DOI QR코드

DOI QR Code

Characteristics of Acute Herbicide Poisoning: Focused on Chlorophenoxy Herbicide

급성 제초제 중독의 임상 양상: Chlorophenoxy계 제초제 중심으로

  • Song, Hakyoon (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Choi, Sangchun (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Jung, Yoon Seok (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Park, Eunjung (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Kim, Hyukhoon (Department of Emergency Medicine, Ajou University School of Medicine)
  • 송하균 (아주대학교 의과대학 응급의학교실) ;
  • 최상천 (아주대학교 의과대학 응급의학교실) ;
  • 정윤석 (아주대학교 의과대학 응급의학교실) ;
  • 박은정 (아주대학교 의과대학 응급의학교실) ;
  • 김혁훈 (아주대학교 의과대학 응급의학교실)
  • Received : 2019.09.16
  • Accepted : 2019.10.27
  • Published : 2019.12.31

Abstract

Purpose: Herbicide-related mortality has decreased since the complete ban of paraquat product sales in 2012, but there still have been other herbicides intoxications with relatively severe complications. Glyphosate and glufosinate herbicides are used widely, and considerable research has been conducted. Chlorophenoxy herbicide is another major herbicide that has shown poor outcomes and mortality without proper management, but research in this area is lacking. Therefore, this study compared the clinical features of chlorophenoxy herbicide with those of other herbicides. Methods: The medical records of patients exposed to herbicides at a tertiary academic university hospital in Korea from May 2014 to April 2019 were reviewed retrospectively. The demographic and clinical data of 135 patients were then analyzed to identify the recent herbicides intoxication trends after the paraquat sales ban, focusing mainly on chlorophenoxy herbicide poisoning. Results: Of the 135 patients, 13 patients (9.6%) had chlorophenoxy herbicide poisoning. No significant differences in all the variables were observed between the chlorophenoxy herbicide poisoning group and non-chlorophenoxy herbicides poisoning groups. Toxic symptoms after poisoning varied from nothing noticeable to confusion; none of the patients had severe complications after their treatments. Conclusion: Acute chlorophenoxy poisoning is relatively less severe, with lower mortality rates than glyphosate and glufosinate poisoning.

Keywords

References

  1. Ko DR, Chung SP, You JS, et al. Effects of paraquat ban on herbicide poisoning-related mortality. Yonsei Med J. 2017;58:859-66. https://doi.org/10.3349/ymj.2017.58.4.859
  2. Kim YK, Kim KH, Moon HJ, et al. Predicting acute Intoxication of glufosinate-containing Herbicides: a comparative study of a group with complication versus the others without complication in single institution. J Korean Soc Emerg Med. 2016;27:52-60.
  3. Jeong WJ, Choi SM, Lee MJ, et al. Prognostic predictors of outcome for poisoning by glyphosate-containing Herbicides, based on initial findings in the emergency department. J Korean Soc Emerg Med. 2006;17:630-6.
  4. Cho SH, Cho NS, Kim SK. Case report of a severely chlorophenoxy-herbicide-poisoned patient treated with hemodialysis. J Korean Soc Emerg Med. 2002;13:578-81.
  5. Bradberry SM, Watt BE, Proudfoot AT, et al. Mechanisms of toxicity, clinical features, and management of acute chlorophenoxy herbicide poisoning: a review. J Toxicol Clin Toxico. l 2000;38:111-22. https://doi.org/10.1081/CLT-100100925
  6. Flanagan RJ1, Meredith TJ, Ruprah M,et al. Alkaline diuresis for acute poisoning with chlorophenoxy herbicides and ioxynil. Lancet. 1990;335:454-8. https://doi.org/10.1016/0140-6736(90)90677-W
  7. Schmoldt A1, Iwersen S, Schluter W. Massive ingestion of the herbicide 2-methyl-4-chlorophenoxyacetic acid (MCPA). J Toxicol Clin Toxicol. 1997;35:405-8. https://doi.org/10.3109/15563659709043374
  8. Bradberry SM, Vale JA, Watt BE, Proudfoot AT. Chlorophenoxy herbicides. In: Brent J, Wallace KL, Burkhart KK, Phillips SD, Donovan JW, eds. Critical care toxicology: Diagnosis and Management of the critically poisoned patient. 1st ed. Philadelphia, Pennsylvania USA: Elsevier Mosby; 2005. p.903-6.
  9. Durakovic Z, Durakovic A, Durakovic S, et al. Poisoning with 2,4-dichlorophenoxyacetic acid treated by hemodialysis. Arch Toxicol. 1992;66:518-21. https://doi.org/10.1007/bf01970679
  10. Hori Y, Tanaka T, Fujisawa M, et al. Toxicokinetics of DL-glufosinate enantiomer in human BASTA poisoning. Biol Pahrm Bull. 2003;26;540-3. https://doi.org/10.1248/bpb.26.540