Alexiou_1986_Am.J.Prev.Med_2_235

Biological monitoring of workers exposed to hazardous or toxic substances is common in industry. Plasma and red blood cell (RBC) cholinesterase activity level monitoring is used to detect early toxic effects of exposure to organophosphate and carbamate insecticides. However, the validity of plasma cholinesterase level monitoring alone in such exposures is of questionable value since depressed, normal, and elevated levels of activity in test results lead to risk assessment dilemmas. The finding of an elevated plasma cholinesterase level in an exposed plant pathologist led to referral for evaluation of test results. We reviewed the prevalence and significance of elevated plasma cholinesterase levels. The prevalence of elevated plasma cholinesterase values ranges from 1.0 percent to 12.9 percent, depending on the kind of testing and populations surveyed. The benefits and/or risks of elevated levels over time remain to be elucidated.