Probable Toxicity of Surface-Active Agent in Commercial Herbicide Containing Glyphosate

Sawada, Yusuke; Nagai, Yoshikazu; Ueyama, Masashi; Yamamoto, Ikuo

doi:10.1016/s0140-6736(88)90379-0

Cited by 79 publications

(72 citation statements)

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“…3,5 In our study, out-of-hospital time was actually longer in the survivor group. This is similar to the reports of Talbot et al and Tominack et al 4,5 This might be due to the fact that a lack of significant symptoms following a minor ingestion did not induce a sense of urgency in the patient or family, leading to the delay in seeking hospital help.…”

Section: Discussionmentioning

confidence: 39%

“…The amount of GlySH ingested in our study population, as in previous reports, is based on estimates and self-reporting, which are unreliable. However, looking at our patients and previous studies, [3][4][5] humans seem to be less tolerant of GlySH than animals. This suggests that the mechanism of toxicity or level of tolerance in humans differs from that in experimental mammals.…”

Section: Discussionmentioning

confidence: 69%

“…[1][2][3][4][5]8 An analysis of three retrospective reviews of 246 cases [3][4][5] revealed that patients presented with nausea and/or vomiting (40%), abdominal pain, and diarrhea (12%) initially, followed by sore throat (41-43%), fever (7%), gastrointestinal mucosal damage (7-43%), transient renal (10-14%) and hepatic (19-40%) dysfunction, metabolic acidosis, pulmonary edema (5-13%), shock (9%), and death (10.5-16.7%). In our study, nausea with or without vomiting (73.8%), sore throat (79.5%), and fever (41.2%) were the most common initial manifestations.…”

Section: Discussionmentioning

confidence: 99%

“…Talbot et al 4 postulated that severe toxicity resulted from the uncoupling of mitochondria oxidative phosphorylation. Sawada and colleagues 1,3 speculated that the POEA surfactant may be responsible for the toxicity. Through the study of intravenous injection of glyphosate, surfactant, and GlySH, Tai et al 11 concluded that surfactant caused cardiac suppression and increasing pulmonary vascular resistance.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5] Ingestion of a large amount of this chemical may place patients at risk for a toxic syndrome that includes gastrointestinal irritation, hepatic and renal dysfunction, cardiovascular instability, and pulmonary insufficiency. [2][3][4][5][6] Although glyphosate-surfactant herbicide (GlySH) is considered to be only slightly toxic in rats, ingestion of a substantial volume of GlySH has been reported to be associated with toxicity and death in humans. 4,5 A number of reports have described the clinical course and outcomes following ingestion;…”

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confidence: 99%

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Clinical Presentations and Prognostic Factors of a Glyphosate — Surfactant Herbicide Intoxication A Review of 131 Cases

Lee¹,

Chen²,

Chi³

et al. 2000

Academic Emergency Medicine

108

103

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Abstract. Objective: Suicide attempts with agricultural chemicals are common in southern Taiwan. Among them, glyphosate-surfactant herbicide (GlySH) intoxication has been encountered with increasing frequency. Although a number of reports have described the clinical course and outcomes following ingestion, predictors of serious complications and mortality have not been elucidated. The purpose of this study was to define predictors of serious complications and probable mortality. Methods: This was a retrospective study of 131 GlySH-intoxicated patients treated at the National Cheng Kung University Hospital from 1988 to 1995. Medical charts were reviewed and clinical and laboratory variables were abstracted, looking for predictors of mortality. Results: The most common symptoms included sore throat (79.5%), and nausea with or without vomiting (73.8%). The most common laboratory findings were leukocytosis (68.0%), low serum bicarbonate (48.1%), and acidosis (35.8%). Overall, 11 of 131 patients (8.4%) died; the mean Ϯ SEM time to death was 2.8 Ϯ 0.8 days after presentation. When comparing the clinical and laboratory characteristics among the survivor and fatality groups, significant differences were identified. Respiratory distress, pulmonary edema, respiratory distress necessitating intubation, shock (systolic blood pressure less than 90 mm Hg), altered consciousness, abnormal chest x-ray, renal failure necessitating hemodialysis, larger amount of ingestion (>200 mL), and hyperkalemia were predictors highly associated with poor outcomes and mortality. Using multiple logistic regression, three predictors were identified, which may predict mortality in severely intoxicated patients. Conclusions: In managing patients who have larger amount of GlySH ingestion, airway protection, early detection of pulmonary edema, and prevention of further pulmonary damage and renal damage appear to be of critical importance. Key words: glyphosate; surfactant; herbicide; intoxication; aspiration; pneumonitis. ACADEMIC EMER-GENCY MEDICINE 2000; 7:906-910 H ERBICIDES containing glyphosate, an alternative to paraquat, have recently been used with increasing frequency in suicide attempts throughout Asia. 1-5 Ingestion of a large amount of this chemical may place patients at risk for a toxic syndrome that includes gastrointestinal irritation, hepatic and renal dysfunction, cardiovascular instability, and pulmonary insufficiency. 2-6 Although glyphosate-surfactant herbicide (GlySH) is considered to be only slightly toxic in rats, ingestion of a substantial volume of GlySH has been reported to be associated with toxicity and death in humans. 4,5 A number of reports have described the clinical course and outcomes following ingestion;From the Departments of Emergency Medicine (HLL, KWC, CHC, LMT) and Internal Medicine (JJH), National Cheng Kung University Hospital, Tainan, Taiwan. Received July 7, 1999; revisions received October 29, 1999, and January 24, 2000; accepted February 21, 2000. Address for correspondence and reprints: Kuan-Wen Chen...

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