Organophosphate compounds have a long history of extensive applications in agricultural industry to control pest caused damages on crops. Despite of their broad-spectrum effectiveness, many of them are potent anti-cholinesterase agents and can cause serious detrimental effects on humans, such as salivation, lacrimation, urination, defecation, gastrointestinal distress, and emesis (commonly summarized by the acronym SLEDGE). Adverse conditions from acute organophosphate poisoning can rapidly deteriorate to severe respiratory failure, which without immediate medical intervention, can lead to death. For decades, the U.S. Department of Defense (DoD) has recognized depression in human red blood cell acetylcholinesterase (RBC-AChE) activity as a valuable biomarker for potential exposure to cholinesterase inhibiting organophosphates. The DoD has established a nation-wide testing network, the DoD Cholinesterase Monitoring Program (CMP), with the DoD Cholinesterase Reference Laboratory (CRL) located at Joint Base-San Antonio, TX and multiple geographically dispersed satellite testing facilities inside the U.S. The program has become a highly versatile tool to offer massive and rapid screening of organophosphate poisoning.
2. Second outcome: Following this session, the attendee will be able to properly interpret human red blood cell acetylcholinesterase activity testing results according to the individual-based baselines and the current DoD population- based reference range.
3. Third outcome: Following this session, the attendee will be able to learn the modern and systematic quality control and quality assurance programs utilized in the DoD CMP and their potential applications in other clinical testing programs.