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doses (chronic poisoning) or delayed effects of clinically defined episodes of
acute poisoning (such as cancers).
Estimates of the extent of acute pesticide poisoning have shown this to be a
significant problem and one that is virtually confined to the countries of the
developing world. Levine (1986) estimated that globally about 1.1 million
cases of acute pesticide poisoning from accidental or unintentional factors
occur each year resulting in about 20 000 deaths. An independent estimate
cited 2.9 million cases of poisoning from all causes with 220 000 deaths; 25%
of all poisonings are due to unintentional factors (Jeyaratnam 1985). The
subject of this paper is mainly unintentional poisoning of occupational origin.
Pesticide types causing acute poisonings
The main classes of pesticides responsible for acute poisoning must be identified
to focus attention on these compounds in prevention programs. In Sri
Lanka, 76% of all acute poisonings were caused by organophosphorous compounds
(Jeyaratnam et al. 1982). Similar findings were observed in other Asian
countries (Jeyaratnam et al. 1987) indicating the important role of this class of
compounds (Fig. 1). More recent results from Sri Lanka (Fernando, this
volume) seem to confirm this conclusion.
However, in a significant percentage of poisoning episodes, the class of
substance responsible was not identified, leading to problems in therapy. A
80-
70 -
60 -
50 -
40-
30-
20-
10-
0
Indonesia
Bipyridyls
Carbamates
D Organic compounds
Copper
Malaysia Sri Lanka Thailand
Others
Fig. 1. Cause of poisoning, by class of chemical, in people admitted to hospital
in four Asian countries.
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