title: Cholinesterase Research Outreach Project (CROP): measuring cholinesterase activity and pesticide use in an agricultural community.
abstract: BACKGROUND
  Australian farmers and their workers are exposed to a wide variety of pesticides. Organophosphate (OP) insecticides are a widely used class of pesticide used for animal husbandry practices (Naphthalophos for sheep dipping, jetting and drench), crop production for pest control (Dimethoate) and in public health (Maldison for head lice). Acute poisonings with this class of insecticide are reported among agricultural workers and children around the globe, due to the inhibition of acetylcholinesterase (AChE). Less is known about chronic exposures. Regular monitoring of erythrocyte AChE will enable farmers to identify potential exposure to organophosphate insecticides and take action to reduce exposures and improve their health and safety practices. This study aims to assess and improve the integration of AChE monitoring into routine point of care health clinics, and provide farming and non-farming people with a link between their AChE activity and their household chemical and agrichemical use.
  
  
  METHODS
  The research will target individuals who work on mixed farming enterprises and routinely using OPs (n = 50) and non-farmers (n = 30). Baseline data are collected regarding demographic, health conditions and behaviours, Kessler 10 (K10) scores, chemical use and personal protection. Baseline anthropometric measures include height, weight, hip and waist circumference, body fat analysis and, biochemical analysis of fasted total serum cholesterol, triglycerides, low-density cholesterol (LDL), high-density cholesterol (HDL) and blood glucose. Analysis of erythrocyte cholinesterase (EAChE) activity is also conducted using a finger prick test. Testing of EAChE is then repeated in all participants every 3 weeks for a maximum of three times over a period 10 weeks. Participants are provided with full feedback and counselling about their EAChE activity after each reading and a detailed summary provided to all participants at the completion of the study. Data will be analysed using repeated measures within a general linear model.
  
  
  CONCLUSIONS
  This work will provide an evidence base and recommendations for the integration of EAChE monitoring into Australian rural health clinics, leading to research which will further quantify pesticide exposure both on the farm and in the home, highlighting the importance of sustaining and providing a safe work and home environment for farming communities.
  
  
  BACKGROUND
  ACTRN12613001256763.
authors.affiliation: National Centre for Farmer Health, Western District Health Service, PO Box 823, Hamilton, Vic, 3300, Australia. j.cotton@deakin.edu.au.|School of Medicine, Deakin University, 75 Pigdons Road, Waurn Ponds, Vic, 3216, Australia. j.cotton@deakin.edu.au.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Cotton
authors.affiliation: School of Medicine, Deakin University, 75 Pigdons Road, Waurn Ponds, Vic, 3216, Australia. paul.lewandowski@deakin.edu.au.
authors.forename: Paul
authors.initials: P
authors.lastname: Lewandowski
authors.affiliation: National Centre for Farmer Health, Western District Health Service, PO Box 823, Hamilton, Vic, 3300, Australia. susan.brumby@deakin.edu.au.|School of Medicine, Deakin University, 75 Pigdons Road, Waurn Ponds, Vic, 3216, Australia. susan.brumby@deakin.edu.au.
authors.forename: Susan
authors.initials: S
authors.lastname: Brumby
mesh_terms: D000110:Acetylcholinesterase / Q000097:blood*; D000382:Agricultural Workers' Diseases / Q000097:blood*; D000818:Animals; D001315:Australia; D002800:Cholinesterase Inhibitors / Q000097:blood*; D004784:Environmental Monitoring / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007306:Insecticides / Q000633:toxicity*; D008297:Male; D016273:Occupational Exposure / Q000032:analysis* / Q000706:statistics & numerical data; D009943:Organophosphorus Compounds / Q000633:toxicity*; D012756:Sheep; D012959:Socioeconomic Factors
chemical_list: D002800:Cholinesterase Inhibitors; D007306:Insecticides; D009943:Organophosphorus Compounds; D000110:Acetylcholinesterase