An analysis of 190 cases of suspected pesticide illness

The diagnosis of mild to moderate pesticide exposure presents a challenge because the signs and symptoms of exposure are similar to those of many other diseases. We reviewed all alleged pesticide injuries seen in a single office during a 6-year period to determine which findings were useful in discriminating between a pesticide-related illness and other causes.

We reviewed retrospectively the charts of 190 patients alleging pesticide illness who were treated in a standardized manner.

One hundred sixteen (116) patients (61.1 percent) were found to have pesticide illness. Important predictors of pesticide illness were anxiety, vertigo, nausea, vomiting, tearing, and weakness. Seventy-four patients (38.9 percent) were found to have nonpesticide-related illness, with nonspecific irritant contact dermatitis and scabies the most common diagnoses. Rash was the only significant predictor of nonpesticide related illness.

It is difficult to relate signs and symptoms to pesticide poisoning, and exposure history is very important. Alternative diagnoses need to be considered. Laboratory tests are not nearly as valuable as many might expect, and skin rash is not a common finding in mild to moderate pesticide poisoning.