Effect of pesticide exposure on serum cholinesterase level and asthma control among children in Naivasha, Kenya

Abstract

Background: Pesticide exposure is a risk factor for asthma exacerbations in flower farm regions in the world. Data on low levels of serum cholinesterase among asthmatic children exposed to the effects of pesticides in Kenya is scanty. Objectives: To compare and identify variables which affect the activity of serum cholinesterases in children exposed and unexposed to pesticides. Methodology: The design was a comparative cross-sectional study that involved exposed and unexposed children. The study was conducted between May and July, 2014 in Naivasha, Kenya. Patients who met the eligibility criteria were selected using convenient sampling. They were interviewed and serum samples were analysed for cholinesterase levels. Descriptive and inferential data analysis was done. Multi-linear regression was done to identify variables that affected cholinesterase activity. Results: Five predictor variables were found to be significantly associated with depression of serum cholinesterase levels on multivariable analysis. These included; nonschool attendance by children [β = -1676.8, 95%CI (-3371.6, 18.1), P = 0.052], not using household pesticides [β =96.3, 95%CI (22.6-170.0), P=0.011]. Others were; not wearing protective gears [β = - 1456.96, 95%CI (- 2594, 1319.82), P = 0.01], female sex [β =695.7, 95%CI (-1296.2, - 95.3), P = 0.024] and no break after spraying [β =1105.5, 95%CI(315.0, 1895.2), P = 0.007]. Conclusion: Parents should be encouraged to follow personal protective measures especially wearing of protective gears as this seemed to confer protection from the effects of pesticide exposure. Recommendations: A local level policy research for program intervention among flower farm workers using indoor insecticides like pyrethrins should be established to help reduce pesticide exposure among the local people. This study suggests that intervention measures need to be done to lower pesticide exposure of farmers. It is also suggested that chronic effects of pesticide cited in certain studies such as carcinogenic effects, poor reproductive outcomes, neurologic and respiratory disorders, impairments of the immune system and birth defects should also be investigated in future studies.