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J Korean Soc Emerg Med > Volume 35(2); 2024 > Article
Journal of The Korean Society of Emergency Medicine 2024;35(2): 143-153.
Comparison of poisoning associated with two herbicides, glufosinate and glyphosate according to serum ammonia levels
Jong Ha Sung , Jong Yoon Park , Seong Jun Ahn , Yong Hwan Kim , Jun Ho Lee , Seong Youn Hwang , Dong Woo Lee
Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
Correspondence  Dong Woo Lee ,Tel: 055-233-6140, Fax: 055-233-6134, Email: calmriver@hanmail.net,
Received: August 10, 2023; Revised: September 20, 2023   Accepted: September 23, 2023.  Published online: April 30, 2024.
ABSTRACT
Objective:
The herbicides, glyphosate and glufosinate, are widely used in Korea. Serum ammonia levels are often elevated in glufosinate poisoning, and its concentrations have been reported to correlate with the prognosis. On the other hand, in glyphosate poisoning presence of hyperammonemia is questionable. Therefore, we conducted a study to evaluate the relationship between serum ammonia levels after consumption of the two herbicides.
Method:
This retrospective study was conducted based on data from a single hospital on glyphosate (Glyp) and glufosinate (Gluf) poisoned patients between 2004 and 2019. The cases of poisoning were divided into four groups according to the serum ammonia levels, namely two with normal ammonia (Glyp-N, Gluf-N) and the other two with elevated ammonia (Glyp-A, Gluf-A). We analyzed the demographics, blood test results, incidence of complications, and in-hospital mortality of the patients. We then re-classified the patients into survival and non-survival groups and evaluated the predictive factors related to mortality.
Results:
Among a total of 601 patients, there were 265, 83, 205, and 48 patients, in the Glyp-N, Glyp-A, Gluf-N, and Gluf-A groups, respectively. There were no statistically significant differences in the demographic characteristics, blood test results, incidence of complications, or mortality between the Glyp-N and Glyp-A groups as opposed to those with glufosinate poisoning. Patients in the Gluf-A group showed a worsening of most clinical indicators, including complications and mortality compared to those in the Gluf-N group. On logistic regression analysis, age, systolic blood pressure (SBP), creatinine, and pH were significant predictors of mortality in the glyphosate group, and SBP, lactate, C-reactive protein, ingested volume, and ammonia were the predictors in the glufosinate group.
Conclusion:
Unlike glyphosate poisoning, in the cases of glufosinate poisoning, the clinical prognosis of patients was closely related to serum ammonia.
Key words: Glyphosate; Glufosinate; Ammonia; Mortality
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