Prevalence of Severe Acetylcholinesterase (AChE) Inhibition and High Blood Pressure in Pesticide Applicators: A Cross-sectional Study in Central Java, Indonesia

Background. Regardless of the unclear mechanism pathway of Organophosphates (OP) exposure and hypertension, a study in Madagascar reported that the prevalence of hypertension in agricultural villages was very high. Nevertheless, OPs disrupt cellular protein metabolism, leading to cardiovascular, reproductive, and thyroid disorders, hormonal systems, and hypertension.

Objective. This study is aimed at exploring the prevalence of severe AChE inhibition and high blood pressure in pesticide applicators in vegetable farming areas in Central Java, Indonesia.

Methods. This study used a cross-sectional design and recruited 151 participants consecutively from two vegetable farming areas in Central Java who were aged 18–65 years and actively using pesticides for at least one year. The participants’ sociodemographic and occupational characteristics were obtained using the structured intervieweradministered questionnaire. This study quantitatively validated the pesticide exposure intensity level (IL) by calculating the lifetime years of pesticide use and the number of days spraying per year to estimate the cumulative exposure level (CEL). Blood pressure was measured with an upper arm digital blood pressure monitor. Acetylcholinesterase (AChE) activity was measured using a spectrophotometer.

Results. The determinant variables of severe AChE inhibition were age ≤50 years, two or more last spraying days, high cumulative exposure level, frequent re-entering of the sprayed farming area, and low educational level. The high cumulative exposure level of pesticides and age of >50 years of study participants are the determinant variables of high blood pressure among the pesticide applicators, with the OR (95% CI) being 1.81 (0.91;3.60) and 3.95 (1.94;7.65), respectively.

Conclusion. Severe AChE inhibition was found in 54% of participants, while the prevalence of high blood pressure (HBP) was approximately 47%. Pesticide cumulative exposure level and applicator's age are the determining factors for both severe AChE inhibition and high blood pressure.