Pyrethrin and Pyrethroide insecticides are commonly applied in homes and businesses and on some agricultural crops. This research used a two-state regional approach to analyze reports of acute pesticide poisonings due to Pyrethrin and Pyrethroide insecticides.  

The Washington State Department of Health and the Oregon Public Health Division collected pesticide poisoning surveillance data from 2001 through 2005. Cases were included if they involved exposure to at least one Pyrethrin or Pyrethroide insecticide. Descriptive statistics were calculated; differences between categories were assessed using Chi-square analysis.  

A total of 407 cases fit our definition. Overall, the rate of poisoning in Oregon was significantly higher than in Washington (incidence rate ratio 1.70, 95% confidence interval 1.40, 2.07), and rates for both states generally increased during the time period. For both states, most exposures resulted in low severity illnesses (92%), and most were classified as possible cases (73%). Only about one-fourth of cases were related to a person’s work. The most common category of clinical signs and symptoms of illness was respiratory (52% of cases), followed by neurological (40% of cases). Exposure route was predominantly inhalation; there was no association between route and case severity. There was a significant association between illness severity and losing time from work or regular activities (p<0.0001).  

Although the majority of Pyrethrin and Pyrethroide poisoning cases were low in severity, adverse reactions have occurred, as transpired in Oregon in 2005. Regional analysis has the potential to improve the surveillance system and provide unique opportunities for targeting preventive interventions. 

Reference:

Walters JK, Boswell LE, Green MK, Heumann MA, Karam LE, Morrissey BF, Waltz JE., Pyrethrin and Pyrethroide illnesses in the Pacific Northwest: a five-year review, Oregon Department of Human Services, Public Health Division, Office of Environmental Public Health, Toxicology, Assessment, & Tracking Services, Oregon Worker Illness and Injury Prevention Program, Portland, OR 97232, USA, Public Health Rep. 2009 Jan-Feb;124(1):149-59.

Researchers at the Johns Hopkins University School of Medicine have found that a chemical commonly used in the production of such medical plastic devices as intravenous (IV) bags and catheters can impair heart function in rats. Reporting online this week in the American Journal of Physiology, these new findings suggest a possible new reason for some of the common side effects—loss of taste, short term memory loss–of medical procedures that require blood to be circulated through plastic tubing outside the body, such as heart bypass surgery or kidney dialysis. These new findings also have strong implications for the future of medical plastics manufacturing.

In addition to loss of taste and memory, coronary bypass patients often complain of swelling and fatigue. These usually resolve within a few months after surgery, but they are troubling, sometimes hinder recovery, but generally go away.

His personal experience with coronary bypass surgery propelled his search for a root cause for the loss of taste phenomenon, reports principal investigator Artin Shoukas, Ph.D., professor of biomedical engineering, physiology and anesthesiology and critical care medicine at Johns Hopkins. “I’m a chocoholic, and after my bypass surgery everything tasted awful, and chocolate tasted like charcoal for months.”

Shoukas and Caitlin Thompson-Torgerson, PhD, a postdoctoral fellow in anesthesiology and critical care medicine suspected the trigger for these side effects might be a chemical compound of some kind.

To test their theory, Shoukas and his team of researchers took liquid samples from IV bags and bypass machines before they were used on patients. The team analyzed the fluids in another machine that can identify unknown chemicals and found the liquid to contain a chemical compound called cyclohexanone. The researchers thought that the cyclohexanone in the fluid samples might have leached from the plastic. Although the amount of cyclohexanone leaching from these devices varied greatly, all fluid samples contained at least some detectable level of the chemical.

The researchers then injected rats with either a salt solution or a salt solution containing cyclohexanone and measured heart function. Rats that got only salt solution pumped approximately 200 microliters of blood per heartbeat and had an average heart rate of 358 beats per minute, while rats injected with cyclohexanone pumped only about 150 microliters of blood per heartbeat with an average heart rate of 287 beats per minute.

In addition to pumping less blood more slowly, rats injected with cyclohexanone had weaker heart contractions. The team calculated that cyclohexanone caused a 50 percent reduction in the strength of each heart contraction. They also found that the reflex that helps control and maintain blood pressure is much less sensitive after cyclohexanone exposure. Finally, the team observed increased fluid retention and swelling in the rats after cyclohexanone injections.

According to Thompson-Torgerson and Shoukas, they would like to figure out how these side effects—decreased heart function and swelling—occur and to what degree cyclohexanone is involved. Despite the findings in this study, they emphasize that patients should listen carefully to the advice of their physicians. “We would never recommend that patients decline this type of treatment if they need it,” says Shoukas. “On the contrary, such technologies are life-saving medical advances, and their benefits still far outweigh the risks of the associated side effects. As scientists, we are simply trying to understand how the side effects are triggered and what the best method will be to mitigate, and ultimately remedy, these morbidities.”

Authors on the paper are Caitlin S. Thompson-Torgerson, Hunter C. Champion, Lakshmi Santhanam, Z. Leah Harris and Artin A. Shoukas, all of Johns Hopkins University School of Medicine.

Reference:
Johns Hopkins, Chemical found in medical devices impairs heart function, Press Release, May 1, 2009