A Fatal Case of Paraquat Poisoning Following Minimal Dermal Exposure

Soloukides, Andreas; Moutzouris, Dimitrios-Anestis; Kassimatis, Theodore I.; Metaxatos, G.; Hadjiconstantinou, Valsamakis

doi:10.1080/08860220601184134

Cited by 38 publications

(31 citation statements)

References 20 publications

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“…A case report described skin burns resulting from minimal accidental paraquat exposure, which subsequently lead to acute renal and respiratory failure and ultimately death. 74 Another report described prolonged dermal paraquat exposure as a result of a crop-dusting accident, also resulting in death. 85 Epidemiology studies have also associated self-reported paraquat usage with Parkinson's disease, most likely because of the increased production of reactive oxygen species resulting from the toxicity of the herbicide.…”

Section: Agriculture and Forestrymentioning

confidence: 99%

Potential Health Effects Associated with Dermal Exposure to Occupational Chemicals

Anderson

Meade

2014

Environ�Health�Insights

142

112

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There are a large number of workers in the United States, spanning a variety of occupational industries and sectors, who are potentially exposed to chemicals that can be absorbed through the skin. Occupational skin exposures can result in numerous diseases that can adversely affect an individual’s health and capacity to perform at work. In general, there are three types of chemical–skin interactions of concern: direct skin effects, immune-mediated skin effects, and systemic effects. While hundreds of chemicals (metals, epoxy and acrylic resins, rubber additives, and chemical intermediates) present in virtually every industry have been identified to cause direct and immune-mediated effects such as contact dermatitis or urticaria, less is known about the number and types of chemicals contributing to systemic effects. In an attempt to raise awareness, skin notation assignments communicate the potential for dermal absorption; however, there is a need for standardization among agencies to communicate an accurate description of occupational hazards. Studies have suggested that exposure to complex mixtures, excessive hand washing, use of hand sanitizers, high frequency of wet work, and environmental or other factors may enhance penetration and stimulate other biological responses altering the outcomes of dermal chemical exposure. Understanding the hazards of dermal exposure is essential for the proper implementation of protective measures to ensure worker safety and health.

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Section: Agriculture and Forestrymentioning

confidence: 99%

Potential Health Effects Associated with Dermal Exposure to Occupational Chemicals

Anderson

Meade

2014

Environ�Health�Insights

142

112

View full text Add to dashboard Cite

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“…Paraquat dichloride (1,1′-dimethyl-4,4′-bipyridinium dichloride, methyl viologen dichloride hydrate, PQ) is a quaternary nitrogen herbicide that has been extensively used all over the world since the middle of the 20th century. Its inherent high toxicity to plants is also extended to humans resulting in both chronic exposure and intentional/accidental acute toxicity, frequently reported as fatal (Almog and Tal, 1967;Hsu et al, 2003;Russell et al, 1981;Soloukides et al, 2007). The lung is known to be the target organ for PQ's cytotoxicity (Dinis-Oliveira et al, 2006a), although the liver and the kidneys may also be affected.…”

Section: Introductionmentioning

confidence: 99%

RBE4 cells are highly resistant to paraquat‐induced cytotoxicity: studies on uptake and efflux mechanisms

Vilas-Boas

Silva

Pinho

et al. 2013

J of Applied Toxicology

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Paraquat (PQ) is a widely used, highly toxic and non-selective contact herbicide, which has been associated with central neurotoxic effects, namely the development of Parkinson's disease, but whose effects to the blood-brain barrier (BBB) itself have rarely been studied. This work studied the mechanisms of PQ uptake and efflux in a rat's BBB cell model, the RBE4 cells. PQ is believed to enter cells using the basic or neutral amino acid or polyamine transport systems or through the choline-uptake system. In contrast, PQ efflux from cells is reported to be mediated by P-glycoprotein. Therefore, we evaluated PQ-induced cytotoxicity and the effect of some substrates/blockers of these transporters (such as arginine, L-valine, putrescine, hemicholinium-3 and GF120918) on such cytotoxicity. RBE4 cells were shown to be extremely resistant to PQ after 24 h of exposure; even at concentrations as high as 50 mM approximately 45% of the cells remained viable. Prolonging exposure until 48 h elicited significant cytotoxicity only for PQ concentrations above 5 mM. Although hemicholinium-3, a choline-uptake system inhibitor, significantly protected cells against PQ-induced toxicity, none of the effects were observed for arginine, L-valine or putrescine. Meanwhile, inhibiting the efflux pump P-glycoprotein using GF120918 significantly enhanced PQ-induced cytotoxicity. In conclusion, PQ used the choline-uptake system, instead of the transporters for the basic or neutral amino acids or for the polyamines, to enter RBE4 cells. P-glycoprotein extrudes PQ back to the extracellular medium. However, this efflux mechanism only partially explains the observed RBE4 resistance to PQ.

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“…Urinary paraquat concentrations of <1 mg/L within 24 hours of toxicity have a high probability of survival. [567] Since patient reported to us after 13 days of ingestion, data regarding serum and urine levels at specific time points is lacking. We did not confirm the presence of paraquat by using dithionite test in urine or plasma.…”

Section: Discussionmentioning

confidence: 99%

Paraquat - A deadly poison: Report of a case and review

Saravu¹,

Sekhar²,

Pai³

et al. 2013

Indian Journal of Critical Care Medicine

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Paraquat is a bipyridilium herbicide used widely in our country and is a highly toxic compound. A 16-year-old female patient was admitted to the emergency department of our tertiary care hospital in South India with the history of alleged consumption of paraquat poison. Since there is dearth of high quality evidence- based treatment for this poisoning, different treatment modalities have been tried to manage patient's condition. In this case, none of the strategies could work well. Most of the patients reported with paraquat intoxication are from agricultural background; usually such patients cannot afford the treatment expenses. This paper presents a fatal case of acute poisoning with paraquat who succumbed to acute respiratory distress syndrome (ARDS).

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A Fatal Case of Paraquat Poisoning Following Minimal Dermal Exposure

Cited by 38 publications

References 20 publications

Potential Health Effects Associated with Dermal Exposure to Occupational Chemicals

Potential Health Effects Associated with Dermal Exposure to Occupational Chemicals

RBE4 cells are highly resistant to paraquat‐induced cytotoxicity: studies on uptake and efflux mechanisms

Paraquat - A deadly poison: Report of a case and review

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