Increased Sensitivity of Unknown Origin. A case of acrodynia, a form of mercury poisoning that occurs in infants and young children, was recently reported after exposure to latex paint containing the fungicide phenylmercuric acetate (Agocs et al., 1990). Mercury exposure occurs when vapor is released from painted surfaces after the paint has dried. Although EPA now forbids the addition of phenylmercuric acetate to interior latex paint (as of August 20, 1990), mercury-containing paint manufactured before this date may still be sold.

There is wide interindividual variability in susceptibility to acrodynia. In 1980 in Buenos Aires, Argentina, three cases of acrodynia were reported when up to 12,000 infants were exposed to a phenylmercuric fungicide used by a commercial diaper service (Gotelli et al., 1985). The reason why particular children are more sensitive than others is unknown.

Chronic Medical Conditions

Exposure to pesticides could exacerbate common childhood conditions. For instance, the increased cholinergic response induced by organophosphates may increase contraction of bronchial muscles and stimulation of bronchial glands. Therefore, asthmatic children might be affected more easily and more severely than normal children.

Interactions with Medication

Children taking medication may be at increased risk from pesticide exposure. Many drugs compromise nutritional status, and this in itself may increase sensitivity to pesticides. In addition, acetylcholinestrase (AChE) inhibitors, antiepileptic drugs, other drugs that act on the central nervous system (centrally acting drugs), propranolol and digoxin, and drugs that alter hepatic blood flow might be of concern.

Acetylcholinesterase Inhibitors

Any child taking AChE inhibitors would be at increased risk from organophosphate exposure. For instance, increased levels of organophosphates would increase the cholinergic effects observed during the use of the cholinesterase inhibitor phospholine iodide (echothiophate) for glaucoma patients.

Antiepileptic Pharmaceuticals

Phenobarbital and phenytoin induce cytochrome P-450 isozymes. Phenobarbital is also known to induce a number of other hepatic drug metabolizing



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement