BACKGROUND: This study aimed to estimate the burden of acute pesticide poisoning and to determine its trend with recently implemented pesticide regulations. METHODS: Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost (YLLs) and years lived with disability (YLDs) due to acute pesticide poisoning using the methods of the Global Burden of Disease Study 2013. The values of YLLs, YLDs, and DALYs were stratified by sex, age groups, intentionality of poisoning, and causative agents. RESULTS: From 2006 to 2014, DALYs decreased by 69% (from 69,550 to 21,742). The decreasing tendency of DALYs was especially marked from 2011. The total burden of acute pesticide poisoning was mainly caused by YLLs and intentional pesticide poisoning. The highest DALYs due to acute pesticide poisoning occurred in those in their 40s and 50s; however, the decreased rates of DALYs were higher in those aged 10–49 years than in those aged more than 50 years. Herbicides including paraquat contributed to the largest proportion of total DALYs. CONCLUSION: As this is the first study to quantify the burden of acute pesticide poisoning using DALYs, our results provide comprehensive evidence of the importance of using strict regulations to prevent public health hazards due to acute pesticide poisoning.
Agrochemicals ; Cost of Illness ; Herbicides ; Humans ; Intention ; Korea* ; Paraquat ; Poisoning* ; Public Health ; Social Control, Formal ; Suicide

PURPOSE: This study examined the patterns of drugs, poisons, and chemicals detected in autopsy samples performed in the Seoul Institute and other regional forensic offices of the National Forensic Service (NFS) between 2014 and 2016. METHODS: The investigation carried out using the laboratory information management system. Forensic toxicological identification and quantitation were performed in autopsy samples, including heart blood, peripheral blood, liver, kidney, vitreous humor and etc. Gas chromatography/mass spectrometry (GC-MS) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) were used to analyze the drugs and poisons. RESULTS: Forensic autopsies were performed on 9,674 cases in this period. Based on the autopsy reports, 699 cases (7.2%) were considered as unnatural deaths caused by fatal intoxication. The number of male deaths was higher than that of female deaths, with the age of 50-59 being the most common age group. CONCLUSION: Drugs comprised the largest number of deaths due to poison, followed by alcohol, agrochemicals, drug with alcohol, carbon monoxide, and cyanide, in that order. Zolpidem was the most frequently used drug in all drug-related intoxication cases.
Agrochemicals ; Autopsy ; Carbon Monoxide ; Female ; Heart ; Humans ; Information Management ; Kidney ; Liver ; Male ; Mass Spectrometry ; Poisoning* ; Poisons ; Seoul ; Spectrum Analysis ; Vitreous Body

Cereal grains are the most important food source for humans. As the global population continues to grow exponentially, the need for the enhanced yield and minimal loss of agricultural crops, mainly cereal grains, is increasing. In general, harvested grains are stored for specific time periods to guarantee their continuous supply throughout the year. During storage, economic losses due to reduction in quality and quantity of grains can become very significant. Grain loss is usually the result of its deterioration due to fungal contamination that can occur from preharvest to postharvest stages. The deleterious fungi can be classified based on predominance at different stages of crop growth and harvest that are affected by environmental factors such as water activity (a(w)) and eco-physiological requirements. These fungi include species such as those belonging to the genera Aspergillus and Penicillium that can produce mycotoxins harmful to animals and humans. The grain type and condition, environment, and biological factors can also influence the occurrence and predominance of mycotoxigenic fungi in stored grains. The main environmental factors influencing grain fungi and mycotoxins are temperature and a(w). This review discusses the effects of temperature and a(w) on fungal growth and mycotoxin production in stored grains. The focus is on the occurrence and optimum and minimum growth requirements for grain fungi and mycotoxin production. The environmental influence on aflatoxin production and hypothesized mechanisms of its molecular suppression in response to environmental changes are also discussed. In addition, the use of controlled or modified atmosphere as an environmentally safe alternative to harmful agricultural chemicals is discussed and recommended future research issues are highlighted.
Aflatoxins ; Agrochemicals ; Animals ; Aspergillus ; Atmosphere ; Biological Factors ; Crops, Agricultural ; Edible Grain ; Fungi* ; Humans ; Mycotoxins ; Penicillium ; Water*

BACKGROUND: Environmentally induced, occupational diseases are increasing worldwide, especially in rural agricultural communities. Poverty-associated malnutrition, environmental hazards and pollution, and lack of access to clean water, safe sanitation, and modern healthcare facilities are often associated with these chronic illnesses. METHOD: The authors systematically reviewed occupational public health issues that have been related to the environment. General interpretations of results were included as per the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Pertinent publications from research databases were reviewed on (A) the risk–benefits, (B) the prevalence of risk factors for various diseases, (C) the benefits of not ignoring the risk factors (i.e., broader evidence), and (D) the risks, effects, and outcomes of different types of interventions. The authors used chronic kidney disease of multifactorial origin (CKDmfo) as an example to explore the theme. Emphasis was given to the regions with emerging economies and developing countries located in the vicinity of the equator. FINDINGS: Geographical, socio-economic and aetiological similarities exist for many chronic non-communicable diseases that are affecting tropical countries around the equator. The authors identified manufacturing, mining, and agriculture as the biggest polluters of the environment. In addition, deforestation and associated soil erosion, overuse of agrochemicals, and irresponsible factory discharge (e.g., chemicals and paint, from rubber and textile factories, etc.), all contribute to pollution. To decrease the escalating incidences of environmentally induced diseases, governments should work proactively to protect the environment, especially watersheds, and take steps to minimise harmful occupational exposures and strictly enforce environmental regulations. CONCLUSION: Creating public awareness of environmental issues and their relationship to public health is essential. This includes regular monitoring and periodic publication of the quality of water, air and soil; preventing deforestation and man-made soil erosion, increasing forest and ground cover, preventing occupational injuries, judicious and safe use of agrochemicals, sustainable agriculture and development programs, and implementing legislation to protect and conserve water heriage and the environment. These actions are essential both for a healthier environment and for the health of the people who live in that environment. Such measures would also decrease public health threats from such, including global-warming-related erratic environmental changes and the occurrence and the spread of non-communicable diseases, such as CKDmfo.
Agriculture ; Agrochemicals ; Chronic Disease ; Conservation of Natural Resources ; Delivery of Health Care ; Developing Countries ; Forests ; Incidence ; Kidney Diseases ; Malnutrition ; Methods ; Mining ; Mortality, Premature ; Occupational Diseases* ; Occupational Exposure ; Occupational Injuries ; Paint ; Prevalence ; Public Health ; Publications ; Renal Insufficiency, Chronic* ; Risk Factors ; Rubber ; Sanitation ; Social Control, Formal ; Soil ; Textiles ; Water

OBJECTIVE: The availability of suicide methods affects the risk of suicide attempts. This study examined the patterns of substances ingested by suicide attempters (SAs) and the characteristics of SAs using psychotropic overdoses. METHODS: Data for 384 of the 462 eligible SAs who used self-poisoning were analyzed. Demographic variables, clinical characteristics, and factors related to the suicide attempts were examined. RESULTS: There were 256 (66.7%) females and 128 (33.3%) males. Roughly half the SAs ingested psychotropics (n=179, 46.6%). Agricultural chemicals (n=84, 21.9%) were the second most frequently ingested substances, followed by analgesics (n=62, 16.1%), household products (n=27, 7.0%), and other prescribed medications (n=23, 6.0%). Among psychotropics, the most frequently overdosed drugs were sedative-hypnotics, including hypnotics (n=104) and benzodiazepines (n=78). SAs favored Z-drugs and alprazolam. When compared with SAs with non-psychotropic overdoses, significantly more SAs with psychotropic overdoses were female (76% vs. 58.5%, p<0.001) and had a psychiatric history (59.8% vs. 29.8%, p<0.001). They had significantly more previous suicide attempts (0.52+/-1.02 vs. 0.32+/-0.80, p<0.05) and lower risk (7.96+/-1.49 vs. 8.44+/-1.99, p<0.01) and medical severity (3.06+/-0.81 vs. 3.37+/-0.93, p<0.005) scores. CONCLUSION: Psychotropic overdose, especially with sedative-hypnotics, was a major method in suicide attempts. It is important that psychiatric patients are carefully evaluated and monitored for suicidality when prescribing psychotropics.
Agrochemicals ; Alprazolam ; Analgesics ; Benzodiazepines ; Drug Overdose ; Female ; Household Products ; Humans ; Hypnotics and Sedatives ; Korea* ; Male ; Prevalence* ; Psychotropic Drugs ; Suicide* ; Suicide, Attempted

BACKGROUND: Livestock breeders including poultry workers are exposed to various agricultural chemicals including pesticides and/or organic solvents. Multiple myeloma is a rare disease in Korea, and few reports have investigated the influence of occupational exposures on multiple myeloma occurrence. CASE PRESENTATION: A 61-year-old male poultry farm worker presented with bone pain and generalized weakness. A bone marrow biopsy was performed, and he was diagnosed with multiple myeloma. The patient had worked in a poultry farm for 16 years and was exposed to various pesticides and organic solvents such as formaldehyde without any proper personal protective equipment. Results of the work reenactment revealed that the concentration of formaldehyde (17.53 ppm) greatly exceeded the time-weighted average (0.5 ppm) and short-term exposure limit (1.0 ppm) suggested in the Korean Industrial Safety and Health Act. CONCLUSIONS: This case report suggests that poultry workers may be exposed to high levels of various hazardous chemicals including pesticides and/or organic solvents. Numerous previous studies have suggested an association between multiple myeloma and exposure to agricultural chemicals; thus, multiple myeloma in this patient might have resulted from the prolonged, high exposure to these chemicals.
Agrochemicals ; Biopsy ; Bone Marrow ; Formaldehyde ; Hazardous Substances ; Hematologic Neoplasms ; Humans ; Korea ; Livestock ; Male ; Middle Aged ; Multiple Myeloma* ; Occupational Exposure ; Pesticides ; Poultry* ; Rare Diseases ; Solvents ; Threshold Limit Values

Medico-legal investigations in Korea depend mostly on postmortem inspection without autopsy. Both untrained physicians and experienced forensic pathologists may not be able to determine the cause and manner of death only by postmortem inspection. The aim of our study was to show the limitations of postmortem inspection by evaluating the discrepancy between the results of postmortem inspection and autopsy after natural death. The manner of death by postmortem inspection changed to unnatural death in 9.4% of the cases (12 cases/127 cases) after autopsy. The cause of death in most cases was consumption of alcohol, agricultural chemicals, and antipsychotic intoxication. The cause of death by postmortem inspection changed in 24.3% of the cases (26 cases/107 cases) among cases of confirmed natural death after autopsy. The positive predictive value of cause of death by postmortem inspection was higher for cardiovascular disease (79.0%) and lower for chronic alcoholism and/or chronic liver disease (28.6%). This study shows that forensic pathologists could make considerable errors in determining the cause and manner of death without autopsy and emphasizes the necessity to refine medico-legal investigations in Korea by introducing the limited autopsy with toxicologic study and supportive postmortem imaging.
Agrochemicals ; Alcoholism ; Autopsy ; Cardiovascular Diseases ; Cause of Death ; Korea ; Liver Diseases

Plant growth retardants are widely used in cultivation of medicinal plant, but there is still lack of scientific guidance. In order to guide the use of plant growth retardants in medicinal plant cultivation efficiently and reasonably, this paper reviewed the mechanism, function characteristic, plant and soil residue of plant growth retardants, such as chlorocholine chloride, mepiquat chloride, paclobutrazol, unicnazle and succinic acid, and summarized the application of plant growth retardants in medicinal plants cultivation in recent years, with focus on the effect of growth and yield of the officinal organs and secondary metabolites.
Agriculture ; Agrochemicals ; pharmacology ; Plant Development ; drug effects ; Plants, Medicinal ; drug effects ; growth & development

PURPOSE: The Tox-Info system is a poisonous substance information database developed by the Korean National Institute of Food and Drug Safety Evaluation. The aim of this study was to estimate the coverage effectiveness of the Tox-Info system by comparing the toxic substances included in the database with the distribution of the toxic substances implicated in the cases of intoxicated patients presenting to emergency departments. The secondary aim of the study was to propose any additional substances that should be added to the database. METHODS: We retrospectively reviewed the medical records of patients suffering with toxic exposure who had visited any of 12 selected emergency departments in Korea from January 2010 to December 2011. The identified toxic substances were classified into groups including prescription drugs, agricultural chemicals, household products, animals or plants, herbal drugs, and others. We calculated the coverage rate of the Tox-Info database relative to the number of intoxication cases and the type of toxic substances involved. RESULTS: A total of 5,840 intoxicated patient records were collected. Their mean age was 46.6+/-20.5 years and 56.2% were female. Of the total intoxication cases, 87.8% of the identified toxic substances were included in the Tox-Info database, while only 41.6% of all of the types of identified toxic substances were included. Broken down by category, 122 prescription drugs, 15 agricultural chemicals, 12 household products, 14 animals or plants and 2 herbal drugs involved in poisoning cases were not included in the Tox-info database. CONCLUSION: This study demonstrated the clinical usefulness of the Tox-Info system. While 87.8% of the substances involved in the cases were included in the Tox-Info database, the database should be continuously updated in order to include even the most uncommon toxic substances.
Agrochemicals ; Animals ; Emergencies ; Female ; Household Products ; Humans ; Korea ; Medical Records ; Prescription Drugs ; Retrospective Studies ; Stress, Psychological

PURPOSE: Incidents of suicide attempt and acute poisoning in the elderly population is rising. This study investigated the clinical nature of acute poisoning and differences between the survival and mortality groups in the elderly. METHODS: We retrospectively investigated 325 patients with acute poisoning who visited the emergency department. Patients were divided into two groups, one survival and one death group. Information regarding patient sex, age, root cause of poisoning, time of year of poisoning, type of intoxicant, duration of time between intoxicant ingestion and arrival at the emergency department, total length of hospital stay, and any previous suicide attempts and subsequent hospitalization were collected. An initial Glasgow Coma Scale (GCS) and an initial and final Poison Severity Score (PSS) for each patient was calculated. RESULTS: The survival rate for men was higher than for women in this study. The most common reason of drug intoxication was suicide, with accidental ingestion and substance abuse occurring in descending frequency. Seasonal factors were reflected in the data with the highest number of incidents occurring in spring and the lowest number in winter. Compared with the mortality group, the survival group had a lower initial PSS with a higher GCS. CONCLUSION: We conclude that being female, having suicide as a root cause, agrochemicals as an intoxicant, low initial Glasgow Coma Scale and high initial Poisoning Severity Score, are all associated with poor prognosis.
Aged ; Agrochemicals ; Eating ; Emergencies ; Female ; Geriatrics ; Glasgow Coma Scale ; Hospitalization ; Humans ; Length of Stay ; Male ; Prognosis ; Retrospective Studies ; Seasons ; Substance-Related Disorders ; Suicide ; Survival Rate