TITLE:
Acute Poisoning among Farmers by Chlorpyrifos: Case Report from Gaza Strip
AUTHORS:
Yasser El-Nahhal
KEYWORDS:
Organophosphorus Insecticides, Poisoned Case, Toxogonin, Atropine
JOURNAL NAME:
Occupational Diseases and Environmental Medicine,
Vol.5 No.2,
May
23,
2017
ABSTRACT: Spraying of
organophosphorus insecticides (OPI) using high volume technique may result in
poisoning cases among farmers or inhabitants in the spraying zone. This study
reported a case among farmers in Gaza Strip, Palestine and discussed the follow
up treatments. Results showed sever fasciculation of tongue and all muscle,
pinpoint pupils not reacting to light, losing consciousness and disoriented,
irritability, followed by diarrhea, vomiting, and severe inhibition of acetyl choline esterase (ACHE).
Irritability and low level of ACHE activity were the unique syndromes of this
case. Management of the poisoning with Atropine injection was not successful
treatment to cure the case. Treatment with Toxogonin as intravenous injection
resulted in relieved the irritability of the poisoned case and cure the patient
at the end point. During the six weeks of follow up period, the case was
severely poisoned in the 1st week, moderate poisoned in the 2nd week and slightly poisoned at the 3rd week. A medical decision to
release the patient was made after ACHE activity level reached 4750 U/L, which very
close to the normal range. The farmers left the hospital after three weeks of
medical treatments and follow up. It is recommended to use Toxogonin in the
management of poisoned cases with OPI immediately on arrival of cases with
losing consciousness.