Cholinesterase Monitoring Rule

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Cholinesterase Monitoring Rule

• Information for Pesticide Handlers

September 2010
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You Will Learn

• What is Cholinesterase?
• What is an employer supposed to do for pesticide
  handlers?
• What are the main elements of the cholinesterase
  monitoring program?
• Where can you get more information?

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What is Cholinesterase?(Abbreviated as ChE)

• Cholinesterase is an important protein in the
  body that is needed for the functioning of your
  nervous system.
• Some pesticides interfere with the function of
  cholinesterase, meaning that you could become ill
  from your pesticide exposure.

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What Does the ChE Monitoring Rule Do?

• The rule provides a medical monitoring program to
  make sure
• That your ChE levels have not dropped
• and
• That you are not at increased risk of
  experiencing pesticide illness from your
  pesticide exposure.

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Who Is The Rule For?

• Agricultural pesticide handlers who handle
• Category I and II
• Organophosphate
• or
• N-methyl-carbamate pesticides.

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Which Pesticides Does the Rule Cover?
It covers pesticides with labels that say
Toxicity Category I or Toxicity Category II
"DANGER"
"WARNING"
DANGER PELIGRO
POISON
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Which Pesticides Does the Rule Cover?
Examples

• Organophosphates
• Guthion
• Lorsban
• Imidan
• Monitor
• Mocap

• N-methyl-carbamates
• Sevin
• Temik
• Lannate
• Vydate

For a complete list of all the pesticides covered
by the rule click here Organophosphates/Carbamat
es Listed Alphabetically by Product Name
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Are You a Pesticide Handler?

• Pesticide Handlers
• Mix, load or apply pesticides
• Dispose of pesticides or containers
• Handle open pesticide containers
• Maintain application equipment
• Act as a flagger

The complete definition for a pesticide Handler
can be found in the definition section of the
Worker Protection Standard Handler Definition
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If You Are A Pesticide Handler

• Your employer must provide ChE monitoring to you
  at no cost when you
• Handle the covered pesticides 30 or more hours in
  any consecutive 30 days.
• The first day of handling starts the clock.
• A baseline test must be done before start work
  with pesticides.

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If You Are A Pesticide Handler

• Your employer must keep records of all hours that
  you handle Category I and II organophosphate or
  N-methyl-carbamate pesticides.
• You and your representatives can see these
  records.

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Are All Handling Hours Included?

• No. There are two exceptions
• Employers do not have to provide testing to
  employees who handle
• N-methyl-carbamate pesticides ONLY.
• If you mix and load using a closed system, those
  hours do not count toward the 30 hours.

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How Does The 30-Day Schedule Work?

• Your employer has two options
• 1. Test you every 30 days no matter how many
  hours you handle pesticides.
• OR
• 2. Test when you handle pesticides 30 or more
  hours in any consecutive 30 days.

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Must You Have A Test?

• No The test includes taking a blood sample
• Your employer must give you the opportunity to be
  tested.
• You make the decision about testing after
  receiving training on ChE inhibiting pesticides
  and talking to a doctor or nurse about the
  benefits and risks of testing.
• You can decline testing by signing a form.

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Can You Change Your Mind Later?

• Yes
• Your employer must then provide you with an
  opportunity to be tested.
• If you are handling pesticides at this time you
  may get a baseline test called a working
  baseline.
• The medical provider may recommend that you not
  handle pesticides for a number of days before
  being tested.

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Must I Use My Employers Doctor?

• Yes -
• Your employer will be paying the cost for all
  medical services.
• Only certain information may be shared with your
  employer. All other medical information remains
  confidential, including the actual test results.
  

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What Happens To My Test Results?

• The doctor will tell your employer only that
• You may continue your normal duties,
• OR
• The pesticide handling practices must be
  evaluated,
• OR
• You must be temporarily removed from exposure
  the worker protection program must be evaluated.

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When Do Test Results Require Action?

• A ChE drop of more than 20 from baseline
  requires a work review to identify and correct
  exposure problems.
• The review must look at
• the condition and use of your PPE (coveralls,
  respirators, gloves etc.)
• General sanitation and decontamination practices
• Pesticide handling practices

Note baseline is the blood test taken before
you handle pesticides
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Can I Be Removed From Work?

• Yes, if
• Red Blood Cell ChE levels drop 30 or more from
  baseline
• OR
• Serum ChE levels drop 40 or more from baseline

Note There are two kinds of ChE tests RBC -
red blood cells, or Serum the fluid that is
part of blood. Both are done in a laboratory from
your blood sample.
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When Can I Return To Work?

• You can return to handling duties when ChE levels
  return to within 20 of your baseline.

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Can I do other work with the same employer?

• Yes, you can do other types of work for the same
  employer.
• You can even handle pesticides that are not
  cholinesterase-inhibitors.
• Your job, salary and benefits will be protected
  for 3 months.
• Pay
• Seniority
• Other rights and benefits

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How Long Before ChE Returns to Normal?

• Plasma cholinesterase levels may return to normal
  within hours to several days.
• Red blood cell cholinesterase levels take longer,
  returning at about 1 per day.

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What If I Get Sick From Pesticides?

• Lowered ChE levels may mean you have been exposed
  to pesticides.
• Removal from exposure prevents potential illness.
• If you do become ill due to exposure, you have
  the right to file an industrial insurance claim
  with the Dept. of Labor Industries.

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Can I See My Records?

• Yes, your employer is required to keep
• Records of time spent handling pesticides
• Medical provider (contact info. posted)
• Test results (medical provider may keep)
• Work recommendations
• Work program evaluations
• Medical removal dates
• Your statements declining the test (if you do)

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Will I Be Given Training?

• Your employer must provide training on the
• Hazards of cholinesterase-inhibiting pesticides.
• The purpose and requirements of cholinesterase
  testing.

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How Will This Rule Be Enforced?

• LI will collect information from employers and
  workers in order to evaluate the rule whenever
• Cholinesterase depression is reported.
• As part of targeted inspection activities.
• Whenever a complaint is received.

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About The Cholinesterase Rule

• You can read the Cholinesterase rule here
  Chapter 296-307-148
• You can read the Pesticide Worker Protection
  Standard here Chapter 296-307-110

More information about Cholinesterase Monitoring
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What If I Have More Questions?

• If you have more questions on your employers
  responsibility to you or you suspect you have
  been poisoned call
• 1-800-4BE-SAFE
• OR
• Call your local Labor and Industries office and
  ask to speak to a compliance officer.
• Click here to get local office locations and
  numbers Local LI Office Location