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Aldicarb poisoning

Biochemistry-Pharmacology-Toxicology, Centre Hospitalier Universitaire, Pointe áPitre, Guadeloupe, French West Indies, France

A Tracqui

Institute of Forensic Medicine, Strasbourg, France

A Chavonnet

Biochemistry-Pharmacology-Toxicology, Centre Hospitalier Universitaire, Pointe á Pitre, Guadeloupe, French

J B Daijardin

Intensive Care Unit, Centre Hospitalier Universitaire, Pointe á Pitre, Guadeloupe, French West Indies, France

M Simonetti

Emergency Department, Centre Hospitalier Universitaire, Pointe á Pitre, Guadeloupe, French West Indies, France

P Kintz

Institute of Forensic Medicine, Strasbourg, France

B Pileire

Biochemistry-Pharmacology-Toxicology, Centre Hospitalier Universitaire, Pointe á Pitre, Guadeloupe, French West Indies, France

Aldicarb (2 ethyl-2 (methylthio) propanal o-[(methlamino)-carbonyl] oxime) is a pesticide manufactured since 1965. This carbamate ester is sold under the tradename, Temiks, and is used as insecticide and nematicide. The Environmental Protection Agency has classified aldicarb in the highest toxicity category and has defined a strict control for its delivery and use. In Brazil and the Caribbean island, aldicarb is illegally used as a household rodenticide with a widespread risk of poisoning. Our study presents the first review of aldicarb poisoning circumstances associated with cliical and analytical findings. Moreover, the oxime treament is discussed. Eighteen patients with cholinergic symptoms admitted to the Emergency Unit and two deceased with a history of aldicarb poisoning were included in the study. As agricultural workers, only two of them could legally use Temikg. Seventy percent of the patients was managed by the Emergency Mobil Unit. Serum cholinesterase activity was always lower than 30% of the normal range and aldicarb was identified by UV spectra and retention time after liquid chromatogrphy separation. The most common muscarinic effect was diarrhea, the main nicotinic sign fasciculation and almost half of the poisoned patients had central nervous system (CNS) depression (Glasgow Coma Score lower than 8). Four patients had serious conduction abnoralities and two of them died. These results suggest that aldicarb intoxication is always severe. Oxime treatment did not produce side effects and should be recommended whenever the pesticide involved is unknown. Effective measures should be implemented to stamp out the illicit use of aldicarb.

Key Words: aldicarb • carbamate poisoning • oxime therapy

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