Article

Unintentional fatal paraquat poisonings among agricultural workers in Costa Rica: Report of 15 cases

  1. Catharina Wesseling MD1,2,3,*,
  2. Christer Hogstedt MD3,4,
  3. Anabelle Picado MD5,
  4. Leif Johansson MD6

Article first published online: 6 DEC 1998

DOI: 10.1002/(SICI)1097-0274(199711)32:5<433::AID-AJIM1>3.0.CO;2-T

Issue

American Journal of Industrial Medicine

American Journal of Industrial Medicine

Volume 32, Issue 5, pages 433–441, November 1997

Additional Information

How to Cite

Wesseling, C., Hogstedt, C., Picado, A. and Johansson, L. (1997), Unintentional fatal paraquat poisonings among agricultural workers in Costa Rica: Report of 15 cases. American Journal of Industrial Medicine, 32: 433–441. doi: 10.1002/(SICI)1097-0274(199711)32:5<433::AID-AJIM1>3.0.CO;2-T

Author Information

  1. 1

    Pesticide Program, Universidad Nacional, Heredia, Costa Rica

  2. 2

    Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden

  3. 3

    National Institute for Working Life, Solna, Sweden

  4. 4

    Department of Occupational Health, Karolinska Hospital, Stockholm, Sweden

  5. 5

    Department of Pathology, Hospital San Juan de Dios, San José, Costa Rica

  6. 6

    Department of Pathology and Cytology, University Hospital, Lund, Sweden

*Division of Epidemiology, Institute of Environmental Medicine, Box 210, Karolinska Institute, 171-77 Stockholm, Sweden

Publication History

  1. Issue published online: 6 DEC 1998
  2. Article first published online: 6 DEC 1998
  3. Manuscript Accepted: 12 MAY 1997

Funded by

  • Department for Research Cooperation, SAREC, of the Swedish International Development Cooperation Agency, SIDA

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Keywords:

  • paraquat;
  • fatal poisoning;
  • occupational exposure;
  • dermal absorption;
  • inhalation;
  • oral intake

Abstract

This study analyzes the exposure circumstances of 15 fatal occupational paraquat poisonings. To evaluate the potential danger of dermal absorption and the amount needed to produce a fatal outcome in the event of oral intake, we reviewed the medical records and autopsy protocols and interviewed relatives. Five fatalities were due to ingestion of a mouthful of paraquat concentrate, and five to intake of a smaller amount; three cases were associated with dermal exposure, and in two, there was no evidence of either oral or dermal exposure. Several cases concerned diluted paraquat spray. The clinical and pathomorphological findings, including a “blinded” evaluation of lung slides, were consistent with paraquat poisoning in all cases. Difficulties in establishing the diagnosis and recognizing the exposure were identified, as well as classification of unintentional poisonings as suicides at autopsy. The findings suggest that paraquat may cause fatal poisonings by ingestion of small amounts, by dermal absorption of diluted paraquat, and possibly by inhalation. More conclusive studies are warranted. Am. J. Ind. Med. 32:433–441, 1997. © 1997 Wiley-Liss, Inc.

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