toxicants in play_miniresearch

8/8/2019 Toxicants in Play_miniresearch

1/50

Contacto, Dela Cruz, Dumduma, Gabo, Gonzaga, Ignacio, Rivera,Sabili, Yang

Toxicants in Play


2/50

Background of the Study

In 2004, the top five causes of death in low-income countries were pneumonia, followed byheart disease, diarrhea, HIV/AIDS and stroke

Due to the expected economic growth in low and

middle-income countries, globally by 2030, thefour leading causes of death are predicted to beischemic heart disease, cerebrovasculardiseases, COPD, and lower respiratory

infections. Environmental exposures contribute significantly

to these diseases

Identifying the various toxicants in the

environment is the first step in addressing theexpected prevalence of diseases in the years to


3/50

Statement of the Problem

This study attempts to investigate thepossible toxicities arising from theexposure to the playground toxicants. Indoing so, the researchers will be able tovalidate the presence of thehypothesized toxicant in the area.

Specifically, it aims to answer thefollowing: Are the pre-identified toxicants present in

the playground?

Do the visitors and employees of theplayground show signs of toxicity from


4/50

Hypotheses

Ha: The visitors and employees of the

Childrens Playground show signs oftoxicities from the playground toxicants.

Ho: The visitors and employees of the

Childrens Playground do not show signs

of toxicities from the playgroundtoxicants.


5/50

Significance of the Study

The results of this study will be of greatimportance to the creation of preventivemeasures to protect the public from theharmful effects of toxicants found in the

area.Not only will the information generated from

this study be important in the treatment ofthe presently prevailing diseases but also

in the early diagnosis of the patients whohad been exposed to the toxicants in thearea.

Furthermore, this study may also arouse the

concern of the government to look moreclosely into the kind of environment that


6/50

Scope and Delimitations

The results of this study will only beapplicable to the area where weconducted our research, the National

Park Development Committee:Childrens Playground in T.M. Kalaw St.,Ermita, Manila.

The questions that were asked in the

survey/ interview were based from thesigns and symptoms of the toxicantspre-identified by the toxicologystudents.

This stud will not deal will the


7/50

Of the Toxicants

Theoretical Background


8/50

Organophosphates- the pesticide/nerve gas

Mechanism of ToxicityOrganophosphate derivatives act by

combining with and inactivating the

enzyme acetylcholinesterase (AChE).This inactivation is irreversible resultingto accumulation of large amounts ofacetylcholine that will result to acholinergic crisis. It is to note thatorganophosphate combination with theenzyme will undergo aging within a fewminutes to some hours. This aging stageremoves one Phosphorus-oxygen bond

that makes the enzyme-OP bond


9/50

Organophosphates

Cardinal Signs and SymptomsVisual disturbances

Respiratory difficulty

Urinary incontinence

AntidotesAtropine

Pralidoxime


10/50

Carbamates- the carbamateinsecticide

Mechanism of ToxicityCarbamate poisoning will result to a

similar mechanism with that of

organophosphates. They combine andinactivate the acetylcholinesteraseenzyme which will lead to accumulationof acetylcholine leading to cholinergiccrisis. However this is reversible sincethe strength of the enzyme OC bond isweaker than the enzyme-OP bond andaging does not occur.


11/50

Carbamates

Cardinal Signs and SymptomsSame symptoms as ORGANOPHOSPHATES

Extensive tearing

Excessive weaknessDizziness

AntidotesAtropine


12/50

Pyrethrum- the Chrysanthemumorganic insecticide

Mechanism of ToxicityBinds to sodium channels, which cause

the delay in sodium channel closing, i.e.,prolonged sodium inactivation. These

substances exhibit a negative afterpotential, indicating that the axon doesnot readily recover to its resting stage.

These substances also cause repetitive

discharges of axonal action potentials inresponse to a single stimulus. Therefore,it can be readily excited again. Theexcessive neuroexcitation caused bythese substances results in

hyperactivity, tremors, and rigidaral sis.


13/50

Pyrethrum

Cardinal Signs and Symptoms Hypersensitivity reactions may occur. In the

skin, the usual lesion is a mild erythematousdermatitis with vesicles, intense puritis and

a bullous dermatitis.

Antidotes

Hypersensitivity reactions should be treatedwith antihistamines, corticosteriods, andbronchodilators

Anaphylaxis may require adrenaline

Contact dermatitis can be treated usinglocal corticosteroids.


14/50

Sodium Monofluoroacetate-pesticide, thecoyote killer

Mechanism of ToxicityFluoroacetate disrupts the citric acid cycle

(also known as the Krebs cycle) by

combining with coenzyme A to formfluoroacetyl CoA, which reacts withcitrate synthase to produce fluorocitrate.A metabolite of fluorocitrate binds verytightly to aconitase, thereby halting thecitric acid cycle. This inhibition results inan accumulation of citrate in the bloodwhich deprives cells of energy.


15/50

Sodium Monofluoroacetate

Cardinal Signs and SymptomsExcitability

Hyperactivity

Convulsions

AntidotesMonoacetin


16/50

Hypochlorite- the swimming pooldisinfectant

Mechanism of Toxicity Intoxications with chlorate salts are

characterized by methemoglobin

formation, hemolysis and renalinsufficiency. It causes a biosyntheticalteration in cellular metabolism and aphospholipid destruction, a formation ofchloramines which interferes in cellularmetabolism, an oxidative action withirreversible enzymatic inactivation inbacteria, and a lipid and fatty aciddegradation


17/50

Hypochlorite

Cardinal Signs and SymptomsEye and throat irritation

AntidotesSodium thiosulfate


18/50

Camphor- rust protectant, the mothrepellant

Mechanism of ToxicityCamphor specifically inhibits

catecholamine secretion by blocking ACh

without affecting agonist binding Camphor causes convulsions by stimulatingthe cells of the cerebral cortex.


19/50

Camphor

Cardinal Signs and SymptomsVertigo

Hallucinations

Convulsions

AntidotesControl convulsions with diazepam


20/50

Fluorides- insecticide the antkiller

Mechanism of ToxicityFluoride binds to calcium and magnesium,

causing hypocalcemia andhypomagnesemia.

Fluoride disrupts many intracellularmechanisms, including glycolysis, G-protein mediated signalling, oxidativephosphorylation, adenosine triphosphate(ATP) production, function of NA/K-ATPase, & potassium channels.


21/50

Fluorides

Cardinal Signs and SymptomsMinor overexposure in children under age

10 can cause tooth mottling

High chronic overexposure can causefluorosis white specks or black/ brown stains on teeth

AntidotesHypercalcemia- IV Calcium Gluconate

Hypomagnesemia- IV Magnesium sulfate


22/50

Sulfites- toxicant in bottled water

Mechanism of Toxicity Ingestion of food containing sulfating

agents can result in Type 1 immediatehypersensitivity reactions in normal,non- asthmatic individuals

Reactions have occurred without evidencefor IgE- mediated mechanisms inasthmatics


23/50

Sulfites

Cardinal Signs and SymptomsBeefy red skin rash, most often affecting

palms, soles, buttocks, and scrotum

characteristic smell of rotten eggs in themouth

Treatment If renal failure occurs, hemodialysis may

be necessary to sustain fluid balanceand normal extracellular fluidcomposition


24/50

Diquat- the aquatic herbicide

Mechanism of toxicityThe mechanism of poisoning has not been

fully elucidated, but it is believed toinvolve inhibition of superoxidedismutase in the lungs, making the lungsparticularly susceptible to oxygentoxicity.


25/50

Diquat

Cardinal Signs and SymptomsRespiratory irritation

Lung injury

AntidotesGastrointestinal decontamination using

bentonite (7.5% suspension), Fullers

Earth (15% suspension), and activatedcharcoal

h i


26/50

Strychnine-pesticide thebitter killer

Mechanism of ToxicityStrychnine is a competitive antagonist of

the inhibitory neurotransmitter glycine atreceptors in the spinal cord, brain stemand higher centers. It results inincreased neuronal activity andexcitability, leading to increasedmuscular activity.


27/50

Strychnine

Cardinal Signs and SymptomsConvulsionsUncontrollable arching of neck and backjaw tightness

TreatmentTreatment consists of removing the drug from

the body (decontamination) and gettingsupportive medical care in a hospital setting

Supportive care includes intravenous fluids(fluids injected directly into a vein),medications for convulsions and spasms,and cooling measures for high temperature


28/50

Organochlorines- the insecticideDDT

Mechanism of ToxicityToxicity in humans is largely due to

stimulation of the central nervoussystem. The organochlorines disturb the

neuronal membrane causinghyperexcitability of the nervous system.Specifically, cyclodienes,hexachlorocyclohexanes, and toxapheneorganochlorines inhibit GABA-mediatedchloride influx in the CNS, while DDTaffects potassium and voltage-dependent sodium channels. Thesechanges can result in agitation,

confusion, and seizures. Cardiac effectshave been attributed to sensitization of


29/50

Organochlorines

Cardinal Signs and SymptomsHeadache, dizziness, nausea and vomitingKidney and Liver failure

TreatmentDermal decontaminationGI decontamination- Cholestyramine may

be used alternatively to bind thesehighly lipophilic agents. It reducesreabsorption and retains bound agent inthe GI tract for fecal elimination.

li id


30/50

Oxalic Acid- the pulpwoodbleach

Mechanism of ToxicityOxalates combines with serum calcium to

form an insoluble calcium oxalate. Thiswill lead to a decrease in the bloodcalcium (Ca+2 )level leading to violentmuscular stimulation with convulsionsand collapse.


31/50

Oxalic Acid

Cardinal Signs and symptomsAnuria

Cyanosis

Slow healing ulcers

Antidotesprecipitate oxalate by giving calcium orally

P t i B t h


32/50

Potassium Bromate- thedye

Mechanism of ToxicityOn contact with acids, such as gastric

hydrochloric acid, potassium bromatereleases hydrogen bromate, which isan irritating acid.


33/50

Potassium Bromate

Cardinal Signs and symptomsCyanosis

Vomiting and collapse

AntidotesSodium thiosulfate


34/50

Sodium Perborate- in cleaningproducts & bleaches

Mechanism of toxicity It appears that boron has a special affinity

for the central nervous system, liver andbody fat


35/50

Sodium Perborate

Cardinal signs and symptomsBoiled lobster appearance, erythematous

and exfoliative rash

Anemia

AntidotesSkin Decontamination- wash skin with

soap and waterGI Decontamination- Remove poison by

ipecac emesis followed by activatedcharcoal


36/50

Methodology


37/50

The Research Area

NationalParkDevelopmentCommittee: ChildrensPlaygroundat T.M.Kalaw St.,Ermita,Manila.


38/50

Interview Questionnaire

The questions that were asked were basedon the signs and symptoms of thetoxicants pre-identified by the researchers.

The questions were designed in such a waythat will validate the exposure to thepossible toxicants.

Based on the number of positive responses

to each question, the researchers will beable to identify if the respondents wereindeed suffering from intoxication due toexposure to the toxicants.

Twenty nine respondents were interviewed,


39/50

Interpretation and Analysis ofResults


40/50

Pre- identified Toxicants

Question No. Type of Toxicant Signs and Symptoms

1 Organophosphates Urinary incontinence, confusion, anxiety

2 Carbamates Extensive tearing, excessive weakness, dizziness

3 Pyrethrum Severe dermatitis

4 Na monofluoroacetate Hyperactivity, convulsions

5 Hypochlorite Eye and throat irritation

6 Camphor Vertigo, hallucinations

7 Fluorides Fluorosis, white specks or black/ brown specks on teeth

8 Sulfites Beefy red skin rash, most often affecting palms, soles, buttocks, and scrotum;characteristic smell of rotten eggs in the mouth

9 Diquat Lung damage

10 Strychnine Uncontrollable arching of neck and back, jaw tightness

11 Organochlorines Liver and kidney failure

12 Oxalic Acid Slow healing ulcers

13 Potassium Bromate Cyanosis

14 Sodium Perborate Peeling of the skin particularly in the palm, soles or buttocks

15 Sodium Perborate Anemia


41/50

Survey Results


42/50

Interpretation

The data gathered from the survey show that majority ofthe respondents do not exhibit any signs or symptoms of

toxicity from the pre-identified toxicants. On the otherhand, a significant number of respondents responded

positive to the survey questions

59% of the respondents said that they experienceeye and throat irritation, a sign of hypochloritepoisoning

Poisoning with strychnine was also prevalent, signs

of which were uncontrollable arching of neck andback accompanied by tightness of the jaw, whichreceived 52% positive response

41% of the respondents said that they experienceextensive tearing, excessive weakness and

dizziness which are signs of carbamate toxicity and


43/50

Interpretation

The responses from other toxicants were notas significant as that with hypochlorite,

strychnine, carbamates and sodium perborate

38% of the respondents showed signs ofpyrethrum toxicity

34% of the respondents showed signs of toxicitywith camphor

31% of the respondents showed signs of toxicity

with fluorides21% of the respondents showed signs of toxicity

with organophosphates, sodiummonofluoroacetate and sulphites

7% of the respondents showed signs of toxicity

with diquat, organochlorines and oxalic acid


44/50

Respondents Predisposed to Other Types ofToxicants


45/50

Interpretation

The respondents were also asked abouttheir vices in order to determinewhether they were also predisposed to

intoxication with other agents asidefrom the pre-identified poisons

The results of the survey show that

majority of the respondents wereneither alcoholics nor smokers


46/50

Discussion of Results


47/50

Discussion

As observed from the gathered data at theNational Park Development Committee:Childrens Playground at T.M. Kalaw St.,Ermita, Manila, the possible toxicants thatare present in the area are hypochlorites,strychnine, carbamates, and sodiumperborate. Due to the escalation ofpesticide use, the uncontrolled applicationof various cleaning agents, and theirinappropriate storage and disposal, visitorswho often go to the playground and staythere for a long period of time with theirfamilies or friends become exposed toacute toxicities of these agents. Employeeswho take care of the said area are moreexposed, since they are the ones utilizing


48/50

In the study, considerable toxicity(greater than 40%) has been seen in theemployees of the park and on some ofthe perennial visitors. Eye and throat

irritation, excessive tearing andweakness, and peeling of the skin in thepalm, soles or buttocks are some of thesigns and symptoms experienced by the

workers and visitors interviewed. Thereare also other signs of toxicities found inthe area but they are not as prevalentas the four mentioned above.


49/50


50/50

Proper use, handling and disposal of theseagents should be implemented strictly byadministrations of different recreationalparks for the health safety of the general

public visiting these places. Employeesshould be well-informed or properlyeducated on these chemicals, and howthese would affect the public health. Theyalso have to ensure easy access to firstaids on these chemicals (if applicable), incase acute poisoning from these chemicalsoccurs. Substitution to other cleaningalternatives that incur less or no toxicity

toxicants in play_miniresearch

Documents