Cases Of Pesticide Poisoning Research Articles

Revolutionising pesticide detection: a high-sensitivity electrochemical sensor with CdS/g-C3N4/MWCNTs for paraquat monitoring

ABSTRACT Over a decade, the Malaysia National Poison Centre found that 40% of pesticide poisoning cases may be linked to excessive paraquat (PQ) in water, soil, or food, underscoring the widespread impact on public health and emphasising the importance of detecting even trace amounts of PQ residues in the environment. Thus, this study presents a novel electrochemical sensor based on multiwalled carbon nanotubes (MWCNTs) reinforced cadmium sulphide co-anchoring on graphitic carbon nitride (CdS/g-C3N4) nanocomposites for PQ detection. The CdS/g-C3N4 nanocomposite was successfully synthesised and characterised through FTIR, XRD, EDX, FESEM and TEM analysis. The modified electrode (CdS/g-C3N4/MWCNTs PE) exhibited improved electrocatalytic activity, as demonstrated by cyclic voltammetry (CV) and impedance spectroscopy. The CdS/g-C3N4/MWCNTs PE displayed a high CV peak and low Rct value which corresponded to a higher electron transfer rate, reduced charge transfer resistance and enhanced mass transport properties. The electrochemical sensor’s performance was evaluated for the detection of PQ, and it demonstrated a linear response in a range of 1.0 µM to 0.1 mM with a limit of detection of 0.14 μM. Furthermore, the sensor exhibited selectivity with a less than 16% potential interference from various organic chemicals and inorganic ions. The sensor’s applicability was tested by quantifying PQ in real water samples, showing excellent recovery percentages ranging from 98.9% to 102.0%. The developed electrochemical sensor provides a practical solution for the rapid and accurate monitoring of PQ levels in the environment. This work establishes the foundation for the development of a selective electrochemical sensor for pesticide analysis, addressing both public health and environmental concerns.

An artificial intelligence-based approach for an urgent detection of the pesticide responsible of intoxication

Acute poisoning by pesticides in Morocco is an important public health issue, because the use of pesticides has become both massive and anarchic. This is the cause of deaths whose incidence is unfortunately increasing. Unfortunately, these deaths are not always accidental. Pesticides are also used as a means of suicide; according to the WHO, these are means suicide chemicals most used in the world, since, out of the 800,000 suicides recorded per year, more than a third are caused by this type of product. Even more serious, these suicides are currently being observed among children and teenagers. Faced with this alarming figure, and in order to prevent deaths and improve emergency treatment of cases of pesticide poisoning, it becomes important to use the potential of artificial intelligence in the treatment of these admissions. Our approach is essentially based on machine learning algorithms, including decision support software capable of predicting, based on major clinical signs, the most likely pesticide responsible of the intoxication in the triage room. This, before moving on to the confirmation stage based on biological and toxicological investigations, which are often costly and time-consuming.

Study on occurrence of agrochemical poisoning in Bovines at veterinary clinics of Udgir

In view of unavailability of data on agrochemical poisoning in livestock animals in India, the present work was conducted with objective to study the epidemiological aspects of agrochemical poisoning in bovines over a period of five years. A total of 98 cases of pesticide poisoning in bovines have been reported during 2016-2020 at Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Udgir with hospital prevalence of 0.39%. Among various agrochemicals, insecticide poisoning was responsible for 45.91% cases, fungicide for 17.34%, herbicides for 16.32%, unknown pesticides for 10.20%, fertilizers for 7.14% and rodenticides for 3.06% cases of poisoning in bovines. Year-wise higher number of cases were reported during 2016 (30.61%) followed by 2017, 2019 (19.38% each) and 2018 (18.36%) while, month- wise highest number of poisoning cases were reported in months of November (14.28%), December (13.26%), July and September, October (11.22% each). Season-wise highest occurrence of poisoning was observed during monsoon and post-monsoon seasons while least occurrence was observed during summer season. Age-wise highest occurrence of agrochemical poisoning was reported in 4-6 year and 0-2 year age-group animals. Species-wise occurrence of poisoning revealed highest occurrence in cattle (65.31%) than buffaloes (34.69%). Among cattle 67.18% male animals while 32.82% female animals were affected. All buffaloes confirmed for poisoning were female. The findings of the present study will be helpful for formulating strategies to reduce exposure of livestock animals to agrochemicals.

Differences in the characteristics of people who purchase pesticides from shops for self-harm versus those who use pesticides available in the domestic environment in Sri Lanka.

Data from South Asia indicate that for 15%-20% of suicide attempts, pesticides are purchased from shops; otherwise, pesticides are obtained from an individual's house or nearby environment. We aimed to investigate the difference between individuals who directly purchase pesticides from shops for suicide attempts and suicide deaths versus those related to accessing the pesticides from an individual's house or nearby environment. We conducted two comparative studies in rural Sri Lanka: (1) non-fatal shop cases (n = 50) were survivors of self-poisoning with pesticides who ingested the pesticides after purchasing them from a shop; non-fatal domestic cases (n = 192) were survivors who accessed pesticides from their house or nearby environment. (2) fatal shop cases (n = 50) were individuals who died after ingesting pesticides they purchased for the act; fatal domestic cases (n = 102) were patients who died after ingesting pesticides they accessed at house or nearby environment. Logistic regression analysis was used to assess the characteristics which distinguished between the shop and domestic cases. Data indicate that 20.7% and 32.9% of individuals who used pesticides for suicide attempts and suicide deaths had purchased them from shops, respectively. Being a non-farmer was the main distinguishing characteristic of shop cases: adjusted odds ratios (AOR) 8.9, 95% confidence intervals (CI) 3.2-24.4 for non-fatal shop cases, and AOR 4.0, 95% CI 1.5-10.6 for fatal shop cases. Non-fatal shop cases also had higher suicide intent (AOR 3.0, CI 1.0-8.9), and ingesting an insecticide (AOR 4.8, CI 1.8-1.0-8.9) than non-fatal domestic cases. A high suicide intent of individuals who purchase pesticides for the event explains the high proportion of such fatal cases. Such high suicide intent makes the prevention implications difficult to spell out for those individuals who purchase pesticides for self-poisoning. However, our findings are valuable for clinicians to assess pesticide poisoning cases in hospitals.

Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban

BackgroundPrevious studies have shown that pesticide bans were associated with reduced fatal pesticide self-poisoning cases in high, and low-and-middle-income countries. We aimed to investigate the characteristics of pesticide poisoning patients admitted to two Malaysian hospitals and the early impact of the national paraquat ban implemented on 1st January 2020 in a culturally heterogenous South-East-Asian upper-middle-income setting.MethodsData were collected from an East (Bintulu) and a West (Ipoh) Malaysian hospital medical records in 2015–2021 and 2018–2021, respectively. Logistic regression analyses were conducted to investigate the association of aspects such as socio-demographic and clinical characteristics, paraquat ban with the types of pesticides involved (paraquat versus non-paraquat versus unknown) ,and the outcomes (fatal versus non-fatal).ResultsFrom the study sample of 212 pesticide poisoning patients aged 15 years or above, the majority were self-poisoning cases (75.5%) with a disproportionate over-representation of Indian ethnic minority (44.8%). Most pesticide poisoning cases had socio-environmental stressors (62.30%). The commonest stressors were domestic interpersonal conflicts (61.36%). 42.15% of pesticide poisoning survivors had a psychiatric diagnosis. Paraquat poisoning accounted for 31.6% of all patients and 66.7% of fatalities. Case fatality was positively associated with male gender, current suicidal intent, and paraquat poisoning. After the paraquat ban, the proportion of pesticide poisoning cases using paraquat decreased from 35.8 to 24.0%, and the overall case-fatality dropped slightly from 21.2 to 17.3%.ConclusionsSocio-environmental stressors in specific domestic interpersonal conflicts, seemed more prominent in pesticide poisoning compared to psychiatric diagnosis. Paraquat accounted for the majority of pesticide-associated deaths occurring in hospitals in the study areas. There was preliminary evidence that the 2020 paraquat ban led to a fall in case fatality from pesticide poisoning.

Epidemiological characteristics of pesticide poisoning in Chengdu City from 2012 to 2021

Objective: To explore the present situation and epidemiological characteristics of pesticide poisoning in Chengdu City from 2012 to 2021, and to provide scientific evidence for further prevention and control. Methods: In January 2022, the pesticide poisoning report cards of Chengdu City from 2012 to 2021 were collected from the China Disease Control and Prevention Information System. The data of the report card was reorganized and the distribution characteristics of pesticide poisoning such as time, region, gender, age and pesticide types were analyzed. Results: 14326 cases of pesticide poisoning were reported in Chengdu City from 2012 to 2021, 651 deaths, and the fatality rate was 4.54%. The cases of productive pesticide poisoning and unproductive pesticide poisoning were 504 and 13822, respectively. The fatality rates of productive and unproductive pesticide poisoning were 1.39% and 4.66%, which were significant different (χ(2)=11.99, P=0.001). The highest reported cases of pesticide poisoning was in 2013 (1779) and the lowest in 2021 (1047). The number of reported cases showed a downward trend year by year (t=-12.30, P<0.001), and the fatality rates also showed a downward trend year by year (χ(2)(trend)=25.48, P<0.001). The fluctuation range of unproductive pesticide poisoning cases in each month of the year was small, and the productive pesticide poisoning mainly occurred from May to August. The regions with the largest number of reported poisoning cases were Pengzhou (1620), Jianyang (1393), Jintang (1266) and Qionglai (1158). The high incidence of poisoning was among 25-54 years old (50.21%, 7193/14326). The fatality rate in the age group 75-96 years old was the highest (8.98%, 95/1058), and the fatality rates increased gradually with age (χ(2)(trend)=186.03, P<0.001). The pesticides causing poisoning were mainly insecticide (43.86%, 6284/14326) and herbicides (35.75%, 5121/14326). Herbicides paraquat had the highest fatality rate (9.54%, 286/2998) . Conclusion: Pesticide poisoning in Chengdu City is mainly unproductive poisoning. Health education should be carried out for key areas and people, and the control of highly toxic pesticides such as insecticide and herbicides should be strengthened.

Epidemiological profile of pesticide poisoning cases in the State of Sergipe, Brazil: a retrospective analysis from 2007 to 2021

We aimed to characterize the epidemiological profile of reported cases of pesticide poisoning in the state of Sergipe between 2007 and 2021. Secondary data were obtained from the National Database of Notifiable Diseases Information System (SINAN) and National Toxicological Information System (SINITOX), through the Department of Informatics of the Unified Health System (DATASUS) and analysis performed using the free tool Google Sheets. During the studied period, 960 cases of exogenous pesticide poisoning were registered in the state. The municipality of Aracaju had the highest percentage of the number of cases. The incidence prevailed in females, in the 20-39 age group, in the brown race and among those with incomplete primary education. The most used toxic agent was rodenticide, suicide attempt predominated as a circumstance of use. Most cases resulted from a single acute exposure, confirmed by the clinical-epidemiological method, and evolved to a cure without sequelae. This study traced the epidemiological profile of the State of Sergipe with regard to the intoxication of the population and, in addition, brought little explored data and information that directly impacts policies aimed at reducing morbidity and mortality resulting from the use of pesticides.

Hygienic assessment of the population risk after consumption of agricultural products grown with the application of triazole class-based fungicides

The problem of pesticide poisoning is particularly acute among countries whose primary source of income is agriculture (India, China, Brazil, Mexico, Argentina etc.). About 3 million cases of intentional and unintentional pesticide poisoning are reported in the world annually, resulting in the death of more than 250000 people. In Ukraine, by 2020, more than 250 pesticide preparations containing active substances of the triazole class. Aim of the work. Hygienic assessment of the population risk after consumption of agricultural products grown with the application of triazole class-based fungicides. Materials and methods. We analyzed the resistance parameters of triazole fungicides (difenoconazole, prothioconazole, cyproconazole, and metconazole) and strobilurin (azoxystrobin) in various crops. To determine the content of active substances in crops, we used modern methods of high-performance liquid and gas chromatography. For the integral assessment of the hazard indicators was used, the indicators of the allowable daily intake, the half-life periods in plants and the average daily consumption of the product were evaluated. Research results. The risk assessment for the population, calculated according to the methodology showed that the risk values of triazoles were 0.0002-0.2239, strobilurins – 0.0002-0.0016, which does not exceed the acceptable (less than 1). Calculations carried out according to the method show that all studied compounds of triazoles class belong to the moderately hazardous when consuming treated products of rapeseed, soybean, sunflower, sugar beet and hazardous when consuming cereals; strobilurin - low hazard when consumed the most of the studied cultures. Differences in hazard classes are primarily due to differences in the behaviour of pesticides in different crops and the length of the vegetative season.

Clinical presentation of various APP cases admitted in S.N.M.C., Agra clinical profiling of acute pesticide poisoning (APP) cases admitted in tertiary care hospital of north India

Poisoning is a significant health problem around the world. In India being an agriculture based economy, Pesticide Poisoning contributes largest sum in poisoning cases. The study was conducted in Emergency Department of S.N. Medical College and Hospital, Agra from Sept 2018 to Sept 2019 to investigate Acute Pesticide Poisoning (APP) cases in the region. Majority of cases in our study were from age group of 21-30 yrs with mean age of 28.10 ± 11.38 yrs with male predominance. In This study we found out that APP is 61% of all poisoning cases, out of them maximum cases belongs to OP poisoning which clinically presented with Dyspnea/Tachypnea, Sweating, Vomiting, Abdominal pain. Mortality in APP cases was found to be 10.5%. Although case fatality ratio is highest in cases of celphos (AlP) which most commonly presented with symptoms of Paresthesias, Diarrhea, and Abdominal pain.

Exogenous pesticide poisoning in the state of Espírito Santo, Brazil, 2007-2016: spatial distribution and temporal trend in the incidence rate and case fatality ratio of notified cases.

To describe the spatial distribution of pesticide poisoning cases and analyze the temporal trend in the incidence rate and case fatality ratio of this event in the state of Espírito Santo, Brazil. This was a time series study of confirmed cases of pesticide poisoning registered on the Notifiable Health Conditions Information System (SINAN) between 2007 and 2016. Incidence rates were presented in thematic maps. Scatter plots were used to show the incidence and case fatality ratio of cases. There was an increasing incidence rate of poisoning in the period regarding the total number of cases, by sex and age group - except for those aged 70 years and over. There was a decreasing case fatality ratio until 2012, with a subsequent increase. Eight municipalities presented the highest notification rates (30 to 46 new cases/100,000 inhabitants). There was an increase in the incidence of notifications in the period. There was a decrease in case fatality ratio until 2012, subsequently followed by an increase.

A study on demographic, clinical and prognostic profile of pesticide poisoning cases in a rural tertiary care medical college hospital

A study on demographic, clinical and prognostic profile of pesticide poisoning cases in a rural tertiary care medical college hospital

Evidence of exposure to organophosphorus toxicants by detection of the propionylated butyrylcholinesterase-derived nonapeptide-adduct as a novel biomarker

Organophosphorus (OP) nerve agents represent a class of highly toxic chemical warfare agents banned by the Chemical Weapons Convention. Nevertheless, in the past few years they have been used repeatedly for warfare, assassination and attempted murder. In addition, the chemically related OP pesticides were frequently used for suicide and may be deployed for terroristic attacks. Therefore, sensitive and selective bioanalytical methods are indispensable to investigate biological specimens as pieces of evidence to prove poisoning. OP agents form long-lived covalent reaction products (adducts) with endogenous proteins like human serum albumin (HSA) and butyrylcholinesterase (BChE). The adducted nonapeptide (NP) obtained by proteolysis of the BChE-adduct is one of the most sensitive and important biomarkers. We herein present a novel class of NP-adducts propionylated at its N-terminal phenylalanine residue (F195). The biomarker derivative is produced by addition of propionic anhydride to the NP-adduct inducing its quantitative conversion in aqueous buffer within 5 min at room temperature. Afterwards the mixture is directly analyzed by micro-liquid chromatography-electrospray ionization tandem-mass spectrometry (µLC-ESI MS/MS). The sensitivity of the method is comparable to that of the non-derivatized NP-adduct. These characteristics make the method highly beneficial for forensic analysis especially in cases in which the OP agent does not form adducts with HSA that are typically targeted as a second biomarker of exposure. This novel procedure was successfully applied to nerve agent-spiked samples sent by the Organisation for the Prohibition of Chemical Weapons (OPCW) as well as to plasma samples of real cases of pesticide poisoning.

Epidemiological analysis of pesticide poisoning in Tianjin from 2009 to 2018

Objective: To understand the present situation, law and characteristics of pesticide poisoning in Tianjin, and provide scientific basis for the formulation of pesticide poisoning control strategy. Methods: In August 2019, the related pesticide poisoning report card was derived from the China Disease Prevention and Control Information System. A total of 864 pesticide poisoning cases from 2009 to 2018 in Tianjin were studied, and the data were processed by SPSS 24.0, statistical analysis was performed by 2-test. Results: from 2009 to 2018, a total of 56 pesticide poisoning deaths were reported in Tianjin, with a case fatality rate of 6.48% (56/864) , including 166 cases of productive pesticide poisoning (19.21%) and 698 cases of non-productive pesticide poisoning (80.79%) , the difference of case fatality rate was statistically significant (χ(2)=11.72, P<0.05) . With the most cases of pesticide poisoning (144 cases) in 2012 and the least (48 cases) in 2018. The cases were mainly distributed in Jizhou (312 cases) , Baodi District (247 cases) and Jinnan district (140 cases) , with a total of 699 cases (80.90%) . The time was mainly from May to August, in which non-productive pesticide poisoning occurred in each month, the concentration of productive pesticide poisoning occurred from April to August in spring and summer, and reached its peak in July and August. The age range from 35 to 44 years old was the most (188 cases, 21.76%) , and the age below 15 years old was the least (8 cases, 0.93%) . Pesticide was the most common drug type (551 cases, 63.77%) . Conclusion: The departments concerned should strengthen the education and supervision of pesticide safety, improve the farmers'awareness of harm and self-protection, so as to reduce and prevent the occurrence of pesticide poisoning in this city.

Cholinesterase as a biomarker to identify cases of pesticide poisoning

The clinical care of the intoxicated, as well as the epidemiological surveillance activities of the population exposed to pesticides, require reference values ​​to be able to make decisions based on science. Cholinesterases are biomarkers discovered in the early twentieth century that currently work as auxiliaries in the diagnosis of acute and chronic poisoning. Methodology: In this study we will review 28 investigations that used as a biomarker the cholinesterase in pesticide poisoning, found in search engines PubMed, Dialnet, Redalyc, Crossreff and Google Scholar. Results: 71.42% of the articles reported a decrease in cholinesterase in the population under study and 28.57% report not having detected a decrease in cholinesterase in the study population. Conclusions: We recommend that researchers always consider the delicacy of these enzymes and remember the most important factors that can affect cholinesterase values ​​in addition to pesticides.

Pesticide poisoning - 10 years retrospective analysis

Background: According to the World Health Organization, the incidence of pesticide poisoning is estimated between 1 and 5 million victims with 300,000 lethal cases annually. Thus, it is recognized as a major public health related problem around the world. Aims and Objectives: The socioeconomic status, religious and cultural influences, and the availability of pesticide poisons determine the pattern of pesticide poisoning, which will help to manage the poisoning cases. Materials and Methods: A retrospective study of deaths due to pesticide poisoning cases was conducted in Forensic medicine and Toxicology department, Government Medical College, Amritsar (Punjab) from January 1, 2006, to December 31, 2015. During this period out of total 10217 autopsies that were conducted that alleged to have died due to pesticide poisoning, 483 cases of pesticide poisoning deaths had been studied. The present study was approved by the institutional ethical committee of Government Medical College, Amritsar. All information has been taken under consideration of medical ethical committee. Results: Young males from rural areas in the age group of 21–40 years are more prone and have high more mortality as a result of pesticide poisoning. The most common fatal pesticide poisons found in the study were aluminum phosphide, organo phosphorus, organo chloro compound, and zinc phosphide, widely used in agriculture. Conclusion: Health education and strict legal intervention regarding storage, handling and transportation of poisonous substances to restrict the easy availability should be mandatory.

The Use of Pesticides in Suicide Attempts in the Eastern Mediterranean Region of Turkey.

In parallel with common usage areas, pesticide poisonings are encountered in the community due to reasons such as no wearing of protective clothing and masks during use, unintentional consumption and suicide-intended intake. In this study was aimed to examine the cases who applied to the emergency department with pesticide poisoning and share of suicide cases. This study is a retrospective record study based on the files of 234 patients who reported to the emergency department for pesticide and rodenticide poisoning between 2014 and 2018. The patients were compared in terms of sociodemographic, substance type, prognosis, and accident/suicide status. Chi-square test, Binary logistic regression analysis were used in the analysis of the data. Organophosphates was the most common substance recorded as a cause of poisoning, while rat poison placed second. 38% of the acute poisoning cases were suicide attempts. Poisoning among men was found to be prominently due to accident whiles among women suicidal poisoning was more prominent. While the mortality rate is 4.7% in all acute intoxication cases, the mortality rate in poisonings with suicidal purposes is 5.6%. Patients with psychiatric diseases have a 28-fold higher risk of intoxication of attempting suicide. The most common comorbid psychiatric disorders in acute pesticide poisoning are anxiety and depression. A major proportion of pesticide poisoning cases is suicide attempts. Suicide attempt is at the forefront in women and death rates are higher in people with psychiatric illness. It may be advisable to avoid the easy accessibility of pesticides.

Pesticide poisoning risk attributable to ambient temperature: a time series analysis in Qingdao China during 2007–2018

ABSTRACT Pesticide poisoning prevention has become a public health issue of great concern. We estimated the association between temperature and attributable risk of pesticide poisoning using 3,545 pesticide poisoning cases in Qingdao China from June 2007 to July 2018. A distributed lag non-linear model was applied to estimate the temperature-pesticide poisoning associated with the assessment of attributable number and fraction. The hot temperature is responsible for the pesticide poisoning incidence, with backward and forward attributable fractions, respectively, 7.79% and 7.61%. Most of the pesticide poisoning burden (backward attributable fraction 5.30% and forward attributable fraction 5.06%) was caused by mild hot (22°C-26°C), whereas the burden due to extreme hot (27°C-31°C) was small (backward attributable fraction 2.94% and forward attributable fraction 2.69%).

True and Pseudo Cholinesterase levels in short and long-term of pesticides exposures

The present study is aimed to study and analyze the true and pseudo Cholinesterase levels in the subjects exposed to pesticides during short term by intentional or accidental intake and long term exposure due to their occupation were studied at Department of Biochemistry, SVS medical college and hospital mahbubnagar district. Whole blood cholinesterase levels and Pseudo cholinesterase levels were estimated. 150 people were taken as controls who had no medical illness and a total number of 300 cases of pesticide poisoning were selected, aged between 20 to 55 years, which consist of 150 acute poisoning and 150 chronic poisoning subjects in Mahbubnagar district, were taken as case study, the detailed case history and the type of organophosphorus pesticide taken were recorded. Mean and standard deviation (S.D) of all variables were calculated and compared with those of controls. Statistical significance was assessed and P-value &lt;0.05 were considered significant.&#x0D; During acute poisoning the mean value of Whole blood cholinesterase/True cholinesterase (U / L) in acute poisoning cases on first day was 1.267± 0.612 on 3th day was 1.651±0.647, on 7th day was 2.221±0.684 and at the end of 6 months was 3.970±0.404.The difference between the study group and control group (4.0 ± 0.39) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in acute poisoning cases on first day was 2213.05 ± 1749.81, on 3th day was 2862.3 ± 2025.6, on 7th day was 4008.4 ± 2355.9 and at the end of 6 months was 7708.34 ± 880.72.The difference between the study group and control group (7991.97 ± 1276.5) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months.&#x0D; During chronic poisoning (exposure) the mean value of Whole blood cholinesterase (U/L) in controls is 4.0 ± 0.39 as compared to 3.019 ± 0.848 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in controls was 7991.97 ± 1276.5 as compared to 6214 ± 1189 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant.

Análise espaço-temporal de intoxicação por pesticidas no Rio Grande do Sul

A intoxicação por agrotóxico é causada principalmente pelo consumo de alimentos contaminados e pela exposição aos agentes tóxicos, na aplicação ou no ambiente afetado. O objetivo deste artigo foi analisar os casos de intoxicação por agrotóxicos no Rio Grande do Sul. A metodologia usada foi: estudo ecológico, tendo como unidade de análise o conjunto dos casos de notificações de intoxicação por agrotóxicos, registrados no Sistema de Informação de Agravos de Notificação (Sinan). Calcularam-se as frequências relativas e o coeficiente de correlação de Pearson. No total houve 696 casos de intoxicação no Rio Grande do Sul, com tendência maior na população do sexo masculino (rp = 0,975; p = 0,000), de cor branca (89,9%), residente na zona rural (rp = 0,769 p = 0,043), na população com escolaridade de nível fundamental (74,5%), e a principal exposição ocorreu no trabalho (64%), em circunstância acidental (41,8%), tendo como classificação final a intoxicação por pesticida confirmada (66,4%). Registrou-se o maior percentual de casos no período de novembro a fevereiro, na macrorregião dos Vales (25,8%), Norte (14,5%) e Serra (10,7%). A conclusão foi que o estudo possibilitou apontar as tendências de intoxicação por agrotóxicos no Rio Grande do Sul, constituindo-se, assim, em importante instrumento no embasamento de políticas de controle no comércio e uso de pesticidas.

Doctors experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian\u2019s model

BackgroundPesticides are responsible for a significant percentage of deaths globally with majority occurring in sub-Saharan Africa. Deaths due to pesticide poisoning can be reduced if poisoning cases are managed optimally. However, the quality of care given to pesticide poisoning patients is still insufficient especially in sub-Saharan Africa. This study was aimed at exploring doctors’ experiences on quality of care for pesticide poisoning cases in hospitals in Kampala, Uganda.MethodsFifteen (15) in-depth interviews were conducted with doctors who were directly involved in management of pesticide poisoning patients in the accident and emergency, Medicine, Pediatrics and Intensive Care Unit wards in 5 hospitals in Kampala, Uganda. All interviews were transcribed and subjected to directed content analysis with the guidance of the Donabedian model of quality of care which emphasizes structure, process and outcome measures as pertinent to ensuring quality of care.ResultsDoctors reported structural, process and outcome facets that support diagnosis and treatment of pesticide poisoning cases that improved the quality of care they provided. Among the structures includes hospital units such as Intensive Care Unit (ICU), pediatrics and internal medicine; equipment and clinical guidelines such as airway, breathing and consciousness (ABC) protocol; and doctors’ knowledge and experiences. Doctors relied on history, and signs and symptoms to establish the cause and severity of pesticide poisoning. However, some patients and caretakers provided inaccurate pesticide poisoning history. Due to its availability in hospitals, doctors largely relied on atropine to manage pesticide poisoning cases whether or not relevant to treat the actual pesticide active ingredient responsible for the poisoning. Although majority of the cases treated recovered, those due to suicide were further referred to the hospital psychiatrist. Sharing experiences of managing pesticide poisoning patients among health workers and engaging in sensitization outreaches against pesticide poisoning were reported as potential activities to improve quality of care for pesticide poisoning patients.ConclusionDoctors reflected on the structure, process and outcome measures of quality of care given to pesticide poisoning patients. The implications of hospital structures and clinical process to the quality of the outcomes of care demonstrates their importance in improving management of pesticide poisoning cases in hospitals in Kampala, Uganda.