J Korean Soc Clin Toxicol.  2008 Jun;6(1):9-15.

Clinical Characteristics of Acute Dichlorvos Poisoning in Korea

• Lee MJ
• Park JS
• Kwon WY
• Eo EK
• Oh BJ
• Lee SW
• Suh JH
• Roh HK

Abstract

Purpose: Dichlorvos has been in widespread use as an organophosphate (OP) insecticide compound. The purpose of this study was to access the epidemiology and clinical features of dichlorvos in Korea.
Methods
This was a 38 multi-center prospective study of dichlorvos poisoning using surveys, a structural reporting system and review of hospital records from August 2005 to July 2006. A total of 54 patients with acute dichlorvos poisoning on a national basis were enrolled. We analyzed the epidemiologic characteristics and clinical manifestations of dichlorvos poisoning. In addition, the clinical features of dichlorvos poisoning were compared with others OP compounds.
Results
During the study period, compounds involving pure OP poisoning were dichlorvos (22.7%), methidathion (8.4%), and phosphamidon (6.7%). In acute dichlorvos poisoning, all ingestion routes were oral. Intentional poisoning involved 74.1% of cases. The common initial complaints involved gastrointestinal (64.8%), systemic (61.1%), central or peripheral nervous system (53.7%), and respiratory symptoms (50.0%). The median arrival time to hospital after dichlorvos poisoning was 2.6 hours and mean hospitalization duration was 7.1 days. 2-PAM was administered in 35 patients in mean doses of 6.3 g/day intravenously. Atropine was administered in 30 patients with a mean dose of 62.8 mg/day (maximal 240 mg/day). Overall mortality rate for dichlorvos poisonings were 14.8% (8/54). Immediate causes for death included sudden cardiac arrest or ventricular dysrhythmias (50%), multi-organ failure (25%), acute renal failure (12.5%), and unknown causes (12.5%).
Conclusion
When compared to previous reports, dichlorvos poisoning displayed relatively moderate severity. The presence of a lower GCS score, altered mental status, serious dysrhythmias, systemic shock, acute renal failure, and respiratory complications upon presentation were associated with a more serious and fatal poisoning.

Keyword

Dichlorvos; Organophosphate; Poisoning

MeSH Terms

Acute Kidney Injury
Atropine
Death, Sudden, Cardiac
Dichlorvos
Eating
Hospital Records
Hospitalization
Humans
Korea
Organothiophosphorus Compounds
Peripheral Nervous System
Phosphamidon
Pralidoxime Compounds
Prospective Studies
Shock
Atropine
Dichlorvos
Organothiophosphorus Compounds
Phosphamidon
Pralidoxime Compounds