Further clinical observations on the pulmonary effects of paraquat ingestion.

Abstract

Five patients are reported who developed evidence of acute lung damage after proved ingestion of paraquat. In two the lung changes resolved; in one an aspiration pneumonia occurred, which was successfully treated, while two developed fatal pulmonary oedema. These pulmonary complications after paraquat intoxication appear more common than the progressive pulmonary fibrosis previously described. It is suggested that acute pulmonary oedema is a response to large doses, usually of Gramoxone, that subclinical lung changes result from small doses, usually of Weedol, and that pulmonary fibrosis occurs after intermediate doses.Preliminary data on plasma paraquat concentrations suggest that these are of value in prognosis.

Toxicology of Specific Substances

“…Poisoning with paraquat in humans initially produces damage to the gastrointestinal tract, including the mouth and pharynx, and to the liver and kidneys. Often partial recovery occurs and then from 10 days onwards clinical signs and symptoms referable to the respiratory tract develop (Higenbottam et al 1979) and death normally occurs from respiratory failure. There is no effective treatment for paraquat-induced lung damage and the only effective measures involve the prevention of absorption of the herbicide from the gastrointestinal tract.…”

Biomarkers of Pesticide Exposure

“…Accidental and suicidal ingestion cases have contributed data on the relation of plasma and urine values to mortality (Davidson and MacPherson 1972;Galloway and Petri 1972;Wright et al 1978;Ackrill et al 1978;Proudfoot et al 1979;Higenbottam et al 1979). Lavy et al (1983) measured paraquat concentrations in urine of vineyard workers during spraying for weed control; none was detected.…”

Pulmonary Damage due to Paraquat Poisoning through Skin Absorption

“…The incidence of death ranges from 33 to 55% [5]. However, a small number of survivors have been reported who developed varying degrees of lung damage, ranging from transient pleural effusions [6] and resolving pulmonary infiltrates [5] to pulmonary fibrosis [7], We describe a patient who developed non-lethal pul monary fibrosis secondary to pecutaneous paraquat poi soning.…”