Coye M J, Lowe J A, Maddy K T
J Occup Med. 1986 Aug;28(8):619-27. doi: 10.1097/00043764-198608000-00018.
An estimated 4 to 5 million persons work in agriculture; within this sector, mixers, loaders, applicators, and other workers who directly handle agricultural chemicals are at highest risk for pesticide-related illnesses. Among field workers, seasonal workers engaged in certain cultivation and harvesting operations are also at risk of exposure to pesticide residues. Biological screening for agricultural workers is limited at present to pesticide mixers, loaders, and applicators, and consists almost exclusively of measurements of cholinesterase activity to estimate inhibition by organophosphate and carbamate compounds. We review here the measurement and interpretation of cholinesterase activity in occupationally exposed populations and the correlation between cholinesterase activity and symptoms of acute and chronic illness among agricultural workers. The only state to mandate medical surveillance for agricultural workers is California: criteria for surveillance, baseline cholinesterase determination, periodicity of testing, and criteria for removal from and return to work are described, and alternative approaches for screening and clinical evaluations are discussed.
据估计，有400万至500万人从事农业工作；在这个行业中，搅拌机操作员、装载机操作员、施药员以及其他直接接触农用化学品的工人面临与农药相关疾病的风险最高。在田间工人中，从事某些种植和收割作业的季节工也有接触农药残留的风险。目前，对农业工人的生物筛查仅限于农药搅拌机操作员、装载机操作员和施药员，几乎完全是通过测量胆碱酯酶活性来估计有机磷和氨基甲酸酯类化合物的抑制作用。我们在此回顾职业暴露人群中胆碱酯酶活性的测量和解读，以及农业工人中胆碱酯酶活性与急慢性疾病症状之间的相关性。唯一强制要求对农业工人进行医学监测的州是加利福尼亚州：描述了监测标准、胆碱酯酶基线测定、检测周期以及离岗和返岗标准，并讨论了筛查和临床评估的替代方法。
