Peripheral nerve dysfunction among workers with long term occupational exposure to pesticides

A comparative cross-section study was carried out on 36 workers with long-term exposure to pesticide [pesticide sprayers] and 20 pesticide unexposed controls, from Dekernes, Dakahlia Governorate, Egypt. General medical examination and neurological evaluation were performed to elicit sensory, motor manifestation; as well as neurophysiological study including nerve conduction and electromyography. Plasma cholinesterase level was estimated and correlated to neurological findings. Carbamates and Organophosphates were sprayed by most pesticide sprayers. Most of them had practiced pesticide application with improper personal hygiene, concerning: storage, mixing and preparation, spraying, disposal, and after work cleaning up. Symptoms of neuropathy; lower limbs sensory nerve signs; ankle hyporeflexia were insignificantly prevalent among pesticide sprayers while no motor signs were detected among them. A highly significant decrease of the conduction velocity and amplitude of motor unit action potential [MUAP] of the lower limbs examined nerves, and insignificant decrease of their terminal latencies was observed among pesticide sprayers compared to the control. This picture is not evident in the upper limbs examined nerves, in which the conduction velocities are decreased but with no statistical significant difference. This was consistent with axonal neuropathic affection of the examined lower limbs nerves. As regards sensory nerve conduction study there was a highly significant increase of the terminal latency; highly statistical significant decrease of the CV and amplitude of the superficial peroneal nerves and significant decrease of amplitude of upper limbs examined nerves among pesticide sprayers when compared with that of controls. Accordingly peripheral poly neuropathies were found to be more prevalent among pesticide sprayers [38.9%] compared to the control [5.0%]. Of them, 78.6% were subclinical neuropathies and 21.4% were possible neuropathies. Pesticide sprayers had a highly statistically significant lower plasma AChE mean level [1548.9 +/- 801.7 mu/ml] compared to the controls [6751.7 +/- 990.8 mu/ml]. The pesticide sprayers who worked from 15-20 years had the lowest AChE mean level, but the difference was statistically insignificant. Among pesticide sprayers, the means of AChE levels were significantly lower in the workers with neuropathy [981.7 +/- 524.9 mu/ml] more than those without neuropathy [1911.9 +/- 742.5 mu/ml]. Neuropathy was more prominent among sprayers who exposed for long duration [more than 5 years] [11.1 +/- 4.5 years]. Pesticide sprayers are vulnerable to develop peripheral neuropathy 2.78 folds increase when compared to controls. So reduction and legislative control of the pesticide use and disposal seem the best options to protect pesticide sprayers, farmers and the environment from the adverse effects of pesticides. Also the use of protective equipment, the adoption of safety practices during field work, the health education programs about the risks of pesticide exposure, will help a lot to decrease the risk from the exposure to pesticides among pesticide sprayers. Pre-employment measurement of AChE, Occupational health surveillance and periodic medical monitoring with emphasis on the peripheral nervous system are recommended for all pesticide sprayers

influence of different storage conditions on the stability of amitriptyline and fluphenazine in biological specimens

The aim of this research is to study the effect of different storage conditions [different temperatures and formalin preservation] on the stability of amitriptyline and fluphenazine in some biological samples. The LD[50] of amitriptyline and fluphenazine were administrated orally to rabbits which were sacrificed two hours after administration of the drugs. The tissues were stored at different conditions for six months. U.V. Spectrophotometer was used for estimation of the drugs at different periods. The results revealed that both amitriptyline and fluphenazine were rapidly declined in samples stored at room temperature [25 - 38°C]. It could not be detected in brain and liver samples at the end of three weeks, in the kidney at the end of four weeks and in plasma at the end of six weeks. While fluphenazine could not be detected in the brain at the end of three weeks, in the kidney and liver at the end of four weeks and in the plasma at the end of six weeks. At fridge temperature [5°C], amitriptyline could not be detected in brain and liver at the end of four weeks, in kidney samples at the end of six weeks. While fluphenazine could not be detected in brain at the end of four weeks, in kidney and liver at the end of six weeks, in plasma both of them couldn't be detected at the end of eight weeks. At freezer temperature [-20°C], amitriptyline could be detected up to the end of six months of the storage in the different samples with different relative recovery percent 80%, 75%, 69.57%, and 63.00% [for plasma, kidney, brain and liver samples respectively]. While fluphenazine could be detected up to the end four months of the storage in the plasma, kidney, and liver with different relative recovery percent [19.77%, 13.88%, and 11.56% respectively]. In brain fluphenazine could be detected up to the end of twelve weeks with a relative recovery percent of 15.76%. In samples preserved in 10% formalin solution, amitriptyline could be detected up to the end of six months of the storage in the different samples with high relative recovery percents [90.81%, 90.18%, 87.84% and 86.14%] for the kidney, plasma, brain, and liver respectively. While fluphenazine could not be detected in brain samples at the end of six weeks. It could not be detected in liver, kidney, and plasma at the end of eight weeks of the storage. In conclusion amitriptyline is stable in tissues stored at freezer [-20°C] and that preserved in formalin solution. While fluphenazine is stable in tissues stored at freezer [-20°C] for sometime, but it is not stable in the samples stored at room temperature, fridge temperature, and in samples preserved in formalin solution