If a second cholinesterase test confirms a drop in cholinesterase, what action should be taken regarding the pesticide handler?

• A. Continue handling pesticides but with enhanced PPE
• B. Remove the handler from contact with organophosphate and carbamate insecticides until baseline is restored
• C. Reassign to non-exposure duties only
• D. Ignore minor fluctuations in levels

Answer: (B)

Cholinesterase monitoring is used to detect exposure to organophosphate and carbamate pesticides. When a second test confirms a drop, it shows real inhibition of the enzyme, which can lead to serious symptoms if exposure continues. The safest response is to remove the pesticide handler from contact with these pesticides until their cholinesterase level returns to their individual baseline. PPE alone cannot safely counteract enzyme inhibition, and continuing work after a confirmed drop keeps the worker at risk. Once levels have recovered to baseline and any medical evaluation is satisfied, the person can be cleared to resume exposure with appropriate precautions.