Pyridostigmine, working and toxicity on platelet

I read the recent publication by Leong et al on the effect of pyridostigmine or Mestinon on human platelet aggregation with a great interest.1 In medicine, pyridostigmine has been investigated for its effect on biochemical and hematological parameters. Indeed, such effects have already been studied in animal models.2 Somani et al reported on significant change due to receipt of pyridostigmine in a biochemical parameter, creatinine phosphokinase but not in red blood cells or platelets.2 However, Husain et al recently noted that pyridostigmine plus exercise might induce change in platelet enzymes.3 This might be the explanation for the possible toxicity of exposure to pyridostigmine among the workers who have to work hard and are exposed to pyridostigmine.