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American Journal of Emergency Medicine

American Journal of Emergency Medicine

IF: 2.7
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Assessment of glufosinate-containing herbicide exposure: A multi-center retrospective study

Published:1 December 2021 DOI: 10.1016/j.ajem.2021.08.017 PMID: 34392143
Jen-Tso Hsiao MD , Hsiu-Yung Pan MD , Chia-Te Kung MD , Fu-Jen Cheng PhD , Po-Chun Chuang MD

Abstract

Background

Exposure to glufosinate ammonium, an herbicide used worldwide, can cause CNS and respiratory toxicities. This study aimed to analyze acute human glufosinate ammonium poisoning.

Materials and methods

This multicenter retrospective cohort study involved five medical institutes affiliated with the Chang Gung Memorial Hospital system. Patients with glufosinate ammonium exposure visiting the emergency department (ED) between January 2008 and December 2020 were included.

Results

In total, 95 patients were enrolled. Compared to exposure via the non-oral route, patients exposed orally (n = 61) had lower GCS scores, higher mortality rates, and longer hospital lengths of stay (P-value: <0.001, 0.002, and < 0.001, respectively). In the subgroup analysis among oral exposure patients, the survival group had a lower amount of estimated glufosinate ingestion than the non-survival group (10.5 [3.4–27] vs. 40.5 [27–47.3] g, P-value: 0.022), lower rate of substance co-exposure (9 [19.6%] vs. 10 [66.7%] P-value: 0.001), and lower rate of paraquat co-exposure (0 [0%] vs. 7 [46.7%] P < 0.001) compared with the mortality group. In the orally-exposed and non-paraquat co-exposure patients (n = 54), age > 70 years and GCS score < 9 at triage presented a high sensitivity (100.00%, 95% CI: 63.06–100.00%) and medium specificity (58.70%, 95% CI: 43.23–73.00%) in predicting mortality.

Conclusion

Old age, change in consciousness, and paraquat co-exposure were associated with higher mortality in human glufosinate poisoning. Age > 70 years and GCS score < 9 at triage could be predictors of mortality in patients with acute oral glufosinate poisoning.

Substances (2)

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Procduct Name CAS Molecular Formula Supplier Price
Glufosinate-ammonium 77182-82-2 C5H18N3O4P 370 suppliers $8.00-$1137.79
Paraquat 4685-14-7 C12H14N2+2 84 suppliers Inquiry

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