What are the effects of endosulfan on the human body?

Effects of Endosulfan on the Human Body

Endosulfan is a highly toxic organochlorine pesticide that primarily affects the central nervous system, causing severe neurological toxicity including seizures, status epilepticus, and can lead to death even with small exposures.

Neurological Effects

Endosulfan's primary mechanism of toxicity is antagonism of the GABA-A receptor chloride ionophore in the central nervous system 1. This disruption of GABAergic inhibition results in:

• Seizures (75% of poisoning cases) 2
• Status epilepticus (33% of cases), which can become super-refractory 3
• Altered consciousness and low sensorium (81% of cases) 2
• Convulsions or tremors 4
• Mental confusion 4

The neurological effects of endosulfan are particularly concerning as they can occur even at doses below those causing overt toxicity 5.

Systemic Effects

Beyond neurological manifestations, endosulfan poisoning affects multiple organ systems:

Hepatic Effects

• Elevated liver enzymes (transaminases) 2
• Potential hepatotoxicity 4

Renal Effects

• Azotemia (elevated blood urea nitrogen) 2
• Kidney damage 4

Metabolic Effects

• Metabolic acidosis 2
• Endocrine disruption through induction of P450 oxygenases 1

Hematological Effects

• Leukocytosis 2

Acute Poisoning Management

Management of endosulfan poisoning is challenging as there is no specific antidote 4:

1. Immediate respiratory support - 69% of hospitalized patients require mechanical ventilation 2
2. Seizure control - Aggressive anticonvulsant therapy is critical, with preemptive treatment recommended 2
3. Hemodynamic support - 19% of cases require vasoactive agents 2
4. Supportive care for multi-organ dysfunction

Mortality and Long-term Outcomes

• In-hospital mortality rate is approximately 19% 2
• Survivors of acute poisoning may not show gross neurological sequelae at discharge 2, though long-term follow-up data is limited
• Death can result from multiple systemic complications even after initial recovery from acute poisoning 3

Environmental and Exposure Concerns

Endosulfan has been used for over 50 years in agriculture 1. Despite being classified as a restricted organochlorine pesticide, it continues to be used particularly in developing countries 4. The Endocrine Society has identified endosulfan as an endocrine-disrupting chemical with potential health impacts 6.

Special Considerations

• Combined exposure with other pesticides (like methyl parathion) can produce more severe behavioral alterations than exposure to endosulfan alone 5
• Monitoring biological samples, such as breast milk, can provide an effective method of observing elimination of this environmentally persistent organic pollutant 4

Endosulfan poisoning represents a significant public health concern, particularly in regions where it remains in agricultural use. The high toxicity and lack of specific antidotes underscore the importance of strict regulation and eventual worldwide ban of this dangerous pesticide.