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Cholinesterase (ChE) Monitoring Training for Pesticide Handlers. Department of Labor & Industries WISHA Services. How are some pesticides a human health risk?. Certain pesticides called cholinesterase-inhibitors affect the nervous system in ways that can cause illness. Nervous system.

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cholinesterase che monitoring training for pesticide handlers

Cholinesterase (ChE) MonitoringTraining for Pesticide Handlers

Department of Labor & Industries WISHA Services

how are some pesticides a human health risk
How are some pesticides a human health risk?

Certain pesticides called

cholinesterase-inhibitors

affect the nervous system

in ways that can cause

illness.

nervous system
Nervous system
  • Nerve cells send electrical signals to each other
  • A chemical called a “transmitter” communicates the electrical signal across the gap between the nerves
nervous system4
Nervous system
  • CHOLINESTERASE removes the transmitter so the nerve is ready for the next signal
  • Insects and humans share the same transmitter and cholinesterase system
what can effect cholinesterase levels
What can effect cholinesterase levels?
  • Medical conditions
    • Liver diseases
    • Blood diseases
  • Certain medications
  • Certain pesticides
what pesticides effect the cholinesterase system
What pesticides effect the cholinesterase system?
  • Organophosphates and N-methyl-carbamates
    • Over-exposure may decrease available cholinesterase
    • Nerves continuously fire (no “off switch”)
    • Effecting muscles, glands, and organs
which pesticides are most dangerous
Which pesticides are most dangerous?
  • Toxicity category I
    • on the label
  • Toxicity category II
    • on the label

"DANGER"

"WARNING"

examples of covered pesticides
Organophosphates

Guthion

Lorsban

Imidan

Monitor

Mocap

N-methyl-carbamates

Sevin

Temik

Lannate

Vydate

Examples of covered pesticides*

*These are just examples, you can get a full list from L&I or the Department of Agriculture

what are some symptoms of overexposure
Headache

Blurred vision

Loss of balance

Nausea

Diarrhea

Sweating

Change in heart rate

Difficulty breathing

Muscle twitching

Convulsions

Unconsciousness

Death

What are some symptoms of overexposure?
will you always be sick
Will you always be sick?
  • No, ChE levels return on their own
  • Most common treatment is removal from exposure
  • Hospitalization only with severe poisoning
  • There is some evidence of long-term effects

(memory loss, depression, poor muscle control)

can cholinesterase che levels be monitored
Can cholinesterase (ChE) levels be monitored?

YES,

  • Simple blood test
    •  blood ChE =  nervous system ChE
  • Yearly off season baseline test followed by tests during the season
types of cholinesterase
Types of cholinesterase
  • Nervous system cholinesterase
  • Blood cholinesterases
    • Red blood cell (RBC) cholinesterase

- Same as nervous system cholinesterase

    • Plasma (serum) cholinesterase
why is a baseline test necessary
Why is a baseline test necessary?
  • Each person has their own normal ChE levels
  • Periodic tests are compared to baseline
  • Allows doctors to determine when cholinesterase levels have:
    • Dropped
    • Returned to your normal level
what are the benefits of cholinesterase monitoring
What are the benefits of cholinesterase monitoring?
  • Helps to prevent illness
  • Increases hazard awareness
  • Supports a safer workplace
  • Allows for better medical care
  • Helps to protect your family
cholinesterase monitoring rule
Cholinesterase Monitoring Rule
  • Chapter 296-307-148
  • Part of the Pesticide Worker Protection Standard
  • Adopted December 2003
  • Became effective February 2004
background
Background
  • 1993 - Cholinesterase monitoring recommendation
  • 1995 - TAG report on cholinesterase monitoring
  • 1997 - L&I sued for not adopting a mandatory monitoring rule
  • 2002 - Rios decision, L&I directed to initiate rulemaking on a mandatory monitoring rule.
who does the rule apply to
Who does the rule apply to?
  • Agricultural pesticide handlers

Who

  • Handle category I and II organophosphate or N-methyl-carbamate pesticides
what is pesticide handling
What is pesticide handling?

It includes:

  • Mixing / loading / applying
  • Disposing of pesticides or containers
  • Handling open pesticide containers
  • Maintaining application equipment
  • Acting as a flagger
when must your employer provide cholinesterase monitoring
When must your employer provide cholinesterase monitoring?
  • Provided at no cost when you:
    • Handle covered pesticides 30 or more hours in any consecutive 30 days*
  • Employer must keep records of all hours handling covered pesticides

*First day of handling starts the clock

are all hours spent handling included
Are all hours spent handling included?

NO,

  • Employers do not need to provide testing to employees who handle only N-methyl-carbamate pesticides
  • Hours spent mixing and loading using closed systems do not need to be included in determining periodic testing
how does the 30 day schedule work
How does the 30 day schedule work?
  • Your employer has two options:

1. Test every 30 daysno matter how long you handle pesticides

OR

2. Test when 30 hour handling time is met

      • No more often than every 30 days
must you be tested
Must you be tested?

NO,

  • Employer must give you the opportunity
  • You make the decision about testing after talking to a doctor or nurse
  • You can accept or decline testing by signing a form at the medical clinic
  • You may your change mind at any time
must i go to the doctor or clinic my employer chooses
Must I go to the doctor or clinic my employer chooses?

YES,

  • Your employer will be paying the cost for all medical services
  • Only your test results may be shared with your employer. All other medical information remains confidential
when do cholinesterase che test results require action
When do Cholinesterase (ChE) test results require action?
  • Work practice evaluation
    • ChE drop of >20% from baseline
  • Exposure removal
    • RBC ChE drop of >30%
    • Plasma ChE drop of >40%
    • Resume handling when levels return to

within 20% of baseline

if i am removed does this mean i can t work
If I am removed does this mean I can’t work?
  • No, you can perform other duties
  • Your job, salary and benefits will be protected for up to 3 months
    • Pay
    • Seniority
    • Other rights and benefits
how long does it take for cholinesterase to return to normal
How long does it take for cholinesterase to return to normal?
  • Plasma cholinesterase levels may return to normal within hours to several days
  • RBC cholinesterase levels take longer, returning at about 1% per day
can i see my records
Can I see my records?
  • Yes, you’re employer is required to keep:
    • Time spent handling
    • Medical provider (contact info. posted)
    • Test results (medical provider may keep)
    • Work recommendations
    • Work program evaluations
    • Medical removal dates
    • Declination statements
will you be given training
Will you be given training?
  • Your employer must provide training on the:
    • Hazards of cholinesterase-inhibiting pesticides
    • The purpose and requirements of cholinesterase testing
how will this rule be enforced
How will this rule be enforced?
  • L&I will collect information from employers and workers in order to evaluate the rule whenever:
    • Cholinesterase depression is reported
    • As part of targeted inspection activities
    • Whenever a complaint is received
how will we know if the rule is working
How will we know if the rule is working?
  • Scientists and a group of employer and worker representatives will evaluate the rule
  • All reports and recommendations will be available to the public
  • L&I must submit reports to the legislature at the end of each year
consultation findings
Consultation findings*
  • Respiratory protection
    • No fit testing
    • No cartridge change schedule
    • Removing respirator during application
    • Not cleaning respirator after use
    • Improper storage

*Possible exposure routes no common link has been established

consultation findings33
Consultation findings*
  • Decontamination
    • Inadequate eyewash or emergency showers
    • Inconsistent hand washing
    • Protective coveralls worn home home
    • Baseball type caps worn during application
    • Equipment not rinsed after each use

*Possible exposure routes no common link has been established

consultation findings34
Consultation findings*
  • Personal Protective Equipment (PPE)
    • Inconsistent use
    • PPE not rinsed after each use
    • Gloves not always worn during equipment maintenance e.g. unplugging nozzles

*Possible exposure routes no common link has been established

consultation findings35
Consultation findings
  • In most cases employers and handlers are found to be in compliance with all WPS requirements
  • Handlers are encouraged to pay attention to the details of safe pesticide handling
  • Report any problems to your employer
slide36
2005
  • The exposure threshold changes to 30 hours in any consecutive 30 days
  • Baseline testing will begin in the beginning of January
  • Be active in your medical care
  • Participate in L&I consultation activities
  • Contact your local L&I office if you have any questions