Acute human self-poisoning with imidacloprid compound: A neonicotinoid insecticide

Mohamed, Fahim, Gawarammana, Indika, Robertson, Thomas A., Roberts, Michael S., Palangasinghem, Chathura, Zawahir, Shukry, Jayamanne, Shaluka, Kandasamy, Jaganathan, Eddleston, Michael, Buckley, Nick A., Dawson, Andrew H and Roberts, Darren M. (2009) Acute human self-poisoning with imidacloprid compound: A neonicotinoid insecticide. PLoS One, 4 4: 1-5. doi:10.1371/journal.pone.0005127

Author Mohamed, Fahim
Gawarammana, Indika
Robertson, Thomas A.
Roberts, Michael S.
Palangasinghem, Chathura
Zawahir, Shukry
Jayamanne, Shaluka
Kandasamy, Jaganathan
Eddleston, Michael
Buckley, Nick A.
Dawson, Andrew H
Roberts, Darren M.
Title Acute human self-poisoning with imidacloprid compound: A neonicotinoid insecticide
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2009-04-08
Sub-type Article (original research)
DOI 10.1371/journal.pone.0005127
Open Access Status DOI
Volume 4
Issue 4
Start page 1
End page 5
Total pages 5
Editor Michael Gravenor
Place of publication United States
Publisher Public Library of Science
Collection year 2010
Language eng
Subject C1
920407 Health Protection and/or Disaster Response
730210 Environmental health
Formatted abstract
Background: Deliberate self-poisoning with older pesticides such as organophosphorus compounds are commonly fatal
and a serious public health problem in the developing world. The clinical consequences of self-poisoning with newer
pesticides are not well described. Such information may help to improve clinical management and inform pesticide
regulators of their relative toxicity. This study reports the clinical outcomes and toxicokinetics of the neonicotinoid
insecticide imidacloprid following acute self-poisoning in humans.

Methodology/Principal Findings: Demographic and clinical data were prospectively recorded in patients with imidacloprid
exposure in three hospitals in Sri Lanka. Blood samples were collected when possible for quantification of imidacloprid
concentration. There were 68 patients (61 self-ingestions and 7 dermal exposures) with exposure to imidacloprid. Of the
self-poisoning patients, the median time to presentation was 4 hours (IQR 2.3–6.0) and median amount ingested was 15 mL
(IQR 10–50 mL). Most patients only developed mild symptoms such as nausea, vomiting, headache and diarrhoea. One
patient developed respiratory failure needing mechanical ventilation while another was admitted to intensive care due to
prolonged sedation. There were no deaths. Median admission imidacloprid concentration was 10.58 ng/L; IQR: 3.84–
15.58 ng/L, Range: 0.02–51.25 ng/L. Changes in the concentration of imidacloprid in serial blood samples were consistent
with prolonged absorption and/or saturable elimination.

Conclusions: Imidacloprid generally demonstrates low human lethality even in large ingestions. Respiratory failure and
reduced level of consciousness were the most serious complications, but these were uncommon. Substitution of
imidacloprid for organophosphorus compounds in areas where the incidence of self-poisoning is high may help reduce
deaths from self-poisoning.

Copyright: @ 2009 Mohamed et al.
Keyword Self-Poisoning
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 20 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 23 Mar 2010, 10:04:31 EST by Fiona Mactaggart on behalf of Medicine - Princess Alexandra Hospital