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巴西的农药暴露和中毒:中毒控制中心报告的病例的严重程度、临床表现和处理。

Pesticide exposure and poisoning in Brazil: Outcome severity, clinical manifestations and management of cases reported to a poison control center.

机构信息

Postgraduate Program in Pharmaceutical Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.

Toxicological Information and Assistance Center of Espírito Santo (CIATox-ES), Vitória, ES, Brasil.

出版信息

Arch Environ Occup Health. 2023;78(3):177-186. doi: 10.1080/19338244.2022.2161456. Epub 2022 Dec 26.

Abstract

This work aimed to identify variables associated with increased risk of outcome severity as well as to describe clinical manifestations/symptoms and management of pesticide-related cases reported to a poison center in Brazil. An increased risk of more severe outcomes was observed when exposures occurred in rural areas, involved suicide attempts and moderately to extremely hazardous pesticides. Clinical manifestations with higher frequencies included vomiting, nausea, sialorrhea, headache, miosis and sweating. From the treatment initially applied to the patient, 51.91% encompassed gastric lavage, but this procedure was only recommended in 20.01% of cases by the CIATox. Identifying risk factors associated with poor outcome, describing clinical manifestations, and contrasting initial treatment measures adopted against those recommended by the Poison Center can help determine diagnosis, prognosis and ensure appropriate clinical interventions are used in cases of pesticide poisoning.

摘要

本研究旨在确定与结局严重程度增加相关的变量,并描述向巴西中毒中心报告的与农药相关的病例的临床表现/症状和处理方法。当暴露发生在农村地区、涉及自杀企图以及中等至极高度危险的农药时,观察到结局更严重的风险增加。更高频率出现的临床表现包括呕吐、恶心、流涎、头痛、瞳孔缩小和出汗。从最初应用于患者的治疗措施来看,51.91%包括洗胃,但 CIATox 仅建议在 20.01%的病例中采用该方法。确定与不良结局相关的危险因素,描述临床表现,并将采用的初始治疗措施与中毒中心推荐的措施进行对比,有助于确定诊断、预后,并确保在农药中毒病例中使用适当的临床干预措施。

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