<unk>  is toxic to humans (Category II) by the oral route and moderately toxic (Category III) through the skin. Pure<unk> , when ingested, is highly toxic to mammals, including humans, causing severe inflammation and potentially leading to severe lung damage, acute respiratory distress syndrome (ARDS), and death. The mortality rate is estimated between 60-90%.<unk>  is also toxic when inhaled and is in the Toxicity Category I (the highest of four levels) for acute inhalation effects. For agricultural uses, the EPA determined that particles used in agricultural practices (400–800 μm) are not in the respirable range.<unk>  also causes moderate to severe irritation of the eye and skin. Diluted<unk>  used for spraying is less toxic; thus, the greatest risk of accidental poisoning is during mixing and loading<unk>  for use. The standard treatment for<unk>  poisoning is first to remove as much as possible by pumping the stomach. Fuller's earth or activated charcoal may also improve outcomes depending on the timing. Haemodialysis, haemofiltration, haemoperfusion, or antioxidant therapy may also be suggested. Immunosuppressive therapy to reduce the inflammation is an approach suggested by some, however only low certainty evidence supports using medications such as glucocorticoids with cyclophosphamide in addition to the standard care to reduce mortality. It is also unknown if adding glucocorticoid with cyclophosphamide to the standard care has unwanted side effects such as increasing the risk of infection. Oxygen should not be administered unless SpO2 levels are below 92%, as high concentrations of oxygen intensify the toxic effects. Death may occur up to 30 days after ingestion. Lung injury is a main feature of poisoning. Liver, heart, lung, and kidney failure can occur within several days to weeks that can lead to death up to 30 days after ingestion. Those who suffer large exposures are unlikely to survive. Chronic exposure can lead to lung damage, kidney failure, heart failure, and oesophageal strictures. The mechanism underlying<unk> 's toxic damage to humans is still unknown.The severe inflammation is thought to be caused by the generation of highly reactive oxygen species and nitrite species that results in oxidative stress. The oxidative stress may result in mitochondrial toxicity and the induction of apoptosis and lipid peroxidation which may be responsible for the organ damage. it is known that the alveolar epithelial cells of the lung selectively concentrate<unk> . It has been reported that a small dose, even if removed from the stomach or spat out, can still cause death from fibrous tissue developing in the lungs, leading to asphyxiation. Accidental deaths and suicides from<unk>  ingestion are relatively common. For example, there are more than 5,000 deaths in China from<unk>  poisoning every year. Long-term exposures to<unk>  would most likely cause lung and eye damage, but reproductive/fertility damage was not found by the United States Environmental Protection Agency (EPA) in their review.<unk>  pot" During the late 1970s, a controversial program sponsored by the US government sprayed<unk>  on cannabis fields in Mexico. Following Mexican efforts to eradicate marijuana and poppy fields in 1975, the United States government helped by sending helicopters and other technological assistance. Helicopters were used to spray the herbicides<unk>  and 2,4-D on the fields; marijuana contaminated with these substances began to show up in US markets, leading to debate about the program. Whether any injury came about due to the inhalation of<unk> -contaminated marijuana is uncertain. A 1995 study found that "no lung or other injury in cannabis users has ever been attributed to<unk>  contamination". Also a United States Environmental Protection Agency manual states: "... toxic effects caused by this mechanism have been either very rare or nonexistent. Most<unk>  that contaminates cannabis is pyrolyzed during smoking to dipyridyl, which is a product of combustion of the leaf material itself (including cannabis) and presents little toxic hazard." In a study by Imperial Chemical Industries, rats who inhaled<unk>  showed development of squamous metaplasia in their respiratory tracts after a couple of weeks. This study was included in a report given to the State Department by the Mitre Corporation. The U.S. Public Health Service stated that "this study should not be used to calculate the safe inhalation dose of<unk>  in humans." Use in suicide and murder A large majority (93 percent) of fatalities from<unk>  poisoning are suicides, which occur mostly in developing countries. For instance, in Samoa from 1979 to 2001, 70 percent of suicides were by<unk>  poisoning. Trinidad and Tobago is particularly well known for its incidence of suicides involving the use of Gramoxone (commercial name of<unk> . In southern Trinidad, particularly in Penal, Debe from 1996 to 1997, 76 percent of suicides were by<unk> , 96 percent of which involved the over-consumption of alcohol such as rum. Fashion celebrity Isabella Blow committed suicide using<unk>  in 2007.<unk>  is widely used as a suicide agent in third-world countries because it is widely available at low cost. Further, the toxic dose is low (10 mL or 2 teaspoons is enough to kill). Campaigns exist to control or even ban<unk> , and there are moves to restrict its availability by requiring user education and the locking up of<unk>  stores. When a 2011 South Korean law completely banned<unk>  in the country, death by pesticide plummeted 46%, contributing to the decrease of the overall suicide rate. The indiscriminate<unk>  murders, which occurred in Japan in 1985, were carried out using<unk>  as a poison.<unk>  was used in the UK in 1981 by a woman who poisoned her husband. Steven David Catlin killed two of his wives and his adoptive mother with<unk>  between 1976 and 1984. Parkinson's disease In 2011, a US National Institutes of Health study showed a link between<unk>  use and Parkinson's disease in farm workers. A co-author of the paper said that<unk>  increases production of certain oxygen derivatives that may harm cellular structures, and that people who used<unk> , or other pesticides with a similar mechanism of action, were more likely to develop Parkinson's.<unk> -induced toxicity in rats has also been linked to Parkinson's-like neurological degenerative mechanisms. A study by the Buck Institute for Research on Aging showed a connection between exposure to<unk>  and iron in infancy and mid-life Parkinson's in laboratory mice. A 2013 meta-analysis published in Neurology found that 'exposure to<unk>  ... was associated with about a 2-fold increase in risk' of Parkinson's disease.<unk>  is structurally similar to MPP+, a known fast-acting inducer of Parkinson's disease in primate brains. The chloride of MPP+ was sold under the trade name Cyperquat.<unk>  also induces oxidative stress in invertebrates such as Drosophila melanogaster.<unk> -fed flies suffer early-onset mortality and significant increases in superoxide dismutase activity. While in 2022 UK farmers were calling for a ban on the UK production of<unk> , a BBC article stated that "There is no scientific consensus and many conflicting studies on any possible association between<unk>  and Parkinson's"; in the USA a class action against Syngenta is ongoing; the company refutes the claims but has paid £187.5 million into a settlement fund.
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