Occupational determinants of serum cholinesterase inhibition among organophosphate-exposed agricultural pesticide handlers in Washington State

Organophosphorus pesticide exposure from house dust and parent-reported child behavior in Latino children from an orchard community

BACKGROUND

Organophosphorus pesticide (OP) exposure is known to have adverse effects on the nervous system. Children from agricultural communities are at risk of exposure to these chemicals from their indoor environments that can lead to neurological and developmental problems, including changes in behavior.

OBJECTIVE

The aim of this study is to evaluate whether the take-home pathway exposure is associated with behavioral and emotional problems in Latino Orchid Community children.

METHOD

The study was implemented over a period of two years (2008-2010) in an orchard farming community with a total of 324 parents who had children between the ages of 5-12 years old. Mothers of the children were asked to complete the Child Behavior Checklist (CBCL) and dust from their carpets was collected. Emotional and behavioral deficits were assessed based on the CBCL and house dust was assessed for OP concentrations. In this study, correlations between OPs in house dust and CBCL subscales were estimated using linear regression models with total OP concentrations classified by tertiles. This study also facilitated the comparison between the agricultural and non-agricultural families in terms of behavioral deficits and house dust concentrations of pesticides.

RESULTS

The data from the study shows that there was a positive association between the concentration of OP residues in house dust and internalizing behavior (β=2.06, p=0.05) whereas the association with externalizing behavior was not significant after accounting for sociocultural covariates. Significant positive associations of OP residues with somatic problems (p=0.02) and thought problems (p=0.05) were also found.

CONCLUSION

The data support a potential role of OP exposure in childhood development, with a specific focus on internalizing behavior. Future work focused on longitudinal studies may uncover the long-term consequences of OP exposure and behavior.

Comparing Longitudinal Measures of Cholinesterase as Biomarkers for Insecticide Exposure Among Latinx Children in Rural Farmworker and Urban Nonfarmworker Communities in North Carolina

OBJECTIVE

In a 2-group prospective design, this study compared seasonal cholinesterase levels of Latinx children in rural farmworker families and comparable urban children to assess the impact of environmental exposure to cholinesterase-inhibiting insecticides.

METHODS

Quarterly blood samples and passive dosimeter wristbands were collected over 2 years in 8-year-old children (74 rural, 62 urban). Laboratory analysis assessed total cholinesterase, acetylcholinesterase, and butyrylcholinesterase from blood samples, and insecticides from wristbands.

RESULTS

In spring and summer, total cholinesterase and acetylcholinesterase levels were depressed in rural children compared with winter and fall. Butyrylcholinesterase was depressed in rural children in fall compared with spring and summer. Adjustment for insecticide exposure did not affect these associations.

CONCLUSIONS

Environmental exposures to cholinesterase-inhibiting insecticides have measurable biochemical effects on blood cholinesterases in rural children from farmworker families.

Organophosphorus Poisoning: Acute Respiratory Distress Syndrome (ARDS) and Cardiac Failure as Cause of Death in Hospitalized Patients

Industrial production of food for animals and humans needs increasing amounts of pesticides, especially of organophosphates, which are now easily available worldwide. More than 3 million cases of acute severe poisoning are estimated to occur worldwide every year, and even more cases remain unreported, while 200,000–350,000 incidentally or intentionally poisoned people die every year. Diagnostic and therapeutic procedures in organophosphate poisoning have, however, remained unchanged. In addition to several neurologic symptoms (miosis, fasciculations), hypersecretion of salivary, bronchial, and sweat glands, vomiting, diarrhea, and loss of urine rapidly induce dehydration, hypovolemia, loss of conscience and respiratory distress. Within hours, signs of acidosis due to systemic hypoxia can be observed at first laboratory investigation after hospitalization. While determination of serum-cholinesterase does not have any diagnostic value, it has been established that hypoalbuminemia alone or accompanied by an increase in creatinine, lactate, or C-reactive protein serum levels has negative prognostic value. Increased serum levels of C-reactive protein are a sign of systemic ischemia. Protective mechanical ventilation should be avoided, if possible. In fact, acute respiratory distress syndrome characterized by congestion and increased weight of the lung, accompanied by heart failure, may become the cause of death. As the excess of acetylcholine at the neuronal level can persist for weeks until enough newly, locally synthesized acetylcholinesterase becomes available (the value of oximes in reducing this time is still under debate), after atropine administration, intravenous albumin and fluid infusion should be the first therapeutic interventions to reestablish normal blood volume and normal tissue oxygenation, avoiding death by cardiac arrest.

An exploratory study; the gap between real reference interval and currently used reference interval of RBC AChE activities in South Korea

The current reference interval (RI) FOR red blood cell acetylcholinesterase (RBC AChE) activity in South Korea was established with data obtained from populations outside the country. The aim of this study was to assess the transferability of current RI of RBC AChE activity for organophosphate (OP) poisoning and determine the biological characteristics, real RI, and interindividual variation in RBC AChE activity in South Korea. Data were retrospectively collected for RBC AChE activity as measured by the modified Ellman's method for 782 patients who presented to our hospital. The clinical course did not differ significantly with the degree of deviation of RBC AChE activity from the currently used RI in 195 patients exposed to OP. RBC AChE activity was associated with gender and smoking status but not age or body mass index (BMI); however, a regression model incorporating age, gender, smoking status and BMI explained only a small portion of the variance in RBC AChE activity in South Korea. The RI of RBC AChE activity was 9,403-16,825 U/L, with 13.9% interindividual variation. The range of RBC AChE activity in South Korea is wider than RI currently used in clinical practice and exhibited a high degree of interindividual variation. In the absence of collecting pre-exposure values, it is recommended to conduct serial measurements, rather than one-point measurements, of RBC AChE activity as evidenced by the RI in OP poisoning.

Urinary Metabolites of Organophosphate Pesticides among Pregnant Women Participating in the Japan Environment and Children's Study (JECS)

Organophosphate pesticides (OPPs) exhibit neurodevelopmental toxicity. To evaluate the effect of prenatal exposure to OPPs in the Japan Environment and Children's Study, a nationally representative birth cohort study, 4575 maternal urine samples were analysed for six OPP metabolites, i.e., dialkylphosphates (DAPs). This study aimed to investigate predictors of urinary DAPs using machine learning approaches and to assess the cumulative risk based on relative potency factors among Japanese pregnant women. The median creatinine-normalised urinary concentrations (interquartile ranges) of dimethylphosphate, dimethylthiophosphate and diethylphosphate, which had a detection rate of 50% or higher, were 3.53 (1.91-6.78), 4.09 (1.66-10.8) and 3.28 (1.88-5.98) µg/g-creatinine, respectively. Possible predictors of urinary DAP concentrations were the month of urine sampling, consumption of apple and maternal body mass index. When fenitrothion was used as an index chemical for cumulative risk assessment, 0.36% of participants exceeded the lower 95% confidence limit of the benchmark dose₁₀.

Pesticide exposure and adverse health effects associated with farmwork in Northern Thailand

OBJECTIVES

To assess pesticide exposure and understand the resultant health effects of agricultural workers in Northern Thailand.

METHODS

This was a cross-sectional study. We quantified exposure to pesticides, including chlorpyrifos, methomyl, and metalaxyl, by air sampling and liquid chromatography/mass spectrometry. We estimated differences in self-reported health outcomes, complete blood counts, cholinesterase activity, and serum/urine calcium and creatinine concentrations at baseline between farmworkers and comparison workers, and after pesticide spraying in farmworkers only.

RESULTS

This study included 97 men between the ages of 22 and 76 years; 70 were conventional farmworkers; and 27 did not report any prior farmwork or pesticide spraying. None of the farmworkers wore standardized personal protective equipment (PPE) for the concentrated chemicals they were working with. Methomyl (8.4-13 481.9 ng/m3 ), ethyl chlorpyrifos (11.6-67 759 ng/m3 ), and metalaxyl (13.9-41 191.3 ng/m3 ) were detected via personal air sampling. When it came to reporting confidence in the ability to handle personal problems, only 43% of farmworkers reported feeling confident, which reflects higher stress levels in comparison to 78% of comparison workers (P = .028). Farmworkers also had significantly lower monocyte counts (P = .01), serum calcium (P = .01), red blood count (P = .01), white blood cell count (P = .04), and butyrylcholinesterase activity (P < .0001), relative to comparison workers. After adjusting for body mass index (BMI), age, and smoking, methomyl air concentrations were associated with a decrease in farmworker acetylcholinesterase activity (beta = -0.327, P = .016).

CONCLUSIONS

This population of farmworkers had significant alterations in stress measures and clinical biomarkers, including decreased blood cell counts and cholinesterase activity, relative to matched controls. These changes are potentially linked to occupational pesticide exposures. Improving PPE use presents a likely route for preventive intervention in this population.

Factors affecting use of personal protective equipment and pesticide safety practices: A systematic review

An evidence-based understanding of factors influencing PPE use and pesticide safety practices has the benefit of facilitating the design of interventions to minimize exposure to pesticides and the promotion of the utilization of PPE and safety practices among agricultural pesticide handlers. The aim of this study, therefore, is to review the available literature on the use of PPE in agricultural pesticide handlers in world regions, and also the factors associated with the use of PPE and pesticide safety practices in farmers and farm workers. Full-text articles published on PubMed, Scopus, and ISI databases between 1999 and 2019 were reviewed and the scientific evidence was evaluated. One hundred and twenty-one articles were eligible for inclusion in this quantitative synthesis: 110 evaluated PPE use in agricultural pesticide handlers, and 23 focused on factors affecting PPE use and pesticide safety practices. Considerable evidence was found to show that the most basic PPE worn among pesticide handlers in all world regions was a long sleeve shirt (66.1%), long sleeve trousers (71.1%), and a hat (47.3%). The lowest basic PPE worn was an apron (8.6%), goggles (24.3%), gloves (40.5%), boots (42.3%), and mask (43.2%). The PPE worn (except for an apron) was proportionally higher in farmers than in farm workers. There is considerable evidence to suggest that the significant determinants associated with PPE use and pesticide safety practices are as follows: (1) demographic factors (i.e. education/literacy level, experience of illness, income); (2) farm structure factors (i.e. farm size); (3) behavioral and psychosocial factors (i.e. contact with pesticides, perceptions, attitudes, awareness, norms and beliefs); and (4) environmental factors (i.e. information about pesticides, access to extension services, training program, and farm organization). Therefore, there is a recognizable need for a life-long education program with training to change the perception and behavior of pesticide handlers sustainably.

Systematic Literature Review of the Take-Home Route of Pesticide Exposure via Biomonitoring and Environmental Monitoring

BACKGROUND

Exposure to pesticides via take-home can be an important pathway for farmworkers' families.

OBJECTIVE

The aim of this review was to summarize and analyze the literature published during the last decade of exposure to pesticides via take-home pathway in farmworkers' families.

METHODS

We conducted a systematic review to identify peer-reviewed articles of interest; only articles related to take-home pathway that included some sort of pesticide monitoring were considered for inclusion. Systematic reviews, literature reviews, and meta-analyses were excluded, resulting in a total of 39 articles elected for analysis. The articles were summarized based on the location of the study, population (sample size), pesticide analyzed, and type of sample.

RESULTS

The majority of the reviewed studies were conducted in the U.S., but there seems to be an increase in literature on pesticide take-home pathway in developing countries. Most of the articles provided evidence that farmworkers' families are exposed to pesticides at higher levels than non-farmworkers' families. The levels may depend on several factors such as seasonality, parental occupation, cohabitation with a farmworker, behavior at work/home, age, and gender. Community-based interventions disrupting the take-home pathway seem to be effective at reducing pesticide exposure.

DISCUSSION/CONCLUSION

The take-home pathway is an important contributor to overall residential exposures, but other pathways such as pesticide drift, indoor-residential applications, and dietary intake need to be considered. A more comprehensive exposure assessment approach is necessary to better understand exposures to pesticides.

Insecticide toxic effects and blood biochemical alterations in occupationally exposed individuals in Punjab, Pakistan

Biomonitoring of people exposed to hazardous materials provides opportunities for early identification of several diseases, particularly in those individuals who are constantly exposed to pesticides, such as pesticide operators and workers in pesticide manufacturing industry. However, data on this hot topic are limited in Pakistan. In this study, insecticide toxic effects and biochemical alterations (i.e., damage in DNA and enzyme activity) were studied in blood samples of occupationally exposed individuals from Punjab, Pakistan. Eight out of twenty-seven blood samples (29.6%) of the pesticide operators were found positive in five insecticides, with the maximum concentration found for chlorpyrifos-methyl (0.039 μg/mL). Eleven out of twenty-seven blood samples (40.7%) of the pesticide industry workers were found positive in eight insecticides, with the maximum concentration found for endosulfan (0.051 μg/mL). Comet tail length was 16.88 ± 4.57 μm in pesticide industry workers and 16.33 ± 3.78 μm in pesticide operators, which were significantly higher (P < 0.01) than that recorded in the control group (4.84 ± 2.21 μm). Values of serum cholinesterase (SChE) concentration were slightly lower (P > 0.05) in exposed individuals, whereas values of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) concentration were significantly higher (P < 0.01) in exposed individuals compared with control group. Exposure duration and total insecticide concentration in blood samples were positively associated with comet tail length, ALT activity, AST activity, and ALP activity, but negatively with SChE. DNA damage was higher in smokers vs. non-smokers. Also, a positive association was found between comet tail length and number of cigarettes per day. Overall, occupational exposure to insecticides can pose serious health risks to pesticide operators and workers in pesticide manufacturing industry, highlighting the necessity of personal protection in those groups for preventing exposure and resultant health disorders.

[Biomonitoring in exposure to pesticides, its contribution to epidemiological surveillance of pesticide applicators in Cordoba, Argentina]

OBJECTIVE

To assess the level of exposure to pesticides and its correlation with perceived health indicators and injury biomarkers (genotoxic alterations and those caused by butyrylcholinesterase enzyme activity) in the population of pesticide applicators in extensive crops (PAEC) in Córdoba, Argentina.

METHODS

Transversal study, in PAEC (n = 47) randomly selected from a sample of 2000, and non-exposed subject controls (n = 52). The sociodemographic variables, exposure conditioning, and perceived health were surveyed by means of a self-administered questionnaire; biological indicators of genotoxicity: micronuclei, chromosomal aberrations and kite assay, and butyrylcholinesterase activity.

RESULTS

40% of PAEC have over 10 years' length of service and almost 50% of them reside less than 500 m from the sprinkled fields; they report low rates of personal protective equipment use while mixing, applying, or repairing the equipment. General, cardio-respiratory, and dermatological symptoms were greater among PAEC (p <0.05) as well as indicators of genotoxic injury (p <0.001). The butyrylcholinesterase activity was negatively associated with levels of exposure to pesticides.

CONCLUSIONS

The PAEC show an important negative impact on health linked to exposure to pesticides. The exposure scales associated to the use of biomarkers were a useful tool for monitoring pesticide applicators' health.

Occupational predictors of urinary dialkyl phosphate concentrations in Mexican flower growers

Background Flower growers have high potential for exposures to pesticides. Occupational factors, such as tasks performed, the production method (organic or conventional), the use of personal protective equipment (PPE), and workplace characteristics influence the intensity of pesticide exposure. Objective To evaluate occupational characteristics affecting urinary concentration of dialkylphosphate (DAP) metabolites of organophosphate pesticides among a group of Mexican floricultural workers. Methods A questionnaire was administered to 117 workers who also provided a first morning urine sample. According to tasks performed and the production methods, pesticide contact was defined as low, medium, or high. PPE use was categorized as acceptable, fairly acceptable, and unacceptable. Urinary concentration of DAP metabolites were determined using gas-liquid chromatography. Association between occupational characteristics and DAP urinary concentrations was assessed by means of linear regression models. Results After adjusting for potential confounders, the workers in the medium and high contact categories had significantly higher DAP concentrations than those in the low contact category (β: 0.3, CI 95%: 0.1-0.5). Greenhouse workers had greater DAP concentrations than outdoors workers (β: 0.3, CI 95%: 0.1-0.5). Compared with non-acceptable use of PPE, acceptable use of PPE was associated with lower DAP concentrations (β: -0.4, CI 95% -0.6 to -0.1). Conclusion Improved safety training is needed for correct PPE usage, especially among flower growers who use conventional pest control methods and who work in a greenhouse environment.

Assessment of exposure to pesticides in rural workers in southern of Minas Gerais, Brazil

The aim of the study was to assess of occupational exposure to pesticides in rural workers using genotoxicity test, bioindicators and clinical evaluation. Blood, urine and buccal samples from persons, rural workers exposed to a complex mixture of pesticides with organophosphates (n=94) and without organophosphates (n=94) were collected to compare the activities of cholinesterases, the levels of urinary dialkyl phosphates, genotoxicity data, from a cytome assay. Biomarkers were analysed by traditional/published methods Control group consisted of 50 other persons, non- occupationally exposed to pesticides from the city of Alfenas, Minas Gerais, Brazil. All subjects underwent a clinical evaluation. In the group exposed to organophosphates, the activity of acetylcholinesterase, butyrylcholinesterase and total cholinesterase was lower by 63.8%, 12.8%, and 14.8%, respectively, and 92.6% of the group had dialkyl phosphates present in their urine. The cytome assay was used to measure biomarkers of DNA damage (micronuclei and/or elimination of nuclear material by budding), cytokinetic defects (binucleated cells), and proliferative potential (basal cell) and/or cell death (condensed chromatin, karyorrhectic, pyknotic, and karyolytic cells). The group exposed to organophosphates showed significant changes in all these parameters compared to the control group and showed significant changes in budding, condensed chromatin and karyolytic cells compared with the group non-exposed to organophosphates. Data from the clinical evaluation showed significant changes in the central nervous, respiratory and auditory systems. The studied biomarkers are able to distinguish occupational and environmental exposure to pesticides and the data showed hazardous exposure to organophosphates and afforded valuable data to estimate the risk to cancer development.

Longitudinal Assessment of Blood Cholinesterase Activities Over 2 Consecutive Years Among Latino Nonfarmworkers and Pesticide-Exposed Farmworkers in North Carolina

OBJECTIVE

This study (1) describes patterns of whole blood total cholinesterase, acetylcholinesterase, and butyrylcholinesterase activities across the agricultural season, comparing farmworkers and nonfarmworkers; and (2) explores differences between farmworkers' and non-farmworkers' likelihood of cholinesterase depression.

METHODS

Blood samples from 210 Latino male farmworkers and 163 Latino workers with no occupational pesticide exposure collected 8 times across 2 agricultural seasons were analyzed. Mean cholinesterase activity levels and depressions 15% or more were compared by month.

RESULTS

Farmworkers had significantly lower total cholinesterase and butyrylcholinesterase activities in July and August and lower acetylcholinesterase activity in August. Farmworkers had significantly greater likelihood of cholinesterase depression for each cholinesterase measure across the agricultural season.

SIGNIFICANCE

A repeated-measures design across 2 years with a nonexposed control group demonstrated anticholinesterase effects in farmworkers. Current regulations designed to prevent pesticide exposure are not effective.

Blood α-synuclein in agricultural pesticide handlers in central Washington State

Epidemiologic studies suggest that occupational exposure to pesticides might increase Parkinson disease risk. Some pesticides, such as the organophosphorus insecticide chlorpyrifos, appear to increase the expression of α-synuclein, a protein critically involved in Parkinson disease. Therefore, we assessed total blood cell α-synuclein in 90 specimens from 63 agricultural pesticide handlers, mainly Hispanic men from central Washington State, who participated in the state's cholinesterase monitoring program in 2007-2010. Additionally, in age-adjusted linear regression models for repeated measures, we assessed whether α-synuclein levels were associated with butyrylcholinesterase-chlorpyrifos adducts or cholinesterase inhibition measured in peripheral blood, or with self-reported pesticide exposure or paraoxonase (PON1) genotype. There was no evidence by any of those indicators that exposure to chlorpyrifos was associated with greater blood α-synuclein. We observed somewhat greater α-synuclein with the PON1-108T (lower paraoxonase enzyme) allele, and with ≥ 10 h of exposure to cholinesterase inhibiting insecticides in the preceding 30 days, but neither of these associations followed a clear dose-response pattern. These results suggest that selected genetic and environmental factors may affect α-synuclein blood levels. However, longitudinal studies with larger numbers of pesticide handlers will be required to confirm and elucidate the possible associations observed in this exploratory cross-sectional study.

Pesticide use and cholinesterase inhibition in small-scale agricultural workers in southern Brazil

A controlled cross-sectional study of family growers of fruit and vegetables was conducted between October 2009 and October 2010 to characterize the use of pesticides, establish the socio-demographic profile, and analyze cholinesterase activity in small-scale agricultural workers in Southern Brazil. Data was collected for 173 workers and 179 controls. A structured questionnaire was applied collecting socio-demographic information and determining knowledge and work practices in relation to pesticide use. The benchmarks for total cholinesterase (ChEs) and butyrylcholinesterase (BuChE) were obtained from the average enzymatic activity of the occupationally unexposed group (control). The mean age of the exposed population was 40.0 ± 11.2 years. The symptoms differed significantly (p<0.05) between the exposed and unexposed populations. Forty (23.1%) workers showed symptoms associated with exposure to pesticides. The average value of enzymatic activity in the occupationally unexposed group for ChEs was 6.3 μmol/mL/min among males and 5.6 μmol/mL/min among females while for BuChE was 2.4 μmol/mL/min among males and 2.0 μmol/mL/min among females. Eight (4.6%) workers had high inhibition (>30%) of ChEs activity, whereas no workers showed high inhibition (>50%) of BuChE. Potential factors involved include gender, education, pesticide orientation, exposure, and hygiene measures.

Determinants of butyrylcholinesterase inhibition among agricultural pesticide handlers in Washington State: an update

OBJECTIVES

Organophosphate (OP) and N-methyl-carbamate (CB) insecticides are used widely in agriculture to manage insect pests of economic importance. Agricultural workers are more likely to suffer exposure because of the widespread use of OP/CBs in agriculture, and pesticide-related illnesses among handlers may be more severe when compared to other farm workers. The goal of this study was to identify occupational and personal characteristics associated with butyrylcholinesterase (BuChE) inhibition in participants recruited from the Washington State Cholinesterase Monitoring Program from 2006 to 2011.

METHODS

We conducted a longitudinal study among agricultural pesticide handlers in Washington State during the OP/CB spray season (March-July) over a 6-year period (2006-2011). Linear mixed effects regression models were used to evaluate BuChE inhibition in relation to self-reported occupational and personal characteristics.

RESULTS

Relative to pre-season baseline levels, the mean decrease in BuChE activity during the OP/CB spray season over all years of the study period was 3.77% (P < 0.001). Greater BuChE inhibition was observed among handlers who reported using multiple OP/CBs (β = -2.70, P = 0.045), mixed or loaded OP/CBs (β = -3.97, P = 0.002), did not store personal protective equipment (PPE) in a locker at work (β = -3.4, P = 0.014), or did not wear chemical-resistant boots (β = -16.6, P < 0.001).

DISCUSSION AND CONCLUSIONS

The Washington State Cholinesterase Monitoring Program has provided a valuable opportunity to evaluate potential sources of OP/CB exposure among agricultural pesticide handlers. Several previously reported associations were confirmed in the current analysis, which included a larger number of pesticide handlers enrolled over a longer time period. The use of multiple OP/CBs and mixing/loading activities were significant risk factors, and the use of chemical-resistant boots and lockers for PPE storage were protective factors. Our findings point toward logical interventions to reduce exposure such as the implementation of engineering controls for mixing/loading activities, requirements for appropriate footwear, and the regular use of lockers for PPE storage.

Longitudinal assessment of chlorpyrifos exposure and self-reported neurological symptoms in adolescent pesticide applicators

OBJECTIVES

Occupational exposure of organophosphorus pesticides, such as chlorpyrifos (CPF), in adolescents is of particular concern because of the potential vulnerability of the developing neurological system. The objectives of this study were to examine how neurological symptoms reported over the application season vary across time, whether these effects are reversible postapplication and if there are associations between CPF biomarkers and neurological symptoms in an adolescent study population.

SETTING

The longitudinal study was conducted in two agricultural districts of Menoufia Governorate, Egypt between April 2010 and January 2011.

PARTICIPANTS

Male adolescent participants, including CPF applicators (n=57) and non-applicators (n=38), were recruited.

PRIMARY AND SECONDARY OUTCOME MEASURES

Self-reported data for 25 neurological symptoms were collected at 32 time points over the 8-month period before, during and after the application season. Additionally, urine and blood samples were collected to measure urine trichloro-2-pyridinol (TCPy), a CPF-specific biomarker and blood cholinesterase activity.

RESULTS

Applicators and non-applicators report the highest numbers of symptoms during the application season, followed by a reduction in symptoms after the application ended. Applicators reported a greater percentage of neurological symptoms, relative to baseline, than non-applicators after accounting for potential covariates. Among the applicators, cumulative TCPy was positively and significantly associated with the average percentage of symptoms (B=4.56, 95% CI 3.29 to 5.84; p<0.001). Significant associations (p=0.03-0.07) between the change in butyrylcholinesterase activity from the preapplication to the postapplication season and several domains of neurological symptoms were also found, even after adjusting for potential covariates.

CONCLUSIONS

These observations demonstrate changes in the reporting of symptoms across the application season, showing an increase in symptom reporting during application and recovery following the end of pesticide application. These findings reinforce the growing concern regarding the neurotoxic health effects of CPF in adolescent applicators in developing countries and the need for developing and implementing intervention programmes.

Longitudinal assessment of chlorpyrifos exposure and self-reported neurological symptoms in adolescent pesticide applicators

OBJECTIVES

Occupational exposure of organophosphorus pesticides, such as chlorpyrifos (CPF), in adolescents is of particular concern because of the potential vulnerability of the developing neurological system. The objectives of this study were to examine how neurological symptoms reported over the application season vary across time, whether these effects are reversible postapplication and if there are associations between CPF biomarkers and neurological symptoms in an adolescent study population.

SETTING

The longitudinal study was conducted in two agricultural districts of Menoufia Governorate, Egypt between April 2010 and January 2011.

PARTICIPANTS

Male adolescent participants, including CPF applicators (n=57) and non-applicators (n=38), were recruited.

PRIMARY AND SECONDARY OUTCOME MEASURES

Self-reported data for 25 neurological symptoms were collected at 32 time points over the 8-month period before, during and after the application season. Additionally, urine and blood samples were collected to measure urine trichloro-2-pyridinol (TCPy), a CPF-specific biomarker and blood cholinesterase activity.

RESULTS

Applicators and non-applicators report the highest numbers of symptoms during the application season, followed by a reduction in symptoms after the application ended. Applicators reported a greater percentage of neurological symptoms, relative to baseline, than non-applicators after accounting for potential covariates. Among the applicators, cumulative TCPy was positively and significantly associated with the average percentage of symptoms (B=4.56, 95% CI 3.29 to 5.84; p<0.001). Significant associations (p=0.03-0.07) between the change in butyrylcholinesterase activity from the preapplication to the postapplication season and several domains of neurological symptoms were also found, even after adjusting for potential covariates.

CONCLUSIONS

These observations demonstrate changes in the reporting of symptoms across the application season, showing an increase in symptom reporting during application and recovery following the end of pesticide application. These findings reinforce the growing concern regarding the neurotoxic health effects of CPF in adolescent applicators in developing countries and the need for developing and implementing intervention programmes.

Surface display of recombinant Drosophila melanogaster acetylcholinesterase for detection of organic phosphorus and carbamate pesticides

Acetylcholinesterase (AChE) is commonly used for the detection of organophosphate (OP) and carbamate (CB) insecticides. However, the cost of this commercially available enzyme is high, making high-throughput insecticide detection improbable. In this study we constructed a new AChE yeast expression system in Saccharomyces cerevisiae for the expression of a highly reactive recombinant AChE originating from Drosophila melanogaster (DmAChE). Specifically, the coding sequence of DmAChE was fused with the 3′-terminal half of an α-agglutinin anchor region, along with an antigen tag for the detection of the recombinant protein. The target sequence was cloned into the yeast expression vector pYes-DEST52, and the signal peptide sequence was replaced with a glucoamylase secretion region for induced expression. The resultant engineered vector was transformed into S. cerevisiae. DmAChE was expressed and displayed on the cell surface after galactose induction. Our results showed that the recombinant protein displayed activity comparable to the commercial enzyme. We also detected different types of OP and CB insecticides through enzyme inhibition assays, with the expressed DmAChE showing high sensitivity. These results show the construction of a new yeast expression system for DmAChE, which can subsequently be used for detecting OP and CB insecticides with reduced economic costs.

Breaking the take home pesticide exposure pathway for agricultural families: workplace predictors of residential contamination

BACKGROUND

Pesticides used in agriculture can be taken into worker homes and pose a potential risk for children and other family members. This study focused on identification of potential intervention points at the workplace.

METHODS

Workers (N = 46) recruited from two tree fruit orchards in Washington State were administered a 63-item pesticide safety questionnaire. Dust was collected from commuter vehicles and worker homes and analyzed for four organophosphorus (OP) pesticides (azinphosmethyl, phosmet, chlorpyrifos, malathion).

RESULTS

Geometric mean azinphosmethyl concentrations in dust for three worker groups (16 pesticide handlers, 15 green fruit thinners, 15 organic orchard workers) ranged from 0.027-1.5 μg/g, with levels in vehicle dust higher than in house dust, and levels in house dust from handlers' homes higher than levels from tree fruit thinners' homes. Vehicle and house dust concentrations of azinphosmethyl were highly associated (R(2) = 0.44, P < 0.001). Significant differences were found across worker groups for availability of laundry facilities, work boot storage, frequency of hand washing, commuter vehicle use, parking location, and safety training.

CONCLUSIONS

These findings support a focus on intervention activities to reduce take home pesticide exposure closer to the source of contamination; specifically, the workplace and vehicles used to travel to the workplace.

Health care access and health care workforce for immigrant workers in the agriculture, forestry, and fisheries sector in the southeastern US

BACKGROUND

The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the US is comprised primarily of Latino immigrants. Health care access for these workers is limited and increases health disparities.

METHODS

This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers.

CONTENTS

Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers. C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US.

Contributions of inhalation and dermal exposure to chlorpyrifos dose in Egyptian cotton field workers

OBJECTIVE

Chlorpyrifos exposures were assessed in 12 Egyptian cotton field workers.

METHODS

3,5,6-trichloro-2-pyridinol (TCPy) was measured in 24-hour urine samples to estimate absorbed dose. Workshift air samples were used to calculate chlorpyrifos inhalation dose.

RESULTS

Patches on legs had the highest chlorpyrifos loading rates among body regions sampled. Geometric mean chlorpyrifos air concentrations were 5·1, 8·2, and 45·0 μg/m(3) for engineers, technicians, and applicators, respectively; peak TCPy urinary concentrations were 75-129, 78-261, and 487-1659 μg/l, respectively; geometric mean doses were 5·2-5·4, 8·6-9·7, and 50-57 μg/kg, respectively, considering TCPy excretion half-life values of 27 and 41 hours. All worker doses exceeded the acceptable operator exposure level of 1·5 μg/kg/day. An estimated 94-96% of the dose was attributed to dermal exposure, calculated as the difference between total dose and inhalation dose.

DISCUSSION

Interventions to reduce dermal exposure are warranted in this population, particularly for the hands, feet, and legs.

Cholinergic involvement and manipulation approaches in multiple system disorders

Within the autonomic system, acetylcholine signaling contributes simultaneously and interactively to cognitive, behavioral, muscle and immune functions. Therefore, manipulating cholinergic parameters such as the activities of the acetylcholine hydrolyzing enzymes in body fluids or the corresponding transcript levels in blood leukocytes can change the global status of the autonomic system in treated individuals. Specifically, cholinesterase activities are subject to rapid and effective changes. The enzyme activity baseline increases with age and body mass index and depends on gender and ethnic origin. Also, the corresponding DNA (for detecting mutations) and RNA (for measuring specific mRNA transcripts) of cholinergic genes present individual variability. In leukocytes, acetylcholine inhibits the production of pro-inflammatory cytokines, suggesting relevance of cholinergic parameters to both the basal levels and to disease-induced inflammation. Inversely, acetylcholine levels increase under various stress stimuli, inducing changes in autonomic system molecules (e.g., pro-inflammatory cytokines) which can penetrate the brain; therefore, manipulating these levels can also effect brain reactions, mainly of anxiety, depression and pain. Additionally, neurodegenerative diseases often involve exacerbated inflammation, depression and anxiety, providing a focus interest group for cholinergic manipulations. In Alzheimer's disease, the systemic cholinergic impairments reflect premature death of cholinergic neurons. The decline of cholinesterases in the serum of Parkinson's disease and post- stroke patients, discovery of the relevant microRNAs and the growing range of use of anticholinesterase medications all call for critical re-inspection of established and novel approaches for manipulating cholinergic parameters.

Repeated pesticide exposure among North Carolina migrant and seasonal farmworkers

BACKGROUND

Limited data document the multiple and repeated pesticide absorption experienced by farmworkers in an agricultural season or their risk factors.

METHODS

Data were collected from 196 farmworkers four times at monthly intervals in 2007. Urine samples were tested for 12 pesticide urinary metabolites. Questionnaire data provided measures of exposure risks.

RESULTS

Farmworkers had at least one detection for many pesticide urinary metabolites; for example, 84.2% had at least one detection for acephate, 88.8% for 3,5,6-trichloro-2-pyridinol. Most farmworkers had multiple detections for specific metabolites; for example, 64.8% had two or more detections for acephate, 64.8% for 3,5,6-trichloro-2-pyridinol, 79.1% for 3-phenoxybenzoic acid, and 86.7% for 2,4-dichlorophenoxyacetic acid. Housing type had a consistent significant association with metabolite detections.

CONCLUSIONS

Farmworkers are exposed to multiple pesticides across an agricultural season, and they experience repeated exposures to the same pesticides. Reducing farmworker pesticide exposure and delineating the health outcomes of this exposure require more detailed data. Am. J. Ind. Med. 53:802-813, 2010. (c) 2010 Wiley-Liss, Inc.

Development of a computer-based survey instrument for organophosphate and N-methyl-carbamate exposure assessment among agricultural pesticide handlers

BACKGROUND

Assessment of occupational pesticide exposures based on self-reported information can be challenging, particularly with immigrant farm worker populations for whom specialized methods are needed to address language and cultural barriers and account for limited literacy. An audio computer-assisted self-interview (A-CASI) survey instrument was developed to collect information about organophosphate (OP) and N-methyl-carbamate (CB) exposures and other personal characteristics among male agricultural pesticide handlers for an ongoing cholinesterase biomonitoring study in Washington State.

OBJECTIVES

To assess the feasibility of collecting data using the A-CASI instrument and evaluate reliability for a subset of survey items.

METHODS

The survey consisted of 64 items administered in Spanish or English on a touch-screen tablet computer. Participants listened to digitally recorded questions on headphones and selected responses on the screen, most of which were displayed as images or icons to facilitate participation of low literacy respondents. From 2006-2008, a total of 195 participants completed the survey during the OP/CB application seasons on at least one occasion. Percent agreement and kappa coefficients were calculated to evaluate test-retest reliability for selected characteristics among 45 participants who completed the survey on two separate occasions within the same year.

RESULTS

Almost all participants self-identified as Hispanic or Latino (98%), and 97% completed the survey in Spanish. Most participants completed the survey in a half-hour or less, with minimal assistance from on-site research staff. Analyses of test-retest reliability showed substantial agreement for most demographic, work history, and health characteristics and at least moderate agreement for most variables related to personal protective equipment use during pesticide applications.

CONCLUSIONS

This A-CASI survey instrument is a novel method that has been used successfully to collect information about OP/CB exposures and other personal characteristics among Spanish-speaking agricultural pesticide handlers.