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Cholinesterase Monitoring
NEW: As planned, the Public Health Laboratory will no longer be providing cholinesterase testing services under WAC 296-307-148, Cholinesterase Monitoring. The department has selected Pathology Associates Medical Laboratories (PAML) to provide all cholinesterase testing services in 2007. Information regarding PAML can be found here http://www.paml.com/. PAML will be contacting participating medical providers through the month of December to set up service accounts. The start date for submission of blood samples for baseline testing will be set in the next few weeks and will be posted on this web page as soon as confirmed.
Contact Juana Bastine, PAML Toxicology Account Representative, 509-755-8953 / 800-541-8941 x8953 or jbastine@paml.com with any questions.
Rule adoption - Chapter 296-307-148 WAC, Cholinesterase Monitoring
The Department of Labor and Industries (L&I) has amended the cholinesterase monitoring rule to reflect current program practices and address stakeholder recommendations. The new rule language was adopted on December 20, 2005, and becomes effective February 1, 2006.
What are employers required to do?
The rule requires employers of agricultural pesticide handlers who use toxicity class I or II organophosphate or N-methyl-carbamate pesticides to take the following steps:
- Record the number of hours employees spend handling these pesticides.
- Implement a medical monitoring program for workers who could meet or exceed the handling threshold of 30 or more hours in any consecutive 30-day period.
- Identify a medical provider to provide medical monitoring services.
- Make baseline and periodic cholinesterase testing available to employees who could meet or exceed the handling threshold.
- Investigate work practices when a handler’s red blood cell (RBC) or serum cholinesterase level drops more than 20 percent below the employee’s personal baseline.
- Remove employees from handling and other exposures to organophosphate and N-methyl-carbamate pesticides when recommended by your health care provider.
- Provide training on cholinesterase monitoring to covered employees.
- Report employee handling hours to the medical provider with each periodic test.
- Maintain medical monitoring and other records for seven years.
Employer Cost Reimbursement
Employers may request reimbursement for the reasonable costs of training, recordkeeping, and medical expenses for cholinesterase monitoring by submitting the Cholinesterase Monitoring Reimbursement Request form along with required documentation.
Resources
- Read the rule
Medical
Monitoring Providers list (137 KB PDF) - Handler
Hours Tracking - Instructions (59 KB PDF)
Handling hours Spreadsheet (695 KB Excel) - Worker Protection Standard Checklist of Requirements - This form can
be used to help evaluate your
worker protection program and pesticide handling practices. - List of covered pesticides
- WRD
33.27: Cholinesterase Depression (DOSH Policy) (137 KB PDF)
What is cholinesterase?
Cholinesterase (acetyl cholinesterase) is an enzyme that removes the chemical neurotransmitter acetylcholine, from the junctions between nerves cells. Cholinesterase serves as the nervous system’s “off switch” and is essential to the normal function of the nervous system.
Why monitor cholinesterase levels?
Exposure to organophosphate or N-methyl-carbamate pesticides may lower the level of available cholinesterase. Without the normal protective levels of cholinesterase, nerves in the body may be over stimulated to the point of exhaustion, leading to symptoms ranging from blurred vision, diarrhea and tremors to seizures, loss of consciousness and even death.
Monitoring cholinesterase levels in the blood through simple laboratory tests can detect cholinesterase depression prior to the onset of illness. When significant cholinesterase depression is identified employers are required to evaluate their pesticide worker protection program and make corrections to prevent further over-exposure.
What are the benefits of cholinesterase monitoring?
The cholinesterase monitoring Cost Benefit Determination and Small Business Impact Statement identified the following benefits of cholinesterase monitoring:
- Prevention of illness after over-exposure
- Increase hazard awareness and improve overall workplace safety related to pesticide use
- Improve pesticide illness diagnosis and reporting
- Provide greater certianty about frequency of pesticide over-exposure
- Decrease the risk of unintended exposures to workers families.
Additional Resources
- 2007
Final Report: Cholinesterase Monitoring of Pesticide Handlers in
Agriculture (191KB PDF)
- 2007
Cholinesterase Anaysis - Report from University of Washington (1389KB
PDF)
- 2006
Cholinesterase Monitoring Report to the Legislature (88KB PDF)
- Final
Report - Cholinesterase Monitoring of Pesticide Handlers
in Agriculture: 2004 – 2006 (3687KB PDF)
- Worker
Protection Standard Checklist (157KB PDF) can
be used to evaluate your pesticide worker protection program and
employee pesticide handling practices.
- Cholinesterase monitoring fact sheets for employees:
- Concise
Explanatory Statement (1787KB PDF).
- Cost
Benefit Determination (398KB PDF).
- Jorge's New Job - Washington - PDF Booklet
- Pesticide Worker Protection Standard (WPS).
- Questions
and answers document (129KB PDF).
- Sample
Training Program - (Spanish version) (82KB
PDF) .
-
2004 L&I Report to the Legislature (156KB
PDF).
-
2005 L&I Report to the Legislature (173KB
PDF).
-
2005 L&I Final Report: Cholinesterase Monitoring of Pesticide Handlers
in Agriculture (2201KB PDF).
- The
Scientific Advisory Committee for Cholinesterase Monitoring: 2004
Report to the Department of Labor & Industries (856KB
PDF) .
Contact L&I
The L&I office in your area has industrial hygienists who can assist with specific questions. Please call your local area L&I office and ask for a consultation supervisor.
Region 1: 425-290-1300
Island, San Juan, Skagit, Snohomish, and Whatcom counties.
Region 5: 509-454-3700 or 1-800-354-5423
Adams--west side, Asotin, Benton, Chelan, Columbia, Douglas, Franklin, Grant, Kittitas, Okanogan, Walla Walla and Yakima counties.
Ask an Expert
E-mail
a Specialist - If you have questions about Cholinesterase.
