Pesticides

Pesticides
Pesticides are a source of significant exposure.  More and more farmers use custom 
applicators but approximately half of farmers still apply pesticides.  Proper training 
and licensure is required of farmers before they can apply pesticides.  Many of the 
very toxic pesticides have been taken off the market but there are still many 
concerns regarding toxicity.

Acute Poisoning
Pesticides used in Minnesota include the fumigants, organophosphates, carbamates, 
herbicides, and fungicides, in descending order of acute toxicity.  Organophosphates 
and carbamates are the only pesticides with antidotes, often requiring very high doses 
of atropine in severe poisoning.  The general principles of acute pesticide poisoning 
treatment involve decontamination, oxygenation, cardiorespiratory support, 
suppression of seizures, and avoidance of contamination of others.  Treat 
contaminated clothing as hazardous waste.  Only carbamate and organophosphate 
poisoning involves the use of atropine while organophosphate poisoning alone also 
requires the administration of pralidoxime. Diagnosis of organophosphate poisonings 
is made on history, symptoms, and cholinesterase levels. A helpful acronym outlining 
the cholinergic symptoms is SLUDGE. It is important to recognize that more poisonings 
occur from intentional suicide attempts or accidental ingestion by children.  It is 
essential that pesticides are stored safely in the properly labeled containers and 
away from children.

Information essential to adequately treating the exposed person that is contained on the labels includes:
o  Product name/active ingredients/EPA number
o  Signal word of toxicity (danger, warning, caution)
o  Restricted entry interval (REI)
o  Recommended Personal Protective Equipment (PPE)
o  Early entry PPE
o  Environmental hazards
o  Immediate first aid
o  Directions for use
o  Storage and disposal information

The Minnesota Poison Control Center (1-800-764-7661) at the Hennepin County Medical 
Center is an essential resource in acute poisonings.   An essential reference that should be 
in every rural clinic and Emergency Department is the Environmental Protection Agency 
(EPA) text by Reigert that can be ordered free of charge.  Another excellent web-based 
reference is the National Pesticide Information Center and ExToxNet which give 
more background on pesticides, including chronic and environmental effects.