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급성 제초제 중독의 임상 양상: Chlorophenoxy계 제초제 중심으로

Characteristics of Acute Herbicide Poisoning: Focused on Chlorophenoxy Herbicide

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Purpose: Herbicide-related mortality has decreased since the complete ban of paraquat product sales in 2012, but there still have been other herbicides intoxications with relatively severe complications. Glyphosate and glufosinate herbicides are used widely, and considerable research has been conducted. Chlorophenoxy herbicide is another major herbicide that has shown poor outcomes and mortality without proper management, but research in this area is lacking. Therefore, this study compared the clinical features of chlorophenoxy herbicide with those of other herbicides. Methods: The medical records of patients exposed to herbicides at a tertiary academic university hospital in Korea from May 2014 to April 2019 were reviewed retrospectively. The demographic and clinical data of 135 patients were then analyzed to identify the recent herbicides intoxication trends after the paraquat sales ban, focusing mainly on chlorophenoxy herbicide poisoning. Results: Of the 135 patients, 13 patients (9.6%) had chlorophenoxy herbicide poisoning. No significant differences in all the variables were observed between the chlorophenoxy herbicide poisoning group and non-chlorophenoxy herbicides poisoning groups. Toxic symptoms after poisoning varied from nothing noticeable to confusion; none of the patients had severe complications after their treatments. Conclusion: Acute chlorophenoxy poisoning is relatively less severe, with lower mortality rates than glyphosate and glufosinate poisoning.

Abstract

Purpose: Herbicide-related mortality has decreased since the complete ban of paraquat product sales in 2012, but there still have been other herbicides intoxications with relatively severe complications. Glyphosate and glufosinate herbicides are used widely, and considerable research has been conducted. Chlorophenoxy herbicide is another major herbicide that has shown poor outcomes and mortality without proper management, but research in this area is lacking. Therefore, this study compared the clinical features of chlorophenoxy herbicide with those of other herbicides. Methods: The medical records of patients exposed to herbicides at a tertiary academic university hospital in Korea from May 2014 to April 2019 were reviewed retrospectively. The demographic and clinical data of 135 patients were then analyzed to identify the recent herbicides intoxication trends after the paraquat sales ban, focusing mainly on chlorophenoxy herbicide poisoning. Results: Of the 135 patients, 13 patients (9.6%) had chlorophenoxy herbicide poisoning. No significant differences in all the variables were observed between the chlorophenoxy herbicide poisoning group and non-chlorophenoxy herbicides poisoning groups. Toxic symptoms after poisoning varied from nothing noticeable to confusion; none of the patients had severe complications after their treatments. Conclusion: Acute chlorophenoxy poisoning is relatively less severe, with lower mortality rates than glyphosate and glufosinate poisoning.

참고문헌 (10)

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  2. 김영기, "단일 기관에서 경험한 Glufosinate 급성 중독 후 발생한 의학적 합병증의 발병 예측인자에 관한 비교 분석", 대한응급의학회지, 27(1), pp.52~60 (2016), 대한응급의학회
  3. 정원중, "글리포세이트 계 제초제 음독 환자의 응급실 초기 검사에 따른 예후 예측", 대한응급의학회지, 17(6), pp.630~636 (2006), 대한응급의학회
  4. 조수형, "혈액투석에 의해 치유된 중증의 Chlorophenoxy계 제초제 중독환자 1례", 대한응급의학회지, 13(4), pp.578~581 (2002), 대한응급의학회
  5. Bradberry SM, "Mechanisms of toxicity, clinical features, and management of acute chlorophenoxy herbicide poisoning: a review", J Toxicol Clin Toxico, 38, pp.111~122 (2000)
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  8. Bradberry SM, "Critical care toxicology: Diagnosis and Management of the critically poisoned patient", pp.903~906 (2005), Elsevier Mosby
  9. Durakovic Z, "Poisoning with 2,4-dichlorophenoxyacetic acid treated by hemodialysis", Arch Toxicol, 66, pp.518~521 (1992)
  10. Hori Y, "Toxicokinetics of DL-glufosinate enantiomer in human BASTA poisoning", Biol Pahrm Bull, 26, pp.540~543 (2003)

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