Prognostic Predictors of Outcome for Poisoning by Glyphosate-containing Herbicides, Based on Initial Findings in the Emergency Department

Jeong, Won Jung; Choi, Se Min; Lee, Mi Jin; Choi, Kyoung Ho; Park, Kyu Nam; Lee, Won Jae; So, Byung Hak

Abstract

PURPOSE: Glyphosate is a widely used herbicide and has been considered to have low mammalian toxicity. However, a number of reports have described an increasing frequency of glyphosate poisoning with severe associated complications. The purpose of this study is to indentify predictors of serious complications based on initial findings.
METHODS
This retrospective study was performed from January 1, 2000 to March 31, 2006 at four university hospital emergency departments in Seoul and Kyung-Gi Do, Korea. Thirty-six patients were classified into two groups according to severity of symptoms. Initial clinical and laboratory findings were reviewed. RESULT: Glasgow coma scale (GCS) scores of severe poisoning group (SP, n=13) were significantly lower than those of mild poisoning group (MP, n=23). White blood cell (WBC) counts and serum creatinine concentrations were significantly higher in the SP group. WBC count, GCS score, serum amylase and creatinine concentrations were significant prognostic predictors as indicated by univariate logistic regression analysis. By multivariate analysis, two predictors were identified: serum amylase concentration (odds ratio=1.015) and serum creatinine concentration (odds ratio=357.309).
CONCLUSION
In managing cases of poisoning from glyphosate-containing herbicides, clinical and laboratory findings must be carefully evaluated. Serum amylase and creatinine concentrations are especially important for quickly determing which patients require intensive care.