Wagner S L, Orwick D L
Department of Agricultural Chemistry, Oregon State University, Corvallis 97331-7301.
Pediatrics. 1994 Jul;94(1):94-7.
A 12-week-old infant girl developed persistent hypertonicity of the extremities, and, at the age of 8 months, it was discovered that her home had been treated with an excessive application of the organophosphate insecticide diazinon 5 weeks prior to the onset of symptoms. An estimation of her daily diazinon dose and possible correlation with her disease was made.
Analyses were performed for residues of diazinon in the home and for metabolites of diazinon in the infant. The infant was removed from the home.
Six months after application the remaining diazinon residue on the floor was 230 ng/cm2 vs 38 ng/cm2 expected immediately after a normal application. Vacuum cleaner dust contained 1700 parts per million of diazinon. The air contained 2.8 ng/m3. The infant's urine contained 60 parts per billion of diethylphosphate and 20 parts per billion of diethylthiophosphate which calculates to a diazinon dose of approximately 0.02 mg/kg/d. When the infant was removed from the home, muscle tone returned to normal shortly thereafter.
The evidence for an association between organophosphate exposure and the sole de-velopment of hypertonicity without other signs of intoxication in an infant is presented. Physicians should consider organophosphate insecticide exposure as a possible cause of hypertonicity in infants.
一名12周大的女婴出现四肢持续性肌张力亢进，在8个月大时发现其家中在症状出现前5周曾过度使用有机磷杀虫剂二嗪农。对她每日的二嗪农剂量进行了估算，并分析了其与疾病的可能关联。
对家中的二嗪农残留以及婴儿体内的二嗪农代谢物进行了分析。婴儿被带离该住所。
施用二嗪农6个月后，地板上残留的二嗪农为230纳克/平方厘米，而正常施用后立即预期的残留量为38纳克/平方厘米。吸尘器灰尘中二嗪农含量为百万分之1700。空气中二嗪农含量为2.8纳克/立方米。婴儿尿液中二乙基磷酸酯含量为十亿分之60，二乙基硫代磷酸酯含量为十亿分之20，据此计算出二嗪农剂量约为0.02毫克/千克/天。当婴儿被带离住所后，肌张力很快恢复正常。
本文提供了有机磷暴露与婴儿仅出现肌张力亢进而无其他中毒迹象之间存在关联的证据。医生应将有机磷杀虫剂暴露视为婴儿肌张力亢进的可能原因。
