Acute Human Self-Poisoning with Imidacloprid Compound: A Neonicotinoid Insecticide
Open Access
- 8 April 2009
- journal article
- case report
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 4 (4), e5127
- https://doi.org/10.1371/journal.pone.0005127
Abstract
Deliberate self-poisoning with older pesticides such as organophosphorus compounds are commonly fatal and a serious public health problem in the developing world. The clinical consequences of self-poisoning with newer pesticides are not well described. Such information may help to improve clinical management and inform pesticide regulators of their relative toxicity. This study reports the clinical outcomes and toxicokinetics of the neonicotinoid insecticide imidacloprid following acute self-poisoning in humans. Demographic and clinical data were prospectively recorded in patients with imidacloprid exposure in three hospitals in Sri Lanka. Blood samples were collected when possible for quantification of imidacloprid concentration. There were 68 patients (61 self-ingestions and 7 dermal exposures) with exposure to imidacloprid. Of the self-poisoning patients, the median time to presentation was 4 hours (IQR 2.3–6.0) and median amount ingested was 15 mL (IQR 10–50 mL). Most patients only developed mild symptoms such as nausea, vomiting, headache and diarrhoea. One patient developed respiratory failure needing mechanical ventilation while another was admitted to intensive care due to prolonged sedation. There were no deaths. Median admission imidacloprid concentration was 10.58 ng/L; IQR: 3.84–15.58 ng/L, Range: 0.02–51.25 ng/L. Changes in the concentration of imidacloprid in serial blood samples were consistent with prolonged absorption and/or saturable elimination. Imidacloprid generally demonstrates low human lethality even in large ingestions. Respiratory failure and reduced level of consciousness were the most serious complications, but these were uncommon. Substitution of imidacloprid for organophosphorus compounds in areas where the incidence of self-poisoning is high may help reduce deaths from self-poisoning.Keywords
This publication has 21 references indexed in Scilit:
- Do Targeted Bans of Insecticides to Prevent Deaths from Self-Poisoning Result in Reduced Agricultural Output?Environmental Health Perspectives, 2008
- Severe neuropsychiatric manifestations and rhabdomyolysis in a patient with imidacloprid poisoningThe American Journal of Emergency Medicine, 2007
- The impact of pesticide regulations on suicide in Sri LankaInternational Journal of Epidemiology, 2007
- Pharmacokinetic Considerations in Clinical ToxicologyClinical Pharmacokinetics, 2007
- Toxicology of the newer neonicotinoid insecticides: Imidacloprid poisoning in a humanClinical Toxicology, 2007
- Quantitative determination of piritramide in human plasma and urine by off‐ and on‐line solid‐phase extraction liquid chromatography coupled to tandem mass spectrometryRapid Communications in Mass Spectrometry, 2005
- NEONICOTINOID INSECTICIDE TOXICOLOGY: Mechanisms of Selective ActionAnnual Review of Pharmacology and Toxicology, 2005
- Pesticide poisoning in south India: opportunities for prevention and improved medical managementTropical Medicine & International Health, 2005
- Self poisoning with pesticidesBMJ, 2004
- SELECTIVE TOXICITY OF NEONICOTINOIDS ATTRIBUTABLE TO SPECIFICITY OF INSECT AND MAMMALIAN NICOTINIC RECEPTORSAnnual Review of Entomology, 2003