Intra-individual variation in plasma and erythrocyte cholinesterase activities and the monitoring of uptake of organo-phosphate pesticides.

The measurement of plasma and erythrocyte cholinesterase activities is used to monitor absorption of anti-cholinesterase organo-phosphorus compounds. A fall in an individual's enzyme activity signifies excessive exposure if it is clearly greater than the normal intra-individual variation found in unexposed subjects. The extent of normal variation in enzyme activity as measured is dependent on both the true intra-individual biological variation and the precision of the method used. This report defines normal variation in plasma and erythrocyte cholinesterase activity using the assay developed and used routinely in our laboratory. We have also defined the relation between the precision of the assay used by a laboratory and the sensitivity with which a significant depression in successive enzyme measurements can be detected. This allows occupational physicians, who use cholinesterase measurements to monitor organo-phosphate exposure, to establish percentage depressions from their method precision data that may possibly indicate organo-phosphate uptake between successive enzyme measurements. We have calculated that, with our analytical precision, percentage drops between two successive measurements that are greater than 15 and 7.5 per cent for the plasma and erythrocyte enzymes respectively suggest significant organo-phosphorus absorption in pesticide workers.