title: A multicenter retrospective survey of poisoning after ingestion of herbicides containing glyphosate potassium salt or other glyphosate salts in Japan.
abstract: BACKGROUND
  A multicenter retrospective survey of patients poisoned by herbicides containing glyphosate salts in Japan was conducted to identify differences in symptoms and outcome of poisoning.
  
  
  METHODS
  Participants were patients who were transported to emergency facilities between October 2006 and March 2014 after consuming herbicides containing glyphosate potassium salt (GlyK(+)) (the K-group) or other glyphosate salts (the O-group). Questionnaires were mailed to 38 emergency facilities that agreed to participate in the study.
  
  
  RESULTS
  Serum potassium levels upon arrival were significantly higher (p < 0.01), and abnormal electrocardiogram findings were significantly more common (p < 0.01) in the K-group (n = 55) than in the O-group (n = 62). Conversely, acute lung injury (ALI) including acute respiratory distress syndrome (ARDS) (p = 0.05) and liver injury (LI) (p < 0.01) were significantly more common during hospitalization in the O-group, although no significant differences in the duration of hospital stay (p = 0.92) or outcomes (p = 0.95) were observed between the two groups.
  
  
  CONCLUSIONS
  The ingestion of products containing glyphosate isopropylamine or ammonium salts, and polyoxyethyleneamine (POEA) as a surfactant, can cause severe organ injury. Physicians should note that the ingestion of products containing glyphosate potassium salt and surfactants other than POEA can cause hyperkalemia, potentially leading to fatal arrhythmias or cardiac arrest.
authors.affiliation: a Emergency Medical Center & Poison Center, Saitama Medical University Hospital , Iruma-gun , Saitama , Japan ;
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Kamijo
authors.affiliation: b Center for Suicide Prevention, National Institute of Mental Health, National Center of Neurology and Psychiatry , Tokyo , Japan ;
authors.forename: Michiko
authors.initials: M
authors.lastname: Takai
authors.affiliation: c Department of Emergency Medicine , School of Medicine, Teikyo University , Tokyo , Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Sakamoto
mesh_terms: D055371:Acute Lung Injury / Q000139:chemically induced / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005998:Glycine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000506:poisoning; D006540:Herbicides / Q000008:administration & dosage / Q000506:poisoning*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000209:etiology / Q000473:pathology*; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000506:poisoning; D011188:Potassium / Q000008:administration & dosage* / Q000097:blood; D011437:Propylamines / Q000008:administration & dosage / Q000506:poisoning; D012128:Respiratory Distress Syndrome / Q000139:chemically induced / Q000473:pathology; D012189:Retrospective Studies; D013501:Surface-Active Agents / Q000008:administration & dosage / Q000506:poisoning; D011795:Surveys and Questionnaires; D055815:Young Adult; D000097797:Glyphosate
chemical_list: D005998:Glycine; D006540:Herbicides; D011092:Polyethylene Glycols; D011188:Potassium; D011437:Propylamines; D013501:Surface-Active Agents; D000097797:Glyphosate; C054694:polyoxyethyleneamine; C035263:2-propylamine
keywords: Arrhythmia; cardiac arrest; glyphosate-surfactant herbicide; hyperkalemia