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Cholinesterase Research Outreach Project (CROP): measuring cholinesterase activity and pesticide use in an agricultural community.

Cotton J, Lewandowski P, Brumby S - BMC Public Health (2015)

Bottom Line: Regular monitoring of erythrocyte AChE will enable farmers to identify potential exposure to organophosphate insecticides and take action to reduce exposures and improve their health and safety practices.This work will provide an evidence base and recommendations for the integration of EAChE monitoring into Australian rural health clinics, leading to research which will further quantify pesticide exposure both on the farm and in the home, highlighting the importance of sustaining and providing a safe work and home environment for farming communities.ACTRN12613001256763.

View Article: PubMed Central - PubMed

Affiliation: National Centre for Farmer Health, Western District Health Service, PO Box 823, Hamilton, Vic, 3300, Australia. j.cotton@deakin.edu.au.

ABSTRACT

Background: Australian farmers and their workers are exposed to a wide variety of pesticides. Organophosphate (OP) insecticides are a widely used class of pesticide used for animal husbandry practices (Naphthalophos for sheep dipping, jetting and drench), crop production for pest control (Dimethoate) and in public health (Maldison for head lice). Acute poisonings with this class of insecticide are reported among agricultural workers and children around the globe, due to the inhibition of acetylcholinesterase (AChE). Less is known about chronic exposures. Regular monitoring of erythrocyte AChE will enable farmers to identify potential exposure to organophosphate insecticides and take action to reduce exposures and improve their health and safety practices. This study aims to assess and improve the integration of AChE monitoring into routine point of care health clinics, and provide farming and non-farming people with a link between their AChE activity and their household chemical and agrichemical use.

Methods/design: The research will target individuals who work on mixed farming enterprises and routinely using OPs (n = 50) and non-farmers (n = 30). Baseline data are collected regarding demographic, health conditions and behaviours, Kessler 10 (K10) scores, chemical use and personal protection. Baseline anthropometric measures include height, weight, hip and waist circumference, body fat analysis and, biochemical analysis of fasted total serum cholesterol, triglycerides, low-density cholesterol (LDL), high-density cholesterol (HDL) and blood glucose. Analysis of erythrocyte cholinesterase (EAChE) activity is also conducted using a finger prick test. Testing of EAChE is then repeated in all participants every 3 weeks for a maximum of three times over a period 10 weeks. Participants are provided with full feedback and counselling about their EAChE activity after each reading and a detailed summary provided to all participants at the completion of the study. Data will be analysed using repeated measures within a general linear model.

Discussion: This work will provide an evidence base and recommendations for the integration of EAChE monitoring into Australian rural health clinics, leading to research which will further quantify pesticide exposure both on the farm and in the home, highlighting the importance of sustaining and providing a safe work and home environment for farming communities.

Trial registration: ACTRN12613001256763.

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Related in: MedlinePlus

Guide to severity of acute poisoning with anti-cholinesterase agents (Source: Modified from California Environmental Protection Agency 2002)
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Fig2: Guide to severity of acute poisoning with anti-cholinesterase agents (Source: Modified from California Environmental Protection Agency 2002)

Mentions: In addition to completion of the agrichemical use survey of 13 questions, self-reported chemical use is recorded during each visit. Participants are provided with counselling regarding their EAChE levels in accordance with AgriSafe guidelines (Fig. 2). The USA’s Department of Pesticide Regulation specifies that a drop to 70 % or lower in red blood cell AChE or to 60 % or lower in plasma cholinesterase relative to the individual’s baseline is an indication for immediate removal of the individual from all exposure to organophosphate and carbamate pesticides [25]. Participants will be provided with a summary of their EAChE baseline and subsequent results at the conclusion of the study. This methodology reflects recent exposures and is used to provide feedback at the time of testing. However, it is noted that the level of current exposure is not a measure of long-term exposure and that the clinical parameters around long-term exposure are not well defined.Fig. 2


Cholinesterase Research Outreach Project (CROP): measuring cholinesterase activity and pesticide use in an agricultural community.

Cotton J, Lewandowski P, Brumby S - BMC Public Health (2015)

Guide to severity of acute poisoning with anti-cholinesterase agents (Source: Modified from California Environmental Protection Agency 2002)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4526178&req=5

Fig2: Guide to severity of acute poisoning with anti-cholinesterase agents (Source: Modified from California Environmental Protection Agency 2002)
Mentions: In addition to completion of the agrichemical use survey of 13 questions, self-reported chemical use is recorded during each visit. Participants are provided with counselling regarding their EAChE levels in accordance with AgriSafe guidelines (Fig. 2). The USA’s Department of Pesticide Regulation specifies that a drop to 70 % or lower in red blood cell AChE or to 60 % or lower in plasma cholinesterase relative to the individual’s baseline is an indication for immediate removal of the individual from all exposure to organophosphate and carbamate pesticides [25]. Participants will be provided with a summary of their EAChE baseline and subsequent results at the conclusion of the study. This methodology reflects recent exposures and is used to provide feedback at the time of testing. However, it is noted that the level of current exposure is not a measure of long-term exposure and that the clinical parameters around long-term exposure are not well defined.Fig. 2

Bottom Line: Regular monitoring of erythrocyte AChE will enable farmers to identify potential exposure to organophosphate insecticides and take action to reduce exposures and improve their health and safety practices.This work will provide an evidence base and recommendations for the integration of EAChE monitoring into Australian rural health clinics, leading to research which will further quantify pesticide exposure both on the farm and in the home, highlighting the importance of sustaining and providing a safe work and home environment for farming communities.ACTRN12613001256763.

View Article: PubMed Central - PubMed

Affiliation: National Centre for Farmer Health, Western District Health Service, PO Box 823, Hamilton, Vic, 3300, Australia. j.cotton@deakin.edu.au.

ABSTRACT

Background: Australian farmers and their workers are exposed to a wide variety of pesticides. Organophosphate (OP) insecticides are a widely used class of pesticide used for animal husbandry practices (Naphthalophos for sheep dipping, jetting and drench), crop production for pest control (Dimethoate) and in public health (Maldison for head lice). Acute poisonings with this class of insecticide are reported among agricultural workers and children around the globe, due to the inhibition of acetylcholinesterase (AChE). Less is known about chronic exposures. Regular monitoring of erythrocyte AChE will enable farmers to identify potential exposure to organophosphate insecticides and take action to reduce exposures and improve their health and safety practices. This study aims to assess and improve the integration of AChE monitoring into routine point of care health clinics, and provide farming and non-farming people with a link between their AChE activity and their household chemical and agrichemical use.

Methods/design: The research will target individuals who work on mixed farming enterprises and routinely using OPs (n = 50) and non-farmers (n = 30). Baseline data are collected regarding demographic, health conditions and behaviours, Kessler 10 (K10) scores, chemical use and personal protection. Baseline anthropometric measures include height, weight, hip and waist circumference, body fat analysis and, biochemical analysis of fasted total serum cholesterol, triglycerides, low-density cholesterol (LDL), high-density cholesterol (HDL) and blood glucose. Analysis of erythrocyte cholinesterase (EAChE) activity is also conducted using a finger prick test. Testing of EAChE is then repeated in all participants every 3 weeks for a maximum of three times over a period 10 weeks. Participants are provided with full feedback and counselling about their EAChE activity after each reading and a detailed summary provided to all participants at the completion of the study. Data will be analysed using repeated measures within a general linear model.

Discussion: This work will provide an evidence base and recommendations for the integration of EAChE monitoring into Australian rural health clinics, leading to research which will further quantify pesticide exposure both on the farm and in the home, highlighting the importance of sustaining and providing a safe work and home environment for farming communities.

Trial registration: ACTRN12613001256763.

Show MeSH
Related in: MedlinePlus