Clinical profile of patients presenting with inhalational organophosphorus poisoning in central India: a retrospective study

Sachin Divekar, Sandeep M. Bhelkar, Prabhakar Hiwarkar, Monika Masare


Background: World Health Organisation (WHO) report through International Programme on Chemical Safety (IPCS), poisoning is a significant global public health problem. According to WHO data, in 2012 an estimated 193,460 people died worldwide from unintentional poisoning. Intentional and unintentional pesticide poisoning has been acknowledged as a serious problem in many countries, including India, Limited literature available on clinical profile of organophosphorus poisoning cases, with this background present study was attempted. Objective of the study was to know the clinical presentation of OP poisoning cases admitted in tertiary care hospital.

Methods: A retrospective record based observational study was conducted.

Results: A total of 535 patients presented in the emergency department with the clinical features of OP poisoning. Mean age of the persons presenting in the emergency was 33.3±10.1 years. Nausea and vomiting is the most commoner symptom reported by 60.7% of patients followed by giddinesss (41.3%), loose motion (28.2%) and secretions (9.5%). Signs like abnormal pupil size, fasciculations and inability to neck holding were common with 23.55% 19.3% and 21.1% respectively. Statistical significance was found between Serum acetylcholine esterase level and outcome of patients (p<0.01). 96.1% received treatment less than half an hours. 18 patients required ventilator and among these 13 were died.

Conclusions: Majority of the patients were of young age with males outnumbering females. Nausea and vomiting was the most common symptom reported by the patients while abnormal pupil size was the most common sign observed at the emergency department.


Clinical profile, Farmers, Inhalational, Organophosphorus poisoning, Outcome

Full Text:



World Health Organization. Poisoning prevention and management. 2016.

Batra AK, Keoliya AN, Jadhav GU. Poisoning : an unnatural cause of morbidity and mortality in rural India. J Asso Physicians India. 2003;51:955-9.

Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health. 2007;7(237):1-15.

Jaiprakash H, Sarala N, Venkatarathnamma PN, Kumar TN. Analysis of different types of poisoning in a tertiary care hospital in rural South India. Food Chem Toxicol. 2011;49(1):248-50.

Vinay SB, Gurudatta PS. Profile of poisoning cases in district and medical college hospitals of north Karnataka. Indian J Forensic Med Toxicol. 2008;2(2):26-8.

Chiddarwar VA, Chiddarwar VV, Jain JM, Kumar S, Singhania SS. Study of clinical profile of household and agricultural insecticide poisoning patients with reference to serum cholinesterase levels. Int J Pharma Bio Sci. 2013;4(1):781-8.

Suliman MI, Jibran R, Rai M. The analysis of organophosphates poisoning cases treated at Bahawal Victoria Hospital, Bahawalpur in 2000-2003. Pakistan J Med Sci. 2006;22(3):244-9.

Srivastava A, Peshin SS, Kaleekal T, Gupta SK. An epidemiological study of poisoning cases reported to the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi. Human Experim Toxicol. 2005;24(6):279-85.

Banerjee I, Tripathi SK, Roy AS. Clinico-epidemiological characteristics of patients presenting with organophosphorus poisoning. North Am J Med Sci. 2012;4(3):147-50.

Reddy DN. Pesticide poisonings in Yavatmal district in Maharashtra : untold realities. Pesticide Action Network India. 2017:1-57.

Selvaraj T, Sudharson T. Demographic and clinical profile of organophosphorus poisoning cases in a medical college hospital, Tamil Nadu. Indian J Forensic Community Med. 2016;3(2):124.

Edwin G, Manjaly J, John J. Clinical profile and outcome of organophosphate poisoning cases in a tertiary care hospital in central Kerala. Int J Recent Trends Sci Techn. 2015;14(2):338-43.

Raddi D, Anikethana GV. Clinical profile of organophosphorus poisoning in a tertiary care hospital. Indian J Basic Applied Med Res. 2014;4(1):14-22.

Padmanabha TS, Gumma K, Kulkarni GP. Study of profile of organophosphorus poisoning cases in a tertiary care hospital, North Karnataka, Bidar, India. Int J Pharma Bio Sci. 2014;5(1):332-9.

Joshi SC, Prakash C, Joshi A, Joshi G. Profile of organophosphorus poisoning at tertiary care hospital in Uttarakhand. J Indian Academy Forensic Med. 2013;35(4):346-8.

Thunga G, Ganna SK, Khera K, Pandey S, Vidya SS. Evaluation of incidence, clinical characteristics and management in organophosphorus poisoning patients in a tertiary care hospital. J Toxicol Environment Health Sci. 2010;2(5):73-6.

Marahatta SB, Singh J, Shrestha R, Koju R. Poisoning cases attending emergency department in Dhulikhel Hospital Kathmandu University Teaching Hospital. Kathmandu Uni Med J. 2009;7(26):461-9.

Patel DJ, Tekade PR. Profile of organophosphorus poisoning at Maharani Hospital, Jagdalpur, Chhattisgarh: a three years study. J Indian Academy Forensic Med. 2011;33(2):102-5.

Gannur DG, Prakash RKN. Organophosphorus compound poisoning in Gulbarga region a five year study. J Forensic Med Toxicol. 2008;2(1):3-11.

Chataut J, Adhikari NP, Sinha SB. Pattern of organophosphorous poisoning : a retrospective community based study. Kathmandu Uni Med J. 2011;9(34):31-4.

Shah N, Mundhra S. Clinical profile of organophosphate poisoning at a tertiary-care center. Int J Med Sci Public Health. 2016;5(8):1621-5.

Shetti AN, Bhumika R, Singla B, Mustilwar RG. Correlation of serum acetylcholinesterase with the ventilation need, ICU stay and outcome in organophosphorus poisoning: a retrospective study. Anaesthesia Pain Intensive Care. 2017;21(2):199-203.

Goswamy R, Chaudhuri A, Mahashur AA. Study of respiratory failure in organophosphate and carbamate poisoning heart and lung. J Crit Care. 1994;23(6):466-72.