The New Cholinesterase Monitoring Rule PDF Version

(Part of Pesticide Issues Conference)

John Furman
Pacific Northwest Agricultural Safety and Health Center

Background

  • 1993 – Voluntary recommendations
  • 1995 – TAG report
  • 2002 – Rios decision
Cholinesterase Monitoring Rule

  • Chapter 296-307-148, WAC
  • Effective date: February 1, 2004
Intent of the New Rule

“To identify pesticide handlers with depressed cholinesterase levels before illness occurs.”

Cholinesterase (ChE)

  • Enzyme present in the nervous system and other tissues
  • Acts as the nervous system’s “Off Switch” by removing the neurotransmitter acytelcholine
Exposure to Cholinesterase-inhibiting Pesticides

  • Overexposure decreases available cholinesterase
  • May result in over stimulation of the nervous system.
Symptoms of Cholinesterase Depression
  • Headaches
  • Muscle twitch or weakness
  • Shortness of breath
  • Diarrhea
  • Convulsions
  • Coma
  • Dizziness
  • Nausea
  • Stomach pain
  • Anxiety
  • Pinpoint pupils
Cholinesterase-inhibiting Pesticides*

  • Organophosphates
    • Guthion
    • Lorsban
    • Imidan
    • Monitor
    • Mocap
  • N-methylcarbamates
    • Sevin
    • Temik
    • Lannate
    • Vydate
These are only examples for a full list go to the WSDA pesticide page

Cholinesterase Testing

  • Simple blood tests
  • Measures both red blood cell (RBC) and plasma cholinesterase (ChE)
  • Periodic tests compared to individual’s baseline
  • Change in blood ChE levels reflect change in nervous system ChE levels
What does this Rule Require?

Maintain Handling Records 296-307-14805

  • Documents all time each employee spends handling the covered pesticide.
  • Handling records must be kept for 7 years
  • Accessible to employees and medical professionals
Handling Includes

  • Mixing, Loading, Transferring
  • Applying
  • Handling Opened Containers
  • Disposing of pesticide or containers
  • Maintenance of contaminated equipment
Monitoring Thresholds WAC 296-307-14810

  • Beginning February 1, 2004, employees who handle covered pesticides for 50 or more hours in any consecutive 30-day period
  • *Beginning February 1, 2005, employees who handle covered pesticides for 30 or more hours in any consecutive 30-day period
Exemptions

  • Employees who handle only N-methylcarbamate pesticides will be exempt from the both the baseline and periodic monitoring requirement.
  • Hours spent mixing and loading using closed systems (Lock ‘N Load, soluble packets or “solupak”) will not be counted for periodic testing.
Obtain a Medical Provider WAC 296-307-14815

  • Contract with a medical provider to:
    • Provide baseline and periodic cholinesterase testing
    • Interpret tests and make recommendations
  • The provider must use the Washington State Department of Health Laboratory.
Make testing available Make testing available WAC 296-307-14820

Make testing available to all employees who will meet the exposure threshold:
  • Do baseline testing each year at least 30 days since last exposure to covered pesticides
  • Do Periodic testing:*
    • Once every 30 days; OR.
    • Within 3 days of any 30-day period where the employee has met or exceeded the handling hours threshold.
Employer response to a 20% decrease in cholinesterase levels from the baseline:

Evaluate:
  • Work practices
  • Protective Clothing
  • Respirator
  • Sanitation
Employer Response to a 30% decrease in red blood cell or a 40% decrease in plasma cholinesterase levels:

  • Temporarily remove the employee from exposure
  • Evaluate your worker protection program
  • Return the employee to handling or other exposures to covered pesticides when levels return to within 20% of baseline
Provide Medical Removal Protection WAC 296-307-14830

  • Employers must maintain the employee’s pay, benefits and seniority
  • Protection will not exceed 3 months
What other records must be maintained? WAC 296-307-14835

  • Maintain the following records for 7 years
    • Name of medical provider
    • Cholinesterase test results*
    • Medical provider recommendations
    • Work practice evaluations
    • Medical removal dates
    • Declination forms
*Your medical provider will retain test results and any personal medical information for you

Provide training WAC 296-307-14840

  • Ensure employees receive training that includes*
    • The health hazards of organophosphate and N-methyl-carbamate pesticides
    • The purpose and requirements of cholinesterase monitoring
*Can be provided along with current handler training

Questions?

John Furman, PhD. MSN, COHN-S
Dept. Labor & Industries
360-902-5666
Furk235@lni.wa.gov

Disclaimer and Reproduction Information: Information in NASD does not represent NIOSH policy. Information included in NASD appears by permission of the author and/or copyright holder. More

Reviewed for NASD: 06/2006