Paraquat poisoning

Paraquat poisoning is a leading public health problem in several developing countries such as those in Asia, Pacific nations, and the Americas. Due to its accessibility and affordability, many people from said countries use paraquat to commit suicide. 

Because ingestion is the route of exposure that is most likely to result in poisoning, the most immediate signs of paraquat poisoning include pain and swelling in the mouth and throat, tongue sores, stomach pain, vomiting, and bloody diarrhea. 

Treatment for poisoning involving the use of paraquat initially consists of removing the toxic chemical out of your system and preventing further absorption with the help of activated charcoal or Fuller’s earth. 

However, even if someone survives poisoning by paraquat, it is highly likely that they will suffer from its permanent consequences, including Parkinson’s disease

In fact: 

Countless farmers and agricultural workers who regularly worked with paraquat are now filing a paraquat poisoning lawsuit after they developed Parkinson’s disease and were able to identify what caused them to develop the disorder – the toxic herbicide they have handled for years. 

What is Paraquat poisoning?

Paraquat poisoning is a form of fatal poisoning that results from the inhalation, ingestion, or skin absorption of the toxic weed killer paraquat. And although ingestion most frequently results in poisoning, other routes of exposure can also be fatal. 

One of the more commonly known immediate symptoms of paraquat poisoning through ingestion is the paraquat tongue, which is characterized by ulcers and burning sensation on the tongue. 

What are the paraquat poisoning symptoms

What are the paraquat poisoning symptoms?

The signs of paraquat toxicity to humans may vary from mild to severe and acute to chronic. The most important paraquat poisoning symptoms are listed below. 

  • Abdominal pain: One of the most immediate signs of paraquat poisoning are the gastrointestinal symptoms, which occur in the digestive tract, including abdominal pain. It can also cause burning pain in the upper abdomen as it damages the lining of the stomach and intestines.  
  • Bloody diarrhea: Because paraquat spreads easily by way of ingestion, symptoms tend to develop quickly. Damage in the gut may also result in diarrhea that could become bloody. 
  • Nausea and vomiting: two gastrointestinal symptoms that are commonly experienced immediately after paraquat ingestion. Someone who has swallowed paraquat may vomit with blood-tinged sputum or a blue-colored fluid, which is the color that manufacturers inject paraquat with.  
  • Confusion: Individuals who suffer from paraquat poisoning may show signs of central nervous system (CNS) toxicity, which include confusion. Confusion is often a sign that the level of poisoning is severe and may result in death in a few days.  
  • Seizures: Nervous system damage that results from paraquat intoxication can lead to seizures. One of the known reasons for this is the oxidative stress that paraquat can cause, which can lead to the production of excessive free radicals, and ultimately results in seizures.   
  • Difficulty breathing: Paraquat accumulates quickly in the lungs, making them fill up with fluids, which leads to breathing difficulties. Even those who manage to survive paraquat exposure will likely continue to suffer from difficulty breathing.  
  • Fast heart rate: Ingestion of lethal amounts of paraquat usually results in a rapid or irregular heart rate, cardiovascular collapse, and eventual death. Evidence exists that there is a 50% mortality rate among paraquat poisoning patients who experience cardiovascular collapse and multiple organ failure. 

What happens after Paraquat Poisoning?

After paraquat poisoning, the immediate signs of intoxication often show up, including pain and swelling of the mouth and throat and other gastrointestinal symptoms, such as abdominal pain, nausea, vomiting, and bloody diarrhea. 

The paraquat mechanism of action triggers these symptoms, as the chemical causes direct damage to the lining of the stomach and mouth when it comes into contact with these organs. After that, paraquat inflicts further damage to the body by causing toxic chemical reactions throughout the other organs, including the kidney and the liver. 

What are Paraquat side effects?

Paraquat is known to cause adverse effects on several organs of the body. The most common paraquat side effects are listed below. 

  • Kidney failure: Paraquat intoxication is characterized by multi-organ failure that occurs over a few hours or days, and therefore can adversely affect the kidney. It can cause kidney failure and kidney disease that can be fatal.  
  • Lung damage: Studies about paraquat toxicity on animals and humans have demonstrated the chemical’s serious effects on lungs. In fact, there is a term for the damage that paraquat causes on the lungs: paraquat lung. The disease is associated with bacterial pneumonia and respiratory failure. Lung damage is also the least treatable symptom of paraquat poisoning.  
  • Scarring of the esophagus: Paraquat is a caustic agent, which means it is capable of destroying living tissue through chemical action. Injuries to the esophagus are commonly present in paraquat poisoning patients.  
  • Heart failure: Because the toxic weed killer has been shown to attack multiple organs in the body through oxidative stress, it also adversely affects the cardiovascular system.  
  • Liver failure: Paraquat is a potent herbicide that causes severe tissue damage in several organs, including the liver. The liver is particularly sensitive to the oxidative damage that paraquat causes, often resulting in the reduction of the flow of bile from the liver called cholestasis.  
  • Lung scarring: Also known as pulmonary fibrosis, this condition is characterized by lung tissue becoming damaged and scarred. Lung scarring is one of the long-term effects of paraquat exposure, and it makes breathing more difficult for a person as it progresses.  
  • Parkinson’s disease: Perhaps the most controversial long-term effect linked to paraquat exposure is Parkinson’s disease. Aside from the main reason behind environmental organizations pushing for a paraquat ban, it is also what plaintiffs of the paraquat lawsuit claim to suffer from after being exposed to the herbicide. Parkinson’s disease occurs due to the oxidative stress and mitochondrial dysfunction that paraquat causes, which ultimately leads to cell damage and death in the region of the brain called substantia nigra. 

Does paraquat cause Parkinson's

Does Paraquat cause Parkinson’s?

Yes, paraquat may cause Parkinson’s disease and a growing body of research shows the link between the two. Long-term exposure to paraquat has long been associated with an increased risk of Parkinson’s disease, especially in farmers and other agricultural workers who often handle the chemical at their workplace.

In fact, the first paraquat lawsuit was filed in 2017 by farmers and agricultural laborers who used paraquat on farms and later developed Parkinson’s disease.  

Evidence exists that paraquat neurotoxicity occurs due to a mechanism called oxidative stress, which destroys the cells of the nervous system in a way that closely resembles how nerve cells lose function in Parkinson’s disease. 

Does Paraquat cause cancer?

No, paraquat does not cause cancer, as there is little evidence to suggest that paraquat is a cancer-causing agent. However, previous studies have suggested a potential relationship with some forms of cancer, including non-Hodgkin’s lymphoma (NHL). 

And while the evidence linking NHL to paraquat herbicide exposure may be lacking, plenty of studies have shown an association between a similar herbicide and NHL. 

The chemical in question is Roundup, the world’s most widely used herbicide. Animal and human population studies have both found a link between Roundup exposure and non-Hodgkin’s lymphoma. 

What’s more is that in 2015, the World Health Organization’s International Agency for Research on Cancer classified glyphosate, the active ingredient in Roundup, as a probable human carcinogen. 

Does Paraquat cause ALS?

Yes, paraquat causes ALS or amyotrophic lateral sclerosis. Also known as Lou Gehrig’s Disease, ALS is a progressive neurological disease that affects nerve cells in the brain and spinal cord that control voluntary muscle movement. 

Recent research has shown that there appears to be an increased risk of ALS associated with paraquat exposure. Despite decades of research, experts have not unearthed any genetic link to ALS, but they have always suspected pesticide exposure to be a key factor in the development of the disease. 

Aside from paraquat, other pesticides such as chlorpyrifos, glyphosate, and permethrin have also been linked by recent studies to the fatal disease. 

Can Paraquat cause essential tremors?

No, paraquat cannot cause essential tremors. However, Parkinson’s disease (PD) caused by paraquat can be misdiagnosed as essential tremor. Essential tremor is a nerve disorder that causes involuntary shaking of your hands, arms, head, trunk, and other body parts. 

Although both neurological disorders affect movement and tend to get worse over time, they have key differences. For instance, essential tremors are felt more when in motion, while tremors in PD are felt more when the affected body parts are resting. 

Unfortunately, because the symptoms of the two diseases tend to overlap, someone who has a history of paraquat exposure may be misdiagnosed as having essential tremors. This is where the importance of seeking a second or even a third opinion comes in – oftentimes, when paraquat exposure victims receive a diagnosis, they have no way of knowing anymore that it was the toxic chemical that caused them to develop Parkinson’s disease. 

Can Paraquat cause Lewy body dementia?

No, paraquat cannot cause Lewy body dementia (LBD), which is a type of progressive dementia that occurs due to the formation of clumps of proteins called Lewy bodies in the brain. 

LBD can lead to problems with thinking, reasoning, behavior, and independent function. While there are known toxic causes of dementia, including exposure to heavy metals, carbon monoxide, solvents, and other pesticides, paraquat is not one of them. 

What is the paraquat poisoning mortality rate

What is the Paraquat poisoning mortality rate?

The paraquat poisoning mortality rate statistics indicates that fatality is still very high, and can vary between 50% and 90%, despite large variations in treatment today. However, in cases of intentional self-poisoning using concentrated formulations, mortality rate approaches up to 100%. 

A fatal dose of paraquat is around 30 mg/kg, which is about 7-8 mL of the 24.6% solution sold commercially. 

What is the paraquat poisoning treatment?

Early identification of paraquat intoxication and timely administration of treatment are the cornerstone of management. The most common options for paraquat poisoning treatment are listed below:

1. Prevention of gastrointestinal absorption

The first method of treatment should be aimed at preventing further gastrointestinal absorption of paraquat. Physicians routinely give adsorbent substances such as activated charcoal and Fuller’s earth. Gastric lavage, especially without the use of an adsorbent, is typically not recommended as it has not shown any clinical benefit. It can also cause complications, such as aspiration, electrolyte imbalance, and paraquat organ damage through mechanical injury to the throat, esophagus, or stomach.

2. Removal of paraquat from the blood

Hemoperfusion is a tool for blood cleansing and is sometimes considered for removal of paraquat from the blood. However, evidence exists that its benefits may be limited because paraquat is eliminated rapidly from the body, which means it can only remove a modest amount of the chemical from the system. Furthermore, the timeframe in which hemoperfusion is most effective is very short (within only two hours post-ingestion). Starting the procedure any time after that is unlikely to change clinical outcomes.

3. Immunotherapy and Antioxidants

Immunotherapy is the treatment of disease by using the body’s own immune system. When it comes to paraquat intoxication, immunosuppression, or dampening of the immune system, is widely practiced. It is often done with dexamethasone, cyclophosphamide, and methylprednisolone. The theory is that immunosuppression interferes with the acute inflammatory response caused by paraquat and, as a result, inhibits the processes that lead to pulmonary fibrosis and eventual death. However, its evidence for efficacy is still very weak. Antioxidants are also widely used as treatment for paraquat poisoning, including vitamins E and C, N-acetylcysteine (NAC), and salicylic acid. They are believed to be beneficial through free radical scavenging and anti-inflammatory actions.

4. Additional Methods

Other treatment recommendations for paraquat intoxication include ventilation, medications, and intravenous fluids. Ventilation is used to improve breathing following paraquat poisoning, especially during the early onset of symptoms. However, ventilatory support is often futile in severe cases. Medications, on the other hand, are also used to reduce symptoms such as difficulty breathing and low blood pressure. Lastly, intravenous fluids or fluids given through an IV needle are supportive treatments that help replace water or sugar a patient may need as swallowing becomes difficult for them after paraquat poisoning.  

Can Paraquat poisoning be cured?

No, paraquat poisoning cannot be cured. Most of the time, the damages and long-term consequences of paraquat intoxication are not reversible. In some cases where the victim has survived, permanent side effects are highly likely. 

What to do if you’ve been exposed to paraquat?

Immediate medical attention is the key to preventing the severe side effects of paraquat. However, there are also things you can do to lessen the impacts of the chemical on your body. Listed below are the things you should do if you’ve been exposed to paraquat.

  • Remove any clothing immediately: If you suspect that you have come in contact with paraquat, remove your clothes immediately after handling the chemical. Place your clothing, including shoes and boots in a plastic bag, away from the family laundry. You can choose to completely discard the contaminated garment or immediately wash it yourself. 
  • Wash the exposed area: In case of skin contact, wash the exposed area thoroughly with lots of soap and water for at least 15 mins. If much of the body has been exposed, shampoo can also be used to remove chemicals from the hair. If the skin appears burned, avoid applying ointments or powders. Instead, cover it with a clean cloth after washing.  
  • Remove contact lenses: If you wear contact lenses, remove them after you have thoroughly washed your hands for at least five minutes. Rinse out your eyes for 15 minutes from the nose side of the eye to the ear side to avoid cross contamination.  
  • Go to the nearest hospital right away: Seek immediate medical attention if you think you have been exposed to paraquat. Receiving timely treatment is often the key to surviving paraquat poisoning. If you are someone who works regularly with paraquat, always follow the directions stated on the label and visit the doctor for regular medical check-ups. While there is no antidote for paraquat intoxication, it can be prevented by reading the label of the product and following the directions. 

Can you survive Paraquat poisoning?

Yes, you can survive paraquat poisoning, especially in its acute stages, but not without the lasting effects. In milder cases, some patients have managed to survive paraquat intoxication, especially those who presented early to the emergency room to seek medical attention.

However, in severe cases, the risk of permanent side effects is high, including lung scarring, kidney failure, heart problems, and esophageal scarring, to name a few. 

But this is not the case for everyone. It is worth noting that paraquat poisoning is still the leading cause of pesticide-related death in many developing countries, and in the U.S., thousands of people have filed a paraquat lawsuit targeting the chemical, filed by individuals who developed Parkinson’s disease and other health issues after exposure to it.

How to prevent Paraquat poisoning?

Paraquat poisoning can be prevented by simply reading and understanding everything that is indicated on the label of the product before using it. The key to paraquat safety is following the directions and detailed information contained on the label on how to use the herbicide correctly and legally. 

Labels are also legal documents that contain information on potential dangers associated with a product and instructions one should follow on mixing, applying, storing, and disposing of it. The paraquat label is your guide to using the weed killer safely, as it also contains directions on first aid in the event of poisoning.

What is paraquat poisoning antidote?

There is no paraquat poisoning antidote to date, despite the medical and technological advancements available to us at the present time. There is no proven cure that exists for poisoning by paraquat. As the Environmental Protection Agency put it, “Only one sip can kill” and there is no antidote to save you.

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