Hydrogen cyanamide exposure: a case series from Pavia Poison Control Centre

Area of Science:

• Toxicology
• Environmental Health
• Agricultural Science

Background:

• Hydrogen cyanamide (HC) is a plant growth regulator previously marketed as Dormex.
• HC was withdrawn from the Italian market in 2008 and is not authorized in Europe.
• Exposure to HC can cause severe health effects, including irritation, burns, organ damage, and a disulfiram-like reaction with alcohol.

Purpose of the Study:

• To analyze all cases of hydrogen cyanamide exposure reported to a Poison Control Centre.
• To evaluate the temporal and geographic distribution of these exposures.
• To investigate the clinical manifestations, including those associated with alcohol consumption.

Main Methods:

• Retrospective analysis of hydrogen cyanamide exposures from January 2007 to December 2021.
• Data collected included demographics, exposure route, year, location, intent, alcohol co-ingestion, Poison Severity Score, signs/symptoms, and treatment.
• Thirty subjects were included in the study.

Main Results:

• Most exposures (79%) occurred after market withdrawal, predominantly in Sicily (92%).
• All exposures were unintentional and work-related; 41% involved alcohol co-ingestion.
• Common symptoms included flushing, erythema, dyspnea, nausea, vomiting, and burns; all patients recovered with symptomatic treatment.

Conclusions:

• Hydrogen cyanamide exposure can cause severe clinical effects.
• Despite its withdrawal, illegal use persists, necessitating efforts to combat trade and raise awareness of HC toxicity.
• Poison Control Centres play a vital role in monitoring agricultural product exposures.