Zúñiga-Venegas Liliana, Landeros Natalia, Pancetti Floria, Cortés Sandra, Lucero Boris, Brito Ana M, Acuña-Rodríguez Ian S, Muñoz-Quezada María Teresa
Centro de Investigación y de Estudios Avanzados del Maule (CIEAM), Universidad Católica del Maule, Talca, Chile.
Laboratorio de Investigaciones Biomédicas (LIB), Facultad de Medicina, Universidad Católica del Maule, Talca, Chile.
Front Toxicol. 2025 Aug 18;7:1588408. doi: 10.3389/ftox.2025.1588408. eCollection 2025.
Unintentional pesticide poisoning is a global health concern, disproportionately affecting agricultural workers in developing countries due to inadequate regulations and limited access to protective equipment. While questionnaires offer a cost-effective alternative for assessing organophosphate (OP) pesticide exposure compared to urinary (e.g., Dialkyl Phosphates, DAPs) or blood biomarkers (e.g., acetylcholinesterase, AChE, and butyrylcholinesterase, BChE), these tools require validation against gold-standard methods. This study validated a questionnaire assessing occupational OP exposure among Chilean agricultural workers in the Maule region, contrasting its performance against DAP levels and AChE and BChE inhibition.
A longitudinal study was conducted with 51 agricultural workers. Urinary DAPs, measured via liquid chromatography-tandem mass spectrometry, AChE, and BChE activities, determined by Ellman's method, were measured before (T0) and during (T1) the spray season. The questionnaire was administered at T1. Sensitivity, specificity, predictive values, and Receiver Operating Characteristic (ROC) curve analyses were performed to assess the accuracy.
Urinary DAP levels and AChE inhibition increased in T1 (from 6.54 ± 4.66 to 12.39 ± 9.88 μg/g creatinine, = 0.004, and from 2.26E-3±6.53E-4 to 1.44E-3±2.73E-4 mmol/min*mgProt, < 0.001, respectively), with AChE inhibition (30.99%) exceeding Chilean regulatory threshold. The questionnaire score correlated with AChE inhibition ( = 0.0063) but not with BChE inhibition or DAP levels. Sensitivity was 64%, and specificity improved from 56% to 71% when using a 20% AChE inhibition threshold instead of a 30%.
Agricultural workers in the Maule region are exposed to OP pesticides. The questionnaire shows potential as a screening tool for occupational exposure. These findings highlight the need to reassess the Chilean regulatory limits and refine the tool to enhance risk assessment and intervention planning.
意外农药中毒是一个全球关注的健康问题，由于监管不足和获得防护设备的机会有限，对发展中国家的农业工人影响尤为严重。与尿液生物标志物（如二烷基磷酸酯，DAPs）或血液生物标志物（如乙酰胆碱酯酶，AChE，和丁酰胆碱酯酶，BChE）相比，问卷调查为评估有机磷（OP）农药暴露提供了一种经济有效的替代方法，但这些工具需要与金标准方法进行验证。本研究验证了一份评估智利马乌莱地区农业工人职业性OP暴露的问卷，并将其性能与DAP水平以及AChE和BChE抑制情况进行了对比。
对51名农业工人进行了一项纵向研究。在喷雾季节开始前（T0）和期间（T1），通过液相色谱 - 串联质谱法测量尿液DAPs，采用埃尔曼法测定AChE和BChE活性。在T1时发放问卷。进行敏感性、特异性、预测值和受试者工作特征（ROC）曲线分析以评估准确性。
T1时尿液DAP水平和AChE抑制增加（分别从6.54±4.66增加到12.39±9.88μg/g肌酐，P = 0.004，以及从2.26E - 3±6.53E - 4增加到1.44E - 3±2.73E - 4mmol/min*mgProt，P < 0.001），AChE抑制（30.99%）超过智利监管阈值。问卷得分与AChE抑制相关（P = 0.0063），但与BChE抑制或DAP水平无关。当使用20%的AChE抑制阈值而非30%时，敏感性为64%，特异性从56%提高到71%。
马乌莱地区的农业工人接触到OP农药。该问卷显示出作为职业暴露筛查工具的潜力。这些发现凸显了重新评估智利监管限值并完善该工具以加强风险评估和干预规划的必要性。
