Overview of pesticide exposures reported to the Moroccan Poison Control and Pharmacovigilance Center between 1980 and 2021.

Abstract

Introduction: Acute pesticide exposure is a major concern in Morocco. Pesticides include herbicides, rodenticides, insecticides, and may include unapproved or illegally imported and/or utilized substances. Pesticides can be hazardous and acute intentional exposures can cause death. This study aims to assess the disease burden associated with pesticide exposure as reported to the Moroccan Poison Control and Pharmacovigilance Center, and to identify risk factors for mortality.

Materials and methods: We performed a retrospective analysis of all pesticide exposure cases reported to our poison center between 1980 and 2021. Data were collected through passive and active surveillance. We collected substance data, demographic data, signs and symptoms of toxicity, Poisoning Severity Score and assessed risk factors for exposures and death. Analyses were performed using Excel and SPSS.

Results: We identified 26,136 cases over 42 years (annual average: 594 with a notable increase over time). We could not identify a specific substance in 72% of cases. When a substance was identified, malathion (18%), alpha-chloralose (17%), and metal phosphides (12%) were the most common. Intentional exposures and exposures to metal phosphides had higher mortality risks.

Discussion: Morocco has a high burden of pesticide-related exposures and certain substances and demographics are higher risk. Targeted interventions and regulations may improve disease burden. The true incidence is likely undercounted.

Conclusion: In this analysis, we found exposures to pesticides were common and certain substances were more likely to cause death, with metal phosphides and organophosphate insecticides appearing to be most lethal.