Intoxication due to exposure to contaminated molasses ("rapadura") in three municipalities of the Brazilian state of Rio Grande do Norte: a field epidemiology study

Abstract

This study describes two poisoning outbreaks due to exposure to contaminated molasses in three municipalities of the state of Rio Grande do Norte (Northeastern Brazil) between January and February 2008. Epidemiological investigation was conducted and a case study was carried out. Complementary laboratory and environmental investigations were performed to confirm outbreaks information. Eight cases were probably caused by exposure to contaminated molasses: five cases consumed the product (including a case of death) and three cases had physical exposure. The clinical symptoms were compatible with intoxication/poisoning by organophosphates. Other presented symptoms might be related to SO2 presence, such as hoarseness, watery eyes, eye pain and corneal ulceration. One of the patients who ingested contaminated mollasses presented abnormal erythrocyte acetyl cholinesterase. Exogenous poisoning occurred in two cases: one had an accident with the product and another had occupational poisoning by methamidophos and Sulfite (SO2) contaminated molasses. The quantity of methamidophos found in the molasses ingested by two cases was 3,000 times higher than the acceptable Daily Amount of this substance for humans. Public health measures should be adopted in order to reduce exogenous poisoning incidence, to minimize related problems and to prevent outbreaks caused by contamination with chemical substances, such as those investigated in this study.