The Granobles River Basin in Cayambe of North

Chronic pesticide poisoning is difficult to detect. We sought to develop a low-cost test battery for settings such as Ecuador’s floriculture industry. First we had to develop a case definition; as with all occupational dis-eases a case had to have both sufficient effective dose and associated health effects. For the former, using canonical discriminant analysis we found that adding measures of protection and overall environmental stressors to occupational category and duration of exposure was useful. For the latter, factor analysis sug-gested three distinct manifestations of pesticide poi-soning. We then determined sensitivity and specificity of various combinations of symptoms and simple neu-rotoxicity tests from the Pentox questionnaire, and found that doing so increased sensitivity and specificity compared to use of acethylcholinesterase alone—the current screening standard. While sensitivity and speci-ficity varied with different case definitions, our results support the development of a low-cost test battery for screening in such settings. Key words: pesticide poison-ing; chronic exposure; Neurobehavioral Evaluation System (NES2); biomarker indices of toxicity; Ecuador; floriculture; validity of acetylcholine esterase; environ-mental stressor