Skip to main content
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2000 Mar;57(3):195–200. doi: 10.1136/oem.57.3.195

Self reported symptoms and inhibition of acetylcholinesterase activity among Kenyan agricultural workers

G Ohayo-Mitoko 1, H Kromhout 1, J Simwa 1, J Boleij 1, D Heederik 1
PMCID: PMC1739922  PMID: 10810102

Abstract

OBJECTIVES—This study was part of the East African pesticides project. The general objective was to assess health hazards posed by handling, storage, and use of pesticides, on agricultural estates and small farms with a view to developing strategies for prevention and control of pesticide poisoning. The aim of this paper is to describe the prevalence of symptoms in this population, to relate levels of inhibition to reported symptoms and evaluate at which levels of inhibition symptoms become increased.
METHODS—Complete data were available for 256 exposed subjects and 152 controls from four regions in Kenya. A structured questionnaire on symptoms experienced at the time of interview was given to all subjects and controls. Information was also obtained on sex, age, main occupation, and level of education. Symptoms reported during the high exposure period, were initially clustered in broader symptom categories from reference literature on health effects of pesticides that inhibit cholinesterase (organophosphate and carbamate). Prevalence ratios were estimated for symptoms with changes in cholinesterase activity in serum.
RESULTS—Symptom prevalence in exposed subjects was higher during the high exposure period than the low exposure period, although these differences were not significant. Interestingly, a clear and significant change in symptoms prevalence was found in the controls with a higher prevalence in the low exposure period. Analysis of the relation between cholinesterase inhibition and symptoms showed that prevalence ratios were significantly >1 for respiratory, eye, and central nervous system symptoms for workers with >30% inhibition. Similar results were found for analyses with the actual level of acetylcholinesterase activity.
CONCLUSION—The results suggest the presence of a relation between exposure and acetylcholinesterase inhibition, acetylcholinesterase activity, and respiratory, eye, and central nervous system symptoms. Increased symptom prevalence was found at acetylcholinesterase activities generally considered to be non-adverse.


Keywords: cholinesterase inhibition; symptoms; health effects; Kenya; agricultural workers

Full Text

The Full Text of this article is available as a PDF (137.4 KB).

Selected References

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

  1. Ames R. G., Brown S. K., Mengle D. C., Kahn E., Stratton J. W., Jackson R. J. Cholinesterase activity depression among California agricultural pesticide applicators. Am J Ind Med. 1989;15(2):143–150. doi: 10.1002/ajim.4700150203. [DOI] [PubMed] [Google Scholar]
  2. Ames R. G., Brown S. K., Mengle D. C., Kahn E., Stratton J. W., Jackson R. J. Protecting agricultural applicators from over-exposure to cholinesterase-inhibiting pesticides: perspectives from the California programme. J Soc Occup Med. 1989 Autumn;39(3):85–92. doi: 10.1093/occmed/39.3.85. [DOI] [PubMed] [Google Scholar]
  3. Brown S. K., Ames R. G., Mengle D. C. Occupational illnesses from cholinesterase-inhibiting pesticides among agricultural applicators in California, 1982-1985. Arch Environ Health. 1989 Jan-Feb;44(1):34–39. doi: 10.1080/00039896.1989.9935870. [DOI] [PubMed] [Google Scholar]
  4. Coye M. J., Barnett P. G., Midtling J. E., Velasco A. R., Romero P., Clements C. L., Rose T. G. Clinical confirmation of organophosphate poisoning by serial cholinesterase analyses. Arch Intern Med. 1987 Mar;147(3):438–442. [PubMed] [Google Scholar]
  5. Coye M. J., Lowe J. A., Maddy K. T. Biological monitoring of agricultural workers exposed to pesticides: I. Cholinesterase activity determinations. J Occup Med. 1986 Aug;28(8):619–627. doi: 10.1097/00043764-198608000-00018. [DOI] [PubMed] [Google Scholar]
  6. Davies J. E. Neurotoxic concerns of human pesticide exposures. Am J Ind Med. 1990;18(3):327–331. doi: 10.1002/ajim.4700180314. [DOI] [PubMed] [Google Scholar]
  7. De Bleecker J., Van den Neucker K., Colardyn F. Intermediate syndrome in organophosphorus poisoning: a prospective study. Crit Care Med. 1993 Nov;21(11):1706–1711. doi: 10.1097/00003246-199311000-00020. [DOI] [PubMed] [Google Scholar]
  8. Forget G. Pesticides and the Third World. J Toxicol Environ Health. 1991 Jan;32(1):11–31. doi: 10.1080/15287399109531462. [DOI] [PubMed] [Google Scholar]
  9. Gage J. C. The significance of blood cholinesterase activity measurements. Residue Rev. 1967;18:159–173. doi: 10.1007/978-1-4615-8422-3_5. [DOI] [PubMed] [Google Scholar]
  10. Kashyap S. K., Jani J. P., Saiyed H. N., Gupta S. K. Clinical effects and cholinesterase activity changes in workers exposed to Phorate (Thimet). J Environ Sci Health B. 1984 Jun-Jul;19(4-5):479–489. doi: 10.1080/03601238409372445. [DOI] [PubMed] [Google Scholar]
  11. Khan S. A., Ali S. A. Assessment of certain hematological responses of factory workers exposed to pesticides. Bull Environ Contam Toxicol. 1993 Nov;51(5):740–747. doi: 10.1007/BF00201653. [DOI] [PubMed] [Google Scholar]
  12. Kishi M., Hirschhorn N., Djajadisastra M., Satterlee L. N., Strowman S., Dilts R. Relationship of pesticide spraying to signs and symptoms in Indonesian farmers. Scand J Work Environ Health. 1995 Apr;21(2):124–133. doi: 10.5271/sjweh.19. [DOI] [PubMed] [Google Scholar]
  13. Lander F., Lings S. Variation in plasma cholinesterase activity among greenhouse workers, fruitgrowers, and slaughtermen. Br J Ind Med. 1991 Mar;48(3):164–166. doi: 10.1136/oem.48.3.164. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Lee J., Chia K. S. Estimation of prevalence rate ratios for cross sectional data: an example in occupational epidemiology. Br J Ind Med. 1993 Sep;50(9):861–862. doi: 10.1136/oem.50.9.861. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Lessenger J. E., Estock M. D., Younglove T. An analysis of 190 cases of suspected pesticide illness. J Am Board Fam Pract. 1995 Jul-Aug;8(4):278–282. [PubMed] [Google Scholar]
  16. Lessenger J. E. The pesticide-exposed worker: an approach to the office evaluation. J Am Board Fam Pract. 1993 Jan-Feb;6(1):33–41. [PubMed] [Google Scholar]
  17. Lotti M. Cholinesterase inhibition: complexities in interpretation. Clin Chem. 1995 Dec;41(12 Pt 2):1814–1818. [PubMed] [Google Scholar]
  18. López-Carillo L., López-Cervantes M. Effect of exposure to organophosphate pesticides on serum cholinesterase levels. Arch Environ Health. 1993 Sep-Oct;48(5):359–363. doi: 10.1080/00039896.1993.9936726. [DOI] [PubMed] [Google Scholar]
  19. Markowitz S. B. Poisoning of an urban family due to misapplication of household organophosphate and carbamate pesticides. J Toxicol Clin Toxicol. 1992;30(2):295–303. doi: 10.3109/15563659209038640. [DOI] [PubMed] [Google Scholar]
  20. Maroni M., Järvisalo J., la Ferla F. The WHO-UNDP epidemiological study on the health effects of exposure to organophosphorus pesticides. Toxicol Lett. 1986 Oct;33(1-3):115–123. doi: 10.1016/0378-4274(86)90076-7. [DOI] [PubMed] [Google Scholar]
  21. 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]
  22. Ohayo-Mitoko GJA, Heederik DJJ, Kromhout H, Omondi BEO, Boleij JSM. Acetylcholinesterase Inhibition as an Indicator of Organophosphate and Carbamate Poisoning in Kenyan Agricultural Workers. Int J Occup Environ Health. 1997 Jul;3(3):210–220. doi: 10.1179/oeh.1997.3.3.210. [DOI] [PubMed] [Google Scholar]
  23. Padilla S. Regulatory and research issues related to cholinesterase inhibition. Toxicology. 1995 Sep 1;102(1-2):215–220. doi: 10.1016/0300-483x(95)03050-p. [DOI] [PubMed] [Google Scholar]
  24. Popendorf W. J. Effects of organophosphate insecticide residue variability on reentry intervals. Am J Ind Med. 1990;18(3):313–319. doi: 10.1002/ajim.4700180312. [DOI] [PubMed] [Google Scholar]
  25. Robinson D. G., Trites D. G., Banister E. W. Physiological effects of work stress and pesticide exposure in tree planting by British Columbia silviculture workers. Ergonomics. 1993 Aug;36(8):951–961. doi: 10.1080/00140139308967959. [DOI] [PubMed] [Google Scholar]
  26. Senanayake N., Karalliedde L. Neurotoxic effects of organophosphorus insecticides. An intermediate syndrome. N Engl J Med. 1987 Mar 26;316(13):761–763. doi: 10.1056/NEJM198703263161301. [DOI] [PubMed] [Google Scholar]
  27. Thompson J. W., Stocks R. M. Brief bilateral vocal cord paralysis after insecticide poisoning. A new variant of toxicity syndrome. Arch Otolaryngol Head Neck Surg. 1997 Jan;123(1):93–96. doi: 10.1001/archotol.1997.01900010103016. [DOI] [PubMed] [Google Scholar]
  28. Vandekar M., Plestina R., Wilhelm K. Toxicity of carbamates for mammals. Bull World Health Organ. 1971;44(1-3):241–249. [PMC free article] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES