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Laboratory reporting for tracking of occupational pesticide illness.

Das-R; Geiser-C; Ellerbe-L; Zuzunaga-M; Rosenzweig-H; Pardo-S
Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-004044, 2004 Mar; 1-163
Using clinical laboratories as reporting sources resulted in large numbers of abnormal cholinesterase test results among workers representing a variety of industries and occupations. In our study, approximately 10% of cholinesterase results were depressed compared to laboratory normal range or baseline; most cholinesterase depression appeared to be asymptomatic; approximately 1 % of depression was below the threshold for medical removal. Less than 10% of workers identified by laboratory reporting were successfully interviewed. Less than 1 % of incidents were classified as occupational pesticide illness cases. Most workers in the Medical Supervision program were not evaluated by a physician or notified about the reason for cholinesterase tests or the results. Laboratory reporting was especially useful as a tool to assess the Medical Supervision program. This reporting method also should be considered as a method to conduct pesticide illness surveillance if limitations can be addressed. CDHS, CDPR, and OEHHA should establish a workgroup to explore the following regulatory changes suggested by this study: ( 1) requiring mandatory laboratory reporting as a supplemental system to track occupational pesticide illness; (2) requiring mandatory laboratory reporting as a method for ongoing evaluation of the Medical Supervision program; and (3) revising the Medical Supervision regulations to improve medical monitoring for pesticide-exposed workers, including requirements for physician certification, and worker notification and evaluation.
Pesticides; Occupational-hazards; Workers; Worker-health; Clinical-tests; Laboratory-testing; Cholinesterase-inhibitors; Demographic-characteristics; Surveillance-programs; Agricultural-chemicals; Agricultural-workers
Occupational Health Branch, State of California, Department of Health Services, 1515 Clay Street, Suite 1901, Oakland, CA 94612
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National Institute for Occupational Safety and Health
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Public Health Institute, Oakland, California
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division