Comparative Analysis of Pesticide Versus Pharmaceutical Poisoning Trends and Detection of Synthetic Cannabinoids in Biological Samples: Analytical Challenges

Abstract

Poisoning continues to be a major public health concern in India, with pesticides and pharmaceutical drugs representing two leading causes of toxic exposure. This prospective observational study, conducted from January 2011 to December 2011 in the Department of Forensic Medicine and Toxicology, School of Medical Sciences and Research, Sharda University, Greater Noida, aimed to compare trends, clinical profiles, and outcomes of pesticide and pharmaceutical poisoning, while also examining the analytical challenges in detecting synthetic cannabinoids in biological specimens. A total of 328 poisoning cases were recorded, of which 192 (58.5%) were pesticide-related and 136 (41.5%) involved pharmaceutical agents. The 21-40-year age group accounted for the majority of cases (61.2%), with a male predominance (63.4%). Suicidal intent was the leading cause (65.9%), followed by accidental ingestion (31.4%). Organophosphorus compounds were the most common pesticides (62.5%), whereas sedative-hypnotics and antidepressants predominated among pharmaceuticals. The mean hospital stay was longer for pesticide cases (4.1 ± 2.6 days) than pharmaceutical cases (2.8 ± 1.9 days), and mortality was significantly higher among pesticide exposures (26.5%) compared to pharmaceuticals (10.3%) (p < 0.05). Toxicological analyses confirmed exposure in 86% of pesticide and 78% of pharmaceutical cases. The review of synthetic cannabinoid detection revealed major analytical limitations with conventional immunoassays, emphasizing the need for advanced techniques such as LC-MS/MS and HRMS for accurate identification. The findings highlight pesticide poisoning as a continuing major health threat in India, and underscore the importance of enhanced laboratory capabilities, stricter regulatory control, and comprehensive toxicovigilance to address both traditional and emerging toxicological challenges.