Demonstrator, Department of Community Medicine, North Bengal Medical College and Hospital, Siliguri.
Professor, Department of General Medicine, Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, India; Corresponding Author.
J Assoc Physicians India. 2022 Aug;70(8):11-12. doi: 10.5005/japi-11001-0058.
Herbicides are the chemical compounds used to control the growth of unwanted plants or to eliminate them. The common poisonous herbicides available in India are paraquat, glyphosate, pretilachlor, etc. Ingestion of herbicides with suicidal intention is common in rural India and West Bengal but very scanty literature is available.
We conducted a unicentric, hospital-based, noninterventional, cross-sectional study comprising 50 consecutive patients to estimate the morbidity, case fatality, and clinical features of acute suicidal poisoning of different herbicides used in agricultural fields. Data were collected from history, clinical features, and laboratory findings. Proper statistical method was used for data analysis.
Most of the study population were from 26 to 40 years age group (48%), followed by 13-25 years age group (34%). Paraquat was ingested by 64%, followed by pretilachlor (20%) and glyphosate (16%). Common symptoms were vomiting (60%), abdominal pain (40%), throat discomfort (26%), oral ulcer (24%), decreased urination (50%), and respiratory distress (30%). In laboratory investigation, 64% patients had deranged liver enzymes, 58% patients had acute kidney injury, and 30% patients had alveolar damage. A total of 62% patients were discharged after recovery and 38% patients died. Case fatality rate of paraquat was 56.2%, glyphosate was 12.5%, and pretilachlor was nil (0%).
Herbicides like paraquat and glyphosate are associated with high morbidity and case fatality. Paraquat has the highest case fatality rate. Pre-emergent herbicide pretilachlor is relatively safe.
除草剂是用于控制不需要的植物生长或消灭它们的化学化合物。印度常见的有毒除草剂有百草枯、草甘膦、丙草胺等。出于自杀意图摄入除草剂在印度农村和西孟加拉邦很常见，但相关文献却非常稀少。
我们进行了一项单中心、基于医院的、非干预性、横断面研究，纳入了 50 例连续的患者，以评估不同农业用除草剂急性自杀性中毒的发病率、病死率和临床特征。数据从病史、临床特征和实验室结果中收集。采用适当的统计方法进行数据分析。
研究人群中大多数来自 26 至 40 岁年龄组（48%），其次是 13 至 25 岁年龄组（34%）。64%的患者摄入了百草枯，其次是丙草胺（20%）和草甘膦（16%）。常见症状为呕吐（60%）、腹痛（40%）、喉咙不适（26%）、口腔溃疡（24%）、少尿（50%）和呼吸困难（30%）。在实验室检查中，64%的患者肝酶异常，58%的患者急性肾损伤，30%的患者肺泡损伤。共有 62%的患者在康复后出院，38%的患者死亡。百草枯的病死率为 56.2%，草甘膦为 12.5%，丙草胺为 0%（无死亡）。
百草枯和草甘膦等除草剂发病率和病死率都很高。百草枯的病死率最高。提前使用的除草剂丙草胺相对安全。
