Insecticide poisoning: MedlinePlus Medical Encyclopedia

P Insecticide is a chemical that kills bugs. Insecticide poisoning occurs when someone swallows or breathes in this substance or it is absorbed through the skin.
P This article is for information only. Do NOT use it to treat or manage an actual poison exposure. If you or someone you are with has an exposure, call your local emergency number (such as 911), or your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

T Poisonous Ingredient
P Most household bug sprays contain chemicals called pyrethrins. These chemicals are generally not harmful. But, they can cause life-threatening breathing problems if they are breathed in.
P Stronger insecticides, which a commercial greenhouse might use or someone might store in their garage, contain many dangerous substances. These include:
- Carbamates
- Organophosphates
- Paradichlorobenzenes (mothballs)

T Where Found
P Various insecticides contain these chemicals.

T Symptoms
P Below are symptoms of insecticide poisoning in different parts of the body.
P Symptoms of pyrethrin poisoning:
P LUNGS AND AIRWAYS
- Breathing difficulty
P NERVOUS SYSTEM
- Coma (decreased level of consciousness and lack of responsiveness)
- Convulsions
P SKIN
- Irritation
- Redness or swelling
P Symptoms of organophosphate or carbamate poisoning:
P HEART AND BLOOD
- Slow heart rate
P LUNGS AND AIRWAYS
- Breathing difficulty
- Wheezing
P NERVOUS SYSTEM
- Anxiety
- Coma (decreased level of consciousness and lack of responsiveness)
- Convulsions
- Dizziness
- Headache
- Weakness
P BLADDER AND KIDNEYS
- Increased urination
P EYES, EARS, NOSE, AND THROAT
- Drooling from increased saliva
- Increased tears in the eyes
- Small pupils
P STOMACH AND INTESTINES
- Abdominal cramps
- Diarrhea
- Loss of appetite
- Nausea
- Vomiting
P SKIN
- Blue-colored lips and fingernails
P Note: Serious poisoning can occur if an organophosphate gets on your bare skin or if you don't wash your skin soon after it gets on you. Large amounts of the chemical soak through the skin unless you are protected. Life-threatening paralysis and death can occur very quickly.
P Symptoms of paradichlorobenzene poisoning:
P STOMACH AND INTESTINES
- Diarrhea
- Abdominal pain
- Nausea
- Vomiting
P MUSCLES
- Muscle spasms
P Note: Paradichlorobenzene mothballs are not very toxic. They have replaced the more toxic camphor and naphthalene types.

T Home Care
P Get medical help right away. Do NOT make the person throw up unless poison control or a health care provider tells you to.
P If the chemical is on the skin or in the eyes, flush with lots of water for at least 15 minutes.
P If the person breathed in the poison, move them to fresh air right away.

T Before Calling Emergency
P Have this information ready:
- Person's age, weight, and condition
- Name of the product (ingredients and strength, if known)
- Time it was swallowed
- Amount swallowed

T Poison Control
P Your local poison center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
P This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

T What to Expect at the Emergency Room
P Take the container with you to the hospital, if possible.
P The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated.
P The person may receive:
- Activated charcoal
- Breathing support, including tube through the mouth into the lungs, and breathing machine (ventilator)
- Bronchoscopy: camera down the throat to see burns in the airways and lungs
- Chest x-ray
- EKG (electrocardiogram), or heart tracing
- Endoscopy: camera down the throat to see burns in the esophagus and the stomach
- Fluids by IV (through a vein)
- Medicine called an antidote to reverse the effect of the poison
- Tube through the mouth into the stomach to empty the stomach (gastric lavage)
- Surgery to remove burned skin
- Washing of the skin (irrigation), perhaps every few hours for several days

T Outlook (Prognosis)
P How well someone does depends on how severe their poisoning is and how quickly they receive treatment. The faster medical help is given, the better the chance for recovery. Swallowing these poisons can have severe effects on many parts of the body.
P It is a good sign that recovery will occur if the person continues to improve in the first 4 to 6 hours after they receive treatment.
P Although the symptoms are the same for carbamate and organophosphate poisoning, it is harder to recover after organophosphate poisoning.

T Alternative Names
P Organophosphate poisoning; Carbamate poisoning

T References
P Aaron CK. Organophosphates and carbamates. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 76.
P Borron SW. Pyrethins, repellants, and other pesticides. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, PA: Elsevier Saunders; 2007:chap 77.
P Cannon RD, Ruha A-M. Insecticides, herbicides, and rodenticides. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 146.
P Rhe JW. Pesticides. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 163.
P Zosel AE. General approach to the poisoned patient. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 143.

T Review Date 11/4/2015
P Updated by: Jesse Borke, MD, FACEP, FAAEM, Attending Physician at FDR Medical Services/Millard Fillmore Suburban Hospital, Buffalo, NY. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

