Arch Environ Contam Toxicol (2008) 55:153–159
DOI 10.1007/s00244-007-9095-0
Plasma Cholinesterase Levels and Health Symptoms in Peruvian
Farm Workers Exposed to Organophosphate Pesticides
Hector C. Cataño Æ Elizabeth Carranza Æ
Carlos Huamanı́ Æ Antonio F. Hernández
Received: 6 September 2007 / Accepted: 12 November 2007 / Published online: 19 December 2007
Ó Springer Science+Business Media, LLC 2007
Abstract The purpose of this study was to examine plasma
cholinesterase (PChE) changes and the adverse health effects
associated with chronic low-dose exposure to organophos-
phates (OPs) in a Peruvian agricultural population. A cross-
sectional study with a clinical interview and blood tests was
performed among 213 farm workers from two subtropical
valleys in Peru. The control group consisted of 78 nonex-
posed workers from the same areas. PChE levels from the
two exposed subgroups (pesticide applicators and other
agricultural jobs) were significantly lower than those of
controls (1554 ± 315 U/l, 1532 ± 340 U/l, and
1787 ± 275 U/l, respectively). Fifteen percent of the
exposed population reported a past poisoning by pesticides,
all of them needing medical evaluation and treatment. They
H. C. Cataño
Laboratorio de Biologı́a Molecular, Instituto de Quı́mica
Biológica, Microbiologı́a y Biotecnologı́a, Facultad de Farmacia
y Bioquı́mica, Universidad Nacional Mayor de San Marcos,
Jr Puno 1002, Jardı́n Botánico, Lima 1, Perú
E. Carranza
Laboratorio de Bioquı́mica. Instituto Nacional de Biologı́a
Andina, Facultad de Medicina, Universidad Nacional Mayor de
San Marcos, Av. Alfonso Ugarte s/n- Hospital Loayza, Lima,
Perú
C. Huamanı́
Dirección Ejecutiva de Prevención y Control de Riesgos
Ocupaciones y Ambientales, Centro Nacional de Salud
Ocupacional y Protección del Ambiente para la Salud
(CENSOPAS), Instituto Nacional de Salud (INS), Las Amapolas
450 Lince, Lima, Peru
A. F. Hernández (&)
Department of Legal Medicine and Toxicology,
University of Granada Medical School, Avda. Madrid, 11,
18071-Granada, Spain
e-mail: ajerez@ugr.es
had significantly lower PChE levels as compared to those
without this antecedent. Approximately 61% of the exposed
workers reported pesticide-related symptoms, but no sig-
nificant difference was found in their PChE as compared to
workers without symptoms. On the other hand, the use of
personal protective equipment (PPE) was significantly
associated with higher PChE levels and with a lower risk of
reporting pesticide-related symptoms, which supports the
benefit from using appropriate protective measures. In con-
clusion, data indicate that farm workers exposed to OPs in
developing countries need to be monitored by means of
PChE and an examination of their clinical status, which
would allow identification of farm workers most at risk from
pesticide toxicity. The use of correct PPE is highly
recommended.
Introduction
Farm workers are challenged by numerous occupational
hazards, exposure to pesticides being one of the most sig-
nificant (Strong et al. 2004). The major risks take place
during mixing, loading, and spraying of pesticides (Mek-
konnen and Ejigu 2005). Organophosphates (OPs) have
been the pesticides most widely used all over the world in
order to increase the agricultural production (WHO-UNEP
1990). At the present time, these chemicals are increasingly
used in developing countries such as Peru due to their
inexpensiveness and efficacy. The toxic effects of OPs are
largely associated with short-term exposures to high con-
centrations of pesticide (acute exposure) that cause
inhibition of acetylcholinesterase, the enzyme involved in
hydrolyzing the neurotransmitter acetylcholine at the nerve
endings (Dyer et al. 2001). However, the contribution of
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