Abstract
ABSTRACTThe study was designed to analyze the incidence and pattern of anticoagulant rodenticide intoxication in east China and to discuss strategies of diagnosis based on laboratory analysis experience. A total of 117 patients with anticoagulant rodenticide poisoning confirmed by toxicological analysis in east China were included in this study from 2011 to 2013. The mean concentration of anticoagulant rodenticide, age, and gender of these patients, as well as the mode and type of poisoning, were discussed. The age ranged from less than 1 to 80 years with the feeble preponderance of males (M = 53.0%, F = 47.0%). The 0–9 age group covered the largest ratio of these anticoagulant rodenticide poisoning patients. Accidental or voluntary ingestion seems to be the most common cause of intoxication, with still the poisoning cause being unknown for a large number of positive analyses. Bromadiolone was the most commonly observed anticoagulant rodenticide found in the biological samples, followed by brodifacoum. The concentrations of bromadiolone and brodifacoum that were detected in the first collected whole blood from each patient ranged from 1 to 878 ng/mL (mean 97.9 ng/mL) and from 0.5 to 1566 ng/mL (mean 225.1 ng/mL), respectively. The data analysis shows a high incidence of anticoagulant rodenticide poisoning without awareness of the poisoned subjects, clearly emphasizing the need for toxicological analysis in patients with vitamin K-dependent coagulation disorder and restriction on availability of anticoagulant rodenticide.
Highlights
Anticoagulant rodenticides, which can be divided into first-generation and second-generation compounds, are widely used in agricultural and urban rodent control
A total of 117 patients with anticoagulant rodenticide poisoning confirmed by toxicological analysis in east China were included in this study from 2011 to 2013
The data analysis shows a high incidence of anticoagulant rodenticide poisoning without awareness of the poisoned subjects, clearly emphasizing the need for toxicological analysis in patients with vitamin K-dependent coagulation disorder and restriction on availability of anticoagulant rodenticide
Summary
Anticoagulant rodenticides, which can be divided into first-generation and second-generation compounds, are widely used in agricultural and urban rodent control. The United States Environmental Protection Agency banned most residential uses of SGARs from 2011 [5]. Their use remains legal for agricultural, industrial and some commercial applications in the United States and are widely used in many other countries. Bromadiolone and brodifacoum are the most commonly used SGARs in China, and involved in the majority of anticoagulant rodenticide poisoning cases. From 2005 to 2010, 46 anticoagulant rodenticide poisoning patients were treated in a Henan Province hospital [7]. From July 2008 to April 2011, 12 patients were diagnosed with anticoagulant rodenticide occult poisoning in a Changsha hospital [8]. In 2009, 176 middle-school students in Leqing were sent to hospital after consuming food that had been accidently contaminated with bromadiolone [9]
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