Risk factors, erythrocyte acetylcholinesterase inhibition, and self-reported symptoms of pesticide intoxication among farmers in Thailand: A cross-sectional study.

Abstract

Organophosphate and carbamate pesticides are widely used, and their adverse health effects remain a serious problem. This investigation aimed to describe risk factors, erythrocyte acetylcholinesterase (AChE) inhibition, and self-reported symptoms and to derive an association between influence factors and erythrocyte AChE inhibition among farmers in Thailand. A cross-sectional study was conducted on 71 farmers from August to October 2022. General characteristics and pesticide exposure factors were elicited via a questionnaire-based interview. The erythrocyte AChE inhibition was assessed using the EQM Test-mate Cholinesterase (Model 400) instrument. Data were presented descriptively and analyzed statistically using Chi-square and binary logistic regression. Most farmers were over 50 years old and had an abnormal body mass index (BMI) without alcohol consumption and smoking. Aprons (18.31%) and protective eyewear (12.68%) as personal protective equipment (PPE) were found to be used less often. The level of hemoglobin-adjusted erythrocyte AChE (Q) was considered normal when it was 59.15% and abnormal when it was 40.85%. Self-reported symptoms were confirmed to be associated with lower erythrocyte AChE levels. The Chi-square analysis showed that shortness of breath, irritation, headache, dizziness, sleep fragmentation, and memory problems were significantly associated with erythrocyte AChE (p < 0.05). The bivariate analysis revealed that farmers who consumed alcohol while using pesticides (mixing, loading, and spraying) (OR=35.821, 95% CI=4.591-279.490), who did not wear a mask while using pesticides (OR=11.898, 95% CI=1.061-133.440), and who did not wear boots while using pesticides (OR=0.166, 95% CI=0.031-0.890) had an increased likelihood of having a severe inhibition of erythrocyte AChE. These findings suggest that the promotion of risk prevention practices must be imposed on appropriate pesticide handling and PPE use among farmers.