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Background. Parkinson’s disease (PD) is a ubiquitous disease. However, PDs prevalence in the population of agricultural communities lacks understanding and there has been no epidemiological study on the association between pesticides exposure factors and risk for PD. Objective. To investigate the potential association between organophosphate pesticides exposure and Parkinsonism by using a screening questionnaire in agricultural areas. Material and Methods. Ninety elderly people living in agricultural areas participated in a cross-sectional study conducted at Tambon Hua-Rua Health Promoting Hospital in April 2014. Screening questionnaires for Parkinson’s disease, Test-mate ChE (Model 400) for blood cholinesterase (ChE) levels of both blood enzymes erythrocyte cholinesterase (AChE), and plasma cholinesterase (PChE) were used as measurement tools. Descriptive statistics for frequencies and percentage distributions were used primarily to summarize and describe the data. Sensitivity, specificity, positive and negative predictive values were calculated. Results. The age range of the participants was 50 to 59 years old, with an average age of 53.9+2.87 years. The majority of the participants were female (62.2%), 82.2% of respondents were farmers. Most of participants (76.7%) reported that they applied insecticides in their farms. Ninety persons participated and completed the 11-item questionnaire. Of these, 17 (18.9%) felt that they lost balance when turning or that they needed to take a few steps to turn right around and 16.7% of participants indicated that they felt the need to move slowly or stiffly. The study found the prevalence of abnormal AChE levels was 28.9% (95%CI=19.81-39.40) and 17.8% of PChE levels (95%CI=10.52-27.26). To predict Parkinsonism, AChE, and PChE level, with a cutoff score of 5 or higher there had to be a sensitivity of 0.31, specificity of 1.00, positive predictive value (PPV) of 1.00 and negative predictive value (NPV) of 0.78 for AChE. While PChE, the score value of 5 or more had a sensitivity of 0.19, specificity of 0.93, PPV of 0.38 and NPV of 0.84. Conclusion. This study described an association between pesticides exposure and Parkinsonism. The questionnaire appears to be useful for Thai agriculturists as a screening tool for Parkinsonism and cholinesterase levels regarding to pesticides exposure.
Background. Use of pesticides has been documented to lead to several adverse health effects. Farmers are likely to be exposed to pesticides through dermal exposure as a result of mixing, loading, and spraying. Organophosphate pesticides (OPs) are widely used in most of the agricultural areas throughout Thailand. OPs are cholinesterase inhibitors and blood cholinesterase activity is used as a biomarker of OP effects. Objective. This study aims to determine the association between blood cholinesterase activity and organophosphate pesticide residues on chili farmer’s hands and their adverse health effects. Materials and Methods. Ninety chili farmers directly involved with pesticide applications (e.g. mixing, loading, spraying) were recruited and were interviewed face to face. Both enzymes, erythrocyte acetylcholinesterase (AChE) and plasma cholinesterase (PChE), were tested with the EQM Test-mate Cholinesterase Test System (Model 400). Hand wipe samples were used for collecting residues on both hands and OP residues for chlorpyrifos and profenofos were quantified using gas chromatography equipped with a flame photometric detector (GC-FPD). Results. The average activity (±SD) of AChE and PChE was 2.73 (±0.88) and 1.58 (±0.56) U/mL, respectively. About 80.0% of the participants had detectable OP residues on hands. The median residues of chlorpyrifos and profenofos were found to be 0.02 and 0.03 mg/kg/two hands, respectively. Half of participants reported having some acute health symptoms within 48 hours after applying pesticides. When adjusted for gender, number of years working in chili farming, and frequency of pesticide use, AChE activity (Adjusted OR = 0.03, 95%CI: 0.01-0.13) and detected OP residues on hands (Adjusted OR = 0.15, 95%CI: 0.02-0.95) were significantly associated with having health effects, but no significant association was found in PChE activity (Adjusted OR = 2.09, 95%CI: 0.63-6.99). Conclusions. This study suggests that regular monitoring for blood cholinesterase and effective interventions to reduce pesticide exposure to prevent health effects should be provided to chili farmers.
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