Paraquat Poisoning

What is paraquat poisoning?

Paraquat dichloride, or paraquat, is a highly toxic (poisonous) liquid herbicide (plant or weed killer). Commercial farmers may use paraquat to kill weeds or dry out certain crops, like cotton, before harvesting them.

You can get paraquat poisoning if you swallow, touch or inhale paraquat. Consuming just 1 teaspoon (tsp) of paraquat can cause death. The chemical can also cause serious illness or death if it touches your clothing, eyes or skin.

How common is paraquat poisoning?

A small number of people in the U.S. die from paraquat poisonings each year. People at the highest risk of exposure are commercial farmers and some people who might use paraquat-based weed killers for home gardening use. People living near agricultural areas where paraquat is used or sprayed may be exposed to the herbicide through drift or runoff. Restrictions on buying and using paraquat have helped reduce the number of poisonings. In addition, paraquat sold in the U.S. contains blue dye, a foul odor and an ingredient that causes you to vomit (throw up). These safety measures have made paraquat easier to identify and get out of your body if you swallow it.

What are the symptoms of paraquat poisoning?

Paraquat often damages your digestive tract and respiratory system first. Early signs of paraquat poisoning include:

• Choking.
• Swelling in your throat.
• Diarrhea, which may be bloody.
• Irritation or redness in your mouth or throat.
• Nosebleed.
• Sore throat.
• Stomach pain.
• Vomiting or vomiting blood.

Within hours, the chemical moves into other parts of your body and can cause:

• Coma.
• Confusion.
• Fast heart rate.
• Muscle weakness.
• Seizures.
• Shock (dangerously low blood pressure).
• Trouble breathing.

What causes paraquat poisoning?

In many cases, paraquat poisoning occurs when someone pours paraquat into another container and another person mistakenly drinks it. Paraquat can also harm you if it touches your skin, especially if that skin is open due to a cut, rash or other skin damage. Some people get paraquat poisoning by breathing in particles or getting them in their eyes during a paraquat spraying.

What are the complications of this condition?

Paraquat poisoning can cause death or permanent damage to vital organs, including your:

• Heart.
• Kidneys.
• Liver.
• Lungs.

The severity of complications depends on:

• How much paraquat you were exposed to.
• Type of exposure (swallowing, inhaling or touching).
• Your overall health.

How do providers diagnose paraquat poisoning?

To diagnose paraquat poisoning, first responders may ask you how much paraquat you touched, swallowed or inhaled. Providers will likely begin treating you for poisoning right away, before ordering tests. They’ll check your vital signs, including your:

• Blood pressure.
• Breathing rate.
• Pulse.
• Temperature.

What tests do providers use to diagnose paraquat poisoning?

You may need medical tests to diagnose or rule out problems and guide your treatment, including:

• Blood test.
• Urinalysis (urine test).
• Heart tests, like an electrocardiogram (EKG) or echocardiogram.
• Lung imaging tests, like a CT scan (computed tomography scan) of your chest or chest X-ray.
• Upper endoscopy.

How do providers treat paraquat poisoning?

The first step in treating paraquat poisoning is to try and stop or reduce the absorption of the chemical into your body. First responders or emergency room providers may:

• Give you activated charcoal or Fuller’s earth, which can stop your body from absorbing certain poisons.
• Remove clothing that may have paraquat on it.
• Guide a tube through your nose and into your stomach to remove paraquat from your stomach.
• Wash exposed skin or flush your eyes with water for several minutes.

After these initial steps, you’ll likely need to stay in the hospital for several days to weeks, and may receive:

• Breathing support from a ventilator if you’re unable to breathe on your own.
• Dialysis to support your kidney function.
• Hemoperfusion to remove toxins from your blood.
• Intravenous (IV) fluids for hydration.
• Medications to raise very low blood pressure or treat other symptoms.

Is there an antidote for paraquat poisoning?

There’s no antidote or cure for paraquat poisoning. Providers will try to minimize the damage by removing paraquat from your body and providing supportive care to help you recover.

Do providers give oxygen for paraquat poisoning?

Usually, providers won’t give oxygen if you have paraquat poisoning. Because paraquat reacts with oxygen in your body, adding more oxygen to your lungs makes paraquat poisoning worse.

How can I prevent paraquat poisoning?

You can prevent paraquat poisoning by following the U.S. Environmental Protection Agency (EPA) guidelines and restrictions on this chemical. The guidelines state that to use paraquat, you:

• Need a valid and current paraquat license and training from the EPA.
• Can only use the chemical on commercial farms, not on personal property or in residential areas.
• Must store the chemical in its original, labeled container and keep it locked up and out of reach of others.

What should I do if I think I have paraquat poisoning?

If you think you or someone else may have touched, inhaled or swallowed paraquat, call 911 (or your local emergency services number) or go to the nearest emergency room immediately.

If you think you got paraquat on your clothing, call 911 immediately and:

• Try to remove your clothing without touching the areas that were exposed. Wear gloves or use tongs or other tools to remove your clothing if possible.
• Put your clothing, gloves and tools in a sealed plastic bag, then put that bag inside another sealed plastic bag.
• Take a shower, washing your entire body with soap and water.

What’s the outlook for this condition?

Some people survive paraquat poisoning if they’re exposed to a small amount and get medical care right away. However, not everyone survives paraquat poisoning, even with proper treatment.

How do I take care of myself after paraquat poisoning?

Some people who survive paraquat poisoning recover fully, while others have long-term health issues. Before you leave the hospital, your provider will talk with you about any ongoing treatment you need, such as medications or outpatient dialysis. Attend all your recommended follow-up visits with your provider and tell them if you have any new symptoms or health issues.

A note from Cleveland Clinic

If you think you were exposed to paraquat, don’t wait — get emergency medical care immediately. Your healthcare team will start working right away to remove toxins from your body. Remember, prompt care is the best way to minimize damage, so don’t delay.