Best Practices in the Detection and Monitoring of Pesticide Exposure
Recorded On: 06/15/2023
Summary: Farmers and agricultural workers are routinely exposed to a wide variety of chemicals. Toxicity Category I and II organophosphates (OPs) and N-methyl carbamates are cholinesterase-inhibiting insecticides commonly used in agriculture to kill insects or prevent them from damaging or destroying crops. Over-exposure to these chemicals results in the inhibition of the enzyme cholinesterase (ChE) which is utilized in the body’s conducting tissue, such as nerve and muscle motor sensory fibers. Acute toxic effects can include confusion, headache, and even loss of consciousness. Severe inhibition of ChE in the body can result in muscle paralysis, respiratory failure, seizures, coma, and death. Currently, there is no practice standard or national medical surveillance program for cholinesterase monitoring.
Purpose: This webinar will review cholinesterase testing and monitoring protocols based on programs from both California and Washington. Presenters will discuss ChE and its function in the body, routes of exposure, who is at risk, signs and symptoms, treatments, and prevention of exposure. Most importantly, presenters will share an established and recently updated protocol algorithm to guide your medical monitoring program. This protocol is designed to create awareness among your workers, set standards based on acceptable safe practices, and reduce incidents in the workplace.
Objectives: At the end of this webinar, participants will be able to …
- Understand the health risks of cholinesterase (ChE)-inhibiting pesticide exposure.
- Describe the aspects of exposure associated with decreased levels of ChE (who is at risk, type of pesticides, routes, signs and symptoms, treatment, and prevention)
- Recognize the importance of establishing accurate baseline ChE monitoring for people who work with ChE-inhibiting pesticides in agriculture.
- Recognize the importance of accurate and consistent ongoing ChE monitoring for people who work in agriculture.
- Understand and follow the protocol for the ChE monitoring algorithm.
Intended Audience: Occupational safety managers, doctors, nurses, nurse practitioners, physician assistants, and educators whose practice will be enhanced with the most current information on cholinesterase exposure and management
Charlotte Halverson, RN, BSN, COHN-S
Total Farmer Health Coach, AgriSafe Network
Charlotte served as the Clinical Director for AgriSafe thru the end of 2022 and is currently a Total Farmer Health Coach. Prior to this role, she worked for several years in hospital acute care settings and community education. During those years, Charlotte developed and managed a Rural Outreach Health service and a Parish Health Ministry department serving nine counties in northeast Iowa. She is a "charter graduate" of the University of IA agricultural occupational medicine course, is certified in occupational hearing conservation and completed the NIOSH Spirometry training. From 1997 to 2013, she provided agricultural occupational health services and program development for the National Education Center for Agricultural Safety.
Steve Kirkhorn, MD, MPH, FACOEM
As AgriSafe Medical Director, Dr. Kirkhorn is responsible for the strategic direction and technical review of the occupational health curriculum, resources, and services. Dr. Kirkhorn serves as the medical leader liaison offering program wide engagement and collaboration, visibility, and opportunity directly contributing to AgriSafe’s success.
In addition to his role at AgriSafe, Dr Kirkhorn serves as Occupational Medicine Advisor to the NIOSH Upper Midwest Center for Agricultural Safety and Health at the University of Minnesota.
He received a BS in Zoology and MD at the University of Minnesota and a MPH in Environmental Health at the University of Minnesota School of Public Health. He served as the Academic Director of the Midwest Center for Occupational Health and Safety of the HealthPartners Occupational Environmental Medicine Residency. He is boarded in Occupational Medicine and Family Practice and has been on the adjunct faculty of the University of Minnesota and University of Wisconsin Family Medicine Departments. He has been a practicing Occupational Medicine physician since 1991 and prior to that was a rural Family Practitioner for 10 years in Alaska and Wisconsin. He had completed a year sabbatical and fellowship in Agricultural Medicine in 1997-1998.
He previously was the Medical Director of the National Farm Medicine Center and Chair of Occupational Health and Chair/ Regional Service Line Director of Occupational Health at Marshfield Clinic in Wisconsin. He has previously been on the board of AgriSafe and editor for 8 years of the Journal of Agromedicine as well as participating in of multiple agricultural health organizations nationally and in Minnesota and Wisconsin.
He is the recently retired Director and Section Chief of Occupational Health at the Minneapolis Veterans Administration Health Care System and Adjunct Associate Professor in the Division of Environmental Health Sciences in the University of Minnesota School of Public Health and Assistant Clinical Professor in the Department of Medicine University of Minnesota Medical School.
His interests include, agricultural and rural occupational and environmental health, curriculum development, as well as birdwatching, biking, and kayaking. He is also a Master Naturalist through the University of Minnesota Extension.