What action is advised for a worker if cholinesterase levels fall below baseline?

• A. Remove the handler from exposure until levels normalize
• B. Continue exposure using PPE only
• C. Switch to a lower toxicity pesticide and continue
• D. Increase exposure to test tolerance

Answer: (A)

When cholinesterase levels drop below a worker’s baseline, the immediate priority is to remove them from exposure. A drop in cholinesterase means the pesticide is inhibiting the enzyme that helps break down acetylcholine, which can lead to overstimulation of nerves and a range of symptoms from fatigue and weakness to salivation, sweating, cramps, and confusion. Stopping exposure gives the body a chance to recover, and levels can return to normal as new enzyme is produced.

After removal, levels should be rechecked and the worker should not resume exposure until the baseline level is reached and medical clearance is given. Once baseline is restored, the job can be resumed only with reviewed controls to prevent recurrence, such as adjusted application practices or choosing less toxic products.

Continuing exposure with PPE only would not reverse the existing enzyme inhibition, switching to a lower toxicity product and continuing still risks ongoing exposure, and increasing exposure to test tolerance is unsafe. The key is stopping exposure to allow recovery and ensuring it is safe before returning to work.