The family physician of a 22-year-old Pee Dee farmer consulted
with the Agromedicine Program. His patient thought he had been overexposed to
Orthene. The day before the farmer had sprayed Orthene during the morning and
then applied a fertilizer that afternoon. By the end of the workday he was
experiencing nausea and vomiting and also had mild tremors in his right arm. He
showered and then went to bed still feeling ill.
Although the farmer awoke the next morning feeling much
better, he decided to see his physician. He was concerned that if the Orthene had
poisoned him, he may experience delayed effects. Orthene is an organophosphate insecticide.
Upon questioning by the physician, it was learned that
Orthene spray had drifted onto the farmer’s head and chest during application. He
did not stop work to wash or to change his clothing. He wore the same clothes
until showering that night some 12 hours later.
Is this a case of organophosphate poisoning? Probably.
Although the farmer denied having the classic signs of acute organophosphate toxicity
(e.g. miosis, salivation, and tearing), his nausea, vomiting, and tremors were
consistent with overexposure. Since the farmer was feeling much better, the
physician decided not to obtain a blood sample for cholinesterase.
Organophosphate insecticides are absorbed by the skin
and absorption tends to be slow. In this case, the farmer had prolonged
exposure since he did not decontaminate himself until 12 hours after exposure.
This incident could have been easily prevented.
Note: This
case reinforces the need for pesticide applicators to adhere to the following safety
precautions when mixing and applying pesticides:
1)
Pesticides spilled or sprayed
onto exposed skin should be immediately washed away with soap and water.
2)
Contaminated clothing should
be immediately changed. The contaminated clothing should be laundered in hot
water and detergent separately from other laundry. Severely contaminate
clothing should be washed twice.
3)
Leather work gloves and
boots contaminated with pesticides cannot be effectively cleaned and should be discarded.
DEPARTMENT OF FAMILY MEDICINE – DIVISION OF PUBLIC HEALTH AND PUBLIC SERVICE
MEDICAL UNIVERSITY OF SOUTH CAROLINA, 171 ASHLEY AVENUE, CHARLESTON, SC 29425-2217