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Paradoxical elevation of plasma cholinesterase
N G Alexiou1, J F Williams, H W Yeung
1Department of Comprehensive Medicine, University of South Florida College of Medicine, Tampa 33612.
American Journal of Preventive Medicine
|July 1, 1986
Summary
Monitoring workers exposed to organophosphate and carbamate insecticides using plasma cholinesterase activity is common. However, elevated levels present diagnostic challenges, questioning its sole diagnostic value in occupational health.
Area of Science:
- Occupational Health
- Toxicology
- Biochemistry
Background:
- Biological monitoring is crucial for assessing worker exposure to toxic substances.
- Cholinesterase activity in plasma and red blood cells (RBC) monitors exposure to organophosphate and carbamate insecticides.
- Current risk assessment faces dilemmas due to variable plasma cholinesterase levels (depressed, normal, elevated).
Observation:
- An elevated plasma cholinesterase level was observed in an exposed plant pathologist.
- This case prompted an evaluation of the prevalence and significance of elevated plasma cholinesterase.
- Elevated values occur in 1.0% to 12.9% of surveyed populations, varying by test and group.
Findings:
- The diagnostic validity of plasma cholinesterase monitoring alone is questionable.
- Elevated plasma cholinesterase levels, though infrequent, pose interpretation challenges.
- The long-term health implications of elevated plasma cholinesterase require further investigation.
Implications:
- Rethinking the sole reliance on plasma cholinesterase for monitoring insecticide exposure is necessary.
- Further research is needed to understand the clinical significance and health outcomes associated with elevated cholinesterase levels.
- Improved diagnostic strategies may be required for accurate risk assessment in occupational toxicology.