RESUMO
This study aims to determine the degree of acetylcholinesterase inhibition and neurological symptoms for each of the psychiatric disorders diagnosed in the farm workers of a rural population in the state of Baja California, Mexico. We conducted a cross-sectional study on 140 agricultural workers (exposed participants). The study was run using the Mini International Neuropsychiatric Interview Diagnostic Test (MINI), a pre-established questionnaire to diagnose the mental state of each agricultural worker. Analysis of enzymatic activity was carried out using the modified Ellman method. The results showed that, among agricultural workers with slightly inhibited enzymatic activity, 25% met the criteria for the diagnosis of major depression with suicidal attitudes, 23.9% with inhibited enzymatic activity showed generalized anxiety, 23.5% showed combined depressionâ»anxiety, and 22% met the criteria for major depression and no psychiatric diagnosis disorder. These results suggest the need for the development of effective public-health strategies to inform farm workers about integrated pesticide management in order to prevent serious health complications.
Assuntos
Doenças dos Trabalhadores Agrícolas/epidemiologia , Doenças dos Trabalhadores Agrícolas/etiologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/etiologia , Exposição Ocupacional/estatística & dados numéricos , Intoxicação por Organofosfatos/complicações , Intoxicação por Organofosfatos/epidemiologia , Acetilcolinesterase/sangue , Adolescente , Adulto , Doenças dos Trabalhadores Agrícolas/diagnóstico , Estudos Transversais , Fazendeiros , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , México/epidemiologia , Pessoa de Meia-Idade , Exposição Ocupacional/análise , Intoxicação por Organofosfatos/diagnóstico , Psicometria/estatística & dados numéricos , População Rural , Adulto JovemRESUMO
The objective was to evaluate the characteristics of exposure to OP pesticides and health status in Chilean farm workers from the Maule Region. An occupational health questionnaire was administered in 207 agricultural and non-agricultural workers. For the group of agricultural workers, we asked about specific occupational exposure history and symptoms of OP pesticide poisoning. The main health problem of the exposed group was previous OP pesticide poisoning (p < 0.001). Fifty-six percent of agricultural workers reported symptoms consistent with acute OP pesticide poisoning. The use of respiratory personal protective equipment and younger age were protective against these symptoms, and number of years of OP pesticide exposure was positively associated with reporting symptoms of poisoning. Of the pesticide applicators 47 % reported using chlorpyrifos. The regulations regarding use and application of pesticides should be strengthened, as should training and intervention with workers to improve the use of personal protective equipment.
Assuntos
Exposição Ocupacional , Intoxicação por Organofosfatos/epidemiologia , Praguicidas/intoxicação , Adolescente , Adulto , Idoso , Chile , Fazendeiros , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Ocupacional/estatística & dados numéricos , Intoxicação por Organofosfatos/etiologia , Adulto JovemRESUMO
OBJECTIVES: to evaluate and indicate the procedure to be followed in the health unit, both for diagnosis and the treatment of acute exogenous intoxications by carbamates or organophosphates. METHODS: a descriptive study based on retrospective analysis of the clinical history of patients diagnosed with intoxication by carbamates or organophosphates admitted at the emergency unit of the Hospital de Urgências de Sergipe Governador João Alves (HUSE) between January and December of 2012. Some criteria were evaluated, such as: intoxicating agent; patient's age and gender; place of event, cause, circumstances and severity of the intoxication; as well as signs and symptoms of the muscarinic, nicotinic and neurological effects. RESULTS: seventy patients (average age: 25 ± 19.97) formed the study's population. It was observed that 77.14% of them suffered carbamate intoxication. However, organophosphate intoxications were more severe, with 68.75% of patients presenting moderate to severe forms. Suicide attempt was the leading cause of poisoning, with 62 cases (88.57% of total). Atropine administration was an effective therapeutic approach for treating signs and symptoms, which included sialorrhea (p = 0.0006), nausea (p = 0. 0029) and emesis (p < 0.0001). The use of activated charcoal was shown effective, both in combating the signs and symptoms presented by both patient groups (p < 0.0001). CONCLUSION: it is concluded that the use of atropine and activated charcoal is highly effective to treat the signs and symptoms developed by patients presenting acute exogenous intoxication by carbamates or organophosphates.
Assuntos
Carbamatos/intoxicação , Intoxicação por Organofosfatos/tratamento farmacológico , Adolescente , Adulto , Idoso , Atropina/administração & dosagem , Atropina/uso terapêutico , Brasil/epidemiologia , Carvão Vegetal/administração & dosagem , Carvão Vegetal/uso terapêutico , Criança , Pré-Escolar , Antagonistas Colinérgicos/administração & dosagem , Antagonistas Colinérgicos/uso terapêutico , Serviço Hospitalar de Emergência , Feminino , Lavagem Gástrica/normas , Humanos , Lactente , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Intoxicação por Organofosfatos/epidemiologia , Estudos Retrospectivos , Tentativa de Suicídio/estatística & dados numéricos , Adulto JovemRESUMO
Summary Objectives: to evaluate and indicate the procedure to be followed in the health unit, both for diagnosis and the treatment of acute exogenous intoxications by carbamates or organophosphates. Methods: a descriptive study based on retrospective analysis of the clinical history of patients diagnosed with intoxication by carbamates or organophosphates admitted at the emergency unit of the Hospital de Urgências de Sergipe Governador João Alves (HUSE) between January and December of 2012. Some criteria were evaluated, such as: intoxicating agent; patient's age and gender; place of event, cause, circumstances and severity of the intoxication; as well as signs and symptoms of the muscarinic, nicotinic and neurological effects. Results: seventy patients (average age: 25±19.97) formed the study's population. It was observed that 77.14% of them suffered carbamate intoxication. However, organophosphate intoxications were more severe, with 68.75% of patients presenting moderate to severe forms. Suicide attempt was the leading cause of poisoning, with 62 cases (88.57% of total). Atropine administration was an effective therapeutic approach for treating signs and symptoms, which included sialorrhea (p=0.0006), nausea (p=0. 0029) and emesis (p lt0.0001). The use of activated charcoal was shown effective, both in combating the signs and symptoms presented by both patient groups (p <0.0001). Conclusion: it is concluded that the use of atropine and activated charcoal is highly effective to treat the signs and symptoms developed by patients presenting acute exogenous intoxication by carbamates or organophosphates.
Resumo Objetivo: avaliar e indicar os procedimentos a serem seguidos na unidade de saúde tanto para o diagnóstico como para o tratamento de intoxicações agudas exógenas por carbamatos ou organofosforados. Métodos: estudo descritivo baseado na análise retrospectiva da história clínica de pacientes diagnosticados com intoxicação por carbamatos ou organofosforados admitidos em uma unidade de emergência, entre janeiro e dezembro de 2012. Foram avaliados alguns critérios, como: agente intoxicador; idade do paciente e gênero; causa de envolvimento, circunstâncias e gravidade da intoxicação; sinais e sintomas dos efeitos neurológicos muscarínicos e nicotínicos. Resultados: setenta pacientes (idade média: 25±19,97 anos) formaram a população de estudo. Foi observado que 77,14% deles sofreram intoxicação por carbamatos. Os casos mais graves foram intoxicados por organofosforados, com 68,75% dos pacientes apresentando formas moderadas a graves. Tentativa de suicídio foi a causa principal de envenenamento, com 62 casos (88,57% do total). A administração de atropina foi uma medida terapêutica efetiva para tratamento de sinais e sintomas, como sialorreia (p=0,0006), náusea (p=0,0029) e êmese (p<0,0001). O uso do carvão ativado mostrou efetividade para o combate dos sinais e sintomas apresentados por pacientes em geral (p<0,0001). Conclusão: o uso de atropina e de carvão ativado é uma medida terapêutica altamente efetiva para combater os sinais e sintomas apresentados por pacientes vítimas de intoxicação aguda exógena por carbamatos ou organofosforados.