Clinical Confirmation of Organophosphate Poisoning by Serial Cholinesterase Analyses

Coye, Molly Joel; Barnett, Paul G.; Midtling, John E.; Velasco, Antonio R.; Romero, Pablo Ortiz; Clements, Charlie L.; Rose, Theodore G.

doi:10.1001/archinte.1987.00370030042010

Cited by 57 publications

(22 citation statements)

References 8 publications

(2 reference statements)

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“…It was speculated that lower cholinesterase activity was associated with a higher frequency of pesticide exposure and attributed this to the cumulative effect of repeated exposure, but it could also be explained simply by the fact that people who have used pesticides more often have had more opportunity to develop a lowered cholinesterase activity. The greatest adverse effect among people who were exposed was an abnormal cholinesterase level, which confirms earlier studies on the effect of pesticides on the body, that people who are exposed to pesticides are more likely to have abnormal cholinesterase levels because use of pesticides has been found to be positively associated with pesticide poisoning (Coye et al, 1987;Edmiston and Maddy 1987;Faria et al, 2004;NIPC, 2004;Saunders et al, 1987;Xue et al, 1987).…”

Section: Baseline Cholinesterase Activitysupporting

confidence: 76%

Butyrylcholinesterase activity among farm male pesticide handlers in Naivasha, Kenya

Mambo¹,

Njagi²,

Orinda³

2013

Afr. J. Agric. Res.

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To investigate the incidence of pesticide poisoning using serum cholinesterase activity patterns in a horticultural farm, 616 people comprising of 496 pesticide handlers (test group) and a control group of 120 persons participated in the study. A semi-structured questionnaire was used to obtain demographic information, while the activities of serum cholinesterase, serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, alkaline phosphatase and bilirubin were estimated using standard commercial kits and absorbance measured using kinetic colorimetric tests. All the pesticide handlers (100%) were males, with majority (80.3%) aged 20 to 35 years old. Of the test population, 6% had significant cholinesterase enzyme depressions with no symptoms of exposure recorded. Significant difference (p<0.05) was observed in baseline cholinesterase activity between the test and control groups with a calculated intra-personal variation of 5.75%. Between the test and control groups, no correlation was observed on the baseline cholinesterase activity (r 2 = 0.003). Difference in cholinesterase activity was not significant (p>0.05) between the test and control groups based on years of handling pesticides. Use of pesticides in successive spray seasons significantly inhibited cholinesterase activity among the spray team, supervisors and harvesters (p<0.05). Higher cholinesterase activity was observed in the 31 to 40 age group with significant changes in cholinesterase activity (p<0.05) observed among those aged below 40 years. The study indicates that cholinesterase activity can be used effectively as an indicator of exposure to pesticides.

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Section: Baseline Cholinesterase Activitysupporting

confidence: 76%

Butyrylcholinesterase activity among farm male pesticide handlers in Naivasha, Kenya

Mambo¹,

Njagi²,

Orinda³

2013

Afr. J. Agric. Res.

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“…The low level of pseudocholinesterase activity in this patient's serum combined with the normal dibucaine number indicates that this patient has inhibited but genetically normal enzyme activity. Studies of agricultural workers exposed to organophosphate insecticides, common pseudocholinesterase inhibitors, found that only modest reductions in measured enzyme activity, 11,12 such as seen in this patient, were associated with symptoms of organophosphate poisoning.…”

Section: Discussionmentioning

confidence: 53%

Grand Mal Seizure in a Child 30 Minutes After Cyclogyl (Cyclopentolate Hydrochloride) and 10% Neo-Synephrine (Phenylephrine Hydrochloride) Eye Drops Were Instilled

Demayo¹,

Reidenberg

2004

Pediatrics

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ABSTRACT. A grand mal seizure is an unexpected, rare adverse event in a child receiving eye drops to dilate the pupils for an eye examination. A case is reported of a convulsion in a 23-month-old boy after he received Cyclogyl (cyclopentolate) and Neo-Synephrine (phenylephrine) eye drops before ophthalmoscopy. His serum sodium was 125 mEq/L, and he had low plasma pseudocholinesterase activity. Children exposed to organophosphate insecticides and other pseudocholinesterase inhibitors may be at risk for cyclopentolate toxicity. Pediatrics 2004;113:e499 -e500. URL: http://www.pediatrics.org/cgi/ content/full/113/5/e499; seizures, cyclopentolate, eye drops. P atients undergoing ophthalmoscopy in hospital for various reasons are given eye drops often for cycloplegia and mydriasis to facilitate examination of the retina. The agents commonly used are 10% phenylephrine eye drops to dilate the pupils and Cyclogyl (cyclopentolate) in the form of 0.5% or 1% eye drops to paralyze the iris (cycloplegia) temporarily. Cyclogyl is a muscarinic receptor antagonist similar to atropine. It shares certain rarely occurring side effects with atropine, which include the possibility of epileptic seizures. We present the case of a toddler without a prior history of seizures that had a grand mal seizure lasting 30 minutes after he got 1 drop in each eye, every 5 minutes, of 10% Neo-Synephrine and 1% Cyclogyl, for a total of 3 drops of each over a 15-minute period. His seizures began 45 minutes after he received the last dose of each eye drop. CASE REPORTA previously healthy 23-month-old white male infant came by ambulance to the hospital because of second and third degree scald burns involving both feet and ankles in stocking distribution. This injury was incurred by his being immersed at 6 pm in a tub of hot water. He was brought to a local emergency department by his mother 4 2 ⁄3 hours after the accident (she said she had been told by phone to wait and see whether his feet became blistered and swollen before coming in). He was triaged, stabilized, and burn-dressed in the local emergency department and transferred by ambulance to this hospital for treatment in our burn center.He arrived at our emergency department ϳ7 3 ⁄4 hours after the scalding. His temperature was 37.6°C, his pulse was 160 beats per minute, and his respirations were 32 per minute. He was crying, withdrawn, and in pain. He didn't talk. His weight was 11.88 kg (25th percentile), height was 93 cm (a little less than the 95th percentile), and head circumference was 49 cm (50th percentile). He showed a normal physical examination, except for a diaper rash, and a normal neurologic examination. There was no external evidence of head trauma or other trauma apart from the scald burns involving both feet and ankles in a stocking distribution. Some were of partial thickness, but most were full thickness.The local emergency department had referred his case to the City of New York Child Protective Services before he was transferred.In our emergency department he was given 1 mg o...

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“…3 For workers without a baseline RBC-ChE value, repeated tests have been recommended after removal from exposure to determine the level at which RBC-ChE values stabilize. 4,5 RBC-ChE values, however, may continue to increase for several months after last exposure. Therefore, RBC-ChE values should not be considered baseline until they have stabilized.…”

Section: Cholinesterase-inhibiting Pesticidesmentioning

confidence: 99%

Health hazard evaluation report: HETA-95-0074-0080-2599, U.S. Department of the Interior, Fish and Wildlife Service, Chicago, Illinois.

1996

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Clinical Confirmation of Organophosphate Poisoning by Serial Cholinesterase Analyses

Cited by 57 publications

References 8 publications

Butyrylcholinesterase activity among farm male pesticide handlers in Naivasha, Kenya

Butyrylcholinesterase activity among farm male pesticide handlers in Naivasha, Kenya

Grand Mal Seizure in a Child 30 Minutes After Cyclogyl (Cyclopentolate Hydrochloride) and 10% Neo-Synephrine (Phenylephrine Hydrochloride) Eye Drops Were Instilled

Health hazard evaluation report: HETA-95-0074-0080-2599, U.S. Department of the Interior, Fish and Wildlife Service, Chicago, Illinois.

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