This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (24)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Movement Disorders  • Parkinson Disease/ Parkinsonian Disorders  • Occupational and Environmental Medicine  • Alert me on articles by topic

A Population-Based Case-Control Study

Jordan A. Firestone, MD, PhD, MPH; Terri Smith-Weller, MN, COHN; Gary Franklin, MD, MPH; Phillip Swanson, MD, PhD; W. T. Longstreth, Jr, MD, MPH; Harvey Checkoway, PhD

Arch Neurol. 2005;62:91-95.

Background  Pesticide exposures are suspected risk factors for Parkinson disease (PD), but epidemiological observations have been inconsistent.

Objective  To investigate associations between pesticide exposures and idiopathic PD.

Design  Population-based case-control study.

Setting  Group Health Cooperative, a health care system in western Washington State, and the University of Washington.

Participants  Two hundred fifty incident PD case patients and 388 healthy control subjects (age- and sex-matched). We assessed self-reported pesticide exposures using a structured interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined using logistic regression models, controlling for age, sex, and smoking.

Results  Odds ratios for occupational exposures were not significant but suggested a gradient that paralleled occupational exposures (pesticide worker: OR, 2.07; 95% CI, 0.67-6.38; crop farmer: OR, 1.65; 95% CI, 0.84-3.27; animal and crop farmer: OR, 1.10; 95% CI, 0.60-2.00; and dairy farmer: OR, 0.88; 95% CI, 0.46-1.70). Odds ratios for organophosphates paralleled the World Health Organization hazard classifications, with parathion much higher than diazinon or malathion. We also found elevated ORs from herbicides (OR, 1.41; 95% CI, 0.51-3.88) and paraquat (OR, 1.67; 95% CI, 0.22-12.76). We found no evidence of risk from home-based pesticide exposures. We found significantly increased ORs from lifelong well water consumption (OR, 1.81; 95% CI, 1.02-3.21).

Conclusions  The findings for occupational pesticide exposures are consistent with a growing body of information linking pesticide exposures with PD. However, the lack of significant associations, absence of associations with home-based exposures, and weak associations with rural exposures suggest that pesticides did not play a substantial etiologic role in this population.

Author Affiliations: Departments of Neurology (Drs Firestone, Franklin, Swanson, and Longstreth), Environmental and Occupational Health Sciences (Ms Smith-Weller and Drs Franklin and Checkoway), and Epidemiology (Drs Longstreth and Checkoway), University of Washington, Seattle.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Environmental risk factors for Parkinson's disease and parkinsonism: the Geoparkinson study
Dick et al.
Occup. Environ. Med. 2007;64:666-672.
ABSTRACT | FULL TEXT  

Pesticide Exposure and Self-reported Parkinson's Disease in the Agricultural Health Study
Kamel et al.
Am J Epidemiol 2007;165:364-374.
ABSTRACT | FULL TEXT  

Parkinson's disease and pesticide exposures
Dick
Br Med Bull 2007;0:ldl018v1-13.
ABSTRACT | FULL TEXT  

5' and 3' region variability in the dopamine transporter gene (SLC6A3), pesticide exposure and Parkinson's disease risk: a hypothesis-generating study
Kelada et al.
Hum Mol Genet 2006;15:3055-3062.
ABSTRACT | FULL TEXT  

Parkinson's disease and other basal ganglia or movement disorders in a large nationwide cohort of Swedish welders
Fored et al.
Occup. Environ. Med. 2006;63:135-140.
ABSTRACT | FULL TEXT