Here's some info on more pesticides which can cause twitching. These particular ones are grouped under the name "chlorophenoxy herbicides." In answer to Pat's question, I've never been exposed to pesticides, that I know of, in any sort of single, toxic exposure. I did, however, have a very bad drug r eaction to an anti-deprressant/anti-psychotic drug, the whole class of which is chemically similar to some pesticides. The link is definitely close enough to warrant some research. I ran across one that stated right out that it had in a few cases, outright caused Lou Gehrig's disease. From what happened on Guam back around WWII with the cycad seed flour causing AD, PD, and/or ALS in a significant number of people, all having eaten this flour, it lends one to consider that all three diseases may have similar outside causes and environmental factors, but which one a particular person gets probably depends on their susceptibilities, which is driven by their genes. That MTPP which caused pd in those young people is chemicallly similar to paraquat & diquat (info to be posted soon here). Also, I now live in NJ, and since (yes it's true!) there are alot of farms, there is also alot of spraying of pesticides. All the housing complexes too around here spray ALOT (and our dogs still get covered in ticks anyway!) . There is also alot of pollution, and I worked in a building recently for about 4 years, which when it first opened, the tenants who were originally there eventually leftt and it closed down for a while cause everyone was getting sick (sick building syndrorme). When new carpet is installed, tile laid with glue, paint spread around, etc., all this stuff outgasses for a while and these chemical released can be somewhat toxic, especially to those who are ultra-sensitive (MCS??) I know formaldehyde bothers me (I got a sore throat and headache f rom it in high school while dissecting a frog and formaldehyde is used in all kinds of stuff that we produce. I've also heard that the prevalence of pd and ms, etc., is actually worse out in the midwest, which one typically thinks of as cleaner than say, NJ, - but with all the heavy duty pesticides used in farming, etc., it doesn't seem quite so surprising. I wonder if anyone's done any sort of quantitative survey of what diseases farmers are typically afflicted with. That should give some clues to the r ole of pesticides in diseases like pd. So Pat, I don't know really for sure how many/much pesticides I've been exposed to, but I have been exposed somewhat, and I know that the compazine was a big factor. Here goes the info: Subj: twitching - chlorophyenoxy herbicides Date: 95-06-27 18:26:39 EDT From: [log in to unmask] (Tebay, Wendy) To: [log in to unmask] (athome) --PART.BOUNDARY.claven.3d95.2ff0858e.0001 Content-Type: text/plain; charset=us-ascii Commercial products Several hundred commercial products contain chlorophenoxy herbicides in various forms, concentrations, and combinations. Following are names of widely advertised formulations. In some cases, the same name is used for products with different ingredients. Exact composition must therefore be determined from the product label. 2,4-D or 2,4-dichlorophenoxyacetic acid (Agrotect, Amoxone, AquaKleen, BH 2,4-D, Chipco Turf Herbicide `D', Chloroxone, Crisalamina, Crisamina, Crop Rider, D50, Dacamine, Debroussaillant 600, DedWeed SULV, Desormone, Dinoxol, Emulsamine BK, Emulsamine E-3, Envert DT, Envert 171, Super D Weedone, Weedone, Estone, Farmco, Fernesta, Fernimine, Fernoxone, Ferxone, Formula 40, Gordon's Amine 400, Gordon's LV 400 2,4-D, Hedonal, Herbidal, Lawn-Keep, Macondray, Miracle, Netagrone 600, Pennamine D, Planotox, Plantgard, Salvo, Spritz-Hormin/2,4-D, Spritz-Hormit/2,4-D, Superormone Concentre, Transamine, Tributon, Tuban, U 46, U 46 D-Ester, U 46 D-Fluid, Weed-B-Gon, Weedar, Weedatul, Weed-Rhap, Weed Tox, Weedtrol, Gordon's Dymec Turf Herbicide Amine 2,4-D, Gordon's Phenaban 801, Acme Amine 4, Acme Butyl Ester 4, Acme LV 6, Acme LV 4, Gordon's Butyl Ester 600, DMA 4, Dormone). 2,4-DP or 2,4-dichlorophenoxypropionic acid (BH 2,4-DP, Desormone, Hedonal, Hedonal DP, Kildip, Polymone, Seritox 50, U 46, U 46 DP-Fluid, Weedone DP, Weedone 170). 2,4-DB or 2,4-dichlorophenoxybutyric acid (Butoxon, Butoxone, Butyrac, Embutox). 2,4,5-T or 2,4,5-trichlorophenoxyacetic acid (Amine 2,4,5-T for rice, Dacamine, Ded-Weed, Farmco Fence Rider, Forron, Inverton 245, Line Rider, Super D Weedone, T-Nox, Trinoxol, U 46, Weedar, Weedone). MCPA (metaxon, Agroxone, Weedone), MCPB (Can-Trol, PDQ, Thistrol), and MCPP (mecoprop, Methoxone M, Mecopex, Gordon's Mecomec) are 2-methyl, 4-chlorophenoxy aliphatic acids and esters. Dicamba (Banvel) is 2-methyl-3,6 dichlorobenzoic acid. Sodium, potassium, and alkylamine salts are commonly formulated as aqueous solutions, while the less water soluble esters are applied as emulsions. Low molecular weight esters are more volatile than the acids, salts, or long-chain esters. Chlorophenoxy compounds are sometimes mixed into commercial fertilizers to control growth of broadleaf weeds. --PART.BOUNDARY.claven.3d95.2ff0858e.0001 Content-Type: text/plain; charset=us-ascii Confirmation of poisoning Gas-liquid chromatographic methods are available for detecting and measuring chlorophenoxy compounds in blood and urine. These analyses are useful in confirming and assessing the magnitude of chlorophenoxy absorption. Poisonings characterized by unconsciousness have shown initial blood chlorophenoxy concentrations ranging from 80 to more than 1000 mg per liter. Urine samples should be collected as soon as possible after exposure because the herbicides may be almost completely excreted in 24-72 hours, depending on the extent of toxicant absorption and urine pH. Analyses can be performed at special laboratories usually known to local poison control centers. If circumstances indicate strongly that excessive exposure to chlorophenoxy compounds has occurred, INITIATE appropriate TREATMENT measures immediately, not waiting for chemical confirmation of toxicant absorption. --PART.BOUNDARY.claven.3d95.2ff0858e.0001 Content-Type: text/plain; charset=us-ascii Symptoms and signs of poisoning Chlorophenoxy compounds are moderately IRRITATING to skin and mucous membranes. Inhalations of sprays may cause burning sensations in the nasopharynx and chest and coughing may result. Prolonged inhalation sometimes causes dizziness. Adjuvant chemicals added to enhance foliage penetration may account for the irritant effects of some formulations. Manifestations of systemic toxicity of chlorophenoxy compounds are known mainly from clinical experience with cases of deliberate suicidal ingestion of large quantities. The agents most often involved in these incidents have been 2,4-D and mecoprop. The toxic effects of other chlorophenoxy compounds are probably similar but not identical. Few cases of deliberate ingestion of chlorophenoxy compounds have terminated fatally. Irritation of the stomach usually leads to VOMITING soon after ingestion. Pain in the chest and abdomen and diarrhea may ensue. Headache, mental confusion, and bizarre behavior are early manifestations of severe poisoning which may progress to UNCONSCIOUSNESS. MYOTONIA (muscular stiffness on passive movement of the limbs) has occurred in persons poisoned by 2,4-D. Areflexia is sometimes observed. Muscle twitching may or may not be evident. Convulsions occur very rarely. Respiratory drive is not depressed; hyperventilation is sometimes evident. Body temperature may be moderately elevated, but this is rarely a life-threatening feature of the poisoning. With effective urinary excretion of the toxicant, consciousness returns in 48-96 hours. Metabolic acidosis is manifest as a low arterial pH and bicarbonate content. The urine is usually acid. Skeletal muscle injury, if it occurs, is reflected in elevated creatine phosphokinase, and sometimes myoglobinuria. Moderate temporary elevations of blood urea nitrogen and serum creatinine are commonly found as the toxicant is excreted, but acute renal failure is uncommon. Mild leukocytosis and biochemical changes indicative of liver cell injury have been reported. Both tachycardia and bradycardia have been observed. T-wave flattening and inversion may occur. Myotonia and muscle weakness may persist for months after acute poisoning. Electromyographic and nerve conduction studies in some recovering patients have demonstrated a mild proximal neuropathy and myopathy. --PART.BOUNDARY.claven.3d95.2ff0858e.0001 Content-Type: text/plain; charset=us-ascii Toxicology Some of the chlorophenoxy acids, salts, and esters are moderately irritating to skin, eyes, and respiratory and gastrointestinal linings. In a few individuals, local depigmentation has apparently resulted from protracted dermal contact with chlorophenoxy compounds. The chlorophenoxy compounds are absorbed across the gut wall, lung, and skin. They are not significantly fat storable. Excretion occurs almost entirely by the way of urine. Apart from some conjugation of the acids, there is limited biotransformation in the body. The average residence half-life of 2,4-D in the human is about 18 hours, that of 2,4,5-T about 24 hours. These averages lie within very wide ranges (4-140 hours in the case of 2,4-D), depending on the urinary pH (alkalinity enhances secretion). Given in large doses to experimental animals, 2,4-D causes vomiting, diarrhea, anorexia, weight loss, ulcers of the mouth and pharynx, and toxic injury to the liver, kidneys, and central nervous system. Myotonia (stiffness and incoordination of hind extremities) develops in some species and is apparently due to CNS damage: demyelination has been observed in the dorsal columns of the cord, and EEG changes have indicated functional disturbances in the brains of heavily dosed experimental animals. Ingestion of large amounts of chlorophenoxy acids has resulted in severe metabolic acidosis in humans. Such cases have been associated with electrocardiographic changes, myotonia, muscle weakness, myoglo-binuria, and elevated serum creatine phosphokinase, all reflecting injury to striated muscle. Because chlorophenoxy acids are weak uncouplers of oxidative phosphorylation, extraordinary doses may produce hyperthermia from increased production of body heat. Chlorinated Dibenzo Dioxin (CDD) and Chlorinated Dibenzo Furan (CDF) compounds are generated in the manufacture of chlorophenoxy compounds, particularly at excessive temperatures. The 2,3,7,8-tetra CDD form is extraordinarily toxic to multiple mammalian tissues; it is formed only in the synthesis of 2,4,5-T. Hexa-, hepta-, and octa-compounds exhibit less systemic toxicity, but are the likely cause of chloracne (a chronic, disfiguring skin condition) seen in workers engaged in the manufacture of 2,4,5-T and certain other chlorinated organic com-pounds. Although toxic effects, notably chloracne, have been observed in manufacturing plant workers, these effects have not been observed in formulators or applicators regularly exposed to 2,4,5-T or other chlorophenoxy compounds. The medical literature contains several reports of peripheral neuropathy following what seemed to be minor dermal exposures to 2,4-D. It is not certain that exposures to other neurotoxicants were entirely excluded in these cases. Single doses of 5 mg/kg body weight of 2,4-D and 2,4,5-T have been administered to human subjects without adverse effects. One subject consumed 500 mg of 2,4-D per day for 3 weeks without experiencing symptoms or signs of illness. --PART.BOUNDARY.claven.3d95.2ff0858e.0001 Content-Type: text/plain; charset=us-ascii Treatment of EXTERNAL Poisoning by Chlorophenoxy Compounds 1. BATHE and SHAMPOO with soap and water to remove chemicals from skin and hair. Obtain medical treatment if irritation persists. Individuals with chronic skin disease or known sensitivity to these herbicides should either avoid using them or take strict precautions to avoid contact (respirator, gloves, etc.). 2. FLUSH contaminating chemicals from eyes with copious amounts of clean water for 10-15 minutes. If irritation persists, obtain medical treatment. 3. If symptoms of illness occur during or following inhalation of spray, REMOVE victim FROM CONTACT with the material for at least 2-3 days. Allow subsequent contact with chlorophenoxy compounds only if effective respiratory protection is practiced. --PART.BOUNDARY.claven.3d95.2ff0858e.0001 Content-Type: text/plain; charset=us-ascii Treatment of Poisoning by Chlorophenoxy Compounds by INGESTION 1. If substantial amounts of chlorophenoxy compounds have been INGESTED, spontaneous emesis may occur. If vigorous emesis has not occurred measures should be taken to empty the stomach and limit gastrointestinal absorption by GASTRIC INTUBATION, ASPIRATION, and LAVAGE, following placement of a cuffed endotracheal tube. Lavage procedure is described in Organophosphate Insecticides, Treatment, Section 5. Repeated administration of charcoal at half or more the original dosage every 2-4 hours may be beneficial. If gastric aspiration and lavage is not performed due to delay in treatment, and if the patient is fully alert, ADMINISTER CHARCOAL AND LAXATIVE ORALLY, at the dosages indicated in the above reference. 2. Administer INTRAVENOUS FLUIDS to accelerate excretion of the chlorophenoxy compound, and to limit concentration of the toxicant in the kidney. A urine flow of 4-6 ml/minute is desirable. Intravenous saline/dextrose has sufficed to rescue comatose patients who drank 2,4-D and mecoprop several hours before hospital admission. CAUTION: Monitor urine protein and cells, BUN, serum creatinine, serum electrolytes, and fluid intake/output carefully to insure that renal function remains unimpaired and that fluid overload does not occur. Forced ALKALINE DIURESIS has been used successfully in management of suicidal ingestions of chlorophenoxy compounds. Alkalinizing the urine by including sodium bicarbonate (44-88 mEq per liter) in the intravenous solution apparently accelerates excretion of 2,4-D dramatically and mecoprop excretion substantially. Urine pH should be maintained in the 7.6-8.8 range. Include potassium chloride as needed to offset increased potassium losses: add 20-40 mEq of potassium chloride to each liter of intravenous solution. Monitor serum electrolytes carefully. There may possibly be some hazard to the kidneys when urine concentrations of toxicant are very high, so the integrity of renal function and fluid balance should be monitored carefully as the chlorophenoxy compound is excreted. 3. Hemodialysis is not likely to be of significant benefit in poisonings by chlorophenoxy compounds because of the extensive protein binding of these chemicals. 4. Follow-up clinical examination should include electromyographic and nerve conduction studies to detect any neuropathic changes and neuromuscular junction defects. --PART.BOUNDARY.claven.3d95.2ff0858e.0001--