The Relationship Between Paraquat Exposure, Cholinesterase Activity, and Hematological Results Among Sugar Cane Plantation Workers in South Sumatra, Indonesia: A Cross-Sectoral Mediation Analysis
Bibliographic record
Abstract
Paraquat is a significant health problem among plantation workers in developing countries.This study analyzed the relationship between pesticide exposure, cholinesterase activity, hemoglobin levels, and oxygen saturation (SpO₂) as well as the mediating role of cholinesterase activity in workers.An analytical observational study with a crosssectional design was conducted on 90 respondents using random sampling techniques.66.7% of respondents experienced cholinesterase activity inhibition, 64.4% had hemoglobin levels < 13 g/dL, and 38.9% showed SpO₂ values < 95%.Multivariate logistic regression results showed that the use of complete personal protective equipment (PPE) was strongly associated with normal cholinesterase activity (adjusted OR = 56.89;95% CI: 2.58-1256.94).Other significant factors included spraying duration ≤ 4 hours/day (adjusted OR = 42.13;95% CI: 2.04-871.99),spraying frequency ≤ 2 times/week (adjusted OR = 30.41;95% CI: 1.14-814.96),and spraying time (adjusted OR = 62.77; 95% CI: 2.08-1891.12)(p < 0.05).Structural equation modeling (SEM) analysis showed that cholinesterase activity significantly mediated pesticide handling behavior and hemoglobin levels with an indirect effect of β = 0.159 (p = 0.003) and a good model fit index (RMSEA = 0.045).These results indicate that cholinesterase inhibition is a biological pathway of paraquat exposure with hematological disorders.Limitations include the cross-sectional design, which does not allow causal inference, sample size, and limitations in generalizing to the worker population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".