Year: 2013
Type: article
Abstract: Poisoning and pesticidesTo the Editor: The review by the Tygerberg Poison Information Centre (TPIC) in the May SAMJ [1,2] highlights valuable information about the public health importance of pesticides as a source of acute poisoning, particularly among children.The epidemic of poisoning of children related to informal sector sales of street pesticides such as aldicarb, a World Health Organization (WHO) class Ia carbamate and cholinesterase inhibitor, is particularly worrying, given the high toxicity of these products, mainly registered for agricultural uses, and the weak capacity of our health system to identify street pesticide poisonings, particularly from aldicarb. [3]Not only is aldicarb poisoning often misdiagnosed as organophosphate intoxication, but there is very low awareness among health professionals that all forms of pesticide poisoning constitute a medical notifiable condition.[4] Because of its toxicity, aldicarb was banned for any uses in 2012, yet its sale in the informal sector for rodent control is ongoing and widespread, not only in South Africa (SA).[3] That there were no cases of occupational circumstances among the acute poisonings reported or phoned in to the TPIC or seen at the hospital is heartening.However, this finding may also reflect under reporting, as previously documented in SA, [5] or underdiagnosis.For example, London reported a case of mass methyl bromide poisoning, mistakenly diagnosed by a local general practitioner as mass hysteria, among female workers in a local dried fruit factory some years ago.[6] More recent evidence from Tanzania suggests that occupational poisonings are common, but rarely prompt attendance to health facilities because they are generally not severe and farmers who suffer symptoms selftreat, for example with ingestion of milk.[7] The implication that occupational circumstances may be more common than first identified is supported by data showing that, over the period 2000 2008, SA reported over 12 000 cases of pesticide poisoning, many occupational in origin.[8] Moreover, healthcare providers may underestimate or completely miss the presence of occupational exposures underlying a suspected case.The editorial by Verdoorn [9] that accompanied the articles makes the misleading claim that 'the TPIC studies show beyond any doubt that pesticides are not the main agent in human poisoning ... ' and attributes pesticide poisoning to endusers who are 'highly irresponsible' .In fact, the TPIC study stated clearly that ' ... pesticides were the most
Source: South African Medical Journal
DOI: 10.7196/samj.7333
Authors: Leslie London, Hanna-Andrea Rother
Institution: University of Cape Town
Language: English
Subfield: Plant Science
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $311
OpenAlex ID: W2140931381