Home Use of a Pyrethroid-Containing Pesticide and Facial Paresthesia in a Toddler: A Case Report

Abstract

Paresthesias have previously been reported among adults in occupational and non-occupational settings after dermal contact with pyrethroid insecticides. In this report, we describe a preverbal 13-month-old who presented to his primary care pediatrician with approximately 1 week of odd facial movements consistent with facial paresthesias. The symptoms coincided with a period of repeat indoor spraying at his home with a commercially available insecticide containing two active ingredients in the pyrethroid class. Consultation by the Northwest Pediatric Environmental Health Specialty Unit and follow-up by the Washington State Department of Health included urinary pyrethroid metabolite measurements during and after the symptomatic period, counseling on home clean up and use of safer pest control methods. The child’s symptoms resolved soon after home cleanup. A diagnosis of pesticide-related illness due to pyrethroid exposure was made based on the opportunity for significant exposure (multiple applications in areas where the child spent time), supportive biomonitoring data, and the consistency and temporality of symptom findings (paresthesias). This case underscores the vulnerability of children to uptake pesticides, the role of the primary care provider in ascertaining an exposure history to recognize symptomatic illness, and the need for collaborative medical and public health efforts to reduce significant exposures in children.

A Review of the Field on Children’s Exposure to Environmental Contaminants: A Risk Assessment Approach

“…Changes in the types of pesticides and recommendation for their usage has also occurred as researchers have discovered the potential adverse outcomes for reproductive, neurological and carcinogenic outcomes, especially for children and pregnant women [44,45,46,47]. Efforts have been focused on finding safer pesticides for the home (e.g., the replacement of organophosphates and organochlorines with plant-based or synthetic pyrethroids), although even these newer compounds are under scrutiny for suspected allergic and asthmatic outcomes [19,48,49]. Efforts have also been focused on reducing pesticide residue track-in from harsher pesticides used agriculturally, and providing other protective measures for Latino farmworkers and their children [50].…”

Development of a Highly Sensitive Direct Competitive Fluorescence Enzyme Immunoassay Based on a Nanobody–Alkaline Phosphatase Fusion Protein for Detection of 3-Phenoxybenzoic Acid in Urine

“…Pyrethroids are among the safest insecticides marketed. However, because of the large-scale application and continuously increasing use of pyrethroids, a variety of people are exposed to pyrethroids at levels that could be harmful to humans and particularly to vulnerable subpopulations such as children . For example, the potential effects include endocrine disruption, DNA damage in human sperm, primary ovarian insufficiency, liver injury, sensory alterations, and others. , Therefore, it is important to develop a rapid, sensitive, and efficient analytical method for environmental monitoring and assessment of human exposure to pyrethroids and to aid in proper use of these compounds.…”

Factors of Organophosphate Pesticide Exposure on School Children in An Agricultural Area, Indonesia

“…The subjects in the study ranged from 8-12 years old. By the age, children 6-11 years of age showed significantly higher DAP levels than adults (Barr et al, 2004;Curl et al, 2002;Perkins et al, 2016). It likely children absorb more pesticides from their environment than adults (Goldmann, 2004).…”