Fifteen years of experience in cholinesterase monitoring of insecticide applicators.
Fifteen years of experience in cholinesterase monitoring of insecticide applicators.
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DOI：
10.1300/j096v10n03_06
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发表时间：
2005-01-01
影响因子：
2.4
通讯作者：
Lessenger, James E
中科院分区：
文献类型：
--
作者：
Lessenger, James E
简介：测定红细胞和血浆中胆碱酯酶（ChE）水平已成为早期检测杀虫剂处理人员中有机磷和氨基甲酸酯中毒的有用工具。自1974年以来，加州州要求对农药施用者进行测试以预防疾病。本研究是一个审查的测试经验的两个医生和使用一个实验室，以便可以比较到以前的研究由作者和other.METHODS：366名工人谁是指他们的雇主胆碱酯酶活性监测的文件被抽象为病人的数据，雇主识别，和测试数据。结果进入EPIINFO程序进行analysis.RESULTS：在1989年至2004年的15年期间，共有366名工人从45家公司进行了测试。大多数是应用程序。有690次尝试建立基线，其中545次（79%）成功。对228名工人进行了519次监测试验，结果使18名雇员脱离接触，其中大部分是在1996年。自我报告的暴露史和症状仅导致3例应答（0.6%）。成本很高（总计47，160美元，每次测试36美元），特别是考虑到145名（21%）员工未能建立基线。血浆和RBC基线存在月度和年度变化，血浆监测试验存在月度差异，RBC监测无月度差异。当前两个变化15%时，使用第三个基线测试避免了两个假阳性。从胆碱酯酶抑郁症恢复的平均时间为5.38 weeks.Discussion：加州胆碱酯酶监测程序仍然是一个有价值的工具。基线和监测血浆和RBC值的值均存在显著的月度和年度变化，RBC月度差异除外。没有发现自我报告的症状是测量暴露的一个有价值的工具。胆碱酯酶抑制的恢复率是高度可变的。该程序的警告功能非常有效。监测的成本是巨大的，但可能没有一个单一的工人的赔偿cases.CONCLUSIONS：加州胆碱酯酶监测程序作为一个有用的和具有成本效益的手段，防止有机磷和氨基甲酸酯过量。应考虑取消第三个基线测试要求。
INTRODUCTION: Measuring cholinesterase(ChE) enzyme levels in red blood cells (RBC) and plasma has become a useful tool in the early detection of organophosphate and carbamate poisoning in insecticide handlers. Since 1974 the State of California has required testing of pesticide applicators to prevent disease. This study is a review of the testing experience of two physicians and using one laboratory so that a comparison can be made to previous studies by the author and others.METHODS: The files of 366 workers who were referred by their employers for ChE activity monitoring were abstracted for patient data, employer identification, and testing data. Results were entered into the EPIINFO program for analysis.RESULTS: A total of 366 workers from 45 companies were tested over a 15-year period between 1989 and 2004. Most were applicators. There were 690 attempts to establish baselines, of which 545 (79%) were successful. There were 519 monitoring tests on 228 workers, resulting in the removal from exposure of 18 employees, most in 1996. Self-reported exposure history and symptoms resulted in only 3 responses (.6%). The costs were significant ($47,160 total and $36 per test), especially when considering the failure of 145 (21%) employees to establish baselines. There was monthly and yearly variation in plasma and RBC baselines, monthly variance in plasma monitoring tests, and no monthly variance in RBC monitoring. The use of a third baseline test when the first two varied by 15% avoided two false positives. The mean time for recovery from ChE depression was 5.38 weeks.DISCUSSION: The California ChE monitoring program remains a valuable tool. There was significant monthly and yearly variation in values for both baseline and monitoring plasma and RBC values, with the exception of RBC monthly variance. Self-reported symptoms were not found to be a valuable tool in measuring exposure. Rates of recovery from ChE depression were highly variable. The warning feature of the program was very effective. The costs of monitoring were substantial, but possibly not as great as a single workers' compensation case.CONCLUSIONS: The California ChE monitoring program serves as a useful and cost-effective means of preventing organophosphate and carbamate overexposure. Elimination of the third baseline test requirement should be considered.