A group of 31 lettuce harvesters exposed to the organophosphate pesticide mevinphos presented to a local emergency room with moderate cholinergic symptoms and eye and skin irritation, with 22 of the subjects (76%) reporting three or more symptoms. None had baseline cholinesterase values, and plasma cholinesterase activity for all but two workers was above the lower limit of the laboratory normal range. None of the workers received antidotes and all were released for return to work. Twenty-nine workers sought additional care when symptoms persisted, and were followed by the investigators until 12 weeks after exposure. Plasma and red blood cell (RBC) cholinesterase increased until 14 days after exposure. Plasma cholinesterase was estimated to have been inhibited by an average of 15.6% (p less than 0.01), and RBC cholinesterase by 5.6% (p less than 0.01). These findings support the utility of sequential postexposure plasma cholinesterase analyses in confirmation of suspect organophosphate-induced illness when baseline values are not available.

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An epidemiological health study compared the health status of residents of a town exposed to an accidental Catacarb chemical release from an adjacent oil refinery, with the health status of demographically similar residents of an unexposed town in the region. Few studies of Catacarb's effects on humans exist; however, animal studies have shown it to be a respiratory, gastro-intestinal, dermatological and visual irritant. As part of the study, health questionnaires assessing pre-and post exposure symptoms, illnesses and medication use were mailed to residents in both towns. Medication use is sometimes reported to be a more objective and reliable measure of health outcomes 1) . The current paper compared medication use of exposed and unexposed residents. Significant increases after exposure were found in the use of the following medications: antacid, asthma medication, cough and cold medication, eye medication, headache medication and sleep medication. These increases were consistent with reported symptoms, albeit of greater magnitude; no increase in medication use for other illnesses was reported. Medication use in this sample was consistent with patients' report of symptoms and may be a better measure of outcome.

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