Assessment of Occupational Safety and Health Practices for Organophosphate and Carbamate Pesticides in Flower Farms in Naivasha , Nakuru County Kenya

This study sought to explore cholinesterase monitoring practices in selected flower farms in Naivasha, Kenya, as part of occupational safety and health management. Structured questionnaires were administered to 138 personnel in charge of production and employees’ medical to collect data on cholinesterase monitoring practices in place and the challenges experienced in the monitoring by the farms. Majority of the farms (82.6%) used organophosphate and carbamate pesticides for pest control. All the respondents confirmed that only male employees were involved in handling pesticides. Majority of the respondents (70%) reported that their farms conducted regular cholinesterase testing for pesticides handlers. Out of these farms all spray operators were incorporated in the testing program while 85% reported inclusion of spray supervisors and another 70% inclusion of pesticides store men in the testing program. Majority of the respondents (60%) conducted cholinesterase testing after every 3 months of handling pesticides. Cholinesterase baseline is established at a time away from pesticides handling as reported by (70%) of respondents. The most commonly done cholinesterase testing is plasma cholinesterase (PChE) as reported by three quarters of the respondents. Other medical examinations that were conducted for the pesticides handlers included clinical examination (70%) and liver function (10%) of the respondents. Three quarters of the respondents reported that neither cholinesterase nor medical results were sent to the Directorate of Safety and Health Services (DOSHS) as required by law. Most of the respondents (65%) reported that re-deployed pesticides handlers were given 3 – 4 months away from pesticides handling activities and would resume handling duties without cholinesterase re-testing. More than half of the farms (65%) were reported to have an on-site clinic, but 69% did not conduct cholinesterase testing at the farm clinic. Most of respondents (65%) reported their farms used different laboratory for cholinesterase testing. Most respondents (41.2%) reported that it took 11 – 15 days to get laboratory results after conducting the test. 70% of the respondents’ stocked antidotes at the farm, mainly activated charcoal and atropine. 65% of the respondents did not know the existence of a poison information and emergency center in Kenya. Challenges encountered at the farms in the management and monitoring of employees cholinesterase program included: employees personal attributes and beliefs e.g. taking blood samples needed for cholinesterase testing not acceptable to some; cholinesterase tests being expensive especially when many employees are involved since it’s done 3 monthly; few testing facilities; lack of a standardized system of conducting cholinesterase test; difference in the interpretation of cholinesterase results; delay in getting lab results and consequently delay in taking appropriate intervention; blood samples hemolysis; existing medical condition; minimal awareness on cholinesterase as subject; misdiagnosis of cholinesterase inhibition since symptoms may present as other common illnesses; few approved occupational health practitioners; poor quality personal protective equipment (PPE) and use of worn out PPE; long re-entry intervals required after spraying organophosphate and carbamate pesticides; cholinesterase depression levels due to other sources of exposure for some employees e.g. at their own farms, or domestic pesticides.