Clinical Assessment of Acute Organophosphorus Pesticide Poisoning in Pediatric Patients Admitted to the Toxicology Emergency Department

Ioana-Cezara Caba, Violeta Ștreangă, Mona-Elisabeta Dobrin, Cristina Jităreanu, Alexandra Jităreanu, Bianca-Ștefania Profire, Maria Apotrosoaei, Alin-Viorel Focșa, Bogdan Caba, Luminița Agoroaei, Ioana-Cezara Caba, Violeta Ștreangă, Mona-Elisabeta Dobrin, Cristina Jităreanu, Alexandra Jităreanu, Bianca-Ștefania Profire, Maria Apotrosoaei, Alin-Viorel Focșa, Bogdan Caba, Luminița Agoroaei

Abstract

Pesticide poisoning in pediatric patients is still an important reason for presenting to the emergency department in Romania. In this context, the present study aims to raise awareness of the toxicological impact of pesticides on human health in pediatrics. For this purpose, the demographic characteristics, clinical assessment, and outcome of pediatric patients with acute pesticide poisoning admitted to the toxicology department of "Saint Mary" Emergency Children's Hospital from Iasi, were analyzed. This retrospective study focused on the clinical and laboratory data of patients aged under 18 years diagnosed with acute pesticide poisoning between 2010-2020. The statistical analysis was performed using the Statistica 10 package. A total of 49 patients presented with manifestations of acute pesticide poisoning, and the most common pesticide involved was diazinon. The most frequent exposure route was accidentally ingesting pesticide products (95%). The primary clinical manifestations were toxic encephalopathy, coma, depressive disorder, gastric disorders, and respiratory failure. Changes in the glycemic status, liver, and kidney damage were also present. Treatment included decontamination, administration of antidote, supportive care, and recommendations to be closely monitored to avoid a new incident. These results highlight the toxic potential of pesticides on human health and their biological consequences, which require an increase in consciousness of the precautions imposed on their use, especially when children are nearby.

Keywords: biochemical parameters; clinical toxicology assessment; organophosphate pesticide poisoning; pediatric patients; toxicity of pesticides.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of ALT (a), glucose (b), creatinine (c), and urea (d) concentrations by incriminated substance (diazinon/non-diazinon compound).
Figure 2
Figure 2
Graphical representation of scores corresponding to subjects with organophosphorus pesticide poisoning by age.
Figure 3
Figure 3
Mean serum ChE concentration (IU/L) levels in pediatric patients by age and diagnosis.

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