Toxicity of Herbicide Containing Glyphosate

Jackson, J. B.

doi:10.1016/s0140-6736(88)91205-6

Cited by 10 publications

(6 citation statements)

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“…Not all the case reports clearly state that a concentrate or dilute preparation was involved (although in most an implication that the concentrate was used appears to be present). No deaths have been reported following accidental ingestions of GlySH 8–11,15 . Several studies support the notion that GlySH is minimally toxic in the setting of small volume, accidental or occupational exposures (including dermal, ocular, inhalational and oral exposures) 2,13,14,16 .…”

Section: Discussionmentioning

confidence: 90%

“…Industry supported literature in general portrays GlySH as a substance with minimal human toxicity 2,14,15 . Studies on the dermal and inhalational toxicity of GlySH have been conducted, as well as a number of studies, principally on rats and rabbits, of systemic toxicity 2,15,16 . Talbot states that ‘… until recently, the cases were considered very safe and received little attention after admission’ 8 .…”

Section: Discussionmentioning

confidence: 99%

“…Common clinical features attributed to POEA toxicity include gastrointestinal pain, vomiting with aspiration, pulmonary oedema, impaired consciousness and haemolysis 9, 17 . Although POEA toxicity was cited as the cause of death in nine Japanese human cases of Roundup ingestion, the proportion of GlySH toxicity attributable to POEA remains unclear 8,9,15,17 . Glyphosate in isolation has been shown to cause significant corrosive gastrointestinal effects (with likely nausea, vomiting, diarrhoea and possibly gastrointestinal bleeding) 8 .…”

Section: Clinical Features Of Glysh Toxicitymentioning

confidence: 99%

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Glyphosate herbicide formulation: A potentially lethal ingestion

Stella

Ryan

2004

Emergency Medicine

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Glyphosate surfactant herbicide (GlySH) toxicity is an uncommon poisoning. We report two fatalities involving suicidal ingestion of this herbicide. Both deaths occurred despite early recognition of the serious nature of the poisoning and aggressive treatment. The deaths in this series are analysed in the context of a review of existing literature. Although traditionally regarded as minimally toxic, many deaths have been reported following suicidal ingestion. Severe GlySH toxicity may be refractory even to the most intensive supportive care. The triad of pulmonary oedema, metabolic acidosis and hyperkalaemia portends poor outcome. While containing a carbon phosphorus moiety, GlySH does not exhibit organophosphate toxicity. A clinical guide to assessing severity of GlySH toxicity is proposed and treatment modalities discussed.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Features Of Glysh Toxicitymentioning

confidence: 99%

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Glyphosate herbicide formulation: A potentially lethal ingestion

Stella

Ryan

2004

Emergency Medicine

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“…4,15,16 In clinical practice, many GlySH-intoxicated patients presented with mucosal injury of the throat (sore throat) with drooling. Most of the patients were able to overcome these symptoms by conservative treatment; however, some of those severely injured patients developed respiratory distress syndrome, even requiring intubation.…”

Section: Discussionmentioning

confidence: 99%

Clinical Presentations and Prognostic Factors of a Glyphosate — Surfactant Herbicide Intoxication A Review of 131 Cases

Lee¹,

Chen²,

Chi³

et al. 2000

Academic Emergency Medicine

109

103

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Abstract. Objective: Suicide attempts with agricultural chemicals are common in southern Taiwan. Among them, glyphosate-surfactant herbicide (GlySH) intoxication has been encountered with increasing frequency. Although a number of reports have described the clinical course and outcomes following ingestion, predictors of serious complications and mortality have not been elucidated. The purpose of this study was to define predictors of serious complications and probable mortality. Methods: This was a retrospective study of 131 GlySH-intoxicated patients treated at the National Cheng Kung University Hospital from 1988 to 1995. Medical charts were reviewed and clinical and laboratory variables were abstracted, looking for predictors of mortality. Results: The most common symptoms included sore throat (79.5%), and nausea with or without vomiting (73.8%). The most common laboratory findings were leukocytosis (68.0%), low serum bicarbonate (48.1%), and acidosis (35.8%). Overall, 11 of 131 patients (8.4%) died; the mean Ϯ SEM time to death was 2.8 Ϯ 0.8 days after presentation. When comparing the clinical and laboratory characteristics among the survivor and fatality groups, significant differences were identified. Respiratory distress, pulmonary edema, respiratory distress necessitating intubation, shock (systolic blood pressure less than 90 mm Hg), altered consciousness, abnormal chest x-ray, renal failure necessitating hemodialysis, larger amount of ingestion (>200 mL), and hyperkalemia were predictors highly associated with poor outcomes and mortality. Using multiple logistic regression, three predictors were identified, which may predict mortality in severely intoxicated patients. Conclusions: In managing patients who have larger amount of GlySH ingestion, airway protection, early detection of pulmonary edema, and prevention of further pulmonary damage and renal damage appear to be of critical importance. Key words: glyphosate; surfactant; herbicide; intoxication; aspiration; pneumonitis. ACADEMIC EMER-GENCY MEDICINE 2000; 7:906-910 H ERBICIDES containing glyphosate, an alternative to paraquat, have recently been used with increasing frequency in suicide attempts throughout Asia. 1-5 Ingestion of a large amount of this chemical may place patients at risk for a toxic syndrome that includes gastrointestinal irritation, hepatic and renal dysfunction, cardiovascular instability, and pulmonary insufficiency. 2-6 Although glyphosate-surfactant herbicide (GlySH) is considered to be only slightly toxic in rats, ingestion of a substantial volume of GlySH has been reported to be associated with toxicity and death in humans. 4,5 A number of reports have described the clinical course and outcomes following ingestion;From the Departments of Emergency Medicine (HLL, KWC, CHC, LMT) and Internal Medicine (JJH), National Cheng Kung University Hospital, Tainan, Taiwan. Received July 7, 1999; revisions received October 29, 1999, and January 24, 2000; accepted February 21, 2000. Address for correspondence and reprints: Kuan-Wen Chen...

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“…Some studies have suggested that the POEA surfactant may contribute the greater part of the product' s toxicity in humans. [4][5][6] Proposed mechanisms of GlySH toxicity to mammals include uncoupling of oxidative phosphorylation and glyphosate-or POEA-mediated direct cardiotoxicity. 6 There are now a number of (mostly Asian) studies in the literature, reporting the clinical features of GlySH intoxication.…”

Section: Discussionmentioning

confidence: 99%

Fatal Poisoning with Glyphosate-Surfactant Herbicide

Beswick

Millo

2011

Journal of the Intensive Care Society

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A 29-year-old man was admitted following the deliberate (witnessed) ingestion of approximately 300 mL of 'Roundup Ace,' a herbicide containing glyphosate as its active ingredient. On presentation he was agitated and sweating, with partial airway obstruction and trismus. He required intubation and mechanical ventilation for airway control.Initial blood gases were normal but within a few hours of admission he had developed a severe and persistent lactic acidosis. A continuous sodium bicarbonate infusion was commenced in an attempt to reverse this. Hyperkalaemia developed rapidly, and was associated with cardiac arrhythmias including ventricular tachycardia. Hyperkalaemia was initially managed with intravenous calcium gluconate and insulin and dextrose, while a haemofiltration catheter was inserted. Seven hours after admission, the patient was started on continuous veno-venous haemofiltration (CVVHF), which two hours later was changed to haemodiafiltration (CVVHDF) following telephone advice from the National Poisons Information Service. CVVHDF was maintained almost continuously, at a dose of 35 mL/kg/h, for around 40 hours of his 59-hour admission to the critical care unit. Accusol 35 (Baxter International Inc.) was used as the buffer solution.Hypotension became a persistent problem, and by hour 10 of his admission, a noradrenaline infusion was commenced at a rate of 0.543 µg/kg/min. Despite the patient receiving approximately 10 litres of intravenous fluid on the first day of admission alone, and maintaining a mean central venous pressure of around 12.5 cm H 2 O, he was requiring up to 1.43 µg/kg/min of noradrenaline by day 2. Although oesophageal Doppler haemodynamic monitoring was available on the unit it was not used. This was due to fears that the patient was at increased risk of oesophageal perforation, secondary to the corrosive effects of GlySH.Approximately 12 hours after admission, the patient developed torrential watery diarrhoea and a distended abdomen. Serum pH was maintained within a relatively normal range but lactataemia persisted despite CVVHDF (Figure 1). Therefore, when more stable on day 2, CVVHDF was interrupted and the patient had a CT scan of his abdomen to rule out an intra-abdominal cause for the high lactate. The CT revealed an ileus and otherwise apparently normal internal organs. The patient also had an upper GI endoscopy due to concerns that the GlySH ingestion may have caused a stenosed or perforated oesophagus. His oesophagus was ulcerated, though patent, and he had extensive oesophago-gastritis.After returning from the CT scanner and before restarting haemofiltration, the patient suffered a cardiac arrest. Return of spontaneous circulation occurred with cardiopulmonary resuscitation (CPR) and a single synchronised DC shock for ventricular tachycardia. He was placed back on CVVHDF and a transthoracic echocardiogram revealed no structural cardiac Fatal poisoning with glyphosatesurfactant herbicide E Beswick, J MilloA 29-year-old man was admitted following deliberate ingestion of appro...

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Toxicity of Herbicide Containing Glyphosate

Cited by 10 publications

References 0 publications

Glyphosate herbicide formulation: A potentially lethal ingestion

Glyphosate herbicide formulation: A potentially lethal ingestion

Clinical Presentations and Prognostic Factors of a Glyphosate — Surfactant Herbicide Intoxication A Review of 131 Cases

Fatal Poisoning with Glyphosate-Surfactant Herbicide

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