What should be done if cholinesterase levels fall significantly below baseline?

• A. Remove the pesticide handler from exposure until cholinesterase levels return to normal
• B. Continue working with PPE
• C. Increase exposure to build tolerance
• D. Switch to a different pesticide

Answer: (A)

When cholinesterase is inhibited by certain pesticides, the enzyme activity drops as a sign of exposure. If levels fall significantly below baseline, the safest course is to remove the worker from any exposure until the cholinesterase level returns to normal. PPE cannot reverse enzyme inhibition, and continuing work with activation-inhibiting pesticides risks progressing toward symptoms such as muscle weakness, sweating, or trouble breathing. Switching to a different pesticide might be considered later, but only after the person has been removed from exposure and levels have recovered under medical guidance. Work can resume only when a health professional confirms it’s safe to do so.