ORGANOPHOSPHATES
CHEMICAL
EXAMPLES
Chloropyrifos, diazinon,
methyl parathion, malathion, azinphos-methyl, naled, glyphosate
PHYSIOLOGIC
TARGET
Irreversibly inhibits
acetylcholinesterase resulting in muscarinic and nicotinic effects
ACUTE
SYMPTOMS
Vomiting, diarrhea, hypersecretion,
confusion, bronchoconstriction, headache, dizziness, impaired
vision, weakness, stomach cramps, cholinergic crisis, miosis,
fatigue
DIAGNOSIS
Cholinesterase levels
TREATMENT
Supportive care, clear airway,
improve tissue oxygenation, intravenous atropine, pralidoxime
may be indicated, decontamination.
N-METHYL
CARBAMATES
CHEMICAL
EXAMPLES
Carbaryll, aldicarb, fenoxycarb,
methomyl, bendiocarb.
PHYSIOLOGIC
TARGET
Reversibly inhibits acetylcholinesterase
resulting in muscarinic and nicotinic effects.
ACUTE
SYMPTOMS
Malaise, muscle weakness,
CNS depression, dizziness, nausea, vomiting, diarrhea, abdominal
pain, blurred vision, hypersecretion, bronchoconstriction, headache.
DIAGNOSIS
Cholinesterase levels
TREATMENT
Supportive care, clear airway,
improve tissue oxygenation, intravenous atropine, decontamination.
PYRETHRINS
CHEMICAL
EXAMPLES
Pyrethrum
PHYSIOLOGIC
TARGET
Neuronal paralysis, sensitization
ACUTE
SYMPTOMS
Allergic reactions, anaphylaxis,
tremor, ataxia at very high doses
DIAGNOSIS
No diagnostic test
TREATMENT
Decontamination, treat allergic
reactions with antihistamines or steroids.
PYRETHROIDS
TYPE I
CHEMICAL
EXAMPLES
Allethrin, Permethrin,
sumethrin, cyfluthrin, tetramethrin
PHYSIOLOGIC
TARGET
Interference with sodium
channel in neuronal cell membranes repetitive neuronal discharge
ACUTE
SYMPTOMS
Dizziness, irritability to
sound or touch, headache, vomiting, diarrhea, blurred vision.
DIAGNOSIS
No diagnostic test
TREATMENT
Decontamination, supportive
care, symptomatic treatment
PYRETHROIDS
TYPE II (CYANO-PYRETHROIDS)
CHEMICAL
EXAMPLES
Deltamethrin, cypermethrin,
fenvalerate
PHYSIOLOGIC
TARGET
Interferance with sodium
channel and inhibition of gamma-aminobutyric acid (GABA)
ACUTE
SYMPTOMS
Seizures, dizziness, irritability
to sound or touch, headache, vomitiing, diarrhea, paresthesias
DIAGNOSIS
No laboratory test; skin contact
may cause highly unpleasant temporary paresthesias
TREATMENT
Best treated with vitamin
E oil preparations.
ORGANOCHLORINES
CHEMICAL
EXAMPLES
Lindane, endosulfan, dicofol,
methoxychlor
PHYSIOLOGIC
TARGET
Blockade of chloride channel
in the GABA receptor complex
ACUTE
SYMPTOMS
Incoordination, tremores,
paresthesia, hyperesthesia, headache, dizziness, nausea, hyperexcitable
state, seizures
DIAGNOSIS
Detectable in blood and fat.
TREATMENT
Decontamination, supportive
care, anticonvulsants, cholestyramine to clear enterohepatic recirculation,
oxygen, cardiopulmonary monitoring.
CHLOROPHENOXY
COMPOUNDS
CHEMICAL
EXAMPLES
2,4-Dichlorophenoxyacetic
acid (2,4-D), 2,4-DB, 2,4-DP
PHYSIOLOGIC
TARGET
Peripheral neuropathy,
myopathy, metabolic acidosis, skin and mucus membrane irritant,
uncoupler of oxidative phosphorylation
ACUTE
SYMPTOMS
Nausea and vomiting, diarrhea,
headache, confusion, bizarre behavior, peculiar breath odor, myotonia,
low fever, acidosis, EKG changes, CPK elevation, myoglobinuria
DIAGNOSIS
Detectable in urine and blood
TREATMENT
Decontamination, hydration,
forced alkaline diuresis.
DIPYRIDYL
COMPOUNDS
CHEMICAL
EXAMPLES
Paraquat, diquat
PHYSIOLOGIC
TARGET
Corrosive, free radical
formation, lipid peroxidation, selective damages to pneumatocytes
ACUTE
SYMPTOMS
Pain, diarrhea, headache,
myalgias, acute tubular necrosis, delayed pulmonary edema; neurologic
toxicity from diquat
DIAGNOSIS
Urine dithionite test (colorimetric),
detectable in urine and blood
TREATMENT
Decontamination, do not administer
oxygen unless patient develops severe hypoxemia, aggressive hydration,
hemoperfusion.
ANTICOAGULANT
RODENTICIDES
CHEMICAL
EXAMPLES
Warfarin, brodifacoum,
difenacoum, coumachlor, bromadiolone
PHYSIOLOGIC
TARGET
Antagonize vitamin K,
inhibition of clotting factors
ACUTE
SYMPTOMS
Nosebleeds, bleeding gums,
hematuria, melena, ecchymoses, anemia, fatigue, dyspnea
DIAGNOSIS
Elevated PT and INR
TREATMENT
Vitamin K1 (phytonadione),
control seizures.
CHLOROPHENOLS
CHEMICAL
EXAMPLES
Pentachlorophenol (PCP,
Penta)
PHYSIOLOGIC
TARGET
Uncouples oxidative phosphorylation,
skin and mucus membrane irritant
ACUTE
SYMPTOMS
Nose, throat and eye irritation,
dermatitis, muscle spasm, abdominal pain, fever, tremor, thirst,
sweating, tachycardia, hyperthermia, chest constriction, labored
breathing, mental confusion
DIAGNOSIS
Detectable in blood and urine
TREATMENT
Decontamination, supportive
care, control hyperthermia, cardiopulmonary monitoring.
NITROPHENOLS
AND NITROCREOSOLS
CHEMICAL
EXAMPLES
Dinocap
PHYSIOLOGIC
TARGET
Uncouples oxidative phosphorylation;
Affect hepatic, renal and nervous systems
ACUTE
SYMPTOMS
Hyperthermia, tachycardia,
tachypnea, anxiety, confusion, thirst, sweating, fever, headache,
malaise
DIAGNOSIS
Detectable in serum, bright
yellow staining of skin and urine.
TREATMENT
Supportive care, decontamination,
control hyperthermia.
FUMIGANTS
CHEMICAL
EXAMPLES
Methyl bromide
PHYSIOLOGIC
TARGET
Irritant, inhibits sulfhydryl
enzymes and reversibly breaks down ATP; CNS depressant
ACUTE
SYMPTOMS
Headache, dizziness, nausea,
ataxia, tremor, agitation, muscle weakness, visual disturbances,
slurred speech, vomiting, seizures, respiratory distress, pulmonary
edema, convulsions
DIAGNOSIS
Blood or urine bromide levels
TREATMENT
Supportive care, decontamination,
benzodiazepines, dimercaprol, oxygen and diuresis for pulmonary
edema.
FUMIGANTS
CHEMICAL
EXAMPLES
Metam sodium
PHYSIOLOGIC
TARGET
Decomposes in water to
methyl isothiocyanate, severely irritant gas
ACUTE
SYMPTOMS
Eye, lung and mucus membrane
irritation, pulmonary edema
DIAGNOSIS
No diagnostic test
TREATMENT
Supportive care, decontamination.
| HEMATOLOGIC
MALIGNANCIES IN ADULTS |
|
| Non-Hodgkins Lymphoma | Phenoxy herbicides, dichlorophenoxyacetic acid (2,4-D), lindane (used for lice treatment), organophosphates, carbaryl, chlordane, DDT, diazinon, diclorvos, malathion, nicotine, toxaphene, and some fungicides. |
| Soft Tissue Sarcomas | Phenoxy herbicides, chlorophenols with dioxin contaminants, and dioxins |
| CNS MALIGNANCIES IN ADULTS | |
| Brain Tumors | No studies to implicate specific pesticides. However, occupational groups with pesticide exposure have an increased rate of brain tumors. |
| Lung Cancer | Phenoxy herbicides, chlorophenols with dioxin contaminants, and dioxin. |
| Prostate Cancer | No studies to connect specific pesticides; however, occupational exposure increases rate of prostate ca. |
| CHILDHOOD MALIGNANCIES | |
| Childhood Leukemia | Parental and childhood residence in homes with home and garden pesticide use. Parents in presticide-using occupations during pregnancy. |
| Brain and Nervous System Tumors | Home use of pesticides for flea and/or tick pet-treatments, pest strips, termite-control, lindane shampoo, yard and orchard pesticides, home pesticide bombs, and carbaryl for ouotdoor use during gestation and childhood, and occupation during pregnancy. |
