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  3. 卷 12 编号 1 (2024): Continuous volume
  4. Letter

卷 12 编号 1 (2024)

一月 2024

Piperonylbutoxide and the Necessity of Toxicological Assessment of Insecticide Mixtures; a Letter to Editor

  • Dirk Habedank
  • Birgit Habedank

学术急诊医学档案, 卷 12 编号 1 (2024), 1 一月 2024 , 第 e64 页
https://doi.org/10.22037/aaem.v12i1.2434 已出版: 2024-08-25

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摘要

 

With great interest we read the letter by Dr. Faress et al. (1) in which they explain the clinical impression of pyrethroid poisoning in relation to the addition of piperonylbutoxide (PBO). The authors include our case report of an insecticide spray formulation containing cypermethrin, tetramethrin and PBO that induced a myocardial infarction type II in a patient with cardiac comorbidity (2). We fully agree with the authors that the “presence or absence of piperonylbutoxide” may induce different types of pyrethroid poisoning and determination of all suspicious ingredients is “necessary for all clinical toxicologists”. However, we think it is necessary to discuss the current assessment of PBO, and to analyze in detail some of the case reports cited.

关键词:
  • Insecticides
  • toxicity
  • Cardiotoxicity
  • pdf (English)

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1.
Habedank D, Habedank B. Piperonylbutoxide and the Necessity of Toxicological Assessment of Insecticide Mixtures; a Letter to Editor. Arch Acad Emerg Med [网际网络]. 2024年8月25日 [见引于 2026年7月8日];12(1):e64. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2434
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参考

Faress F, Ameri M, Farahani MV, Marashi SM. Piperonylbutoxide as a Dubious Cause of Cardiac Manifestations in Pyrethroid Insecticide Poisoning; a Letter to Editor. Arch Acad Emerg Med. 2023;11(1):e10.

Habedank D, Stubbe B, Ewert R, Kroll A, Atmowihardjo I, Habedank B. Inhalation of publicly available indoor insecticide spray caused myocardial infarction type II: a case report. ESC Heart Fail. 2021;8(4):3403-7.

Franklin M. Methylenedioxyphenyl insecticide synergists as potential human health hazards. Environ Health Perspect. 1976;14:29-37.

Committee for Risk Assessment RAC. Opinion proposing harmonised classification and labelling at EU level 2020 [Available from: https://echa.europa.eu/documents/10162/10d69a257cfb-8167-099a-2aded5e9fc57=.

Conney A, Chang R, Levin W, Garbut A, Munro-Faure A, Peck A, et al. Effects of piperonyl butoxide on drug metabolism in rodents and man. Arch Environ Health. 1972;24(2):97-106.

Regulation (EU) No 528/2012 concerning the making available on the market and use of biocidal products. Evaluation of active substances. Assessment Report. Piperonyl Butoxide. Product-type 18 (insecticides, acaricides and products to control other arthropods) 2017 [Available from: https://echa.europa.eu/documents/10162/a521088e3a21-2bba-96ad-a1fd55e91325.

Babić G, Jović-Stošić J, Todorović V, Kosanović M, Janković S. [Cardiotoxicity of piperonyl-butoxide: a case report]. Pesticidi. 2000;15(4):297-300. Serbian.

Bhaskar EM, Moorthy S, Ganeshwala G, Abraham G. Cardiac conduction disturbance due to prallethrin (pyrethroid) poisoning. J Med Toxicol. 2010;6(1):27-30.

Singh H, Luni FK, Marwaha B, Ali SS, Alo M. Transient Complete Heart Block Secondary to Bed Bug Insecticide: A Case of Pyrethroid Cardiac Toxicity. Cardiology. 2016;135(3):160-3.

Walters JK, Boswell LE, Green MK, Heumann MA, Karam LE, Morrissey BF, et al. Pyrethrin and pyrethroid illnesses in the Pacific northwest: a five-year review. Public Health Rep. 2009;124(1):149-59.

Daiss R, Edwards D. Reregistration eligibility decision for piperonyl butoxide (RED). Office of Pesticide Programs, United States Environment Protection Agency, Washington, DC. 2006.

Namulanda G, Monti MM, Mulay P, Higgins S, Lackovic M, Schwartz A, et al. Acute Nonoccupational Pesticide-Related Illness and Injury-United States, 2007-2011. MMWR Morb Mortal Wkly Rep. 2016;63(55):5-10.

Calvert GM, Beckman J, Prado JB, Bojes H, Schwartz A, Mulay P, et al. Acute Occupational Pesticide-Related Illness and Injury-United States, 2007-2011. MMWR Morb Mortal Wkly Rep. 2016;63(55):11-6.

US Environmental Protection Agency; Office of Pesticide Programs. A Review of the Relationship Between Pyrethrins, Pyrethroid Exposure and Asthma and Allergies. Office of Pesticide Programs: US Environmental Protection Agency; 2009. p. 1–27.

Georgiadis N, Tsarouhas K, Tsitsimpikou C, Vardavas A, Rezaee R, Germanakis I, et al. Pesticides and cardiotoxicity. Where do we stand? Toxicol Appl Pharmacol. 2018;353:1-14.

Natarajan A, Molnar P, Sieverdes K, Jamshidi A, Hickman J. Microelectrode array recordings of cardiac action potentials as a high throughput method to evaluate pesticide toxicity. Toxicol In Vitro. 2006;20(3):375-81.

Ghazouani L, Feriani A, Mufti A, Tir M, Baaziz I, Mansour HB, et al. Toxic effect of alpha cypermethrin, an environmental pollutant, on myocardial tissue in male wistar rats. Environ Sci Pollut Res Int. 2020;27(6):5709-17.

Fischer BC, Rotter S, Schubert J, Marx-Stoelting P, Solecki R. Recommendations for international harmonisation, implementation and further development of suitable scientific approaches regarding the assessment of mixture effects. Food Chem Toxicol. 2020;141:111388.

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