Comparison of the incidence and severity of neurotoxic effects among neurotoxic pesticides and between neurotoxic and other pesticides.

摘要

Organophosphates (OPs), carbamates, organochlorines, pyrethrins and rotenone insecticides are neurotoxic in mammalian systems. The incidence and severity of neurotoxic effects was compared both among these pesticides and between these and other pesticides. The study was conducted based on acute pesticide exposure data from the American Association of Poison Control Center Toxic Exposure Surveillance System (TESS). Severity was determined based on medical outcome, considering the most severe effects---major effect (symptoms were life-threatening or resulted in significant residual disability or disfigurement) and death. Approximately 900,000 single chemical, human, acute pesticide reported exposures from 1993--2001 were analyzed considering 45 neurological and neurologically-mediated effects. Approximately 200,000 acute pesticide reported exposures were due to the pesticides of interest. Of these selected pesticides, OPs accounted for approximately half of all pesticide reported exposures.;Acute exposures with OPs resulted in a higher number of reported 45 neurological effects compared to the other neurotoxic pesticides. Fasciculation was relatively the most common effect among OP poisonings compared to all other pesticides. A relative risk of 12.0 was calculated compared to all other pesticides. The risk was slightly lower when restricted to severe medical outcomes. Carbamate poisonings had a ranking of neurological effects similar to OPs but with lower relative risks.;Some results confirm the current understanding of the neurotoxicology of the pesticides studied and others suggest a new approach to diagnosis and understanding of signs and symptomology associated with acute poisonings. Trends in the incidence and severity of acute pesticide exposures described provide critical information for public health officials in making regulatory decisions. In addition the results described can assist health care providers in treatment options. The merging of multiple, disparate datasets and segmenting specific variables for analysis in addition to critically analyzing clinical effects categories was a novel approach of utilizing AAPCC TESS data. Such methodology provides a new and innovative tool to analyze poisoning data that is applicable to pesticides and other toxic agents. (Abstract shortened by UMI.).