Pyrethrin and Pyrethroid Illnesses in the Pacific Northwest: A Five-Year Review

Walters, Jaime; Boswell, Laura E; Green, Mandy K.; Heumann, Michael; Karam, Lauren E.; Morrissey, Barbara; Waltz, Justin

doi:10.1177/003335490912400118

Cited by 32 publications

(37 citation statements)

References 18 publications

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“…However, various cases of toxicity have been reported due to intentional/suicidal or accidental exposure to these compounds. Walters et al [5] reviewed 407 cases of pyrethrin/pyrethroid poisoning cases through the Washington State Department of Health and the Oregon Public Health Division surveillance data from 2001 through 2005 in the respective states. The incidence of toxicity was reported to be 11.4 per million residents (95% CI: 9.8-12.9) in Oregon State and 6.7 per million residents (95% CI: 5.4-7.6) in Washington State.…”

Section: Discussionmentioning

confidence: 99%

Transient Complete Heart Block Secondary to Bed Bug Insecticide: A Case of Pyrethroid Cardiac Toxicity

et al. 2016

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Pyrethroids are the major components of various commercially used insect repellants. These are less toxic to humans due to their slow absorption and rapid metabolism. However, cases of suicidal and accidental poisoning with household insecticides are not uncommon. We report a case of a 59-year-old female who presented with syncope after an accidental exposure to bed bug repellant spray at home. She was found to be in complete heart block and was treated conservatively. There was complete resolution of symptoms and atrioventricular conduction abnormality on day 2 of hospitalization. She was discharged in a stable condition with an uneventful follow-up course. Cardiac involvement in pyrethroid toxicity is rare. We describe various clinical manifestations and the pathophysiology of toxicity caused by pyrethroid-containing insecticides.

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Section: Discussionmentioning

confidence: 99%

Transient Complete Heart Block Secondary to Bed Bug Insecticide: A Case of Pyrethroid Cardiac Toxicity

et al. 2016

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“…Such manifestations had been reported in several case reports of adults following both occupational and non-occupational exposures to pyrethroid-containing insecticides and their volatilized form [7,8,9]. NW PEHSU requested that the WDOH biomonitoring program provide analysis of the patient’s urine for pyrethroid metabolites.…”

Section: Case Historymentioning

confidence: 99%

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

Perkins

Walters

Sievert

et al. 2016

IJERPH

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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.

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“…Pyrethroids are a class of synthetic insecticides, designed to mimic naturally‐occurring pyrethrins, which are derived from chrysanthemums 1‐5 . Modified to increase their environmental stability and insecticidal potency, pyrethroids are neurotoxins exerting their effect on voltage‐gated sodium channels 1,5‐8 .…”

Section: Introductionmentioning

confidence: 99%

“…Modified to increase their environmental stability and insecticidal potency, pyrethroids are neurotoxins exerting their effect on voltage‐gated sodium channels 1,5‐8 . Synergists such as piperonyl butoxide are typically added to insecticide formulations to prevent metabolism of pyrethroids, and thereby enhance their potency 2‐4 …”

Section: Introductionmentioning

confidence: 99%

“…Pyrethroids are rapidly metabolized by humans to nontoxic metabolites that are excreted by the kidney and the majority of exposures are either asymptomatic or of low severity 1,2,4‐6 . The onset of acute pyrethroid‐related systemic illnesses typically occurs within 48 hours after exposure 14 and includes a range of symptoms: transient respiratory and neurological complaints are common 2,7,8,15 …”

Section: Introductionmentioning

confidence: 99%

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Nontransient third‐degree heart block and persistent respiratory findings as sequelae of acute occupational exposure to pyrethroids insecticide

Alexandri

Spaeth

2020

American J Industrial Med

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We present the case of a worker with occupational exposure to a pyrethroid insecticide who acutely developed nontransient third-degree heart block. In 2000, a 57-year-old male truck driver on his delivery route was accidentally exposed to pyrethroid insecticide being sprayed for West Nile virus containment. Both the driver and his vehicle were coated with the spray. The exposure was prolonged because he did not change his clothes until after his shift ended and he used the same contaminated truck for a week. Within days, he presented with a third-degree heart block, for which he was emergently treated, and a pacemaker was placed. He had no past history of arrhythmias. In the weeks thereafter, he also developed reactive airway dysfunction syndrome (RADS). In the second decade following the exposure, the patient replaced his pacemaker, confirming the permanent nature of his heart block. In addition to the persistence of his exposure-related RADS, he developed restrictive lung disease and was diagnosed with pulmonary interstitial fibrosis in the absence of established risk factors. The patient died in October 2019 from respiratory illness. Most previous reports of pyrethroid-related disorders are limited to acute exposures, in which transient symptoms predominate. To our knowledge, this is the first report of an exposed worker experiencing permanent third-degree heart block, as well as persistent respiratory findings, as possible shortand long-term sequelae of pyrethroid exposure. K E Y W O R D Sexposure, occupational health, pyrethroids, RADS, third-degree heart block

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Pyrethrin and Pyrethroid Illnesses in the Pacific Northwest: A Five-Year Review

Cited by 32 publications

References 18 publications

Transient Complete Heart Block Secondary to Bed Bug Insecticide: A Case of Pyrethroid Cardiac Toxicity

Transient Complete Heart Block Secondary to Bed Bug Insecticide: A Case of Pyrethroid Cardiac Toxicity

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

Nontransient third‐degree heart block and persistent respiratory findings as sequelae of acute occupational exposure to pyrethroids insecticide

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