Environmental Medicine Integrating a Missing Element into Medical Education (1995) / Chapter Skim
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Case Study 34: Poisoning of an Urban Family Due to Misapplication of Household Organophosphate and Carbamate Pesticides
Case Study 34: Poisoning of an Urban Family Due to Misapplication of Household Organophosphate and Carbamate Pesticides
Pages 596-604
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From page 596... ...
Serial measurement of red blood cell and serum cholinesterases soon after exposure and during subsequent months confirmed He diagnosis of pesticide poisoning. This report demonstrates that the misapplication of pesticides commonly used in residences in urban areas can cause acute pesticide poisoning and demonstrates the usefulness of repeated measurements of cholinesterase during He post-exposure period in establishing the correct diagnosis.
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From page 597... ...
This report describes a family with clinical and laboratory evidence of acute pesticide poisoning caused by the excessive application of pesticide products used for urban residential pest control. Environmental History The affected family consisted of three members, a 32 year-old mother, a 35 year-old fader, and their 14 year-old daughter, who were well prior to late November, 1984, when their apartment underwent commercial pesticide application for extermination of fleas.
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From page 598... ...
employing a modification of the Ellman method Aid. Upon examination six weeks after initial exposure, the father reported persistence of selected symptoms including headache, fatigue and throat irritation, Cough these had diminished in intensity.
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From page 599... ...
Physical examinations of all three family members were normal with Me exception of minimal wheezing on forced expiration heard in the lower leR lung of the mother. Pulmonary function tests performed on the two adults were also normal, except for a minimal decrease in the mother's forced vital capacity (78% predicted)
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From page 600... ...
The clinical significance of any specific level of ery~rocyte or plasma cholinesterase is measured by its percent decrease from a baseline pre-exposure level or by the degree to which the values are frankly below the established reference range (11~. Laboratory assessment of organophosphate or carbarnate poisoning is complicated, however, by the relatively high inter-individual and intra-individual variability in levels of erythrocyte and serum cholinesterase.
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From page 601... ...
Midtling and others described an outbreak of acute mevinphos poisoning among a group of 16 lettuce growers in California who developed symptoms compatible with organophosphate poisoning. Cholinesterase levels rose in the weeks following the outbreak of illness (41.
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From page 602... ...
There is limited evidence of the persistence of symptoms beyond He immediate period of organophosphate poisoning (4,21) , though most of He studies of persistent effects have focused on central nervous system effects rather the multi-organ symptoms that characterize acute organophosphate poisoning (22-241.
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From page 603... ...
Recognition and Management of Pesticide Poisonings, Fours Ed., Washington, DC: United States Environmental Protection Agency, 1989.
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From page 604... ...
Davies DR, Rutland PJ. Blood cholinesterase levels and range of personal variation in a healthy adult population.
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