Agricultural Health: info for health care providers

 

Case History: An employee working at a farm cooperative was assigned a number of activities. During the spring and early summer he applied pesticides on corn crops. Over the winter, the co-op had a contract with a clinic for cholinesterase testing. All workers were tested, and the results were recorded. During the following spring, he began feeling ill, and wondered if it was the pesticides making him sick. He asked his boss if he could be retested for pesticide exposure. The boss called the clinic; the employee went in and had a blood test. The acytelcholine esterase (ACE) was about 50% lower compared to the first test.

 

Questions:

What is the appropriate medical action when asked by the boss of this employee?

 

1. Get him out of that line of work immediately, and do not allow him to handle any pesticides for the rest of the year.

 

2. Allow him to continue working and see if he gets better.

 

3. Allow him to continue working, but advise that he must wear rubber gloves and a respirator while handling chemicals.

 

4. There is not enough information to make a recommendation as yet. Hold him from work, while obtaining further occupational history, and then act accordingly.

 

 

 

Answers to Case Study