Pesticide-initiated idiopathic environmental intolerance in South Korean farmers.
This study was designed to study patients with intolerance to pesticide smells. Ten subjects chosen were complaining of vague symptoms such as headache, dizziness, fatigue, nausea, vomiting, abdominal pain, myalgia, flu-like symptoms, etc., whenever exposed to the pesticide smells even at low intensity. To determine whether the etiology of this kind of pesticide hypersensitivity was of organic or psychiatric nature, all the subjects underwent tests as follows: complete blood cell count, urinalysis, and blood chemistry as routine tests; esophogastroduodenoscopy and abdomen ultrasonography for the gastrointestinal symptoms; chest x-ray, pulmonary function tests, and electrocardiography for the respiratory and/or cardiac symptoms; nerve conduction velocity and brain magnetic resonance imaging (MRI) for peripheral and central nerve system symptoms; and K-WAIS, Rey-Kim memory test, Rorschach, Mini Mental State Examination (MMSE), and Minnesota Multiphasic Personality Inventory (MMPI) for psychoanalysis. Of the 10 cases in which the chief complaint was headache, symptoms of two cases were caused by maxillary sinusitis. Another two showed typical multiple chemical sensitivity (MCS) or idiopathic environmental intolerance (IEI). Six out of the 10 cases, whose symptoms closely resembled the others, did not conclusively meet the criteria of classic MCS or IEI. The subjects of this case shared vague fears, both fear of pesticides and hypochondriasis. Some subjects faced financial insecurity and social uncertainty; others felt uneasy about the future of their farming life. Thus, to help verify the causes of MCS or IEI, which is strongly suggestive of pesticide smells, diagnosis needs a dual approach: on the anima and soma. Psychoanalysis can delve into the mental status of the patients to see whether the patients are aware of their symptoms. Clinical tests can see through the physical structure and functions of the organs on which patients' complaints are centered.
Lee
Hae-Sung
HS
Department of Internal Medicine, Soonchunhyang University Hospital, Cheonan, Korea.
Hong
So-Yong
SY
Hong
Zoong-Rock
ZR
Gil
Hyo-Ook
HO
Yang
Jong-Oh
JO
Lee
Eun-Young
EY
Han
Mi-Jung
MJ
Jang
Nam-Woon
NW
Hong
Sae-Yong
SY
D000383:Agriculture; D004781:Environmental Exposure / Q000032:analysis*; D006801:Humans; D007360:Intelligence / Q000502:physiology; D007723:Korea; D008297:Male; D008875:Middle Aged; D018777:Multiple Chemical Sensitivity / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D010575:Pesticides / Q000633:toxicity*; D012903:Smell / Q000502:physiology
D010575:Pesticides