The 3033 pesticide poisoning cases referred to Imam Reza Hospital in Mashhad, Iran from 2000 to 2008 were evaluated retrospectively. Data on different pesticides allocated to Khorasan-Razavi province, Iran were obtained from the ministry of agriculture from 1997 to 2008. A poisoning risk index (number of poisonings divided by pesticide distribution/tons ×10) and mortality risk index (number of deaths divided by pesticide distribution/tons) were calculated. Insecticides had the highest distribution rate, varying between 237 and 679.2 tons/year. The lowest distribution rate was for rodenticides, including aluminum phosphide (AP). 2578 human insecticide exposures were reported, of which 53.34% were females. The seasonal distribution in insecticide poisoning cases suggested a peak in spring and summer (63.15%). A total of 14 fungicides and herbicides poisoning cases were reported during 2000-2008, of which all fully recovered. Distribution of fungicides and herbicides varied between 225 and 580.2 tons/year. During 2000-2008, 406 cases of rodenticides & AP poisoning were referred to this hospital, having a roughly equal prevalence in female (49.8%) and males; of these a total of 6.4% died. The highest amount of rodenticides and AP allocated to the region was 1.832 tons in 2008. There was a significant (P<0.01) relationship between the amount of rodenticides and AP allocated annually and the number of admitted poisoning cases. Poisoning risk indices were 410, 6.5 and 0.04 for rodenticides and AP, insecticides, and fungicides and herbicides, respectively. Mortality risk index was 2.72 for rodenticides and AP and 0.03 for insecticides.

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