Table 1. Adverse health effects caused by selected classes of pesticidesa.
| Chemical/chemical class | Examples of pesticides | Clinical presentation | Route of exposureb |
|---|---|---|---|
| Arsenicals | Arsenic trioxide, CCA, sodium arsenate | Abdominal pain, nausea, vomiting, garlic odour, metallic taste, bloody diarrhoea, headache, dizziness, drowsiness, weakness, lethargy, delirium, shock, kidney insufficiency, neuropathy | O, R, D (rarely) |
| Borates (insecticide) | Boric acid, borax | Upper airway irritation, abdominal pain, nausea, vomiting, diarrhoea, headache, lethargy, tremor, kidney insufficiency | O, R, D (broken skin) |
| Carbamates (insecticide) | Carbaryl, thiram, aldicarb, mecarbam | Malaise, weakness, dizziness, sweating, headache, salivation, nausea, vomiting, diarrhoea, abdominal pain, confusion, dyspnea, dermatitis, pulmonary oedema | O, D |
| Chlorphenoxy compounds (herbicides) | Di/tri- chlorophenoxyacetic acid, MCPP | Upper airway and mucous membrane irritation, abdominal pain vomiting, diarrhoea, tachycardia, weakness, muscle spasm, coma, acidosis, hypotension, ataxia, hypertonia, seizures, dermal irritation, headache, confusion, acidosis, tachycardia | O, D |
| Calciferol (rodenticide) | Cholecalciferol, ergocalciferol | Fatigue, anorexia, weakness, headache, nausea, polyuria, polydipsia, renal injury, hypercalcemia | O |
| Chloralose | Chloralose | Vomiting, vertigo, tremor, myoclonus, fasciculations, confusion, convulsions | O |
| Copper compounds (fungicide) | Copper acetate, copper oleate | Abdominal pain, vomiting, skin/airway/mucous membrane irritation, renal dysfunction, coma | O, R, D |
| Coumarins (rodenticide) | Brodifacoum, warfarin, pindone | Echymoses, epistaxis, excessive bleeding, haematuria, prolonged prothrombin time, intracranial bleed, anaemia, fatigue, dyspnea | O, D (possible) |
| Diethyltoluamide (insect repellent) | DEET (N,N-diethyl-meta-toluamide) | Dermatitis, ocular irritation, headache, restlessness, ataxia, confusion, seizures, urticaria | O, D |
| Dipyridil (herbicide) | Paraquat, diquat | Mucous membrane and airway irritation, abdominal pain, diarrhoea, vomiting, gastrointestinal bleeding, pulmonary oedema, dermatitis, renal and hepatic damage, coma, seizures | O, D (via broken skin) |
| Phosphonates (herbicide) | Roundup, glyphosate | Airway, skin, and mucous membrane irritation, abdominal, pain, nausea, vomiting, shock, dyspnea, respiratory failure | O, R |
| Fluoroacetate (rodenticide) | Sodium fluoroacetate | Vomiting, paresthesias, tremors, seizures, hallucinations, coma, confusion, arrhythmias, hypertension, cardiac failure | O, D (possible) |
| Mercury, organic (fungicide) | Methyl mercury | Metallic taste, paresthesias, tremor, headache, weakness, delirium, ataxia, visual changes, dermatitis, renal dysfunction | O, R, D |
| Metal phosphides (rodenticide, fumigant) | Zinc-, aluminium-, magnesium- phosphide | Abdominal pain, diarrhoea, acidosis, shock, jaundice, paresthesias, ataxia, tremors, coma, pulmonary oedema, tetany, dermal irritation | O, R, D |
| Halocarbons (fumigant) | Cellfume, Methyl bromide | Skin/airway/mucous membrane irritant, cough, renal dysfunction, confusion, seizures, coma, pulmonary oedema | O, R, D |
| Nitrophenolic and nitrocresolic herbicides | Dinitrophenol, dinitrocresol, dinoseb, dinosarn | Sweating, fever, confusion, malaise, restlessness, tachycardia, yellow skin staining, seizures, coma, renal insufficiency, hepatic damage | O, R, D |
| Organochlorines (insecticide) | Aldrin, dieldrin HCB, endrin, lindane | Cyanosis, excitability, dizziness, headache, restlessness, tremors, convulsions, coma, paresthesias, nausea, vomiting, confusion, tremor, cardiac arrhythmias, acidosis | O, R, D |
| Organophosphates (insecticides) | Malathion, parathion, dichlorvos, chlorpyrifos | Headache, dizziness, bradycardia, weakness, anxiety, excessive sweating, fasciculations, vomiting, diarrhoea, abdominal cramps, dyspnea, miosis, paralysis, salivation, tearing, ataxia, pulmonary oedema, confusion, acetylcholinesterase inhibition | O, D |
| Organotin (fungicide) | Fentin acetate, fentin chloride | Airway, skin, and mucous membrane irritation, dermatitis, salivation, delirium, headache, vomiting, dizziness | O, R, D |
| Phenol derivatives (Fungicide, wood preservative) | Pentachlorophenol, dinitrophenol | Skin, airway, and mucous membrane irritation, contact dermatitis, dyspnea, diaphoreses, urticaria, tachycardia, headache, abdominal pain, fever, tremor | O, R, D |
| Pyrethrins, Pyrethroids | Allethrin, cyfluthrin, permethrin | Allergic reactions, anaphylaxis, dermatitis, paresthesias, wheezing, seizures, coma, pulmonary oedema, diarrhoea, abdominal pain | R, D |
| Strychnine (rodenticide) | Strychnine | Muscle rigidity, opisthotonus, rhabdomyolysis | O |
| Thallium (rodenticide) | Thallium sulfate | Abdominal pain, nausea, vomiting, bloody diarrhoea, headache, weakness, liver injury, hair loss, paresthesias, neuropathy, encephalopathy, cardiac failure | O |
| Triazines (herbicide) | Atrazine, prometryn | Mucous membrane, ocular and dermal irritation | O, R, D |
CCA, chromated copper arsenate; HCB, hexachlorobenzene; MCPP, methyl chlorphenoxy propionic acid. a This list is an overview and is not meant to be a comprehensive list of all pesticide and pesticide classes. The health worker is encouraged to use other resources and clinical experience in establishing health effect and causality for acute pesticide poisoning. Suggested online references include: http://www.who.int/whopes/recommendations/IPCSPesticide_ok.pdf, http://npic.orst.edu/npicfact.htm, http://www.epa.gov/pesticides/safety/healthcare/handbook/handbook.pdf, http://www.cdc.gov/niosh/topics/pesticides/pdfs/pest-cd2app2v2.pdf, http://hazard.com/msds/, http://www.epa.gov/pesticides/reregistration/status.htm, http://pesticideinfo.org/, http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?HSDB, http://www.pesticideinfo.org/Search_Countries.jsp. b Route of exposure key: O, oral/ingestion; R, respiratory/inhalation; D, dermal or ocular. Based on references 22–24.