Organophosphate Poisoning in Tehran 2003

Objective: Acute pesticide poisoning has become a major public health problem worldwide. Organophosphate insecticides (OPs) are a common cause of poisoning in developing countries but less so in developed countries (1). A recent published study that was done in Loghman-Hakim Poison Hospital (LHPH) indicated that 18.5% of total mortality was due to pesticides, and of this, 11.94% was due to OPs (2). This study aimed to review the epidemiology, initial clinical abnormalities and management of patients with organophosphate poisoning admitted to the LHPH, Iran, over a 6-month period in 2003. Methods: This was a cross sectional prospective study. The population was patients aged >12 year with OP poisoning admitted to LHPH in 2003. Demographic data included age, sex, route of exposure, intentional or accidental poisoning, type of admission, place of intoxication, length of hospitalization, symptoms, signs, treatment and outcome were reviewed for each case. SPSS Version 11.5 was used to analyse the data. Results: In total 121 acute OP poisoning cases were referred to LHPH in the mentioned period. These represented nearly 1% of all poisoning emergency admissions. 71.2% cases were self poisoning, 23.1% accidental and 1.7% unspecified. The majority of patients were young (mean age 29.3), male (51.2%) and from a rural area (81%). 80% were hospitalized. 82% of poisoning happened at home. Miosis was the most common sign (60%), followed by tachycardia and sweating (48%) while nausea and vomiting (18%) were the most common symptoms, followed by abdominal pain (13.7%). Atropine and pralidoxime was given to 36% of patients in the ED. The majority of patients (80%) stayed in the hospital for approximately 4 days. Average hospital stay per patient was 4--5 days. Seven patients died (5.8%). Conclusion: Methods of prevention to reduce the number of poisonings with these agents, should be carried out.