Secondary contamination in organophosphate poisoning.
Sir,

We read with interest the article by Stacey et al . discussing their experience with treatment of organophosphate/organophosphorus (OP) pesticide poisoning.1 This is an important topic, given the large number of exposures and deaths from poisoning with this class of pesticide worldwide.2 A number of important points have been raised by these authors, on which we would like to comment.

In this case, advanced protective garments were used by treating staff which interfered with patient care, the ED was closed down temporarily, staff were taken off duty (placing a strain on other hospital areas) and the Chemical Incident Response Service were involved. Despite the delay in institution of such procedures, no person was poisoned other than the patient with intentional poisoning. The question remains: was the response taken for this incident necessary?

For secondary contamination to occur, there must be direct contact between staff and the pesticide. This may occur when the pesticide has been spilled on skin or clothes, or if contained in body fluids such as vomit and diarrhoea. OP pesticides are formulated in hydrocarbon solvents, …