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Acute human self-poisoning with imidacloprid compound: a neonicotinoid insecticide.

Mohamed F, Gawarammana I, Robertson TA, Roberts MS, Palangasinghe C, Zawahir S, Jayamanne S, Kandasamy J, Eddleston M, Buckley NA, Dawson AH, Roberts DM - PLoS ONE (2009)

Bottom Line: Imidacloprid generally demonstrates low human lethality even in large ingestions.Respiratory failure and reduced level of consciousness were the most serious complications, but these were uncommon.Substitution of imidacloprid for organophosphorus compounds in areas where the incidence of self-poisoning is high may help reduce deaths from self-poisoning.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Medicine, South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka. fahim@sactrc.org

ABSTRACT

Background: Deliberate self-poisoning with older pesticides such as organophosphorus compounds are commonly fatal and a serious public health problem in the developing world. The clinical consequences of self-poisoning with newer pesticides are not well described. Such information may help to improve clinical management and inform pesticide regulators of their relative toxicity. This study reports the clinical outcomes and toxicokinetics of the neonicotinoid insecticide imidacloprid following acute self-poisoning in humans.

Methodology/principal findings: Demographic and clinical data were prospectively recorded in patients with imidacloprid exposure in three hospitals in Sri Lanka. Blood samples were collected when possible for quantification of imidacloprid concentration. There were 68 patients (61 self-ingestions and 7 dermal exposures) with exposure to imidacloprid. Of the self-poisoning patients, the median time to presentation was 4 hours (IQR 2.3-6.0) and median amount ingested was 15 mL (IQR 10-50 mL). Most patients only developed mild symptoms such as nausea, vomiting, headache and diarrhoea. One patient developed respiratory failure needing mechanical ventilation while another was admitted to intensive care due to prolonged sedation. There were no deaths. Median admission imidacloprid concentration was 10.58 ng/L; IQR: 3.84-15.58 ng/L, Range: 0.02-51.25 ng/L. Changes in the concentration of imidacloprid in serial blood samples were consistent with prolonged absorption and/or saturable elimination.

Conclusions: Imidacloprid generally demonstrates low human lethality even in large ingestions. Respiratory failure and reduced level of consciousness were the most serious complications, but these were uncommon. Substitution of imidacloprid for organophosphorus compounds in areas where the incidence of self-poisoning is high may help reduce deaths from self-poisoning.

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Chemical structure of imidacloprid.
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pone-0005127-g001: Chemical structure of imidacloprid.

Mentions: Imidacloprid (CAS 138261-41-3; figure 1) is the most commonly used neonicotinoid insecticide in Sri Lanka. On the basis of animal studies it is classified as moderately hazardous (Class II WHO; toxicity category II EPA) [9], [10]. It has low acute lethal toxicity to mammals, birds, and fish: the acute oral LD50 (dose that is lethal in 50% of animals) of imidacloprid in rats is 475 mg/kg and the acute dermal LD50 exceeds 5000 mg/kg. It also does not cause eye irritation (rabbits) or skin sensitization (guinea pigs) [11].


Acute human self-poisoning with imidacloprid compound: a neonicotinoid insecticide.

Mohamed F, Gawarammana I, Robertson TA, Roberts MS, Palangasinghe C, Zawahir S, Jayamanne S, Kandasamy J, Eddleston M, Buckley NA, Dawson AH, Roberts DM - PLoS ONE (2009)

Chemical structure of imidacloprid.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2662424&req=5

pone-0005127-g001: Chemical structure of imidacloprid.
Mentions: Imidacloprid (CAS 138261-41-3; figure 1) is the most commonly used neonicotinoid insecticide in Sri Lanka. On the basis of animal studies it is classified as moderately hazardous (Class II WHO; toxicity category II EPA) [9], [10]. It has low acute lethal toxicity to mammals, birds, and fish: the acute oral LD50 (dose that is lethal in 50% of animals) of imidacloprid in rats is 475 mg/kg and the acute dermal LD50 exceeds 5000 mg/kg. It also does not cause eye irritation (rabbits) or skin sensitization (guinea pigs) [11].

Bottom Line: Imidacloprid generally demonstrates low human lethality even in large ingestions.Respiratory failure and reduced level of consciousness were the most serious complications, but these were uncommon.Substitution of imidacloprid for organophosphorus compounds in areas where the incidence of self-poisoning is high may help reduce deaths from self-poisoning.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Medicine, South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka. fahim@sactrc.org

ABSTRACT

Background: Deliberate self-poisoning with older pesticides such as organophosphorus compounds are commonly fatal and a serious public health problem in the developing world. The clinical consequences of self-poisoning with newer pesticides are not well described. Such information may help to improve clinical management and inform pesticide regulators of their relative toxicity. This study reports the clinical outcomes and toxicokinetics of the neonicotinoid insecticide imidacloprid following acute self-poisoning in humans.

Methodology/principal findings: Demographic and clinical data were prospectively recorded in patients with imidacloprid exposure in three hospitals in Sri Lanka. Blood samples were collected when possible for quantification of imidacloprid concentration. There were 68 patients (61 self-ingestions and 7 dermal exposures) with exposure to imidacloprid. Of the self-poisoning patients, the median time to presentation was 4 hours (IQR 2.3-6.0) and median amount ingested was 15 mL (IQR 10-50 mL). Most patients only developed mild symptoms such as nausea, vomiting, headache and diarrhoea. One patient developed respiratory failure needing mechanical ventilation while another was admitted to intensive care due to prolonged sedation. There were no deaths. Median admission imidacloprid concentration was 10.58 ng/L; IQR: 3.84-15.58 ng/L, Range: 0.02-51.25 ng/L. Changes in the concentration of imidacloprid in serial blood samples were consistent with prolonged absorption and/or saturable elimination.

Conclusions: Imidacloprid generally demonstrates low human lethality even in large ingestions. Respiratory failure and reduced level of consciousness were the most serious complications, but these were uncommon. Substitution of imidacloprid for organophosphorus compounds in areas where the incidence of self-poisoning is high may help reduce deaths from self-poisoning.

Show MeSH
Related in: MedlinePlus