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Occupational Medicine Advance Access published online on January 2, 2009
Occupational Medicine, doi:10.1093/occmed/kqn164
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Short Report

Salivary acetylcholinesterase as a biomarker for organophosphate exposure

Vivian Ng, David Koh, Andrew Wee and Sin-Eng Chia

Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

Background Workers exposed to organophosphate (OP) pesticides are required to undergo periodic statutory medical surveillance in several countries.

Aim To study the relationship between serum, erythrocyte and saliva acetylcholinesterase (AChE) levels and to explore the use of salivary AChE as potential biomarker for OP exposure.

Methods A cross-sectional study was conducted on 19 healthy adult male lead-exposed workers who were undergoing six monthly statutory medical examination. Passive drool saliva samples were collected from each worker. Each blood sample was tested for serum and erythrocyte AChE, and each saliva sample was tested for AChE.

Results Among the 19 subjects, the mean (±standard deviation) of salivary, erythrocyte and serum AChE/cholinesterase were 22.7 (±17.4), 17171 (±1467), 8861 (±1876) U/l, respectively. There was a moderate correlation between salivary and erythrocyte AChE (r = 0.42, P = 0.071), but not salivary and serum AChE (r = –0.17, P = 0.48). The level of AChE in saliva was ~1820 times lower than AChE in erythrocytes.

Conclusion It is probably not feasible to use saliva as a replacement for blood for the measurement of AChE levels. This is because of the much lower levels of AChE in saliva relative to erythrocytes, the weak correlation between the two measurements and the previously reported high intra-individual variation of salivary AChE.

Keywords      Acetylcholinesterase; blood; organophosphate exposure; saliva

Correspondence to: David Koh, Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597. Tel: +65 6516 4989; Fax: +65 6779 1489; e-mail: cofkohd{at}nus.edu.sg


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