Cholinesterase research outreach project (CROP): point of care cholinesterase measurement in an Australian agricultural community

Abstract

BackgroundAustralian farmers are routinely exposed to a wide variety of agrichemicals, including herbicides and insecticides. Organophosphate (OP) insecticides are widely used for agricultural production, horticulture and animal husbandry practices. Symptoms of OP toxicity are the results of inhibition of the enzyme acetylcholinesterase (AChE) which is found in many types of conducting tissue in human bodies such as nerve and muscle, central and peripheral tissues, motor and sensory fibres. Cholinesterase can be measured in red blood cells/erythrocytes (AChE) and plasma (PChE). This study aims to explore integration of AChE monitoring into routine health checks for those at risk and also to examine any association between AChE activity and agrichemical use in a Victorian farming community in Australia.MethodsThis was a prospective cohort study, where farmers and non-famers were compared on the levels of AChE at four time points of baseline, 3–4 weeks, 6-weeks and at 9-weeks. Study participants (N = 55) were residents from South West Victoria, aged between 18 and 75 years, spoke English, and had not had a previous known acute chemical accident. A total of 41 farming (had been farming for more than 5 years) and a convenience sample of 14 non-farming individuals met the inclusion criteria. Testing of AChE was repeated for all participants with a maximum of three times over 10 weeks.ResultsThe integration of AChE monitoring was very well accepted by all participants. There was no significant difference in average AChE activity between farming and non-farming participants (one-way ANOVA p > 0.05) in this study. There was no significant difference between personal use of agricultural chemicals on farm and the levels of AChE at baseline (measurement 1) or any of the follow up periods (p > 0.05). However, the mean activity of AChE was significantly lower within follow up periods [F (2.633, 139.539) = 14.967, p < 0.001]. There was a significant reduction of AChE between the follow up at 3-weeks and 6-weeks period (p = 0.015).ConclusionsThe routine monitoring of AChE may allow for early recognition of chronic low-level exposure to OPs when they are used by farmers, provided a reasonable estimate of baseline AChE is available. This work provides an evidence for recommending the integration of AChE monitoring into point of care (POC) procedures in rural health clinics and quantifying pesticide exposure and personal protection both on the farm and in the home. Farmer engagement is crucial to the successful integration of AChE monitoring into rural health clinics in Australia.Trial registrationACTRN12613001256763.

The acetylcholinesterase as indicative of intoxication for pesticide in farmers of conventional and organic cultivation

“…In the study conducted by Vasconcelos et al (2014), by characterizing the profile of 112 rural workers who use pesticides in coffee plantations in Minas Gerais, with respect to the age group, 45 (40.18%) aged between 31 and 50 years and 40 years (35.71%) between 18 and 30 years. Similar mean age was also reported by Cotton et al (2018), in a survey with farmers in a community in Australia, noted that most of the participants in their research were male with an average between 45 and 64 years of age. Vasconcelos et al (2014) mention that the age factor in rural workers can cause a serious health problem, as young people and the elderly are more susceptible to illness due to exposure to chemical agents.…”

“…In studies conducted by Quandt et al (2010), in farmers in North Carolina, there were -reductions in ache activity levels, with decreases >15% of an individual's highest value, identifying and considering a reduction in activity significant colineteric. A recent study by Cotton et al (2018) showed that 14.9% of the 41 farmers involved there was a significant reduction in AChE from exposure to insecticides. Vikkey et al (2017), evaluating levels of poisoning in farmers in the Central Republic of Benin, there was a significant decrease in AChE of 60.61% of the population studies.…”

Evaluation of cholinesterase and lipid profile levels in chronic pesticide exposed persons

“…It is suggested that non farmers may also be exposed but are less likely to regularly monitor their chemical exposure and use personal protective equipment when using chemicals. [52]…”

Pesticide Use and Serum Acetylcholinesterase Levels among Flower Farm Workers in Ethiopia—A Cross-Sectional Study

“…Abnormal cholinesterase level is an indication of worker exposure to pesticides. Thus, it is important to regularly survey these levels to monitor the worker health on flower farms to reduce the potential hazard effects [37,38].…”

“…Also, we would have benefited from repeated measurements of cholinesterase levels. Determining baseline level of cholinesterase for each individual would also have been important because of the wide individual range for cholinesterase [37,38]. We were not able to perform a study including the worker's baseline serum cholinesterase levels because the workers were already working for a while at the time of the study.…”