Poisoning and pesticides

The review by the Tygerberg Poison Information Centre (TPIC) in the May SAMJ highlights valuable information about the public health importance of pesticides as a source of acute poisoning, particularly among children. The epidemic of poisoning of children related to informal sector sales of street pesticides such as aldicarb, a World Health Organization (WHO) class Ia carbamate and cholinesterase inhibitor, is particularly worrying, given the high toxicity of these products, mainly registered for agricultural uses, and the weak capacity of our health system to identify street pesticide poisonings, particularly from aldicarb. Not only is aldicarb poisoning often misdiagnosed as organophosphate intoxication, but there is very low awareness among health professionals that all forms of pesticide poisoning constitute a medical notifiable condition. Because of its toxicity, aldicarb was banned for any uses in 2012, yet its sale in the informal sector for rodent control is ongoing and widespread, not only in South Africa (SA).