38-29: Chlorinated Insecticides Posioning

Lindane (Kwell) and other chlorinated insecticides (chlorophenothane [DDT], lindane, toxaphene, chlordane, aldrin, endrin) are central nervous system stimulants that can cause poisoning by ingestion, inhalation, or direct contact. Most of these agents have been removed from the United States market because of their acute toxicity and their potential to accumulate in the food chain. The estimated lethal dose is about 20 g for DDT, 3 g for lindane, 2 g for toxaphene, 1 g for chlordane, and less than 1 g for endrin and aldrin. The manifestations of poisoning are nervous irritability, muscle twitching, seizures, and coma. Arrhythmias may occur. Liver and kidney damage are reported.

TREATMENT

Give activated charcoal and consider gastric lavage for large recent ingestions. Repeat-dose activated charcoal may be effective for large ingestions. For seizures, give diazepam, 5–10 mg slowly intravenously, or other anticonvulsants as described under Seizure, above.

Perform thorough decontamination of exposed areas with repeated soap and shampoo washing. Personnel caring for such patients must wear protective clothing and gloves, since cutaneous absorption may occur through normal skin.