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American Journal of Epidemiology Advance Access originally published online on November 20, 2006
American Journal of Epidemiology 2007 165(4):364-374; doi:10.1093/aje/kwk024
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTIONS

Pesticide Exposure and Self-reported Parkinson's Disease in the Agricultural Health Study

F Kamel1, CM Tanner2, DM Umbach1, JA Hoppin1, MCR Alavanja3, A Blair3, K Comyns2, SM Goldman2, M Korell2, JW Langston2, GW Ross4 and DP Sandler1

1 National Institute of Environmental Health Sciences, Research Triangle Park, NC
2 The Parkinson's Institute, Sunnyvale, CA
3 National Cancer Institute, Bethesda, MD
4 Pacific Islands VA Health Care System, Honolulu, HI

Correspondence to Dr. Freya Kamel, Epidemiology Branch, MD A3-05, National Institute of Environmental Health Sciences, P.O. Box 12233, Research Triangle Park, NC 27709 (e-mail: kamel{at}mail.nih.gov).

Received for publication December 22, 2005. Accepted for publication July 13, 2006.

Previous studies based on limited exposure assessment have suggested that Parkinson's disease (PD) is associated with pesticide exposure. The authors used data obtained from licensed private pesticide applicators and spouses participating in the Agricultural Health Study to evaluate the relation of self-reported PD to pesticide exposure. Cohort members, who were enrolled in 1993–1997, provided detailed information on lifetime pesticide use. At follow-up in 1999–2003, 68% of the cohort was interviewed. Cases were defined as participants who reported physician-diagnosed PD at enrollment (prevalent cases, n = 83) or follow-up (incident cases, n = 78). Cases were compared with cohort members who did not report PD (n = 79,557 at enrollment and n = 55,931 at follow-up). Incident PD was associated with cumulative days of pesticide use at enrollment (for highest quartile vs. lowest, odds ratio (OR) = 2.3, 95% confidence interval: 1.2, 4.5; p-trend = 0.009), with personally applying pesticides more than half the time (OR = 1.9, 95% confidence interval: 0.7, 4.7), and with some specific pesticides (ORs ≥ 1.4). Prevalent PD was not associated with overall pesticide use. This study suggests that exposure to certain pesticides may increase PD risk. Findings for specific chemicals may provide fruitful leads for further investigation.

case-control studies; herbicides; insecticides; Parkinson disease; pesticides

Abbreviations: AHS, Agricultural Health Study; OR, odds ratio; PD, Parkinson's disease


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