A homeowner was referred to the
Agromedicine Program for assistance after sulfur from an air-blast application
to an adjacent peach orchard drifted onto his property. He reported that he and
two other adult members of the household experienced sinus irritation, dizziness,
coughing, shortness of breath, nausea and vomiting following their exposure.
The symptoms were reported to have persisted for two weeks after the exposure.
Sulfur is used as an acaricide and
fungicide and is approved for use on peaches. It may be moderately irritating
to the skin, eyes, and respiratory tract and it acts as a cathartic when
ingested (Recognition and Management of Pesticide Poisonings, US EPA).
The homeowner requested interpretation of
blood tests which ‘confirmed’ their exposure to the sulfur as well as to
previous pesticide applications to the peach orchard. The three individuals
sought medical attention shortly after their exposure. Blood samples were collected at that
time. The attending physician ordered a
‘pesticide screen’ from a reference laboratory.
The homeowner gave permission to contact
his physician. This same doctor also
treated the other two adults. The physician was consulted and he faxed the lab
reports to the Agromedicine Program for interpretation.
The lab reports were reviewed upon
receipt. Two of the adults (ages 61 and 54) did indeed have detectable
pesticide residues in their blood samples, however the residues were from chlorinated
insecticides that have not been used for over 20 years. The levels reported are
considered to be reflective of general population levels.
There are two lessons for physicians from
this case: 1) there is no routine human substrate screening procedure for the
detection and quantification of pesticides commonly used today, and 2) be sure
you know what you are measuring when you order a screening test.
The attending physician must reassure his
patients that their lab results do not suggest current or future illness.
DEPARTMENT OF FAMILY MEDICINE – DIVISION OF PUBLIC HEALTH AND PUBLIC SERVICE
MEDICAL UNIVERSITY OF SOUTH CAROLINA, 171 ASHLEY AVENUE, CHARLESTON, SC 29425-2217