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. 1985 Apr;142(4):514–518.

Clinical Management of Field Worker Organophosphate Poisoning

John E Midtling 1,2,3,4,5, Paul G Barnett 1,2,3,4,5, Antonio R Velasco 1,2,3,4,5, Pablo Romero 1,2,3,4,5, Charlie L Clements 1,2,3,4,5, Michael A O'Malley 1,2,3,4,5, Michael W Tobin 1,2,3,4,5, Theodore G Rose 1,2,3,4,5, Molly J Coye 1,2,3,4,5, Ira H Monosson 1,2,3,4,5
PMCID: PMC1306075  PMID: 4013266

Abstract

A group of 16 cauliflower workers poisoned by residues of the organophosphate insecticides mevinphos and phosphamidon was followed in weekly clinics with interviews and determinations of plasma and erythrocyte cholinesterase levels. None had preexposure baseline values. Although six had initial erythrocyte cholinesterase values within the laboratory normal range, subsequent testing showed their erythrocyte activity had been significantly inhibited. While the most severe symptoms of the 16 subjects resolved after 28 days, their erythrocyte cholinesterase levels did not reach a plateau until an average of 66 days after exposure, after which most patients continued to report blurred vision, headache, weakness or anorexia. These findings support the view that the diagnostic utility of single cholinesterase levels is limited in the absence of baseline values.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. DURHAM W. F., HAYES W. J., Jr Organic phosphorus poisoning and its therapy. With special reference to modes of action and compounds that reactivate inhibited cholinesterase. Arch Environ Health. 1962 Jul;5:21–47. doi: 10.1080/00039896.1962.10663237. [DOI] [PubMed] [Google Scholar]
  2. FRAWLEY J. P., HAGAN E. C., FITZHUGH O. G. A comparative pharmacological and toxicological study of organic phosphate-anticholinesterase compounds. J Pharmacol Exp Ther. 1952 Jun;105(2):156–165. [PubMed] [Google Scholar]
  3. GAINES T. B. The acute toxicity of pesticides to rats. Toxicol Appl Pharmacol. 1960 Jan;2:88–99. doi: 10.1016/0041-008x(60)90074-0. [DOI] [PubMed] [Google Scholar]
  4. GROB D., HARVEY J. C. Effects in man of the anticholinesterase compound sarin (isopropyl methyl phosphonofluoridate). J Clin Invest. 1958 Mar;37(3):350–368. doi: 10.1172/JCI103615. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Gaines T. B. Acute toxicity of pesticides. Toxicol Appl Pharmacol. 1969 May;14(3):515–534. doi: 10.1016/0041-008x(69)90013-1. [DOI] [PubMed] [Google Scholar]
  6. Kahn E. Pesticide related illness in California farm workers. J Occup Med. 1976 Oct;18(10):693–696. doi: 10.1097/00043764-197610000-00013. [DOI] [PubMed] [Google Scholar]
  7. Namba T. Cholinesterase inhibition by organophosphorus compounds and its clinical effects. Bull World Health Organ. 1971;44(1-3):289–307. [PMC free article] [PubMed] [Google Scholar]
  8. Namba T., Nolte C. T., Jackrel J., Grob D. Poisoning due to organophosphate insecticides. Acute and chronic manifestations. Am J Med. 1971 Apr;50(4):475–492. doi: 10.1016/0002-9343(71)90337-8. [DOI] [PubMed] [Google Scholar]
  9. Rider J. A., Puletti E. J., Swader J. I. The minimal oral toxicity level for mevinphos in man. Toxicol Appl Pharmacol. 1975 Apr;32(1):97–100. doi: 10.1016/0041-008x(75)90198-2. [DOI] [PubMed] [Google Scholar]
  10. SUMERFORD W. T., HAYES W. J., Jr, JOHNSTON J. M., WALKER K., SPILLANE J. Cholinesterase response and symptomatology from exposure to organic phosphorus insecticides. AMA Arch Ind Hyg Occup Med. 1953 May;7(5):383–398. [PubMed] [Google Scholar]
  11. WILLIAMS M. W., COOK J. W., BLAKE J. R., JORGENSEN P. S., FRAWLEY J. P., RIDER J. A., MOELLER H. C., SWADER J., WEILERSTEIN R. W. The effect of parathion on human red blood cell and plasma cholinesterase. AMA Arch Ind Health. 1958 Nov;18(5):441–445. [PubMed] [Google Scholar]
  12. Whorton M. D., Obrinsky D. L. Persistence of symptoms after mild to moderate acute organophosphate poisoning among 19 farm field workers. J Toxicol Environ Health. 1983 Mar;11(3):347–354. doi: 10.1080/15287398309530348. [DOI] [PubMed] [Google Scholar]
  13. Yager J., McLean H., Hudes M., Spear R. C. Components of variability in blood cholinesterase assay results. J Occup Med. 1976 Apr;18(4):242–244. [PubMed] [Google Scholar]

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