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Recognition and management of pesticide poisonings J. Routt Reigart, James R. Roberts

This volume is produced from digital images created through the University of Michigan University Library’s large-scale digitization efforts. The Library seeks to preserve the intellectual content of items in a manner that facilitates and promotes a variety of uses. The digital reformatting process results in an electronic version of the | United States Office of Prevention Environmental Protection Pesticides and Toxic Agency Substances ÃEPA Recognition and Management of Pesticide Poisonings EPA 735-R-98-003 March 1999 www.epa.gov Fifth Edition Recognition and Management of Pesticide Poisonings Fifth Edition 1999 J. Routt Reigart M.D. Professor ofPediatrics Medical University of South Carolina James R. Roberts M.D. M.P.H. Assistant Professor ofPediatrics Medical University of South Carolina Support for this publication was provided by Certification and Worker Protection Branch Field and External Affairs Division Office of Pesticide Programs U.S. Environmental Protection Agency 401 M Street SW 7506C Washington DC 20460 For additional copies or more information Tel 703-305-7666 Fax 703-308-2962 The manual is available in electronic format on the Internet at http www.epa.gov pesticides safety healthcare Acknowledgments We are grateful to the Office of Pesticide Programs Environmental Protection Agency for giving us the opportunity to collaborate on this new edition. Our thanks go to Kevin Keaney Acting Branch Chief for his support and vision and for giving this publication priority attention. Particular mention should also be made of the efforts of Jerome M. Blondell Ph.D. M.P.H. and Ameesha Mehta M.P.H. whose oversight and constant assistance were invaluable in moving this project forward. Ana Maria Osorio M.D. M.P.H. contributed Chapter 3 Environmental and Occupational History to this manual. Experts in clinical toxicology conducted critical reviews of draft material. We are greatly appreciative of the time and effort of the following reviewers Jeffery Lloyd Burgess M.D. M.P.H. Assistant Professor Environmental Occupational Health Unit University of Arizona Prevention Center Matthew C. Keifer M.D. M.P.H. Assistant Professor Department of Medicine Environmental Health University of Washington Wayne R. Snodgrass M.D. Ph.D. Professor and Head Clinical Pharmacology-Toxicology Texas Poison Center Sheldon .