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BMJ Case Rep

Title:		Thiamethoxam intoxication due to occupational inhalational exposure
Author(s):		Nishizawa T; Ikenaka Y; Ichikawa G; Taguchi T;
Address:		"Department of General Internal Medicine, St. Luke's International Hospital, Tokyo, Japan nishizawa.toshinori@gmail.com. Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan. Translational Research Unit, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan. Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan. Department of Pediatrics, Ustunomiya Cerebrospinal Center, Utsunomiya City, Japan. Department of Community Based Medicine, Fujita Health University, Toyoake, Japan. Department of General Internal Medicine, Toyota Regional Medical Center, Toyota, Japan"
Journal Title:		BMJ Case Rep
Year:		2022
Volume:		20221129
Issue:		11
Page Number:		-
DOI:		10.1136/bcr-2022-251110
ISSN/ISBN:		1757-790X (Electronic) 1757-790X (Linking)
Abstract:		"Neonicotinoid is a new class of systemic insecticides that are selectively toxic to insects. However, cases of human toxicity have been reported. A man in his 60s, who worked as a pest control operator (which required the use of thiamethoxam), presented with fever and headache. We investigated the levels of thiamethoxam and clothianidin in the blood and urine. Our results suggested that chronic thiamethoxam intoxication was caused by occupational inhalation exposure and environmental pollution. After cessation of insecticide use, the patient remained asymptomatic but had persistent oral dysesthesia and postural finger tremor, even at undetectable levels of thiamethoxam and clothianidin. This case report is the first to describe human thiamethoxam intoxication after occupational inhalation exposure. When similar symptoms are encountered and a history of insecticide use is confirmed, clinicians should consider the diagnosis of neonicotinoid intoxication"
Keywords:		Male Humans *Inhalation Exposure Thiamethoxam *Insecticides Neonicotinoids Exposures General practice / family medicine Occupational and environmental medicine;
Notes:		"MedlineNishizawa, Toshinori Ikenaka, Yoshinori Ichikawa, Go Taguchi, Tomohiro eng Case Reports England 2022/11/30 BMJ Case Rep. 2022 Nov 29; 15(11):e251110. doi: 10.1136/bcr-2022-251110"