Epidemiological evaluation of acetylcholinesterase-inhibiting pesticides in Colombia, 1996-1997

Abstract

The epidemiological surveillance program for organophosphate and carbamate pesticides (VEO) was created through scientific and technical surveillance and cooperation agreements between the Environmental Health Laboratory at the National lnstitute of Health and the regional health entities. The programme's aim is the early detection of cases of high pesticide levels and the establishment of priorities for the development of promotion, prevention and control actions, which will decrease the incidence of acute poisoning and the chronic effects produced by acetylcholinesterase-inhibiting pesticides (ACHE). Seventeen Regional Health Offices (RHO) and 21.454 people with high risk of exposure to organophosphate (OF) and carbamate (C) pesticides participated in this study during 1996 and 1997. The Limperos and Ranta method, using Lovibond equipment, was used for ACHE analysis of 24,167 blood samples. Abnormal ACHE value prevalence was 6.1% being very similar to that found between 1993 and 1995. The RHO with the highest prevalence after direct standardisation were Bolívar (20.3%) in 1996 and Córdoba (17.7%) in 1997. The variables associated with greater ACHE abnormality prevalence were: for economical activity, air and terrestrial pesticide application work; for occupation, the banderero (the man who indicates already fumigated areas) and the mixer-sprayer-warehousing; and for ages, the 18 to 25 and 6 to 11 age groups. Only 36.1% of those patiicipating in the study were affiliated to the social security general health system; 63.9% were not protected by social security and 7.1% of these had abnormal ACHE values. Epidemiological evaluation for 1996-1997 was compared with previous years (1993-1995) and the population at highest risk was determined. Poisoning levels were quantified and conclusions were drawn to strengthen epidemiological surveillance. The VEO programme was thus able to define national risk levels caused by ACHE-inhibiting pesticides with much higher accuracy.