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Pesticide use and incident Parkinson's disease in a cohort of farmers and their spouses.
Environ Res. 2020 12; 191:110186.ER

Abstract

BACKGROUND

Extensive literature suggests an association between general pesticide use and Parkinson's disease (PD). However, with few exceptions, little is known about associations between specific pesticides and PD.

OBJECTIVE

We evaluated use of pesticides and incident PD in 38,274 pesticide applicators and 27,836 of their spouses in the Agricultural Health Study cohort followed over 20 years.

METHODS

We used self-reported information on ever-use of 50 specific pesticides as of enrollment for both applicators and spouses, and considered intensity-weighted lifetime days (IWLD) reported at enrollment and through the first 5-year follow-up among applicators. We estimated covariate-adjusted hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression. We also examined heterogeneity in associations by history of head injury and chemical resistant glove use.

RESULTS

A total of 373 applicators and 118 spouses self-reported incident doctor-diagnosed PD. Ever-use of the insecticide terbufos (HR:1.31, 95%CI:1.02-1.68) and the herbicides trifluralin (HR:1.29, 95%CI: 0.99-1.70) and 2,4,5-T (HR:1.57, 95%CI:1.21-2.04) was associated with elevated PD risk. On the other hand, diazinon (HR:0.73, 95%CI: 0.58-0.94) and 2,4,5-TP (HR:0.39, 95%CI:0.25-0.62) were associated with reduced risk. We observed heterogeneity in ever-use associations by head injury and chemical-resistant glove use for some pesticides, with higher risk among those who reported a history of head injury, or who did not use gloves. PD risk was also elevated for applicators in the highest category of IWLD for dichlorvos, permethrin (animal use), and benomyl.

CONCLUSIONS

We found evidence of increased PD risk for some pesticides. Our results also suggest higher susceptibility for pesticide-associated PD among individuals with head injury as well as protection with use of chemical resistant gloves, although further research is needed to understand the impact of head injury. Research on current and newer pesticides, including mechanisms relevant to PD, is important given widespread pesticide use.

Authors+Show Affiliations

Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.Westat Inc., Durham, NC, USA.Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI, USA.Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA. Electronic address: sandler@niehs.nih.gov.

Pub Type(s)

Journal Article
Research Support, N.I.H., Intramural

Language

eng

PubMed ID

32919961

Citation

Shrestha, Srishti, et al. "Pesticide Use and Incident Parkinson's Disease in a Cohort of Farmers and Their Spouses." Environmental Research, vol. 191, 2020, p. 110186.
Shrestha S, Parks CG, Umbach DM, et al. Pesticide use and incident Parkinson's disease in a cohort of farmers and their spouses. Environ Res. 2020;191:110186.
Shrestha, S., Parks, C. G., Umbach, D. M., Richards-Barber, M., Hofmann, J. N., Chen, H., Blair, A., Beane Freeman, L. E., & Sandler, D. P. (2020). Pesticide use and incident Parkinson's disease in a cohort of farmers and their spouses. Environmental Research, 191, 110186. https://doi.org/10.1016/j.envres.2020.110186
Shrestha S, et al. Pesticide Use and Incident Parkinson's Disease in a Cohort of Farmers and Their Spouses. Environ Res. 2020;191:110186. PubMed PMID: 32919961.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pesticide use and incident Parkinson's disease in a cohort of farmers and their spouses. AU - Shrestha,Srishti, AU - Parks,Christine G, AU - Umbach,David M, AU - Richards-Barber,Marie, AU - Hofmann,Jonathan N, AU - Chen,Honglei, AU - Blair,Aaron, AU - Beane Freeman,Laura E, AU - Sandler,Dale P, Y1 - 2020/09/10/ PY - 2020/06/05/received PY - 2020/08/27/revised PY - 2020/08/28/accepted PY - 2021/12/01/pmc-release PY - 2020/9/14/pubmed PY - 2021/1/12/medline PY - 2020/9/13/entrez KW - Agricultural health study KW - Farmers KW - Parkinson's disease KW - Pesticides SP - 110186 EP - 110186 JF - Environmental research JO - Environ Res VL - 191 N2 - BACKGROUND: Extensive literature suggests an association between general pesticide use and Parkinson's disease (PD). However, with few exceptions, little is known about associations between specific pesticides and PD. OBJECTIVE: We evaluated use of pesticides and incident PD in 38,274 pesticide applicators and 27,836 of their spouses in the Agricultural Health Study cohort followed over 20 years. METHODS: We used self-reported information on ever-use of 50 specific pesticides as of enrollment for both applicators and spouses, and considered intensity-weighted lifetime days (IWLD) reported at enrollment and through the first 5-year follow-up among applicators. We estimated covariate-adjusted hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression. We also examined heterogeneity in associations by history of head injury and chemical resistant glove use. RESULTS: A total of 373 applicators and 118 spouses self-reported incident doctor-diagnosed PD. Ever-use of the insecticide terbufos (HR:1.31, 95%CI:1.02-1.68) and the herbicides trifluralin (HR:1.29, 95%CI: 0.99-1.70) and 2,4,5-T (HR:1.57, 95%CI:1.21-2.04) was associated with elevated PD risk. On the other hand, diazinon (HR:0.73, 95%CI: 0.58-0.94) and 2,4,5-TP (HR:0.39, 95%CI:0.25-0.62) were associated with reduced risk. We observed heterogeneity in ever-use associations by head injury and chemical-resistant glove use for some pesticides, with higher risk among those who reported a history of head injury, or who did not use gloves. PD risk was also elevated for applicators in the highest category of IWLD for dichlorvos, permethrin (animal use), and benomyl. CONCLUSIONS: We found evidence of increased PD risk for some pesticides. Our results also suggest higher susceptibility for pesticide-associated PD among individuals with head injury as well as protection with use of chemical resistant gloves, although further research is needed to understand the impact of head injury. Research on current and newer pesticides, including mechanisms relevant to PD, is important given widespread pesticide use. SN - 1096-0953 UR - https://www.unboundmedicine.com/medline/citation/32919961/Pesticide_use_and_incident_Parkinson's_disease_in_a_cohort_of_farmers_and_their_spouses_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-9351(20)31083-5 DB - PRIME DP - Unbound Medicine ER -