Trial Registration:https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016657, identifier: DRKS00016657.
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Affiliation(s)
- Franziska Grundler
- Buchinger Wilhelmi Clinic, Überlingen, Germany.,Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Gilles-Eric Séralini
- Department of Biology and Network on Risks, Quality and Sustainable Environment MRSH, University of Caen Normandy, Caen, France
| | - Robin Mesnage
- Gene Expression and Therapy Group, Department of Medical and Molecular Genetics, King's College London, Faculty of Life Sciences and Medicine, Tower Wing, Guy's Hospital, London, United Kingdom
| | - Vincent Peynet
- Institut de Recherche et d'Expertise Scientifique, Europarc, Strasbourg, France
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Semeniuk M, Ceré LI, Ciriaci N, Bucci-Muñoz M, Quiroga AD, Luquita MG, Roma S, Catania VA, Mottino AD, Rigalli JP, Ruiz ML. Protective effect of genistein pre-treatment on paraquat hepatotoxicity in rats. Toxicol Appl Pharmacol 2021; 426:115636. [PMID: 34214573 DOI: 10.1016/j.taap.2021.115636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 12/21/2022]
Abstract
Paraquat (PQ), an herbicide widely used in agriculture, is considered a highly toxic compound. In hepatocytes, P-glycoprotein (P-gp/Abcb1) is a canalicular transporter involved in PQ extrusion from the cell. Previously, we demonstrated that genistein (GNT) induces P-gp in rat liver. In this study, the protective role of GNT pretreatment towards hepatic damage in a model of acute intoxication with PQ in rats, was investigated. Wistar rats were randomized in 4 groups: Control, GNT (5 mg/kg/day sc, 4 days), PQ (50 mg/kg/day ip, last day) and GNT+ PQ. Hepatic lipoperoxidation (LPO) was evaluated by the thiobarbituric acid reactive substances method. Hepatic levels of 4-hydroxynonenal protein adducts (4-HNEp-add) and glutathione-S-transferase alpha (GSTα) protein expression were evaluated by Western blotting. Hepatic glutathione levels and plasma levels of alanine transaminase (ALT) and aspartate transaminase (AST) were also measured. Biliary excretion of PQ was studied in vivo and in isolated perfused liver. PQ was quantified by HPLC. PQ significantly increased AST and ALT activities, malondialdehyde and 4-HNEp-add levels, whereby pretreatment with GNT ameliorated this effect. PQ biliary excretion remained unchanged after treatments in both experimental models. Hepatic GSTα expression was augmented in GNT group. GNT pretreatment increased hepatic glutathione levels in PQ + GNT group. These results agree with the lower content of 4-HNEp-adds in GNT + PQ group respect to PQ group. Unexpectedly, increased activity of P-gp did not enhance PQ biliary excretion. Thus, GNT protective mechanism is likely through the induction of GSTα which results in increased 4-HNE metabolism before formation of protein adducts.
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Affiliation(s)
- Mariana Semeniuk
- Instituto de Fisiología Experimental (CONICET) - Facultad de Ciencias Bioquímicas y Farmacéuticas (UNR), Suipacha 570, (2000) Rosario, Argentina
| | - Lucila Inés Ceré
- Instituto de Fisiología Experimental (CONICET) - Facultad de Ciencias Bioquímicas y Farmacéuticas (UNR), Suipacha 570, (2000) Rosario, Argentina
| | - Nadia Ciriaci
- Instituto de Fisiología Experimental (CONICET) - Facultad de Ciencias Bioquímicas y Farmacéuticas (UNR), Suipacha 570, (2000) Rosario, Argentina
| | - María Bucci-Muñoz
- Instituto de Fisiología Experimental (CONICET) - Facultad de Ciencias Bioquímicas y Farmacéuticas (UNR), Suipacha 570, (2000) Rosario, Argentina
| | - Ariel Dario Quiroga
- Instituto de Fisiología Experimental (CONICET) - Facultad de Ciencias Bioquímicas y Farmacéuticas (UNR), Suipacha 570, (2000) Rosario, Argentina
| | - Marcelo Gabriel Luquita
- Instituto de Fisiología Experimental (CONICET) - Facultad de Ciencias Bioquímicas y Farmacéuticas (UNR), Suipacha 570, (2000) Rosario, Argentina
| | - Stella Roma
- Cátedra de Histología y Embriología, Facultad de Ciencias Médicas-UNR, Santa Fe 3100, (2000) Rosario, Argentina
| | - Viviana Alicia Catania
- Instituto de Fisiología Experimental (CONICET) - Facultad de Ciencias Bioquímicas y Farmacéuticas (UNR), Suipacha 570, (2000) Rosario, Argentina
| | - Aldo Domingo Mottino
- Instituto de Fisiología Experimental (CONICET) - Facultad de Ciencias Bioquímicas y Farmacéuticas (UNR), Suipacha 570, (2000) Rosario, Argentina
| | - Juan Pablo Rigalli
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - María Laura Ruiz
- Instituto de Fisiología Experimental (CONICET) - Facultad de Ciencias Bioquímicas y Farmacéuticas (UNR), Suipacha 570, (2000) Rosario, Argentina.
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Case Fatality as an Indicator for the Human Toxicity of Pesticides-A Systematic Scoping Review on the Availability and Variability of Severity Indicators of Pesticide Poisoning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168307. [PMID: 34444056 PMCID: PMC8394312 DOI: 10.3390/ijerph18168307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 11/18/2022]
Abstract
Objective: To investigate if case fatality and other indicators of the severity of human pesticide poisonings can be used to prioritize pesticides of public health concern. To study the heterogeneity of data across countries, cause of poisonings, and treatment facilities. Methods: We searched literature databases as well as the internet for studies on case-fatality and severity scores of pesticide poisoning. Studies published between 1990 and 2014 providing information on active ingredients in pesticides or chemical groups of active ingredients were included. The variability of case-fatality-ratios was analyzed by computing the coefficient of variation as the ratio of the standard deviation to the mean. Findings: A total of 149 papers were identified of which 67 could be included after assessment. Case-fatality-ratio (CFR) on 66 active ingredients and additionally on 13 groups of active ingredients were reported from 20 countries. The overall median CFR for group of pesticides was 9%, for single pesticides 8%. Of those 12 active ingredients with a CFR above 20% more than half are WHO-classified as “moderately hazardous” or “unlikely to present acute hazard”. Two of seven pesticides considered “unlikely to present hazard in normal use” showed a CFR above 20%. The cross-study variability of reported case fatality was rather low. Studies most often utilized the Glasgow Coma Score for grading the severity of poisoning. Conclusion: Although human pesticide poisoning is a serious public health problem, an unexpectedly small number of publications report on the clinical outcomes within our study period. However, CFRs of acute human pesticide poisoning are available for several groups of pesticides as well as for active ingredients showing moderate cross-study variability. Our results underline that CFR is an indicator of the human toxicity of pesticides and can be utilized to prioritize highly hazardous pesticides especially since there is limited correspondence between the animal-test-based hazard classification and the human CFR of the respective pesticide. The reporting of available poisoning data should be improved, human case-fatality data are a reasonable tool to be included systematically in the periodic statutory review of pesticides and their regulation.
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Park E, Lee J, Lee J, Lee J, Lee HS, Shin Y, Kim JH. Method for the simultaneous analysis of 300 pesticide residues in hair by LC-MS/MS and GC-MS/MS, and its application to biomonitoring of agricultural workers. CHEMOSPHERE 2021; 277:130215. [PMID: 33774252 DOI: 10.1016/j.chemosphere.2021.130215] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
Multiresidual pesticide analysis in hair can provide useful perspectives on the relationship between pesticides and human health. To establish a rapid and simultaneous analytical method using LC-MS/MS and GC-MS/MS, optimization of hair pulverization, extraction solvent and purification with dispersive SPE was performed for 300 pesticides. Hair pulverization was standardized with a ball mill, at 30 Hz for 20 min (10 min twice), using 3-mm diameter beads. For extraction, 0.1% formic acid in acetonitrile was selected, and PSA d-SPE was chosen for clean-up among three different types of solid phase extraction. The limits of quantitation (LOQs) in this method were between 2.5 and 7.5 pg mg-1. In recovery test, fifty milligrams of hair powder were extracted with 0.1% formic acid in acetonitrile, and incubated for three h at 40 ℃. The crude extract was treated using PSA-dSPE, dried under nitrogen gas, and reconstructed with acetonitrile. An aliquot was analyzed with LC- and GC-MS/MS. Recovery ranges were 22.7-131.1%, in LC-MS/MS analysis, and 81.1-151.8% in GC-MS/MS analysis. The validated analysis systems were applied to biomonitoring of ten agricultural workers, and residues of 28 target pesticides were detected in their hair.
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Affiliation(s)
- Eunyoung Park
- Pesticide Chemistry and Toxicology Laboratory, Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, South Korea
| | - Jiho Lee
- Pesticide Chemistry and Toxicology Laboratory, Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, South Korea
| | - Junghak Lee
- Pesticide Chemistry and Toxicology Laboratory, Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, South Korea
| | - Jonghwa Lee
- Pesticide Chemistry and Toxicology Laboratory, Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, South Korea
| | - Hye Suk Lee
- Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy, The Catholic University of Korea, Bucheon, 14662, Republic of Korea
| | - Yongho Shin
- Department of Applied Biology, College of Natural Resources and Life Science, Dong-A University, Busan, 49315, Republic of Korea.
| | - Jeong-Han Kim
- Pesticide Chemistry and Toxicology Laboratory, Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, South Korea.
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Karunarathne A, Bhalla A, Sethi A, Perera U, Eddleston M. Importance of pesticides for lethal poisoning in India during 1999 to 2018: a systematic review. BMC Public Health 2021; 21:1441. [PMID: 34294076 PMCID: PMC8296580 DOI: 10.1186/s12889-021-11156-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 05/27/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Poisoning is a major problem in India. However, there is little systematic information on the key poisons responsible for most deaths by geographical area and over time. We aimed to review the literature to identify the poison classes causing the greatest number of deaths in India over the last 20 years. METHODS We performed a systematic literature review in Medline, Embase and Google Scholar (1999-2018), and Indian online medical journals, to find papers that reported deaths from all forms of poisoning in India, with last search 20 April 2020. We included epidemiological studies, observational studies, randomised trials, interventional studies, and case series published from 1999 to 2018 that showed the number of deaths and autopsy studies indicating the specific poisons or poison classes. Studies providing the case fatality for specific poisons or classes, which enabled calculation of the number of deaths, were also included. We excluded deaths due to animal bites and stings, ethanol or methanol poisoning, and gas inhalation as well as papers reporting a single death (case study of single patient). We grouped the papers into 5-year intervals and identified the two most common poison classes in each paper. We used descriptive statistics to summarise the findings over time based on the causative poison and the location of the study. RESULTS We identified 186 papers reporting 16,659 poisoning deaths between 1999 and 2018. The number of publications per 5-year interval showed no clear trend over the period (48, 38, 67, and 36 for consecutive periods). Half of the deaths (n = 8338, 50.0%) were reported during the first 5 years of the study (1999-2003), the number of deaths declining thereafter (to n = 1714 in 2014-2018). Deaths due to pesticide poisoning (94.5%) were dominant across the study period compared to other classes of poison [hair dye paraphenylenediamine poisoning (2.6%), medicine overdose (1.4%) or plant poisoning (1.0%)]. Among the pesticides, aluminium phosphide was the most important lethal poison during the first 10 years before declining markedly; organophosphorus insecticides were important throughout the period, becoming dominant in the last decade as aluminium phosphide cases declined. Unfortunately, few papers identified the specific organophosphorus insecticide responsible for deaths. CONCLUSION Use of the published literature to better understand the epidemiology of lethal poisoning in India has clear limitations, including secular variation in publishing practices and interest in poisoning. Unfortunately, there are no long-term detailed, combination hospital and community studies from India to provide this information. In their absence, our review indicates that pesticides are the most important poison in India, with organophosphorus insecticides replacing aluminium phosphide as the key lethal poison after government regulatory changes in 2001 reduced the latter's lethality. Plant and hair dye poisoning and medicines overdose caused few deaths. Aluminium phosphide deaths mostly occurred in northern Indian states, whereas deaths from organophosphorus insecticide poisoning occurred throughout India. Paraquat poisoning has become a clinical problem in the last 10 years. Lethal pesticide poisoning remains alarmingly common, emphasising the need for additional regulatory interventions to curtail the burden of pesticide poisoning deaths in India. More detailed reporting about the specific pesticide involved in lethal poisoning will be helpful to guide regulatory decisions.
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Affiliation(s)
- Ayanthi Karunarathne
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Ashish Bhalla
- Department of Internal Medicine, Nehru Hospital, Institute of Medical Education and Research, Chandigarh, India
| | - Aastha Sethi
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Government of Maharashtra, Mumbai, Maharashtra, India
| | - Uditha Perera
- Usher Institute for Population Health Sciences & Informatics, University of Edinburgh, Edinburgh, UK
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
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Thamrin Azis, Maulidiyah M, Muzakkar MZ, Ratna R, Aziza SW, Bijang CM, Agus Salim LO, Prabowo OA, Wibowo D, Nurdin M. Examination of Carbon Paste Electrode/TiO2 Nanocomposite as Electrochemical Sensor for Detecting Profenofos Pesticide. SURFACE ENGINEERING AND APPLIED ELECTROCHEMISTRY 2021. [DOI: 10.3103/s1068375521030029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Kukkar P, Kukkar D, Younis SA, Singh G, Singh P, Basu S, Kim KH. Colorimetric biosensing of organophosphate pesticides using enzymatic nanoreactor built on zeolitic imdiazolate-8. Microchem J 2021. [DOI: 10.1016/j.microc.2021.106242] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Li LR, Chaudhary B, You C, Dennis JA, Wakeford H. Glucocorticoid with cyclophosphamide for oral paraquat poisoning. Cochrane Database Syst Rev 2021; 6:CD008084. [PMID: 34190331 PMCID: PMC8243635 DOI: 10.1002/14651858.cd008084.pub5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND This an update of a Cochrane Review. Paraquat is a widely used herbicide, but is also a lethal poison. In some low- and middle-income countries (LMICs) paraquat is commonly available and inexpensive, making poisoning prevention difficult. Most of the people poisoned by paraquat have taken it as a means of self-poisoning. Standard treatment for paraquat poisoning prevents further absorption and reduces the load of paraquat in the blood through haemoperfusion or haemodialysis. The effectiveness of standard treatments is extremely limited. The immune system plays an important role in exacerbating paraquat-induced lung fibrosis. Immunosuppressive treatment using glucocorticoid and cyclophosphamide in combination has been developed and studied as an intervention for paraquat poisoning. OBJECTIVES To assess the effects of glucocorticoid with cyclophosphamide for moderate to severe oral paraquat poisoning. SEARCH METHODS The most recent searches were run in September 2020. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Injuries Trials Register), Ovid MEDLINE(R), Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE Daily and Ovid OLDMEDLINE, Embase Classic + Embase (Ovid), ISI WOS (SCI-EXPANDED, SSCI, CPCI-S, and CPSI-SSH), and trials registries. We also searched the following three resources: China National Knowledge Infrastructure database (CNKI ); Wanfang Data (); and VIP () on 12 November 2020. We examined the reference lists of included studies and review papers. SELECTION CRITERIA We included randomised controlled trials (RCTs). For this update, in accordance with Cochrane Injuries' Group policy (2015), we included only prospectively registered RCTs for trials published after 2010. We included trials which assessed the effects of glucocorticoid with cyclophosphamide delivered in combination. Eligible comparators were standard care (with or without a placebo), or any other therapy in addition to standard care. Outcomes of interest included mortality and infections. DATA COLLECTION AND ANALYSIS We calculated the mortality risk ratio (RR) and 95% confidence interval (CI). Where possible, we summarised data for all-cause mortality at relevant time periods (from hospital discharge to three months after discharge) in meta-analysis, using a fixed-effect model. We conducted sensitivity analyses based on factors including whether participants were assessed at baseline for plasma paraquat levels. We also reported data on infections within one week after initiation of treatment. MAIN RESULTS We included four trials with a total of 463 participants. The included studies were conducted in Taiwan (Republic of China), Iran, and Sri Lanka. Most participants were male. The mean age of participants was 28 years. We judged two of the four included studies, including the largest and most recently conducted study (n = 299), to be at low risk of bias for key domains including sequence generation. We assessed one study to be at high risk of selection bias and another at unclear risk, since allocation concealment was either not mentioned in the trial report or explicitly not undertaken. We assessed three of the four studies to be at unclear risk of selective reporting, as no protocols could be identified. An important source of heterogeneity amongst the included studies was the method of assessment of participants' baseline severity using analysis of plasma levels (two studies employed this method, whilst the other two did not). No studies assessed the outcome of mortality at 30 days following ingestion of paraquat. Low-certainty evidence from two studies indicates that glucocorticoids with cyclophosphamide in addition to standard care may slightly reduce the risk of death in hospital compared to standard care alone ((RR 0.82, 95% CI 0.68 to 0.99; participants = 322); results come from sensitivity analysis excluding studies not assessing plasma at baseline). However, we have limited confidence in this finding as heterogeneity was high (I2 = 77%) and studies varied in terms of size and comparators. A single large study provided data showing that there may be little or no effect of treatment at three months post discharge from hospital (RR 0.98, 95% CI 0.85 to 1.13; 1 study, 293 participants; low-certainty evidence); however, analysis of long-term results amongst participants whose injuries arose from self-poisoning must be interpreted with caution. We remain uncertain of the effect of glucocorticoids with cyclophosphamide on infection within one week after initiation of the treatment; this outcome was assessed by two small studies only (31 participants, very low-certainty evidence) that considered leukopenia as a proxy or risk factor for infection. Neither study reported infections in any participants. AUTHORS' CONCLUSIONS Low-certainly evidence suggests that glucocorticoids with cyclophosphamide in addition to standard care may slightly reduce mortality in hospitalised people with oral paraquat poisoning. However, we have limited confidence in this finding because of substantial heterogeneity and concerns about imprecision. Glucocorticoids with cyclophosphamide in addition to standard care may have little or no effect on mortality at three months after hospital discharge. We are uncertain whether glucocorticoid with cyclophosphamide puts patients at an increased risk of infection due to the limited evidence available for this outcome. Future research should be prospectively registered and CONSORT-compliant. Investigators should attempt to ensure an adequate sample size, screen participants for inclusion rigorously, and seek long-term follow-up of participants. Investigators may wish to research the effects of glucocorticoid in combination with other treatments.
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Affiliation(s)
- Luying Ryan Li
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | | | - Chao You
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jane A Dennis
- Cochrane Injuries Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Helen Wakeford
- Cochrane Injuries Group, London School of Hygiene & Tropical Medicine, London, UK
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Chang SS, Lin CY, Lee MB, Shen LJ, Gunnell D, Eddleston M. The early impact of paraquat ban on suicide in Taiwan. Clin Toxicol (Phila) 2021; 60:131-135. [PMID: 34152240 DOI: 10.1080/15563650.2021.1937642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Pesticide ingestion is a leading method for suicide worldwide. Paraquat is a highly lethal herbicide when ingested. We assessed the impact of the first-stage ban on the import and production of paraquat (from February 2018) on suicides by pesticide poisoning in Taiwan. METHODS Suicide data by method (pesticide vs. non-pesticide), pesticide (paraquat vs. non-paraquat), and area/sex/age were extracted from the national cause-of-death data files (2011-2019). Negative binomial regression was used to estimate changes in suicide rates in 2019, compared to the expected rates based on pre-ban linear trends (2011-2017). RESULTS The paraquat ban was followed by an estimated 37% (rate ratio [RR] = 0.63, 95% confidence interval [CI] 0.54-0.74) reduction in pesticide suicide rate (190 [95% CI 116-277] fewer suicides) in 2019, mainly due to a 58% (RR = 0.42, 95% CI 0.33-0.54) reduction in paraquat suicides (145 [95% CI 92-213] fewer suicides). Larger absolute reductions in pesticide suicides were found in rural areas, males, and the elderly (aged 65+ years) than their counterparts. Except for a 10% (95% CI 3-18%) reduction in overall suicide rates in the elderly, there was no statistical evidence for a change in non-pesticide and overall (all-method) suicides. CONCLUSION The ban on the import and production of paraquat was followed by a fall in whole-population pesticide and paraquat suicides and elderly suicides in Taiwan.
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Affiliation(s)
- Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chien-Yu Lin
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.,Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Ming-Been Lee
- Taiwanese Society of Suicidology and National Taiwan Suicide Prevention Center, Taipei, Taiwan.,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.,Department of Psychiatry, Shin-Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Lih-Jong Shen
- Department of Mental and Oral Health, Ministry of Health and Welfare, Taipei, Taiwan
| | - David Gunnell
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK.,National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol and Weston National Health Service Foundation Trust, Bristol, UK
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK.,South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka.,Pharmacology, Toxicology, & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Ghimire R, Utyasheva L, Pokhrel M, Rai N, Chaudhary B, Prasad PN, Bajracharya SR, Basnet B, Das KD, Pathak NK, Baral MP, Pande R, Paudel P, Shrestha SK, Bajracharya S, Chaudhary R, Malla GB, Sharma DR, Basnyat B, Maskey MK, Eddleston M. Intentional pesticide poisoning and pesticide suicides in Nepal. Clin Toxicol (Phila) 2021; 60:46-52. [PMID: 34121562 DOI: 10.1080/15563650.2021.1935993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Intentional pesticide poisoning is a major clinical and public health problem in agricultural communities in low and middle income countries like Nepal. Bans of highly hazardous pesticides (HHP) reduce the number of suicides. We aimed to identify these pesticides by reviewing data from major hospitals across the country and from forensic toxicology laboratories. METHODS We retrospectively reviewed medical records of 10 hospitals for pesticide poisoned patients and two forensic laboratories of Nepal from April 2017 to February 2020. The poison was identified from the history, referral note, and clinical toxidrome in the hospitals and from gas chromatography analysis in the laboratories. Data on demographics, poison, and patient outcome were recorded on a data collection sheet. Simple descriptive analysis was performed. RESULTS Among hospital cases (n = 4148), the commonest form of poisoning was self-poisoning (95.8%) while occupation poisoning was rare (0.03%). Case fatality was 5.3% (n = 62). Aluminum phosphide (n = 38/62, 61.3%) was the most commonly identified lethal pesticide for deaths. Forensic toxicology laboratories reported 2535 deaths positive for pesticides, with the compounds most commonly identified being organophosphorus (OP) insecticides (n = 1463/2535; 57.7%), phosphine gas (n = 653/2535; 25.7%; both aluminum [11.8%] and zinc [0.4%] phosphide) and organochlorine insecticides (n = 241/2535; 9.5%). The OP insecticide most commonly identified was dichlorvos (n = 273/450, 60.6%). CONCLUSION The data held in the routine hospital medical records were incomplete but suggested that case fatality in hospitals was relatively low. The pesticides identified as causing most deaths were dichlorvos and aluminum phosphide. Since this study was completed, dichlorvos has been banned and the most toxic formulation of aluminum phosphide removed from sale. Improving the medical record system and working with forensic toxicology laboratories will allow problematic HHPs to be identified and the effects of the bans in reducing deaths monitored.
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Affiliation(s)
- Rakesh Ghimire
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Leah Utyasheva
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | | | - Neshan Rai
- Nepal Public Health Foundation, Kathmandu, Nepal
| | | | - Pratap Narayan Prasad
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | | | - Bhupendra Basnet
- National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | | | | | - Madan Prasad Baral
- Pokhara Academy of Health Science, Western Regional Hospital, Pokhara, Nepal
| | | | | | - Sanu Krishna Shrestha
- Dhulikhel Hospital, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | | | | | | | - Dilli Ram Sharma
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Buddha Basnyat
- Nepal Public Health Foundation, Kathmandu, Nepal.,Patan Academy of Health Sciences, Kathmandu, Nepal
| | | | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
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Buckley NA, Fahim M, Raubenheimer J, Gawarammana IB, Eddleston M, Roberts MS, Dawson AH. Case fatality of agricultural pesticides after self-poisoning in Sri Lanka: a prospective cohort study. Lancet Glob Health 2021; 9:e854-e862. [PMID: 33901424 PMCID: PMC8131203 DOI: 10.1016/s2214-109x(21)00086-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 02/01/2021] [Accepted: 02/16/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Pesticide poisoning is among the most common means of suicide globally, but can be prevented with regulation of the most hazardous agents. We aimed to compare the lethality of pesticides ingested by our cohort, seek evidence on variation between human and regulatory animal toxicity, and establish change over time in the case fatality of individual pesticides in Sri Lanka. METHODS We examined the case fatality of agricultural pesticides in a prospective cohort in nine hospitals serving rural populations in Sri Lanka. We included all patients (>11 years) who had presented to a South Asian Clinical Toxicology Research Collaboration study hospital during the study period. Patients were enrolled by clinical research assistants and were regularly reviewed. Identification of the ingested pesticide was generally on the basis of history or positive identification of the container, supported by nested blood analysis. FINDINGS From March 31, 2002, to Dec 31, 2019, 34 902 patients (median age 29 years [IQR 21-40]; 23 060 [66·1%] male) presented with a possible or known pesticide self-poisoning. We identified 23 139 specific pesticides that were ingested. Poisoning was fatal in 2299 (6·6%) patients. Case fatality varied greatly from 0·0% (several substances) to 41·8% (paraquat). The three most toxic agents (ie, paraquat, dimethoate, and fenthion) were banned between 2008 and 2011. Since 2013, the five agents causing the most deaths (ie, profenofos, propanil, fenobucarb, carbosulfan, and quinalphos) had a case fatality of 7·2-8·6%. A steady decline was seen in overall case fatality of pesticide poisoning (10·5% for 2002-06 to 3·7% for 2013-19), largely attributable to pesticide bans. A modest fall in case fatality for non-banned pesticides was also seen. INTERPRETATION Declines seen in case fatalities of poisonings with non-banned pesticides suggest that medical management improved over time. The human data for acute toxicity of pesticides should drive hazard classifications and regulation. We believe that a global benchmark for registration of pesticides should include a less than 5% case fatality after self-poisoning, which could prevent many deaths and have a substantial effect on global suicide rates. FUNDING The Wellcome Trust and the National Health and Medical Research Council of Australia. TRANSLATIONS For the Sinhala and Tamil translations of the abstract see Supplementary Materials section.
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Affiliation(s)
- Nicholas A Buckley
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka; Pharmacology, Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Mohamed Fahim
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka; Faculty of Allied Health Sciences, Department of Pharmacy, University of Peradeniya, Kandy, Sri Lanka; Pharmacology, Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Jacques Raubenheimer
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka; Pharmacology, Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Indika B Gawarammana
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka
| | - Michael Eddleston
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka; Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology and Therapeutics, Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Michael S Roberts
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka; Basil Hetzel Institute for Translational Health Research, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia; Diamantina Institute, University of Queensland, Brisbane, QLD, Australia
| | - Andrew H Dawson
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka; Pharmacology, Biomedical Informatics and Digital Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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Noghrehchi F, Dawson AH, Raubenheimer JE, Buckley NA. Role of age-sex as underlying risk factors for death in acute pesticide self-poisoning: a prospective cohort study. Clin Toxicol (Phila) 2021; 60:184-190. [PMID: 34032543 DOI: 10.1080/15563650.2021.1921186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is growing evidence in the literature that patients' age is associated with increased risk of death in acute pesticide poisoning. However, few studies have investigated whether the age effect differs between males and females. We aimed to examine the association between age-sex and risk of death in acute pesticide self-poisoning. METHODS A prospective cohort of deliberate pesticide-poisoned patients admitted to ten rural Sri Lankan hospitals between March 2002 and December 2019. The pesticide ingested was identified based on identification of container or history. A mixed effects logistic regression was fitted to investigate the effect of age-sex on death in acute pesticide self-poisoning adjusting for clinical symptoms on admission, measured by Glasgow Coma Scale and Poison Severity Score, and controlling for clustering among hospital sites. RESULTS In total, 201 different pesticides were ingested by patients. 6,643 patients ingested an unknown pesticide. A single pesticide was co-ingested with alcohol by 4,603 patients. Of the 28,303 patients enrolled, 2,028 patients died, resulting in case fatality of 7.2% (95% CI 6.9-7.5). The effect of age on case fatality was stronger for males after 21 years of age. The odds of dying for each 5 years increase in age was 1.26 (95% CI 1.23-1.28) times higher for males versus 1.14 (95% CI 1.10-1.19) times higher for females. Missing data were handled by multiple imputation. CONCLUSION Patient's age-sex are important risk factors for death in acute pesticide self-poisoning even after controlling for clinical effects. The age effect on the odds of dying was significantly different for males and females, with this effect being stronger for males. Given that patient's age and sex are very easy to collect on admission, our study highlights the need for incorporating these risk factors in policy and clinical decisions.
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Affiliation(s)
- Firouzeh Noghrehchi
- Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Biomedical Informatics & Digital Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Andrew H Dawson
- Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Biomedical Informatics & Digital Health, Sydney Medical School, University of Sydney, Sydney, Australia.,Central Clinical School, University of Sydney, Sydney, Australia
| | - Jacques E Raubenheimer
- Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Biomedical Informatics & Digital Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Nicholas A Buckley
- Translational Australian Clinical Toxicology (TACT) Research Group, Discipline of Biomedical Informatics & Digital Health, Sydney Medical School, University of Sydney, Sydney, Australia
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Ahmad A, Zafar A, Zargar S, Bazgaifan A, Wani TA, Ahmad M. Protective effects of apigenin against edifenphos-induced genotoxicity and cytotoxicity in rat hepatocytes. J Biomol Struct Dyn 2021; 40:9306-9317. [PMID: 33998977 DOI: 10.1080/07391102.2021.1926325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Edifenphos (EDF) is an organophosphorus pesticide with antifungal and anti-insecticidal properties. However, EDF accumulates in various agricultural products and causes potential hazards to human health. Although numerous reports have indicated EDF accumulation in agricultural products, toxic effects on cellular system is poorly understood. In the present study, we investigated the cytotoxicity and genotoxicity of EDF in rat hepatocytes and its amelioration by apigenin (a dietary flavonoid). Results showed that EDF inhibited the cell viability, induced oxidative stress, DNA damage, loss of mitochondrial membrane potential (ΔΨm) and caspase-9/-3 activation in rat hepatocytes. Incubation of hepatocytes with N-acetyl cysteine (ROS scavenger) significantly abrogated the ROS generation and apoptosis caused by EDF. In addition, this study also showed that apigenin significantly suppressed the toxic effects of EDF by quenching ROS production thereby abrogating the caspase-9/-3 and apoptosis activation in hepatocytes. Taken together, the findings of this study demonstrate that EDF induces cytotoxicity and DNA damage in hepatocytes, and apigenin can be considered as an effective dietary anti-oxidant regimen against EDF- induced toxicity in cellular system.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Ajaz Ahmad
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Atif Zafar
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Seema Zargar
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Arwa Bazgaifan
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Tanveer A Wani
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Masood Ahmad
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Valbuena D, Cely-Santos M, Obregón D. Agrochemical pesticide production, trade, and hazard: Narrowing the information gap in Colombia. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 286:112141. [PMID: 33676136 DOI: 10.1016/j.jenvman.2021.112141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 06/12/2023]
Abstract
Pesticides are a major tool for the intensification of agriculture, and helped to increase food, feed and biofuel production. Yet, there are persistent concerns about the negative effects of pesticides in human health and the environment, particularly in low and middle income countries (LMICs). Given the lack of information on pesticide exposure and hazard, Colombia exemplifies the need to narrow the information gap on pesticide risk in LMICs. We assessed pesticide hazard in Colombia based on the official toxicity categorization, compared it to more integral international standards, and identified main actions to narrow this information gap. Results showed that Colombia has been a relevant regional actor in pesticide production and trade, reaching almost 75 million kilogrammes and liters sold in 2016. Based on acute toxicity for humans, a quarter of the amount of pesticides sales and imports, and a third of the exports in 2016 ranged from moderately to extremenly toxic. The top-selling agrochemicals in 2016 (glyphosate with 14% of the total sales, chlorpyrifos 7.5% and mancozeb 6.9%) are also commonly used in other countries, reflecting a homogenized global industry. Compared to integral international categorizations, we found that for that year 63% of the pesticides sold with slightly acute toxicity are actually considered highly hazardous pesticides (HHP) for humans or the environment, evidencing the need to use a more integral hazard categorization in the country. Narrowing the information gap in pesticide use and associated risks demands a transparent process of knowledge creation and sharing, including funtional information and monitoring systems. This should be part of an integral assessment and regulation that better defines HHP, their production and trade to reduce pesticide risk while informing a transition towards sustainable food systems.
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Affiliation(s)
- Diego Valbuena
- Land Use Planning Group, Wageningen University, the Netherlands.
| | - Marcela Cely-Santos
- Ciencias Sociales y Saberes de la Biodiversidad, Instituto de Investigación de Recursos Biológicos Alexander von Humboldt, Colombia
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