Ohayo-Mitoko G J, Kromhout H, Simwa J M, Boleij J S, Heederik D
Environmental and Occupational Health Group, Wageningen University, The Netherlands.
Occup Environ Med. 2000 Mar;57(3):195-200. doi: 10.1136/oem.57.3.195.
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.
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.
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.
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.
本研究是东非农药项目的一部分。总体目标是评估在农业庄园和小农场中处理、储存和使用农药对健康造成的危害，以期制定预防和控制农药中毒的策略。本文的目的是描述该人群中症状的流行情况，将抑制水平与报告的症状相关联，并评估在何种抑制水平下症状会增加。
从肯尼亚四个地区获得了256名暴露受试者和152名对照的完整数据。对所有受试者和对照进行了关于访谈时所经历症状的结构化问卷调查。还获取了有关性别、年龄、主要职业和教育水平的信息。在高暴露期报告的症状最初根据抑制胆碱酯酶（有机磷和氨基甲酸酯）的农药对健康影响的参考文献归为更宽泛的症状类别。估计血清胆碱酯酶活性变化时症状的患病率比。
暴露受试者在高暴露期的症状患病率高于低暴露期，尽管这些差异不显著。有趣的是，在对照组中发现症状患病率有明显且显著的变化，低暴露期患病率更高。胆碱酯酶抑制与症状之间的关系分析表明，抑制率>30%的工人呼吸道、眼睛和中枢神经系统症状的患病率比显著>1。对乙酰胆碱酯酶活性实际水平的分析也得到了类似结果。
结果表明暴露与乙酰胆碱酯酶抑制、乙酰胆碱酯酶活性以及呼吸道、眼睛和中枢神经系统症状之间存在关联。在通常认为无不良影响的乙酰胆碱酯酶活性水平下发现症状患病率增加。
