Aldicarb (2-methyl-2(methylthio)
propanal o-[(methylamino)-carbonyl]
oxime) is a
pesticide manufactured since 1965. This
carbamate ester is sold under the tradename,
Temik, and is used as
insecticide and nematicide. The Environmental Protection Agency has classified
aldicarb in the highest toxicity category and has defined a strict control for its delivery and use. In Brazil and the Caribbean island,
aldicarb is illegally used as a household
rodenticide with a widespread risk of
poisoning. Our study presents the first review of
aldicarb poisoning circumstances associated with clinical and analytical findings. Moreover, the
oxime treatment is discussed. Eighteen patients with
cholinergic symptoms admitted to the Emergency Unit and two deceased with a history of
aldicarb poisoning were included in the study. As agricultural workers, only two of them could legally use
Temik. Seventy percent of the patients was managed by the Emergency Mobil Unit. Serum
cholinesterase activity was always lower than 30% of the normal range and
aldicarb was identified by UV spectra and retention time after liquid chromatography separation. The most common
muscarinic effect was
diarrhea, the main nicotinic sign
fasciculation and almost half of the poisoned patients had central nervous system (CNS) depression (Glasgow
Coma Score lower than 8). Four patients had serious conduction abnormalities and two of them died. These results suggest that
aldicarb intoxication is always severe.
Oxime treatment did not produce side effects and should be recommended whenever the
pesticide involved is unknown. Effective measures should be implemented to stamp out the illicit use of
aldicarb.