Organophosphorus (OP) poisoning: Unwanted suicidal deaths to human civilization

Organophosphorus (OP) poisoning: Unwanted suicidal deaths to human civilization

Organophosphorus (OP) is a pesticide compound that controls pests in agriculture fields. China, The United States of America, Brazil, The European Union, and India are the topmost countries to use pesticides in their crops.

Organophosphorus (OP) poisoning for self-harm has become more prevalent nowadays, with a total of 27% to 30% of suicidal deaths reported due to organophosphorus poisoning according to a Journal of BMC Public Health 2007.

What reason can be responsible for OP poisoning?

In 2019, Nepal presented an organophosphorus suicidal death case where the patient was suffering from psychiatric disorders like Bipolar Disorder and Depression. A study in Dhaka Medical College, Bangladesh claimed that most people took suicidal attempts in Bangladesh due to poverty. People related to the agriculture business have more access to OP poisons; domestic violence, relationship imbalance, over-expectation, lack of family bonding, and depression are some dominant causes of organophosphorus suicidal attempts among people.

How does the Organophosphorus compound kill people?

Discussing about the mechanism of action of organophosphorus, these compounds are lipid soluble and easily can cross the Blood Brain Barrier (BBB) and works by inhibiting Acetylcholinesterase (AchE) in humans. AchE is an enzyme that is responsible for breaking down Acetylcholine (Ach) into Acetyl and Choline. Acetylcholine is mainly a neurotransmitter that is responsible for transferring signals to neuron to neuron and controls our nervous system. By blocking AchE, a large amount of Acetylcholine accumulated in our synaptic cleft which possessed three types of effects.

  1. Muscarinic Effect
    • Miosis or onstriction of pupils
    • Bronchorrhea or discharge of excessive watery mucus from lungs
    • Salivation
    • Lacrimation
    • Abdominal pain
    • Bradycardia or decrease of heart rates
    • Urination
    • Defecation
  2. Nicotinic Effect
    • Muscle cramps
    • Seizure
    • Hypertension or high blood pressure
    • Decreased tendon reflex or decrease at the peripheral nerve or root level
  3. Effects on Central Nervous System (CNS)
    • Respiratory depression
    • Comma

Most of the people dies by respiratory failure in organophosphorus poisoning. Victim can experience another life threatening events like Intermediate syndrome which can be occur 2-4 days after acute cholinergic toxicity and might require ventilation and intubation support for the patients.

Is there any treatment for OP poisoning?

The universal approved antidote for organophosphorus poisoning in Atropine. Atropine is a tropane alkaloid compound that is obtained from the plant Atropa belladonna and other plants of the family of Solanaceae. Atropine works by blocking Acetylcholine (Ach) which accumulated largely at synaptic cleft due to OP poisoning. OP directly blocks Acetylcholinesterase (AchE) enzyme, another medication named Pralidoxime which binds with OP and release AchE enzyme. After getting released, AchE enzyme starts to break down Acetylcholine again into Acetate and choline. Thus how a OP patient started recovering.

Conclusion

Pesticide poisoning nowadays became a major concern worldwide. Here, we discussed about suicidal poisoning but most of the patient also suffers from accidental poisoning by inhalation of Organophosphorus compound. Proper measurement should be taken in that case during handling this pesticide. Analyzing the fatal effects, the European Union and United Kingdom banned Organophosphorus compounds. The most used OP pesticide called “Chlorpyrifos” is also banned by the U.S. Environmental Protection Agency (EPA) at 2021 from using on any foods.

Pharmacologist I Researcher Research Coordinator Working site: Rajshahi Medical College Hospital, Rajshahi, Bangladesh Toxicology Society of Bangladesh