Epidemiology of Acute Organophosphate Poisoning in Hospital Emergency Patients

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Abstract
Acute organophosphate (OP) poisoning is a major health issue in developing countries. Organophosphate insecticides inhibit cholinesterase (ChE) enzymatic activity, thereby eliciting cholinergic signs and symptoms. Victims of OP poisoning require immediate hospital emergency room (ER) treatment to prevent a fatal outcome. We present an epidemiologic review of acute OP poisoning in hospital ER patients. Areas of interest include countries with acute OP poisoning, nature of exposure, gender and age of patients, clinical cholinergic features, ChE activity, and health outcome, including recovery rate, case fatality rate, and post-ER complications. The review comprises case reports, hospital surveys, and clinical studies on acute OP poisoning. More studies were conducted in developed than in developing countries. Suicidal and occupational OP poisoning in agricultural workers was prevalent in developing countries, whereas accidental OP poisoning was prevalent in developed countries. Healthcare workers in the ER were also affected by OP poisoning. Both males and females were affected. Children accounted for 35% of the OP-poisoned victims. Patients presented with a classic cholinergic syndrome and serum ChE depresssion, with a recovery rate above 90%. Neurologic impairment was the most frequent complication. Preventing environmental OP exposure and increasing the awareness of pesticide toxicity would reduce acute OP poisoning and protect human health.