Key result
High pesticide exposure shows no significant association with high blood pressure despite severe AChE inhibition.
Why the study?
Although the mechanistic pathway between organophosphate exposure and hypertension remains unclear, organophosphates disrupt cellular protein metabolism and may contribute to cardiovascular disorders and hypertension, motivating an assessment of severe acetylcholinesterase inhibition and high blood pressure in pesticide applicators.
Is high cumulative pesticide exposure associated with severe acetylcholinesterase inhibition and high blood pressure in pesticide applicators in Central Java, Indonesia?
Cross-Sectional (n=151)
Yes
Is high cumulative pesticide exposure associated with severe acetylcholinesterase inhibition and high blood pressure in pesticide applicators in Central Java, Indonesia?
In Indonesian vegetable farmers, severe acetylcholinesterase inhibition (54%) and high blood pressure (47%) are highly prevalent, with cumulative pesticide exposure and age identified as key determinants for both conditions.
High cumulative exposure was associated with severe AChE inhibition in applicators; leaves open hypertension link and requires prospective confirmation.
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.
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Liem et al. (2026) conducted a cross-sectional in Occupational pesticide exposure, severe acetylcholinesterase (AChE) inhibition, and high blood pressure (n=151). High cumulative exposure level (CEL) to pesticides vs. Low cumulative exposure level (CEL) to pesticides (below median CEL) was evaluated on High blood pressure (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg) (OR 1.81, 95% CI 0.91; 3.60, p=0.090). High cumulative pesticide exposure increased odds of severe AChE inhibition (aOR 3.00; 95% CI 1.38-6.52) and showed a trend toward high blood pressure (aOR 1.81; 95% CI 0.91-3.60).
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