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Summaries of first drafts of Environmental Health Criteria (EHC), which were circulated for comments by IPCS in the period of 1994-1995, are presented. EHC drafts on 10 compounds were received in this period.
A prospective study of 559 cases of acute poisoning who came to this hospital over a period of 14 months. 91.4% cases were of self poisoning (suicidal), 8.1% accidental and only 0.5% homicidal. Majority of patients were young (mean age 27 years), males twice the number of females. Almost 3/4th of the total patients belonged to lower socio-economic group (rural more than urban). The common causative factors which led to self poisoning were marital disharmony, economic hardships and scolding/disagreement with other family members. Aluminium phosphide (ALP) was the most commonly abused substance followed by organophosphates and zinc phosphide in 67.8, 13.9 and 4.3% cases respectively. The overall mortality rate in the series was 33.82%, but true mortality rate in patients who consumed ALP was as high as 67.6%. Most of these cases (94.9%) were not given any preliminary treatment in the village primary health centre (PHC) nearest to the site of mishap and they were brought/referred to this hospital straight and thus most valuable time crucial for effective treatment was lost. Easy availability of a highly toxic substance like ALP at peak moments of frustration has added fuel to the fire and pushed up the incidence of self-poisoning. Suggested preventive measures include caging of tablets in plastic packs, stringent restrictions on free supply of ALP and education of medical/paramedical personnel involved in health care delivery at grass root level.
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We report the case of a 17-year-old boy with a significant history of drug and alcohol abuse, which included smoking marijuana mixed with brodifacoum. As a consequence, the patient developed a prolonged coagulopathy that persisted for more than 1 year. To our knowledge, this is the first case reported in the literature in which super-warfarin intoxication has been associated with marijuana smoking. This report should increase the awareness of pathologists and clinicians when examining a patient with a history of drug abuse who exhibits persistent vitamin K1-dependent coagulopathy.
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Thallium is a highly toxic cumulative poison in humans and animals. The use of the metal as a component in ceramic superconductor material (CSM) raised concern about the health risk of CSM to children accidentally swallowing some of the CSM or to occupationally-exposed workers in the electronics industry. This study examined the biological availability of CSM by quantifying the thallium content in organs, blood and fecal matter of Sprague-Dawley rats after a single acute oral exposure to CSM and compares these values to similar thallium measurements from identical exposure to thallium sulfate. The CSM-exposed group had significantly less thallium than the thallium sulfate-exposed group in all tissues/fluids analyzed. This suggested that CSM poses a lower health risk to exposed persons than thallium sulfate.
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A reversed-phase ion-pair liquid chromatographic (LC) method was developed for analysis of steam-rolled oat (SRO) baits fortified with either chlorophacinone or diphacinone. Baits were prepared with and without paraffin wax. Chlorophacinone or diphacinone was extracted from wax-free SRO baits with 5 mM tetrabutylammonium phosphate methanolic ion-pairing solution. Wax baits were initially extracted with petroleum ether and then cleaned up by liquid extraction into methanolic ion-pairing solution containing 20% water. SRO extracts were analyzed with reversed-phase ion-pair LC. Chlorophacinone and diphacinone were quantified by UV absorption at 325 nm. Recoveries from SRO fortified with chlorophacinone at 25 and 150 micrograms/g were 90.7 and 90.8%, respectively, whereas for diphacinone at the same levels, recoveries were 93.5 and 92.3%, respectively. Recoveries from wax baits fortified at 25 and 75 micrograms/g chlorophacinone were 98.5 and 100%, respectively, whereas for diphacinone at the same levels, recoveries were 93.6 and 98.0%, respectively. Method limits of detection for chlorophacinone and diphacinone in SRO baits were estimated to be 1.0 and 0.76 micrograms/g, respectively. Method limits of detection for chlorophacinone and diphacinone in wax baits were estimated to be 4.2 and 2.8 micrograms/g, respectively.
Twenty cases of zinc phosphide (Zn3P2) ingestion (self-poisoning) were seen during the last 5 years (January 1992-December 1996). Poisoning was rare before 1986. Profuse vomiting (100%), pain in abdomen (100%), palpitation and sweating (80%), dyspnea and tachypnea (75%), metabolic acidosis (60%), shock (40%), and hypotension (40%) were the most common presenting features. Five patients (25%) died. The toxic effects were due to liberation of toxic phosphine (PH3) gas which was detected by qualitative silver nitrate paper test in majority of cases.
To estimate the genetic risk associated with pesticide exposure in a defined population, the frequency of micronuclei (MN) in peripheral blood lymphocytes from a group of 22 pesticide sprayers from Concepción, Chile, occupationally exposed to pesticide mixtures was evaluated. After scoring 1,000 binucleated cells for each donor, no significant increases were observed either for the total number of MN or for binucleated cells with MN, when compared with a concurrent control population. In addition, when the effects of different confounding factors such as age, smoking, and drinking habits were considered, no significant effect was observed. Our conclusion is that, in this specific group of workers and under the particular conditions of exposure to pesticides, when evaluated by the micronucleus assay, no genetic risk was detected.
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A captive white-winged wood duck (Cairina scutulata) with bilateral epistaxis and anemia (packed cell volume = 16%) was treated with injectable and oral vitamin K1 and transfused with 40 ml whole blood. Brodifacoum was detected in blood at 0.002 ppm. The bird made an uneventful recovery. This report illustrates the risk of anticoagulant pest control products in a zoological setting.