Acute Poisoning among Farmers by Chlorpyrifos

Poisoning is a very common phenomenon in the world, and it’s also the leading cause of unintentional death, surpassing even motor vehicle crashes. So far, poisoning is usually divided into four classes: food poisoning, drug and pesticides poisoning, poisoning of industrial chemicals and poisoning of natural toxins. And according to the onset time, it’s classified as acute poisoning and chronic poisoning.

In this paper, the author reported a case of acute pesticides poisoning among farmers in Gaza Strip, Palestine and discussed the follow up treatments. In this case, the patient lost consciousness in his farm after spraying chlorpyrifos by using high volume technique at a windy day. Chlorpyrifos, an insecticide belongs to the chemical group Organophosphorus insecticides (OPI), is widely used in Gaza for pest control. After sending to hospital, some physical investigations were conducted to the patient immediately and his skin was washed with warm water containing some soups to enhance removal of poison residue from the skin. Blood samples were also collected from the patient for complete blood chemistry (CBC) and acetyl choline esterase (ACHE) activity determination. All these steps were repeated every day to monitor the level of ACHE. Besides, the patient was given 10 mg atropine in 500 mL normal saline solution (NS) every 6 h intravenous injection (IV), at a late stage double dose of Atropine was given to the patient. Then Diclofen was given as intra muscular injection (IM). After three days stay in the ICU no improvement was seen on the ACHE level, the patient was given 750 mg Toxogonin in 500 mL saline solution every 6 h along with other medical drugs to stop the clinical symptoms.

And then the author analyzed the mechanism of poisoning, mode of poisoning, management of toxic case, and mode of treatment (detoxification). The final result indicated that acute poisoning was associated with severe reduction on ACHE activity and appearance of clinical symptoms. And ACHE activity reached the lowest level during the treatment then the level was elevated after several times injection of Toxogonin at 750 mg. And the case also showed that application of OPI at high volume at windy days could result in many poisoned cases, especially the acute poisoning cases.

In conclusion, the application of pesticides should be cautious and more related information about poisoning should be told to its users to prevent poisoning, which is very harmful to people’s health.

Article by Yasser El-Nahhal, from The Islamic University, Gaza, Palestine.

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Image by Fabio, from Flickr-cc.