Irritant dermatitis among workers cleaning up a pesticide spill: California 1991

An outbreak of dermatitis occurred among county jail inmates who removed dead fish from the Sacramento River in California after a spill of metam sodium. The spilled chemical decomposes to methylisothiocyanate (MITC), a known skin irritant. A retrospective cohort study was conducted among the inmates and their crew leaders. Among 42 jail group members, 27 had dermatitis involving the feet and ankles; dermatitis was associated with lower extremity water contact (RR = 3.4, 95% CI 1.0-11.8); the attack rate increased with length of time spent in the water. For comparison, other state and federal employees who worked in the river at the same time were also interviewed. None reported dermatitis. Over three-quarters (24/31) of these other clean-up workers whose feet became wet changed to dry clothing immediately; none of the jail group changed immediately. The river concentration of MITC measured 20-40 ppb at the time of exposure. We speculate that prolonged wetness, occlusive boots, friction, and heat contributed to chemical irritation at this low concentration; the experience of the other clean-up workers suggests that this outbreak could have been prevented.

Persistent respiratory health effects after a metam sodium pesticide spill

STUDY OBJECTIVE

To report the occurrence of persistent respiratory disorders, including irritant-induced asthma, among adults living and working near an environmental spill of the pesticide, metam sodium, after the derailment of a tank car.

DESIGN

Retrospective clinical case series.

SETTING

California communities situated within one-half mile of the Sacramento River, from Mt. Shasta City to Shasta Lake.

PATIENTS

197 adults referred to a university occupational/environmental health clinic or to a private occupational/environmental health practitioner for evaluation of health problems potentially related to the spill.

MEASUREMENTS AND RESULTS

History, physical examination, review of medical records, spirometry, and methacholine challenge testing revealed 20 cases of persistent irritant-induced asthma and 10 cases of persistent exacerbation of asthma.

CONCLUSIONS

This is the first reported series of cases of persistent irritant-induced asthma involving both community residents and occupationally exposed individuals.

Dermatitis among workers cleaning the Sacramento River after a chemical spill--California, 1991

On July 14, 1991, a train tanker car derailed in northern California, spilling 19,000 gallons of the soil fumigant metam sodium (sodium methyldithiocarbamate) into the Sacramento River north of Redding (Figure 1). The major breakdown product of metam sodium, methylisothiocyanate (MITC), is a known skin irritant at high concentrations (greater than 1%). By July 21, the concentration of MITC in the river, at multiple test sites, measured 20-40 parts per billion (0.01%). On August 6, Shasta County health officials notified the California Department of Health Services (CDHS) of an outbreak of dermatitis among Shasta County jail inmates and crew leaders who had assisted in removing dead fish from the river on July 21-22 in greater than 100 F (greater than 38 C) ambient temperature.

[Experimental study of cardiotoxic effect of the pesticide sulfocarbathione]

Cardiotoxic and atherogenic effects of sulfocarbathione++ administered perorally and by inhalation to sexually mature white rats were studied. Besides, cardiotoxic effect was studied on the embryos and offspring of the exposed dams. Unfavourable effects of the pesticide on the myocardium of sexually mature animals, embryos, offspring were detected, as well as biochemical disorders of atherogenic character.

Ethylenethiourea in air and in urine as an indicator of exposure to ethylenebisdithiocarbamate fungicides

Ethylenethiourea (ETU) is a ubiquitous impurity of the ethylenebisdithiocarbamate (EBDC) fungicides widely used in agriculture and forestry. In the present study, ETU was used as a measure of the exposure to EBDC on potato farms and in pine nurseries during the application of EBDC fungicides and the weeding of the sprayed vegetation. Biological and hygienic monitoring was carried out through the analysis of ETU in the breathing zone and the urine of exposed workers. Even if the concentrations of ETU in the ambient air of pine nurseries exceeded those of potato farms, the concentrations of ETU in the urine of potato farmers exceeded those of pine nursery workers. This result may have been due better protective equipment in the pine nurseries. The excretion rate was 6-10 ng/h during the first 60 h after the cessation of exposure, and it diminished thereafter to 0.2 ng/h over a 22-d observation period.

Environmental and biological monitoring of exposure to ethylenebisdithiocarbamate fungicides and ethylenethiourea

Exposure of workers to ethylenebisdithiocarbamates (EBDCs; maneb or mancozeb) in 29 potato farms was evaluated during the control of potato late blight. Concentrations of EBDCs and ethylenethiourea (ETU), an impurity and degradation product in EBDC formulations, in ambient air were evaluated during pesticide application. Biological monitoring of exposure to EBDCs was carried out by measuring the concentrations of ETU, a metabolite of EBDCs, in urine for 22 days after the end of the exposure. The estimated inhaled doses of ETU and EBDCs during the average four hour application period were 0.07 and 1.8 micrograms/kg, respectively. Only 1-10% of ETU on the clothes reached the skin. The creatinine corrected concentrations of ETU in urine were 0.1-2.5 micrograms/mmol creatinine 24 hours after exposure ended. The estimated half life for eliminating ETU through the kidneys was close to 100 hours. These results indicate that the measurement of ETU in urine is suitable for biological monitoring of exposure to EBDCs.

Acute renal failure and nephrotic syndrome after maneb exposure. A new case with light and electron microscopic study

A new case of nephrotoxic effect of Maneb is related. The patient used this product as fungicide and developed a progressive illness with acute renal failure. The study by light and electron microscopy revealed severe tubular lesions that disappeared some months later with tubular cell regeneration. However, in spite of the renal function returning to normal, a steroid-dependent nephrotic syndrome persisted with glomerular minimal change like lesions.

Chronic exposure to the fungicide maneb may produce symptoms and signs of CNS manganese intoxication

Manganese (Mn) poisoning, a well-known hazard in miners and industrial workers, shares many features with Parkinson's disease. Two young agricultural workers with a parkinsonian syndrome, who mentioned exposure to the fungicide maneb (manganese ethylene-bis-dithiocarbamate), led us to investigate a new possible source of Mn intoxication. Fifty male rural workers with occupational exposure to maneb were compared with 19 rural workers without fungicide exposure. We noted significantly higher prevalence of plastic rigidity with cogwheel phenomenon, headache, fatigue, nervousness, memory complaints, and sleepiness in the exposed group. In addition, we saw other neurologic signs, such as postural tremor, cerebellar signs, and bradykinesia, although without statistical significance. The data suggest that occupational exposure to pesticides containing Mn is a possible source of Mn intoxication of the CNS.

Henoch-Schönlein purpura following thiram exposure

Henoch-Schönlein purpura (HSP) is an uncommon, nonthrombocytopenic hypersensitivity vasculitis that is often idiopathic, but may be induced by infectious agents, drugs, foods, environmental chemicals, or insect bites. To our knowledge, we report the first recognized case of HSP following exposure to the widely used industrial and agricultural agent, tetramethylthiuram disulfide. Few reports of HSP or other vasculitides resulting from exposure to structurally similar compounds are available. Despite the widespread use of tetramethylthiuram disulfide, many cases of exposure may remain unrecognized, resulting in a subsequent failure to properly identify sequelae.

Place of radioactive iodine in treatment of thyrotoxicosis

The effect of treatment of thyrotoxicosis with drugs, radioactive iodine, or surgery in different age groups is reviewed. In Graves' disease and toxic multinodular goitre the remission rate is about 40-50% after antithyroid drugs, but these drugs have little effect in toxic adenoma. Hypothyroidism developed in 35-49% of patients who had had thyroidectomy, and the risks of operation are high. The risk of malignant disease and genetic abnormalities was not significantly greater after treatment with radioactive iodine in any age group. In general, treatment with radioactive iodine should have priority over thyroidectomy at all ages.

Tibial dyschondroplasia in single-comb White Leghorn chicks fed tetramethylthiuram disulfide (a fungicide)

Supplementing a practical chick starter diet with 30 mg tetramethylthiuram disulfide per kg of diet produced tibial dyschondroplasia (TD) in single-comb white leghorn chicks without compromising growth or bone mineralization. The incidence and severity of the lesion increased over time, with the highest incidence (40%) occurring in 4-week-old chickens. Microscopically, the lesion was consistent with the description of TD in broilers. This is the first known report of TD in the layer-type chick, which heretofore was felt to be highly resistant to TD.

The problem of the sensitization to dithiocarbamates in thiuram-allergic patients

Because of the occurrence of hand dermatitis in members of a surgical staff due to allergy to thiuram-containing rubber gloves, an investigation was performed about cross-sensitization between thiuram compounds and dithiocarbamates. Positive reactions to dithiocarbamates were compared with reactions to 8 brands of hypo-allergenic or dithiocarbamate-containing surgical gloves. There appeared to be a marked difference in reactions to the dithiocarbamate-containing gloves. Some brands gave negative or nearly always negative reactions, while other brands caused many positive reactions. Thiuram-allergic patients were advised to wear nonreacting rubber gloves or PVC gloves.