Application of the Test. There is no requirement for administering the
cholinesterase test; however, the U.S. Army Environmental Hygiene Agency
recommends that it be administered monthly, during the spraying season, to all pest
control personnel who work with organophosphates and carbamates. Since
cholinesterase activity is not necessarily the same in all normal persons, a baseline
must first be established for each individual. Once a baseline, or level of normal
cholinesterase activity for that person is established, the monthly test will show any
significant decrease. Such a decrease, in the absence of other contributing factors,
should be considered an indication of excessive exposure and result in an individual's
assignment to other duties.
FIRST AID AND ANTIDOTES
a. First Aid. Procedures for first aid vary according to the type of exposure.
In all cases, a person with knowledge of the incident should accompany the victim to the
medical facility to inform qualified medical personnel about the nature of the accident,
the material being used, the first aid given, and the victim's symptoms following
exposure up to the time of his arrival at the medical facility. The pesticide container or a
label from it should be delivered with the patient to the medical facility. First aid
measures according to the type of exposure are given below.
(1) Pesticide on the skin. Remove contaminated clothing and shoes.
Wash skin and hair with soap and plenty of water. Call a physician.
(2) Pesticide in the eyes. Flush the eyes with running water for 15
minutes. Use a low-pressure water source. Call a physician.
(3) Pesticide inhaled. Remove victim to fresh air and have him lie down.
Loosen his clothing and keep him warm and quiet. Apply mouth-to-mouth resuscitation
if breathing stops. Apply cardiopulmonary resuscitation if breathing and heart beat
stops. Get medical assistance immediately.
(4) Pesticide swallowed. Induce vomiting only if specified on the pesticide
label. Use emetics only as recommended. Apply cardiopulmonary resuscitation if
breathing and heart beat stops. Get medical assistance immediately.
b. Antidotes. The responsible supervisor at each military installation where
pesticides are used must ensure that the nearest medical facility is informed of the
chemicals being used so that antidotes can be made available and medical officers will
be aware of toxic symptoms. Information regarding appropriate treatment may be
obtained from the nearest poison control center. No matter what the nature of the
poison, it is important to reduce the exposure. In the case of exposure,
decontamination should be carried out as soon as the condition of the patient permits.
If poison has been taken internally, a saline laxative may be used to speed evacuation
of the gut; oil laxatives and emetics (vomiting agents) should be avoided where it is
possible that an organic solvent or a chlorinated hydrocarbon insecticide is involved.