Blood cholinesterase level is associated with tremor of farmer with pesticide exposure in Indonesia

Abstract

Background Organophosphates and carbamates are among the most commonly used insecticides worldwide and are known to suppress the activity of acetylcholinesterase (AChE) that will result in nervous system toxicity. Previous studies described positive associations between concurrent AChEactivity, a stable marker of cholinesterase inhibitor pesticide exposure, with tremor in farmer. This study was aimed to identify association between cholinesterase level with tremor in farmer exposed to pesticide exposure in Magelang Regency, Indonesia. Methods This was a cross-sectional study. The subjects were the farmer with history of pesticide exposure in Ngablak, Magelang Regency, Central Java, Indonesia. Cholinesterase level was analyzed from blood. Tremor was assessed using Tremor Rating Scale (TRS). Results In total, 120 subjects aged average 45.8 ± 13.43 years old were included. The average of blood cholinesterase level was 8.73 ± 1.80 kIU/L, with 70 subjects had low level of blood cholinesterase and 86 subjects had tremor. Bivariate analysis showed that blood cholinesterase level was associated with tremor (p = 0.005; 95% CI = 1.39-7.23). Further analysis showed that cholinesterase level was associated with tremor of arm (p = 0,02; 95%CI = 1.58-6.88) Conclusions Blood cholinesterase level, a stable marker of cholinesterase inhibitor pesticide exposure, was positively associated with tremor in farmer as assessed by TRS, especially tremor of arm.