Ohd5218

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
PARESTHESIAS
with a history of well-controlled insulin- DISCUSSION
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 Pyrethrins/Pyrethroids
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.
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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], Web: 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- REFERENCES
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.

Source: http://www.ehd.org/pdf/sources/709.pdf