Document Detail

Is there a relationship between the WHO hazard classification of organophosphate pesticide and outcomes in suicidal human poisoning with commercial organophosphate formulations?
MedLine Citation:
PMID:  20097246     Owner:  NLM     Status:  MEDLINE    
The WHO classification of pesticides by hazard is based primarily on the acute oral and dermal toxicity to rats. In several Asian countries there is no legislation against the sale of Class I insecticides. We evaluated if there was an association between the WHO hazard Class I, II or III organophosphate compound and outcomes in human poisoning. Two-hundred and fifty-one patients with mean (SD) age of 30.4 (11.8) years, admitted with symptomatic poisoning and treated with atropine and supportive care, were followed up until death or hospital discharge. The admission pseudocholinesterase level of 818.8 (1368) IU/L indicated significant suppression of cholinesterase activity. Class I compounds were ingested by 126, Class II by 113 and Class III by 12 patients. The hospital mortality rate was 16.7%, 5.3% and 0% with Class I, II and III organophosphate compounds, respectively (P=0.01). Ventilatory requirements were higher with Class I compared with Class II poisoning (77.0% vs. 54.9%, P<0.001). Patients with Class I poisoning needed mechanical ventilation for a longer period (10.55 (7.4) vs. 7.0 (5.2) days, P=0.002). The linear relationship between the WHO hazard class and mortality in acute organophosphate poisoning mandates the restriction of the sale of organophosphate compounds associated with higher lethality amongst humans.
John Victor Peter; Jayakumar Jerobin; Anupama Nair; Anjana Bennett
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-25
Journal Detail:
Title:  Regulatory toxicology and pharmacology : RTP     Volume:  57     ISSN:  1096-0295     ISO Abbreviation:  Regul. Toxicol. Pharmacol.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-04-21     Completed Date:  2010-07-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8214983     Medline TA:  Regul Toxicol Pharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  99-102     Citation Subset:  IM    
Copyright Information:
(c) 2010 Elsevier Inc. All rights reserved.
Department of Medical Intensive Care, Christian Medical College and Hospital, Vellore 632 004, Tamil Nadu, India.
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MeSH Terms
Hazardous Substances* / classification,  poisoning
Linear Models
Pesticides* / classification,  poisoning
Phosphoric Acid Esters* / classification,  poisoning
Poisoning / enzymology,  mortality,  therapy
Prospective Studies
Pseudocholinesterase / blood
Suicide* / statistics & numerical data
World Health Organization
Grant Support
GR071669MA//Wellcome Trust
Reg. No./Substance:
0/Hazardous Substances; 0/Pesticides; 0/Phosphoric Acid Esters; EC 3.1.1.-/Pseudocholinesterase
Comment In:
Regul Toxicol Pharmacol. 2010 Jul-Aug;57(2-3):338; author reply 339-40   [PMID:  20416267 ]

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