Paraquat dipyridylium is a highly toxic weed killer herbicide. The theory is that as paraquat leads to an acute inflammatory response, interference with this may inhibit the processes that follow that then lead to lung fibrosis and death. Treatment options in paraquat poisoning are limited. At lower doses death may be delayed for several weeks. Summary there is evidence to show that paraquat poisoning is alarmingly common in malaysia. Abstractthe use of herbicide paraquat dichloride by farmers, is one of effort to. Paraquat dichloride ingestion risk message for pesticide.
Paraquat is rapidly but incompletely absorbed and then largely eliminated unchanged in urine within 1224h. Ingestion of paraquat typically results in gastrointestinal gi signs and symptoms including oropharyngeal ulcerations, vomiting, diarrhea and gi bleeding. The very high case fatality of paraquat is due to inherent toxicity and lack of effective treatments. Mar 20, 2015 serum paraquat nomograms correlate serum paraquat concentration with mortality risk the proudfoot nomogram, best cut off for the severity in paraquat poisoningsipp sipp scoreparaquat concentrationmgdl x time since poisoninghrsscore paraquat pq intoxication surviving after combined therapy with hemoperfusion hp, cyclophosphamide ctx, and glucocorticoid. Liquid technical products range from 20% to 50% concentration, but the formulations used in the field range from 0. Poisoning by paraquat herbicide is a major medical problem in parts of asia while sporadic cases occur elsewhere. We analyzed the results of lung function testing in all patients with mild pq poisoning admitted to cangzhou central hospital between january 2012 and august 2017. Paraquat is a bipyridyl compound with no known chronic toxicity or teratogenicity. Paraquat is not mobile in silt loam and silty clay loams, and is slightly mobile in sandy loams. Initial treatment for pq poisoning includes prevention of further absorption of the poison and.
It is poorly absorbed when inhaled, but causes severe illness when ingested orally, death usually occurring within 2 days of ingestion of 50 mgkg. You can get sick if paraquat touches a cut on your skin. Paraquat is rapidly but incompletely absorbed and then largely eliminated unchanged in. Chest computed tomography ct scans revealed obvious pulmonary inflammation, pleural effusion, and fibrous lesions several days after. The training also covers paraquat toxicity, new label requirements and restrictions, consequences of misuse, and other important information. Controversies in paraquat treatment of paraquat poisoning. Paraquat is rapidly but incompletely absorbed and then largely eliminated unchanged in urine within 1224 h. Get a printable copy pdf file of the complete article 1. Effective treatment for paraquat poisoning in rats and its relevance to treatment of paraquat poisoning in man. Upon ingestion, paraquat is rapidly but incompletely absorbed. However, while pre treatment with intravenous vitamin c reduced oxidative stress from paraquat toxicity in rats, vitamin c given soon after paraquat ingestion worsened oxidative stress 98.
The aim of the study was to identify the effects of deliberate ingestion of op or pq on brain stem auditoryevoked potentials baeps. In malaysia women sprayers can spray herbicides, commonly paraquat, 262 days of the year. The major factor affecting the prognosis of patients was the ingested amount of paraquat. Get a printable copy pdf file of the complete article 286k, or click on a page image below to browse page by page. Since pq is known to be highly toxic, ingestion as a mode of suicide is not uncommon. Experience in hospital taiping year 2008 october 2011 med j malaysia vol 68 no 5 october 20 385 in malaysia, numerous cases of intentional self poisoning with paraquat have been reported. Initial clinical signs depend upon the route of exposure. Effects of deliberate ingestion of organophosphate or. Paraquat and diquat 3dudtxdw dqg gltxdw duh lghqwl. Paraquat is not known to have been used in any terrorist attacks or wars. To the best of our knowledge, successful treatment following severe pq poisoning is rare. However, there is not many published literature on studies done locally. Paraquat is an herbicidal agent of bipyridyl group. Paraquat toxicity and lipid peroxidation jama internal.
This is a major concern to epa because paraquat is a restricted use pesticide that should not be. One of the survivals had residual left upper lobe fibrosis radiologically at discharge 5 weeks after paraquat ingestion. Three patients suffered acute renal failure in a few days after ingesting a lethal amount of pq. Early symptoms and signs of poisoning by ingested paraquat are burning pain in the mouth, throat, chest.
The section on laboratory techniques and their availability has been updated and a new section. There are no widely accepted guidelines on treatment of patients with paraquat selfpoisoning and the treatment varies from supportive care alone to various. There are currently no generally accepted guidelines on the treatment of patients with paraquat poisoning. Serum paraquat nomograms correlate serum paraquat concentration with mortality risk the proudfoot nomogram, best cut off for the severity in paraquat poisoningsipp sipp scoreparaquat concentrationmgdl x time since poisoninghrsscore treatment,12 an ingestion of a high dose or severe paraquat poisoning has a poor prognosis. Paraquat 1,1dimethyl4, 4dipyridylium is a broadspectrum liquid herbicide associated with both accidental and intentional ingestion leading to severe and often fatal toxicity. The clinical presentation, clinicopathological findings and treatment are briefly described of three dogs from one south african household, intoxicated with paraquat. Paraquat may also damage the kidneys, liver, and esophagus the tube that food goes down from.
Jan 30, 2020 paraquat affects aerated cells hamster lung v79 cells in a dosedependent manner. Death is by respiratory failure and may occur within a few days after poisoning or as long as a month later. We conducted a systematic search for human studies that report toxicokinetics, mechanisms, clinical features, prognosis and treatment. Discussion paraquat is a bipyridyl herbicide that was first available commercially in 1963. Patients also may have dyspnea and hemoptysis as a result of pulmonary edema or hemorrhage respectively, which can progress to pulmonary fibrosis over the course of days to weeks 14. Clinical features and prognosis of paraquat poisoning in fre. As little as a teaspoon of concentrated paraquat can result in death. If you continue browsing the site, you agree to the use of cookies on this website. Paraquat dichloride, commonly referred to as paraquat, is one of the most widely used herbicides in the united states. If a person survives the toxic effects of paraquat poisoning, longterm lung damage scarring is highly. Clinical features and prognosis of paraquat poisoning in. When accidentally or intentionally ingested, paraquat is a multisystem poison capable of causing toxicity to the lungs, kidney, liver, brain, heart, and.
Epa has warned the applicator community about the high toxicity of paraquat. While evidence is limited, the treatment of diquat poisoning is generally the same as that for paraquat poisoning. Paraquat is a restricted use pesticide rup and is banned for use in several scandinavian countries. Diagnosis is often difficult in the absence of proper history, nonspecific clinical features, and lack of diagnostic. Paraquat is a synthetic, nonselective contact herbicide, marketed as paraquat, paraquat dichloride salt and bismethylsulfate salt. It was banned there in 2002 because of the unacceptable risk of adverse health effects, but industry pressure caused a reversal of the ban in 2006. This holds especially true for the use of extracorporeal treatment methods, which are currently evaluated in a standardized approach. Two cases of paraquat poisoning from kota, rajasthan, india. Jul 31, 2019 10, 11 kongesti sinusoid dengan keparahan yang semakin meningkat sesuai dengan peningkatan dosis herbisida paraquat diklorida yang diberikan pada. Despite treatment, renal and respiratory failure progressed and he died 16 days after ingestion. Liquid technical products range from to concentration, but the formulations used in the. Paraquat poisoning paraquat toxicity %2f parquat lung. Paraquat intoxication and associated pathological findings. Abstractthe use of herbicide paraquat dichloride by farmers, is one of effort to increase the.
Wash mouth with water and give the patient water to drink. Hg fkhplfdoo\ dv gls\ulg\ov paraquat is a synthetic, nonselective contact herbicide, marketed as paraquat, paraquat dichloride salt and bismethylsulfate salt. Paraquat poisoning and colchicine treatment annals of. Immunosuppression is widely practised as a treatment of paraquat selfpoisoning.
Paraquat dichloride ingredients used in pesticide products. It is an important tool for the control of weeds in many agricultural and nonagricultural settings. It is rapidly distributed to lung, liver, kidney and muscle. Paraquat residues disappear rapidly from water by binding onto aquatic weeds and by strong adherence to the bottom mud. Lung dysfunction is an important characteristic of injury induced by paraquat pq. No treatment has proven its effectiveness on mortality. Cdc niosh pocket guide to chemical hazards paraquat. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis.
The survivor often will develop progressive incapacitating and often fatal respiratory failure within 5 to 10 days, due to diffuse fibrosing alveolitis. To evaluate the tolerance or resistance of bacterial strains by the use of paraquat as a sole source of carbon, a mineral salt medium without a carbon source msmc is used. This is a major concern to epa because paraquat is a restricted use pesticide that should not be accessible to the general public and, as with all pesticides, should never be placed into a beverage container. Paraquat poisoning, resulting in serious damage to various organs, may be caused by ingestion of just one teaspoon of paraquat. Successful treatment of patients with paraquat intoxication. Breathing in paraquat may cause lung damage and can lead to a disease called paraquat lung. This study aimed to evaluate the effects of prolonged lowdose methylprednisolone mp treatment on lung function in patients with mild pq poisoning. Within 1224 h after ingestion 90% of the absorbed paraquat is rapidly excreted unchanged in urine. Kinetics of distribution into target tissues can be described by a twocompartment model with timedependent elimination from the central compartment. Diquat is a related herbicide that is often formulated with paraquat. All dogs presented with tachypnoea and dyspnoea 23 days after accidental paraquat ingestion. Paraquat is a fast acting, potent, and nonselective contact herbicide.
In the past, the united states encouraged mexico to use it to destroy marijuana plants. Eating or drinking paraquatcontaminated food or beverages could poison people. Because of the severe lung and kidney involvement, it was suspected that the child had in fact ingested paraquat gramoxone. The training was developed by paraquat manufacturers as part of epas 2016 risk mitigation. Treatment was aimed at reducing gastrointestinal absorption, enhancing elimination by diuresis and avoiding further oxidative damage by administration of antioxidants.
Paraquat dichloride ingestion risk message for pesticide applicators page 3 of 3 epa response see epa actions to adopt measures to poisoning and protect workers fromparaquat. Organophosphate op and paraquat pq ingestion is a serious health problem. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. The preventive administration of activated charcoal or pemba, in situ, within the first hour after ingestion of paraquat is essential. A study on paraquat poisoning in the state of perak in.
It plays a role in how your page is seen by search engine crawlers, and how it appears in serps. A brief synopsis of the mechanism of paraquat toxicity serves as an introduction to other potential treatment options based on the clinical context. Paraquat poisoning is also possible after skin exposure. The most likely route of exposure to paraquat that would lead to poisoning is ingestion swallowing.
Effective treatment for paraquat poisoning in rats and its relevance to. Patients with mild paraquat poisoning treated with. Paraquat damages the lungs, heart, kidneys, adrenal glands, central nervous system, liver, muscles and spleen, causing multiorgan failure. While evidence is limited, the treatment of diquat poisoning is. The lungs may be considered a third compartment from which elimination is very slow. When accidentally or intentionally ingested, paraquat is a multisystem poison capable of causing toxicity to the lungs, kidney, liver, brain, heart, and muscle.
Paraquat and diquat paraquat and diquat are identified chemically as dipyridyls. Paraquat ingestion is a leading cause of fatal poisoning in many parts of asia. Paraquat can be easily mixed with food, water, or other beverages. Mar 30, 2010 sept 2008 my elected 3rd year prestation. Pmc free article rose ms, lock ea, smith ll, wyatt i. A meta description is an html tag in the html code of your website, which allows you to customize a section of text that describes the page itself. Ingestion of even slight quantities of the herbicide paraquat often leads to a fatal outcome within 24 hours due to damage of cell membranes by superoxide ions o with subsequent necrosis of liver, heart, kidneys, and adrenals. This finding confirms that the uptake of paraquat is necessary for the toxicity of this compound and that the paraquat is taken up by a transport system that also transports mgbg. No survival in those with ingestion of more than 30 ml of 20% paraquat ingestiuon 530 ml 57% survival in patients treated with fullers earth withiin 6 hours 40% in non treatment group fitzgerald gr. Paraquat not associated with soil particles can be decomposed to an nontoxic end product by soil bacteria. Full text full text is available as a scanned copy of the original print version. A urine paraquat measurement done on a specimen obtained days after ingestion revealed a level of 0. Restricted use pesticides may be purchased and used only by certified applicators.
Toxicological effects acute toxicity paraquat is highly toxic to animals by all routes of exposure, and is labeled with a dangerpoison signal word. A case report of acute severe paraquat poisoning and long. Paraquat is often used in science to catalyze the formation of reactive oxygen species ros, more specifically, the superoxide free radical. The protective effect of the lungs may have been due to timely treatment at adequate doses. In the united states, pq is restricted to professional users. Paraquat is also often referred to as gramoxone a popular enduse product. Paraquat toxicity is most severe in the lungs and leads to an acute alveolitis. There are relatively few reports of diquat poisoning, but it appears to involve mechanisms and manifest clinical features similar to those of paraquat. A high dose of paraquat or severe poisoning has a poor prognosis. Paraquat is an active agent of herbicides usually used in peat land and. Paraquat affects aerated cells hamster lung v79 cells in a dosedependent manner. All dogs, however, became progressively hypoxic despite treatment and were euthanised.
It is the responsibility of pesticide applicators to ensure that rup products are used safely and. Later, research showed this herbicide was dangerous to workers who applied it to the plants. Paraquat will undergo redox cycling in vivo, being reduced by an electron donor such as nadph, before being oxidized by an electron receptor such as dioxygen to produce superoxide, a major ros. Medical management of paraquat ingestion request pdf. A common pathology behind op or pq poisoning is the generation of reactive oxygen species ros which is known to cause ototoxicity. Wash out stomach and test urine and gastric aspirate, if clear, for presence of paraquat. Paraquat intoxication has a poor prognosis with limited efficiency of treatment approaches. Paraquat usually is ingested orally, with gi absorption of 1% to 5% of the ingested arxlount.
772 447 537 677 1144 941 1275 389 455 756 671 282 882 317 46 1140 886 1265 695 569 422 776 635 505 1405 45 1386 1199 669 3 1567 1464 1529 943 67 201 621 1254 619 338 1062 616 1046 1385 1177 1291