Baker E L, Warren M, Zack M, Dobbin R D, Miles J W, Miller S, Alderman L, Teeters W R
Lancet. 1978 Jan 7;1(8054):31-4. doi: 10.1016/s0140-6736(78)90375-6.
In 1976, epidemic organophosphate insecticide poisoning due to malathion occurred among 7500 field workers in the Pakistan malaria control programme. In July, the peak month of the epidemic, it is estimated that there were about 2800 cases. In field studies low red-cell cholinesterase activities were associated with the signs and symptoms of organophosphate insecticide intoxication. Toxicity was seen with 3 different formulations of the insecticide and was greatest with the products containing increased amounts of isomalathion, a toxic malathion degradation product. Poor work practices, which had developed when D.D.T. was the primary insecticide for malaria control, resulted in excessive skin contact with and percutaneous absorption of the pesticide. Airborne malathion concentrations were very low. Implementation of good work practices and proscription of use of the 2 pesticide formulations most contaminated with isomalathion halted the epidemic in September. An extensive training programme and surveillance system for pesticide toxicity preceded 1977 spraying operations.
1976年，巴基斯坦疟疾控制项目的7500名野外工作者中发生了因马拉硫磷导致的流行性有机磷杀虫剂中毒事件。在疫情高峰期的7月，估计病例数约为2800例。在实地研究中，低红细胞胆碱酯酶活性与有机磷杀虫剂中毒的体征和症状相关。3种不同剂型的该杀虫剂均出现了毒性，其中含有毒性马拉硫磷降解产物异马拉硫磷量增加的产品毒性最大。在滴滴涕作为疟疾控制的主要杀虫剂时形成的不良工作习惯，导致皮肤与该杀虫剂过度接触并经皮吸收。空气中马拉硫磷浓度很低。实施良好工作习惯并禁止使用受异马拉硫磷污染最严重的2种杀虫剂剂型后，疫情于9月得到遏制。在1977年喷洒作业之前开展了广泛的杀虫剂毒性培训项目和监测系统。
