Clinical and Sociodemographic Features of Acute Carbamate and Organophosphate Poisoning: A Study of 70 Adult Patients in North Jordan

Abstract

Objective: To define the sociodemographic and clinical aspects of organic phosphate and carbamate poisoning. Design: The records of 70 adults (33 males and 37 females) with carbamate or organophosphate intoxication admitted to a North Jordan Teaching Hospital over a five-year period were reviewed retrospectively. These patients represented 10% of all drug overdoses admitted over the same period. Results: The most cases occurred in the 15-19 year-old age group and the female to male ratio was 1.1:1. Carbamate intoxication was more than twice as common as organophosphate intoxication. Two thirds (64%) of the patients intended to commit suicide, 26% were due to accidental ingestion and the remaining 10% were from occupational exposure. Muscarinic manifestations were the predominant clinical feature followed by central nervous system and then nicotinic manifestations. Low grade fever, not related to infection, was observed in 49% of the patients and respiratory difficulty in 47%, of which 11% required assisted ventilation. Twenty-nine percent of the patients presented with coma. Three patients died for a hospital mortality of 4%. Conclusions: The widespread use of carbamates and organophosphates as household pesticides and the lack of adequate regulations controlling their sale and application has encouraged teenagers to prefer them as a modality of attempted suicide. This source of poisoning has become a major health problem in some developing countries.