Cholinesterase Testing

Thousands of tons of acetylcholinesterase-inhibiting carbamate and organophosphate pesticides are used throughout the world for agricultural applications as insecticides, acaricides, aphicides, larvicides, and nematocides. Several are used as herbicides (see Chapters 13 and 16).

The direct measurement of carbamate (CM) or organophosphate (OP) pesticide levels in the blood or urine is cumbersome, time consuming, and expensive. Each pesticide requires a separate assay, and the serum level of the chemical might not be directly related to the degree of enzyme poisoning. In some parts of the world, it may take weeks for laboratory results to be returned. Even in witnessed exposures, blood chemical levels may be too low for detection. In addition, self-reported symptoms are inconsistent, vague, and unreliable. Cholinesterase activity testing has the advantage of measuring the degree of physiological response of the neuromuscular junction in a quantifiable manner (1).

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