Ohayo-Mitoko GJA, Heederik DJJ, Kromhout H, Omondi BEO, Boleij JSM
Department of Epidemiology and Public Health, Wageningen Agricultural University, PB 238, 6700 AE, Wageningen, The Netherlands.
Int J Occup Environ Health. 1997 Jul;3(3):210-220. doi: 10.1179/oeh.1997.3.3.210.
Acetylcholinesterase inhibition was determined for 666 Kenyan agricultural workers; 390 (58.6%) mainly pesticide applicators exposed to organophosphate and carbamate pesticides and 276 (41.4%) unexposed controls from four rural agricultural areas during 1993 and 1994. Baseline levels were depressed in the exposed group (6.1 +/- 0.84; 4.09 +/- 0.84) but not in the unexposed group (5.83 +/- 0.91; 5.60 +/- 0.87). Acetylcholinesterase inhibition was found in all exposed individuals and led, on average, to a decrease of baseline acetylcholinesterase levels of 33% (+/-12%). The control groups had a nonsignificant decrease of only 4% (+/- 8%). The exposed subjects in Naivasha (flower growers) had the largest inhibition (36%), followed by Homabay (cotton growers) (35%) and Wundanyi (vegetable growers) (33%). Those in Migori (tobacco growers) had, by far, the least inhibition of acetylcholinesterase activity (26%), indicating inherent factors that led to less inhibition. Acetylcholinesterase activity levels of 115 exposed individuals (29.6%) and no controls were depressed to values below 60% of baseline levels. The dramatic inhibition observed could lead to chronic clinical and subclinical intoxication. These findings show that acetylcholinesterase inhibition can be used as an indicator of organophosphate and carbamate poisoning in occupationally exposed agricultural workers. There is, therefore, an urgent need for primary prevention programs to monitor and address occupational exposures to these hazardous substances in agriculture in Kenya and other developing countries, as well as to use integrated pest management strategies in crop protection.
对666名肯尼亚农业工人进行了乙酰胆碱酯酶抑制情况测定；其中390人（58.6%）主要是接触有机磷和氨基甲酸酯类农药的施药人员，276人（41.4%）是1993年至1994年期间来自四个农村农业地区的未接触对照组人员。接触组的基线水平较低（6.1±0.84；4.09±0.84），而未接触组则没有（5.83±0.91；5.60±0.87）。在所有接触者中均发现了乙酰胆碱酯酶抑制情况，平均导致基线乙酰胆碱酯酶水平下降33%（±12%）。对照组仅出现了4%（±8%）的不显著下降。奈瓦沙（花卉种植者）的接触者抑制率最高（36%），其次是霍马湾（棉花种植者）（35%）和温丹伊（蔬菜种植者）（33%）。米戈里（烟草种植者）的乙酰胆碱酯酶活性抑制率最低（26%），这表明存在导致抑制作用较小的内在因素。115名接触者（29.6%）的乙酰胆碱酯酶活性水平降至基线水平的60%以下，而对照组中无人出现这种情况。观察到的显著抑制可能会导致慢性临床和亚临床中毒。这些发现表明，乙酰胆碱酯酶抑制可作为职业接触农业工人有机磷和氨基甲酸酯中毒的指标。因此，迫切需要开展一级预防项目，以监测和应对肯尼亚及其他发展中国家农业中职业接触这些有害物质的情况，并在作物保护中采用综合虫害管理策略。
