Pesticide poisoning in south India: opportunities for prevention and improved medical management

Abstract

Summary Objective Warangal district in Andhra Pradesh, southern India, records >1000 pesticide poisoning cases each year and hundreds of deaths. We aimed to describe their frequency and distribution, and to assess quality of management and subsequent outcomes from pesticide poisoning in one large hospital in the district. Methods We reviewed data on all patients admitted with pesticide poisoning to a district government hospital for the years 1997 to 2002. For 2002, details of the particular pesticide ingested and management were abstracted from the medical files. Findings During these 6 years, 8040 patients were admitted to the hospital with pesticide poisoning. The overall case fatality ratio was 22.6%. More detailed data from 2002 revealed that two‐thirds of the patients were <30 years old, 57% were male and 96% had intentionally poisoned themselves. Two compounds, monocrotophos and endosulfan, accounted for the majority of deaths with known pesticides in 2002. Low fixed‐dose regimens were used in the majority of cases for the most commonly used antidotes (atropine and pralidoxime). Inappropriate antidotes were also used in some patients. Conclusions It is likely that these findings reflect the situation in many rural hospitals of the Asia Pacific region. Even without an increase in resources, there appear to be significant opportunities for reducing mortality by better medical management and further restrictions on the most toxic pesticides.

Management of Acute Organophosphorus Insecticide Poisoning: An Experience at a University Hospital

“…18 In this study, we observed that out of 111 patients, 60% were males, and 85.6% were within the age limit of 12-30 years. These observations are consistent with the results of Srinivas, et al 19 In his study, males outnumbered females (57% vs. 43%) with all types of pesticides including organophosphorus compounds and two-thirds of them were less than 30 years of age. Similarly in the studies by Safdar 20 , Fahmi and Aziza 21 , number of male victims was higher than females.…”

Clinical profile of organophosphorus poisoning patients at rural tertiary health care centre

“…In parts of northern India, aluminum phosphide causes most deaths in epidemic that started two decades ago. 2 Cases of acute pesticide poisoning (APP) cause significant morbidity and mortality worldwide especially in developing countries. There is no reliable estimate as how many persons per year suffer from pesticide related health effects this is due to several reasons including lack of standardized case definition.…”

The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

“…In present study, variety of complication were observed (Table 12). [12][13][14][15][16] Individuals in this age group are active physically, mentally and socially and thus more prone to various stresses. The present study had more number of illiterate and those studied below intermediate level with majority of cases being related directly or indirectly to farming.…”