A Retrospective Observational Study of Accidental Carbamate Poisoning Among Children Referred to a Tertiary Care Center in Rural Maharashtra, India
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 9 No. 3 (2019),
1 July 2019
,
Page 141-150
https://doi.org/10.32598/ijmtfm.v9i3.26179
Abstract
Background: Carbofuran is a widely-used carbamate insecticide which is listed as highly hazardous (Class 1b) by the World Health Organization (WHO) classification of pesticides. We report the poisonings among children following exposure to carbofuran crystal form, which is used as a household remedy for head lice infestation.
Methods: The medical case records from June 2016 to January 2019 of a Tertiary Care Hospital in rural Maharashtra, India, were examined for the pediatric poisoning due to exposure to blue crystals in sachets being sold as medication for head lice infestation and its confirmation as being carbofuran. A total of 14 such exposures were found among 64 cases of pediatric poisoning (excluding bites and sting envenomation), recorded in the above period. The children were evaluated for their presentations, manner of unintentional poisonings, clinical profile, and outcomes.
Results: The results in carbofuran poisonings showed universal unintentional exposure with the majority of patients being infants and toddlers. It was the most significant single cause of poisoning, excluding bites and envenomation, in the above period. The clinical features of excessive cholinergic activity were consistent with the characteristics of carbamate poisoning. Comparison with other poisonings during the period did not show significant differences concerning variables such as age, sex, religion, and length of hospital stay.
Conclusion: Unintentional poisoning of the class1 pesticide carbofuran, among younger children, is associated with misuse and availability in the environment. Our obtained data about the agent, host, and environmental factors related to the poisoning are consistent with data available on the literature.
- Pesticides
- Poisoning
- Carbamates
- Carbofuran
- Pediatrics
How to Cite
References
World Health Organization. The WHO recommended classification of pesticides by hazard and guidelines to classification 2009. Geneva: World Health Organization; 2009.
Gammon DW, Liu Z, Becker JM. Carbofuran occupational dermal toxicity, exposure and risk assessment. Pest Management Science. 2012; 68(3):362-70. [DOI:10.1002/ps.2270] [PMID] [PMCID]
Gupta RC. Carbofuran toxicity. Journal of Toxicology and Environmental Health. 1994; 43(4):383-418. [DOI:10.1080/15287399409531931] [PMID]
Zwiener RJ, Ginsburg CM. Organophosphate and carbamate poisoning in infants and children. Pediatrics. 1988; 81(1):121-6.
Roberts JR, Karr CJ. Pesticide exposure in children. Pediatrics. 2012; 130(6):e1765-88. [DOI:10.1542/peds.2012-2758] [PMID] [PMCID]
Fukuto TR. Mechanism of action of organophosphorus and carbamate insecticides. Environmental Health Perspectives. 1990; 87:245-54. [DOI:10.1289/ehp.9087245] [PMID] [PMCID]
Jeyaratnam J. Acute pesticide poisoning: A major global health problem. World Health Statastical Quarterly. 1990; 43:139-44.
Branche C, Ozanne-Smith J, Oyebite K, Hyder AA. World report on child injury prevention. Geneva: World Health Organization; 2008.
Hyder AA, Sugerman DE, Puvanachandra P, Razzak J, El-Sayed H, Isaza A, et al. Global childhood unintentional injury surveillance in four cities in developing countries: A pilot study. Bulletin of the World Health Organization. 2009; 87(5):345-52. [DOI:10.2471/BLT.08.055798] [PMID] [PMCID]
Eddleston M, Buckley NA, Gunnell D, Dawson AH, Konradsen F. Identification of strategies to prevent death after pesticide self-poisoning using a Haddon matrix. Injury Prevention. 2006; 12(5):333-7. [DOI:10.1136/ip.2006.012641] [PMID] [PMCID]
Grandjean P. Paracelsus revisited: The dose concept in a complex world. Basic & Clinical Pharmacology & Toxicology. 2016; 119(2):126-32. [DOI:10.1111/bcpt.12622] [PMID] [PMCID]
McConnell R, Hruska AJ. An epidemic of pesticide poisoning in Nicaragua: Implications for prevention in developing countries. American Journal of Public Health. 1993; 83(11):1559-62. [DOI:10.2105/AJPH.83.11.1559] [PMID] [PMCID]
Chaudhry S, Maqbool A, Ijaz M, Ahmad N, Latif M, Mehmood K. The importance of socio-economic status and sex on the prevalence of human pediculosis in government schools children in Lahore, Pakistan. Pakistan Journal of Medical Sciences. 2012; 28(5):952-5.
Goldman L, Tran N. The impact of toxic substances on the poor in developing countries. Washington DC: World Bank; 2002.
Office of the Registrar General and Census Commissioner of India, Ministry of Home Affairs, Government of India. Census of India [Internet]. 2011 [Updated 2019 January 08]. Avaiable from: http://www.censusindia.gov.in/2011census/population_enumeration.html
Sadeghi-Bojd S, Khajeh A. Chronological variations of children poisoning causes in zahedan, South of Iran. International Journal of High Risk Behaviors & Addiction. 2014; 3(3):e19223. [DOI:10.5812/ijhrba.19223] [PMID] [PMCID]
Van Der Hoek W, Konradsen F. Risk factors for acute pesticide poisoning in Sri Lanka. Tropical Medicine & International Health. 2005; 10(6):589-96. [DOI:10.1111/j.1365-3156.2005.01416.x] [PMID]
Hamad MH, Adeel AA, Alhaboob AA, Ashri AM, Salih MA. Acute poisoning in a child following topical treatment of head lice (pediculosis capitis) with an organophosphate pesticide. Sudanese Journal of Paediatrics. 2016; 16(1):63-6. [PMID] [PMCID]
Center for Disease Control and Prevention. Treatment. Atlanta: Center for Disease Control and Prevention; 2017.
Tribaldo EB. Residue analysis of carbamate pesticides in water. ChemInform. 2000; 31(52):537-70.
Rosenthal E. The tragedy of Tauccamarca: A human rights perspective on the pesticide poisoning deaths of 24 children in the Peruvian Andes. International Journal of Occupational and Environmental Health. 2003; 9(1):53-8. [DOI:10.1179/oeh.2003.9.1.53] [PMID]
Devi PI, Thomas J, Raju RK. Pesticide consumption in India: A spatiotemporal analysis. Agricultural Economics Research Review. 2017; 30(1):163-72. [DOI:10.5958/0974-0279.2017.00015.5]
Tenenbaum D. Carbofuran under review. Environmental health perspectives. 2008; 116(10):A425. [DOI:10.1289/ehp.116-a425]
Gunnell D, Eddleston M. Suicide by intentional ingestion of pesticides: A continuing tragedy in developing countries. International Journal of Epidemiology. 2003; 32(6):902-9. [DOI:10.1093/ije/dyg307] [PMID] [PMCID]
Ramsay MA, John Snow MD. Anaesthetist to the queen of England and pioneer epidemiologist. Journal Baylor University Medical Center Proceedings. 2006; 19(1):24-8. [DOI:10.1080/08998280.2006.11928120] [PMID]
Snow J. On the mode of communication of cholera. Edinburgh Medical Journal. 1856; 1(7):668-70. [PMID] [PMCID]
Carson R. Silent Spring. Boston: Houghton Mifflin Company; 1962.
Gunnell D, Fernando R, Hewagama M, Priyangika WD, Konradsen F, Eddleston M. The impact of pesticide regulations on suicide in Sri Lanka. International Journal of Epidemiology. 2007; 36(6):1235-42. [DOI:10.1093/ije/dym164] [PMID] [PMCID]
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