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Plantation Work and Risk of Parkinson Disease in a Population-Based Longitudinal Study
Helen Petrovitch, MD;
G. Webster Ross, MD;
Robert D. Abbott, PhD;
Wayne T. Sanderson, PhD,CIH;
Dan S. Sharp, MD,PhD;
Caroline M. Tanner, MD,PhD;
Kamal H. Masaki, MD;
Patricia L. Blanchette, MD,MPH;
Jordan S. Popper, MD;
Daniel Foley, MS;
Lenore Launer, PhD;
Lon R. White, MD,MPH
Arch Neurol. 2002;59:1787-1792.
Context Parkinson disease (PD) has an unknown cause; however, convincing evidence is emerging that indicates pesticides can selectively injure the dopaminergic system in laboratory animals. Retrospective studies in humans demonstrate a link between exposure to agricultural lifestyle factors and PD.
Objective To determine whether working on a plantation in Hawaii and exposure to pesticides are associated with an increased risk of PD decades later.
Design and Setting Prospective cohort study based on the island of Oahu, Hawaii, with 30 years of follow-up. Years of work on a plantation were assessed by questionnaire at study enrollment in 1965. Self-reported information on pesticide exposure was collected at a separate examination 6 years later.
Participants Participants were 7986 Japanese American men born between 1900 and 1919 who were enrolled in the longitudinal Honolulu Heart Program.
Main Outcome Measures Incident PD was determined by medical record review or by an examination conducted by a study neurologist at a later date.
Results During follow-up, 116 men developed PD. Age-adjusted incidence increased significantly among men who worked more than 10 years on a plantation. The relative risk of PD was 1.0 (95% confidence interval, 0.6-1.6), 1.7 (95% confidence interval, 0.8-3.7), and 1.9 (95% confidence interval, 1.0-3.5) for men who worked on a plantation 1 to 10 years, 11 to 20 years, and more than 20 years compared with men who never did plantation work (P = .006, test for trend). Age-adjusted incidence of PD was higher in men exposed to pesticides than in men not exposed to pesticides although this was not statistically significant (P = .10, test for trend).
Conclusion These longitudinal observations regarding plantation work in Hawaii support case-control studies suggesting that exposure to pesticides increases the risk of PD.
From the Department of Medicine, University of Hawaii John A. Burns School of Medicine (Drs Petrovitch, Ross, Masaki, Blanchette, Popper, and White) and Department of Veterans Affairs (Drs Petrovitch, Ross, and White) Honolulu; Division of Biostatistics and Epidemiology, Department of Health Evaluation Sciences, University of Virginia School of Medicine, Charlottesville (Dr Abbott); National Institute for Occupational Safety and Health, Washington, DC (Drs Sanderson and Sharp); Pacific Health Research Institute (Drs Petrovitch, Ross, Abbott, Masaki, Popper, and White) and Kuakini Medical Center/Honolulu-Asia Aging Study (Drs Petrovitch, Ross, Abbott, Blanchette, Popper, and White), Honolulu; The Parkinson's Institute, Sunnyvale, Calif (Drs Ross and Tanner); and the National Institute on Aging, National Institutes of Health, Bethesda, Md (Mr Foley and Dr Launer).
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