Hi, Welcome to healthcare magic. I have read the query and as Gregor works in a pesticide factory which contains organophosphate compounds, there is a high chance of him to have exposure to organophosphate compound due to inhalation,dermal contact or ingestion. Acetylcholine is a neurotransmitter which acts on receptor in muscle endings, ganglia which is required for the normal contraction of the muscles. In normal conditions,Acetylcholinesterase is an enzyme which causes breakdown of acetylcholine- leading to maintaining adequate concentration of acetylcholine for action without any harmful effects. But in organophosphate poisoning,as it an acetylcholinesterase inhibitor it will cause increase in amount of acetylcholine at the nerve endings and ganglia due to insufficient breakdown of acetylcholine due to absence of acetylcholine esterase. Now,the excess of acetylcholine is causing excessive excitability of muscles leading to muscle spasms which he has along with muscle weakness.The breathing difficulty he has is due to constriction of airways due to respiratory muscle spasms.There can also be presence of other symptoms like increased secretions from body,tremors,headache,etc.in this poisoning. I advice the patients with the similar symptoms who come to the emergency department with an anti cholinergic like atropine or pralidoxime to decrease the amount of acetylcholine and prevent breathing difficulty.Good oxygen supply is essential.Wear masks an protective clothing to prevent from further exposure, Hope I was able to simplify the medical terms involved in this case. Regards, Dr.Tushar Tamboli