March 23, 2004
Vol. 53, No. 6
A N E P I D E M I O L O G Y P U B L I C A T I O N O F T H E O R E G O N D E P A R T M E N T O F H U M A N S E R V I C E S
PESTICIDE POISONING FROM SYNTHETIC PYRETHROIDS
WHEN HEALTH CARE providers SYNTHETIC PYRETHROIDS AND
treatment regimen. The patient cancels
with a history of well-controlled insulin-
of pyrethrins, a natural insecticide pro-
hours before the office visit. The patient
act as contact poisons, affecting the in-
certain pesticides can be similar to those
sect’s nervous system. However, they are
he washes his hands with warm water.
allergens. Contact dermatitis, rhinitis and
different areas of the hands. In each case,
ticides in bugbombs, head lice treatments,
the symptoms resolved after 12–24 hours.
and flea sprays for pets, and are commonly
healthy. Inspection of the hands does not
clude Nix®, Elimite®, Dragon®, Drione®,
pulses and capillary refill. Neurological
gram in the years 2000–2002, the active
pesticide ingredients associated with the
sensation, the patient reports an exacer-
registered for use in the US by the Envi-
largest number of likely pesticide illness
Reported Pesticide-Related Illness
Associated with Pyrethrins/Pyrethroids,
of 6.3% (indicating good control of blood
Cases Associated with
sugar). A dipstick urinalysis is positive
group are more potent in eliciting neuro-
that lack this group, e.g., permethrin1,2
pointment to reassess his current diabetes
Chemical structure of lambda-cyhalothrin
Chemical structure of permethrin
may include headache, fatigue, peripheralneuropathy, and vomiting. A thoroughhistory is generally necessary to identifypesticides as the cause.
The CD Summary
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To report pesticide poisoning and for assistance in evaluation and treatment
files, go to http://www.npic.orst.edu/
Oregon Pesticide Poisoning Prevention Program
fected skin.6,7 Paresthesias are considered
to be a local effect of cutaneous overexpo-
0761, Email: [email protected]
sure to certain synthetic pyrethroids.9 In a
study that looked for in neurological signs
Care Providers Initiative go to: http://
individuals who had experienced paresthe-
1. Soderlund DM, Clark JM, Sheets LP, Mullin LS, et
al. Mechanisms of pyrethroid neurotoxicity:
implications for cumulative risk assessment.
Toxicology 2002; 171:3–59.
2. Flannigan SA, Tucker SB, Key MM, Ross CE et al.
reports have suggested that topical Vita-
Synthetic pyrethroid insecticides: a dermatological
of synthetic pyrethroids are, for obvious
evaluation. Br J Ind Med 1985; 42:363–72.
3. Woollen BH, Marsh JR, Laird WJ, Lesser JE. The
effect of paresthesias through mechanisms
metabolism of cypermethrin in man: differences in
exposure.5,6 Activities associated with a
that are not well understood.10,11 The use
urinary metabolite profiles following oral anddermal administration. Xenobiotica 1992; 22:983–
potential for direct contact with synthet-
ered a substitute for other means of reduc-
4. Williams RL, Bernard CE, Krieger RI. Human
exposure to indoor residential cyfluthrin residues
during a structured activity program. J Expo Anal
education and training of pesticide appli-
5. He F, Wang S, Liu L, Chen S, Zhang Z, Sun J.
Clinical manifestations and diagnosis of acute
mist at or around the time of application.
pyrethroid poisoning. Arch Toxicol 1989; 63:54–8.
6. Tucker SB, Flannigan SA. Cutaneous effects from
occupational exposure to fenvalerate. Arch Toxicol
with the pesticide product labeling.
7. Knox JM, Tucker SB,Flannigan SA. Paresthesia
from cutaneous exposure to a synthetic pyrethroid
insecticide. Arch Dermatol 1984, 120: 744–6.
8. Le Quesne PM, Maxwell IC, Butterworth S.T.G.
Transient facial sensory symptoms following
exposure to synthetic pyrethroids: a clinical and
electrophysiological assessment. Neurotoxicology1980; 2:1–11.
medical case profiles intended to educate
9. Wilks MF. Pyrethroid-induced paresthesia—a
central or local toxic effect? J Toxicol Clin Toxicol2000; 38:103–5.
10. Tucker SB, Flannigan SA, Ross CE. Inhibition of
sure scenarios, and the challenges a clini-
cutaneous paresthesia resulting from synthetic
pyrethroid exposure. Int J Dermatol 1984; 23: 86–9.
11. Song JH, Narahashi T. Selective block of tet-
ramethrin-modified sodium channels by (+/-)-alpha-
tocopherol (vitamin E). J Pharmacol Exp Ther 1995;275:1402–11.
Kerman university of medical sciences, kerman, iran. http://www.kmu.ac.irAntimicrobial resistance pattern of Escherichia coli causing urinary tractinfections, and that of human fecal flora, in the southeast of Iran Author(s): Mansouri, S (Mansouri, S); Shareifi, S (Shareifi, S) Source: MICROBIAL DRUG RESISTANCE-MECHANISMS EPIDEMIOLOGY AND DISEASE Volume: ٨ Issu
Georg Franzen (Hrsg.) Kunst und Seelische Gesundheit mit Beiträgen von Georg Franzen | Ruth Hampe | Karl HörmannMedizinisch Wissenschaftliche VerlagsgesellschaftMWV Medizinisch Wissenschaftliche Verlagsgesellschaft mbH & Co. KGZimmerstr. 1110969 Berlinwww.mwv-berlin.de Bibliografi sche Information der Deutschen Nationalbibliothek Die Deutsche Nationalbibliothek verzeichnet d