Recognizing Acute Pesticide Poisoning - Book Corners

Townsend Letter for Doctors and Patients,  Oct, 2002  by Beatrice Trum Hunter

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Recognition and Management of Pesticide Poisonings

by J. Routt Reigart, MD and James R. Roberts, MD, MPH, eds.

Quality oversized paperback, 236 pages, index of signs and symptoms, index of pesticide products, dosage tables

Office of Prevention, Pesticides & Toxic Substances, US Environmental Protection Agency, gratis

Copies also available in Spanish and in electronic format on the internet at http://www.epa.gov/pesticides/safety/healthcare

This manual has been published by the EPA since 1973, and updated from time to time. The current manual is the 5th edition. The purpose of the manual is to provide health professionals with current information on the health hazards of pesticides in use, and the consensus recommendations for managing cases of poisonings and other injuries inflicted by these substances.

The EPA admits that, commonly, pesticide poisoning is underdiagnosed. Despite urgings to integrate environmental medicine into medical education, health care providers usually receive a very limited amount of training in environmental (or in occupational) health, and especially in pesticide-related illnesses.

As with previous updates of the manual, the 5th edition incorporates new pesticide products that are not necessarily known widely among health professionals. The manual deals almost entirely with acute harmful effects. Admittedly, chronic effects are important but, according to the editors, are "too complex to deal with exhaustively in a manual designed for emergency management." However, appropriate treatment of serious pesticidal exposures represent an important step in avoiding chronic as well as acute toxicity and health problems.

Pesticide decontamination is managed with certain basic techniques that involve the skin, airways, and gastrointestinal tract. Procedures include gastric lavage, catharsis, use of activated charcoal and Ipecac. Suggested dosages are given for different age groups, along with appropriate caveats.

The manual lists commonly used insecticides, herbicides, fungicides, rodenticides, fumigants, disinfectants, and arsenicals, as well as other pesticides. The charts for signs and symptoms include manifestations occurring with the agents, and their poisoning characteristics with various bodily organs. A listing of specific pesticide products offers a quick reference as an index to guide the reader to the needed information.

This manual should be in every health professional's office. It serves as a reminder, in taking a medical history, to include questions about environmental (or occupational) exposures to pesticides, especially if symptoms raise warning signals. The manual is a ready reference, including information about resources from governmental and non-governmental agencies.

COPYRIGHT 2002 The Townsend Letter Group
COPYRIGHT 2003 Gale Group