Using evidence to prevent deaths from pesticide poisoning in rural Asia
Dr Michael Eddleston - Clinical Pharmacology Unit, University/BHF Centre for Cardiovascular Science, University of Edinburgh
Michael Eddleston is a Scottish Senior Clinical Research Fellow, Lister Research Prize Fellow, and Reader in the Clinical Pharmacology Unit, University/BHF Centre for Cardiovascular Science, University of Edinburgh and Director and Consultant Physician at the National Poisons Information Service - Edinburgh unit, Royal Infirmary of Edinburgh.
His research work’s major aim is to reduce deaths from pesticide and plant self-poisoning in rural Asia, a cause of over 350,000 premature deaths each year and the number one global means of suicide. To do this, he performs clinical trials in South Asian district hospitals to better understand the pharmacology and effectiveness of antidotes and community-based controlled trials to identify effective public health interventions. This work is complemented by translational studies of antidotes in minipig models of poisoning in a large animal intensive care facility that Michael established in Edinburgh, and work with the World Health Organisation to aid implementation. Michael also performs clinical and animal research in Edinburgh to improve treatment of other forms of poisoning (such as from cyanide, alcohol, and contrast media) by developing novel antidotes.
Self-poisoning with pesticides is a major clinical problem in rural Asia, killing several hundred thousand people every year. The most important pesticides are organophosphorus insecticides, which are widely used in agriculture and responsible for about 2/3 of deaths. Inhibition of acetylcholinesterase in poisoned humans results in overstimulation of cholinergic synapses in the central nervous system, autonomic nervous system and neuromuscular junction. Deaths occur due to acute respiratory failure, usually before hospital admission, or due to complications of reduced consciousness and respiratory arrest - aspiration pneumonitis and cerebral hypoxia. Over the last 10 years, our clinical toxicology research group has carried out clinical studies in the North Central Province of Sri Lanka to improve treatment and reduce deaths from pesticide poisoning. We have tried to standardise therapy, using the evidence base, and performed randomised controlled trials to test the effectiveness of activated charcoal and pralidoxime. At the same time, using a complementary public health approach and a Haddon matrix as a guide, we have moved out of the hospital and looked for solutions in the community. We have studied the effect of pesticide bans on both human health and agricultural output and are currently assessing the effectiveness of self-storage containers to reduce pesticide poisoning. Our group attempts to develop evidence for possible interventions at multiple levels, including the patient, the community, and government legislation, to ultimately reduce deaths from pesticide poisoning in rural Asia.
The seminar is free, and all are welcome (including members of the public) without needing to book a place. If you have difficulties with stairs, we have a lift to provide access to the lower ground floor.
This event has been taken from the School of Social and Community Medicine website.