The Mixer Who Would Not Wear Gloves

Likely syndrome: The combination of heavy salivation, sweating, blurred vision, abdominal cramps, dizziness and very small pupils after handling a carbamate is consistent with cholinesterase inhibition. Methomyl is a carbamate, and signs can appear quickly after skin contact or inhalation of dust. The small pupils, salivation and sweating are muscarinic signs; confusion and weakness suggest a serious exposure.

First ten minutes:

1. Protect the rescuer. Put on clean gloves and avoid touching Omar's contaminated skin or clothing.
2. Remove him from the source and move him to fresh air and shade. Do not leave him alone.
3. Remove contaminated clothing, including the shirt he wiped his face with. Avoid pulling contaminated clothing over his face.
4. Wash skin thoroughly with soap and water, especially the right forearm and face. Flush eyes with clean water for about 15 minutes if there was eye contact.
5. Call the health centre or emergency service now. Say that methomyl exposure is suspected and that he has salivation, sweating, cramps and pinpoint pupils.
6. Bring the label and SDS with him. Keep his airway open and monitor breathing. If he vomits, turn him on his side to reduce aspiration.
7. Transport immediately. Do not wait to see whether he improves. Atropine is a medical decision and must not be given by the co-worker.

• Do not give him a soft drink or food. He is confused and may vomit; drinks do not treat carbamate poisoning and can complicate airway management.
• Do not induce vomiting. Methomyl poisoning can progress quickly, and vomiting risks aspiration into the lungs. First aid should focus on removing exposure and getting medical care.
• Do not give atropine or any other medicine yourself. Atropine is an antidote used by medical staff with monitoring; the wrong dose or timing can be dangerous.
• Do not let him 'just lie down' and be left alone. His breathing or consciousness could deteriorate. He needs continuous observation and urgent transport.
• Do not send an unprotected worker back to clean up the mixing pad. The spilled dust and contaminated clothing are still a hazard. Clean-up should be done with proper PPE and away from drains.
• Do not hide the product or the label. The health centre needs the active ingredient and concentration to treat him correctly.

Why this matters: Carbamate poisoning can cause respiratory failure. The priority is decontamination, airway support and rapid transport, not home remedies.

The employer should record the incident and investigate why a torn glove, shorts, a cloth face covering and a dust-generating mixing method were allowed. The mixing pad should be reviewed: opening a 500 g bag in wind, at face height, without a proper apron and respirator, caused contamination.

Prevention should include:

• Replacing torn gloves and supplying chemical-resistant gloves, apron, face shield or goggles, and respiratory protection as required by the label and SDS.
• Training on closed mixing or careful opening of soluble bags, mixing at waist height, and standing upwind.
• Providing washing water, soap and a change of clothing at the mixing site.
• Checking that Omar receives medical follow-up and is fit to return to work; do not let him handle pesticides again until cleared.
• Reviewing the SDS and label with all workers, including first-aid and decontamination procedures.
• Keeping records of the incident, the product, the lot number, the amount involved, the symptoms, the treatment and the corrective actions.
• Reporting the incident through the farm's health and safety system and to the relevant authority if required.

The employer should also check whether the product is registered for the yam field use and whether the application method and PPE match the label. The torn glove was not a minor issue; it was the direct route of exposure.