Background: Pesticides have been associated with Parkinson’s disease (PD), but there are few data on important exposure characteristics such as dose–effect relations. It is unknown whether associations depend on clinical PD subtypes.
Objectives: We examined quantitative aspects of occupational pesticide exposure associated with PD and investigated whether associations were similar across PD subtypes.
Methods: As part of a French population-based case–control study including men enrolled in the health insurance plan for farmers and agricultural workers, cases with clinically confirmed PD were identified through antiparkinsonian drug claims. Two controls were matched to each case. Using a comprehensive occupational questionnaire, we computed indicators for different dimensions of exposure (duration, cumulative exposure, intensity). We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) among exposed male farmers (133 cases, 298 controls). We examined the relation between pesticides and PD subtypes (tremor dominant/non-tremor dominant) using polytomous logistic regression.
Results: There appeared to be a stronger association with intensity than duration of pesticide exposure based on separate models, as well as a synergistic interaction between duration and intensity (p-interaction = 0.04). High-intensity exposure to insecticides was positively associated with PD among those with low-intensity exposure to fungicides and vice versa, suggesting independent effects. Pesticide exposure in farms that specialized in vineyards was associated with PD (OR = 2.56; 95% CI: 1.31, 4.98). The association with intensity of pesticide use was stronger, although not significantly (p-heterogeneity = 0.60), for tremor-dominant (p-trend < 0.01) than for non-tremor–dominant PD (p-trend = 0.24).
Conclusions: This study helps to better characterize different aspects of pesticide exposure associated with PD, and shows a significant association of pesticides with tremor-dominant PD in men, the most typical PD presentation.
1Département santé travail, Institut de veille sanitaire, Saint-Maurice, France; 2INSERM, U708, Neuroepidemiology, Bordeaux/Paris, France; 3Unité mixte de recherche épidémiologique et de surveillance en transport, travail et environnement (Umrestte), Université Lyon, Lyon, France; 4Caisse départementale de la Gironde, Mutualité sociale agricole, Bordeaux, France; 5Service de Neurologie, CHU Poitiers, Poitiers, France; 6Université Versailles St-Quentin, UMRS 1018, Villejuif, France; 7Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; 8INSERM U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
Recommended Citation:
Frédéric Moisan,1,2 Johan Spinosi,et al. Association of Parkinson’s Disease and Its Subtypes with Agricultural Pesticide Exposures in Men: A Case–Control Study in France[J]. Environmental Health Perspectives,2015-01-01,Volume 123(Issue 11):1123