For the last 30 years the Joint FAO/WHO Meeting on Pesticide Residues (JMPR) has carried out toxicological evaluations and safety assessments of dithiocarbamate pesticides, continuously adjusting previous appraisals in the light of new data and advances in the understanding of the principles and mechanisms of toxic action of these compounds. The historical narrative of the evaluative process is followed by an account of the present international safety assessment status of the dithiocarbamate pesticides so far examined by the JMPR. They are ferbam, mancozeb, maneb, metiram, nabam, propineb, thiram, zineb, ziram, and the associated substances, ethylenethiourea (ETU) and propylenethiourea (PTU).

OBJECTIVE:To investigate parental smoking patterns and their association with wheezing in children.METHODS:We performed a case-control study that included 105 children between 6 and 23 months of age who were divided into two groups: cases (children with 3 previous episodes of wheezing) and controls (healthy children without wheezing). The children's exposure to cigarette smoking was estimated using a questionnaire completed by the mothers and by the children's urinary cotinine levels.RESULTS:Based on both the questionnaire results and cotinine levels, exposure to cigarette smoking was higher in the households of cases in which the incidence of maternal smoking was significantly higher than that of paternal smoking. Children in this group were more affected by maternal smoking and by the total number of cigarettes smoked inside the house. Additionally, the questionnaire results indicated that the risk of wheezing was dose dependent. The presence of allergic components, such as atopic dermatitis and siblings with allergic rhinitis and asthma, greatly increased the odds ratio when wheezing was associated with cotinine levels.CONCLUSION:Children exposed to tobacco smoke have an increased risk of developing wheezing syndrome. This risk increases in association with the number of cigarettes smoked inside the house and the presence of other allergic components in the family.

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An association between high DDT cord blood levels and prematurity was investigated. Pregnant women with good health and nutritional condition, negative history of past occupational exposure to DDT and absence of recent exposure to DDT were investigated as well as their appropriate for gestational age neonates. A total of 54 maternal-infant pairs were studied and divided in two groups: A-term deliveries (30 pairs), B-preterm deliveries (24 pairs). There was no difference in DDT blood levels between pregnant women of both groups. There was, however, a significant difference in DDT cord blood levels between term and preterm infants, as well as between maternal and neonatal blood levels in both groups. DDT cord blood levels correlated negatively with infants' birth weights. We suggest that there is an association between prematurity and high DDT cord blood levels in a non-occupationally exposed population and the amount of fetal adipose tissue is an important factor determining the cord blood level of this pesticide. We cannot rule out a cause-effect association between high DDT cord blood level and prematurity.

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ResumoObjetivos: O objetivo desta revisão é apresentar, de forma clara e prática, a abordagem terapêutica da criança vítima de intoxicação aguda.Métodos: Foram revistos artigos da literatura, selecionando-se aqueles que tratam das questões envolvendo o tratamento da intoxicação aguda.Resultados: Intoxicação aguda constitui importante problema de saúde pública, particularmente na faixa etária pediátrica. Medicamentos são os principais agentes responsáveis, seguidos muito de perto pelas intoxicações por animais peçonhentos. Seguem-se, de modo expressivo, as intoxicações por produtos domissanitários, pesticidas e produtos químicos de uso industrial. O atendimento do paciente intoxicado segue uma série de etapas, geralmente, mas não necessariamente, seqüenciais, que são as seguintes: avaliação clínica inicial e estabilização, fase em que situações de risco de vida são identificadas e atendidas; reconhecimento da toxíndrome e identificação do agente causal, quando se tenta, através da análise de sinais e sintomas, orientar os testes diagnósticos; descontaminação, com a utilização criteriosa dos métodos disponíveis; administração de antídotos, cujo número comprovadamente eficaz é restrito; aumento da eliminação do tóxico absorvido, que requer conhecimento da cinética do tóxico; e tratamento sintomático.Conclusões: O reconhecimento da síndrome tóxica bem como o conhecimento das etapas básicas da abordagem de um paciente intoxicado são vitais para o sucesso do tratamento. AbstractObjectives: To review the literature, covering the most important aspects of management of acute poisoning.Methods: The most relevant articles on the management of acute poisoning were selected.Results: Acute poisoning is an important matter of public health, particularly for the child. Medicaments are the main responsible agents followed closely by accidents with poisonous animals and household chemical products, pesticides and industrial products. The management of the poisoned patient must proceed through the following sequential stages: initial clinical evaluation and stabilization of the patient, when life-threatening situations are identified and treated; recognition of the toxic syndrome and identification of the causal agent, when the careful analysis of the signs and symptoms help choosing the diagnostic tests; decontamination, with the careful use of the available methods; administration of antidotes, which are small in number and should never delay the other phases; enhancing the elimination of the absorbed toxic, which requires knowledge of the kinetics of the toxic substance; and supportive treatment.Conclusions: The recognition of the toxic syndrome and knowledge of the phases of management are basic conditions for the success of treatment.J. pediatr. (Rio J.). 1999; 75 (Supl.2): S244-S250: poisoning, children, treatment.

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