Dharmani Chandrabhan, Jaga Kushik
School of Public Health, New York Medical College, Valhalla, New York 10595, USA.
Rev Environ Health. 2005 Jul-Sep;20(3):215-32. doi: 10.1515/reveh.2005.20.3.215.
Acute organophosphate (OP) poisoning is a major health issue in developing countries. Organophosphate insecticides inhibit cholinesterase (ChE) enzymatic activity, thereby eliciting cholinergic signs and symptoms. Victims of OP poisoning require immediate hospital emergency room (ER) treatment to prevent a fatal outcome. We present an epidemiologic review of acute OP poisoning in hospital ER patients. Areas of interest include countries with acute OP poisoning, nature of exposure, gender and age of patients, clinical cholinergic features, ChE activity, and health outcome, including recovery rate, case fatality rate, and post-ER complications. The review comprises case reports, hospital surveys, and clinical studies on acute OP poisoning. More studies were conducted in developed than in developing countries. Suicidal and occupational OP poisoning in agricultural workers was prevalent in developing countries, whereas accidental OP poisoning was prevalent in developed countries. Healthcare workers in the ER were also affected by OP poisoning. Both males and females were affected. Children accounted for 35% of the OP-poisoned victims. Patients presented with a classic cholinergic syndrome and serum ChE depresssion, with a recovery rate above 90%. Neurologic impairment was the most frequent complication. Preventing environmental OP exposure and increasing the awareness of pesticide toxicity would reduce acute OP poisoning and protect human health.
急性有机磷中毒是发展中国家的一个主要健康问题。有机磷杀虫剂抑制胆碱酯酶（ChE）的酶活性，从而引发胆碱能体征和症状。有机磷中毒的受害者需要立即在医院急诊室接受治疗，以防止出现致命后果。我们对医院急诊室患者的急性有机磷中毒进行了一项流行病学综述。关注的领域包括发生急性有机磷中毒的国家、接触的性质、患者的性别和年龄、临床胆碱能特征、ChE活性以及健康结局，包括恢复率、病死率和急诊室后的并发症。该综述包括急性有机磷中毒的病例报告、医院调查和临床研究。发达国家开展的研究比发展中国家更多。发展中国家农业工人的自杀性和职业性有机磷中毒较为普遍，而发达国家意外有机磷中毒较为普遍。急诊室的医护人员也会受到有机磷中毒的影响。男性和女性都会受到影响。儿童占有机磷中毒受害者的35%。患者表现出典型的胆碱能综合征和血清ChE降低，恢复率超过90%。神经功能损害是最常见的并发症。预防环境中的有机磷接触并提高对农药毒性的认识将减少急性有机磷中毒并保护人类健康。
