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American Journal of Epidemiology Advance Access originally published online on March 6, 2009
American Journal of Epidemiology 2009 169(8):919-926; doi:10.1093/aje/kwp006
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Parkinson's Disease and Residential Exposure to Maneb and Paraquat From Agricultural Applications in the Central Valley of California

Sadie Costello, Myles Cockburn, Jeff Bronstein, Xinbo Zhang and Beate Ritz

Correspondence to Dr. Sadie Costello, Department of Environmental Health Sciences, School of Public Health, University of California, Berkeley, 50 University Hall, #7360, Berkeley, CA 94720-7360 (e-mail: sadie{at}berkeley.edu).

Received for publication September 12, 2008. Accepted for publication January 6, 2009.

Evidence from animal and cell models suggests that pesticides cause a neurodegenerative process leading to Parkinson's disease (PD). Human data are insufficient to support this claim for any specific pesticide, largely because of challenges in exposure assessment. The authors developed and validated an exposure assessment tool based on geographic information systems that integrated information from California Pesticide Use Reports and land-use maps to estimate historical exposure to agricultural pesticides in the residential environment. In 1998–2007, the authors enrolled 368 incident PD cases and 341 population controls from the Central Valley of California in a case-control study. They generated estimates for maneb and paraquat exposures incurred between 1974 and 1999. Exposure to both pesticides within 500 m of the home increased PD risk by 75% (95% confidence interval (CI): 1.13, 2.73). Persons aged ≤60 years at the time of diagnosis were at much higher risk when exposed to either maneb or paraquat alone (odds ratio = 2.27, 95% CI: 0.91, 5.70) or to both pesticides in combination (odds ratio = 4.17, 95% CI: 1.15, 15.16) in 1974–1989. This study provides evidence that exposure to a combination of maneb and paraquat increases PD risk, particularly in younger subjects and/or when exposure occurs at younger ages.

case-control studies; fungicides, industrial; geographic information systems; herbicides; maneb; paraquat; Parkinson disease; pesticides

Abbreviations: CI, confidence interval; DDE, dichlorodiphenyldichloroethylene; GIS, geographic information system; MPP+, toxic metabolite of 1-methyl-4-phenylpyridinium; OR, odds ratio; PD, Parkinson's disease; PLSS, Public Land Survey System; PUR, Pesticide Use Reporting


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