Department of Medicine, Department of Pharmacology/Therapeutics, Faculty of Medical Sciences, University of Nigeria, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Cardiovasc Toxicol. 2019 Apr;19(2):95-104. doi: 10.1007/s12012-018-9486-7.
Cardiovascular disease has maintained the unenviable position as the number one cause of death in the world. It is now clear that the traditional risk factors of cardiovascular disease are driven by primary factors like globalisation, urbanisation, industrialisation and agricultural practices. Pesticide use is an integral component of modern and improved agriculture. The abuse and misuse of these chemicals has caused significant poisoning worldwide and particularly in low- and middle-income countries where Africa belongs. This review surveys the widening population of people poisoned by pesticides in Africa and examines the possibility of pesticide-induced cardiotoxicity. The exposed group includes workers in pesticide industries, transporters of these chemicals, farmers, farm workers who apply these pesticides, vendors and sellers of farm produce and consumers of foodstuffs that are treated with pesticides as well as persons who consume water and inhale air filled with pesticides. There are numerous animal model studies that employ electrocardiography, echocardiography, enzyme studies and histopathology to demonstrate pesticide-induced cardiotoxicity in many parts of the world. There are also case reports and epidemiological data of pesticide-induced cardiovascular intoxication in man. With the increasing reports of pesticide-induced central system nervous toxicity in Africa, there are enough reasons to suspect cardiovascular system poisoning as well. The poorly developed clinical toxicology specialty may explain the low index of suspicion of pesticide-induced cardiovascular diseases. With the pervading ignorance, indiscriminate sale, unguarded use, lack of adequate legislation, inadequate enforcement of legal institutes associated with pesticide use in Africa, there is no doubt that the increasing prevalence and incidence of cardiovascular diseases may partly be due to exposure to these chemicals. Africans may after all be at risk of pesticide-induced cardiotoxicity, but more studies will be required to examine the pattern of cardiotoxicity as well as factors that modulate its occurence.
心血管疾病一直保持着世界头号死因的不名誉地位。现在很明显，心血管疾病的传统危险因素是由全球化、城市化、工业化和农业实践等主要因素驱动的。农药的使用是现代农业和改良农业的一个组成部分。这些化学物质的滥用和误用在全球范围内造成了严重的中毒事件，尤其是在非洲所属的中低收入国家。本综述调查了非洲因农药中毒而人数不断增加的情况，并探讨了农药诱发的心脏毒性的可能性。暴露人群包括农药行业的工人、这些化学品的运输者、农民、施用这些农药的农场工人、农产品的销售商和销售商以及食用经农药处理的食品的消费者以及食用充满农药的水和吸入空气的人。有许多动物模型研究使用心电图、超声心动图、酶研究和组织病理学来证明世界各地农药诱发的心脏毒性。也有人报告了农药引起的心血管中毒在人类中的病例和流行病学数据。随着非洲农药引起的中枢神经系统毒性报告的增加，有足够的理由怀疑也存在心血管系统中毒。临床毒理学专业发展不佳，可能解释了对农药引起的心血管疾病的低怀疑指数。由于普遍存在的无知、不分青红皂白的销售、不加防范的使用、缺乏充分的立法、与非洲农药使用相关的法律机构执行不力，毫无疑问，心血管疾病的患病率和发病率不断上升部分可能是由于接触这些化学物质。非洲人最终可能面临农药诱发的心脏毒性的风险，但需要更多的研究来检查心脏毒性的模式以及调节其发生的因素。
