Skip to main content
PMC home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2001 Sep;58(9):582–589. doi: 10.1136/oem.58.9.582

Parkinsonism and occupational exposure to pesticides

L Engel 1, H Checkoway 1, M Keifer 1, N Seixas 1, W Longstreth 1, K Scott 1, K Hudnell 1, W Anger 1, R Camicioli 1
PMCID: PMC1740189  PMID: 11511745

Abstract

OBJECTIVE—To examine the risk of parkinsonism related to lifetime occupational exposure to pesticides among a cohort of men, mostly orchardists, in Washington State.
METHODS—All 310 subjects in this study had previously participated in a cohort study of men occupationally exposed to pesticides. Subjects were given a structured neurological examination and completed a self administered questionnaire which elicited detailed information on pesticide (insecticide, herbicide, and fungicide) use throughout their working careers. Demographic characteristics were also sought. Subjects had a mean age of 69.6 years (range 49-96, SD 8.1). There were 238 (76.8%) subjects who reported some occupational exposure to pesticides, whereas 72 (23.2%) reported none. Parkinsonism was defined by the presence of two or more of rest tremor, rigidity, bradykinesia, and impairment of postural reflexes in subjects not on antiparkinsonian medication, or the presence of at least one sign if they were on such medication. Parkinson's disease was not studied explicitly because of the difficulty in distinguishing it from other parkinsonian syndromes. A generalised linear model was used to estimate prevalence ratios (PRs) for parkinsonism relative to history of farming, pesticide use, and use of well water.
RESULTS—A PR of 2.0 (95% confidence interval (95% CI) 1.0 to 4.2) was found for subjects in the highest tertile of years of exposure to pesticides; a similarly increased, non-significant, PR was found for the middle tertile (1.9 (95% CI 0.9 to 4.0)), although a trend test did not show a significant exposure-response relation. No increased risks were found associated with specific pesticides or pesticide classes, nor with a history of farming or use of well water.
CONCLUSION—Parkinsonism may be associated with long term occupational exposure to pesticides, although no associations with specific pesticides could be detected. This finding is consistent with most of the publications on this topic.


Keywords: farmer; parkinsonism; pesticides

Full Text

The Full Text of this article is available as a PDF (147.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barbeau A., Roy M., Bernier G., Campanella G., Paris S. Ecogenetics of Parkinson's disease: prevalence and environmental aspects in rural areas. Can J Neurol Sci. 1987 Feb;14(1):36–41. doi: 10.1017/s0317167100026147. [DOI] [PubMed] [Google Scholar]
  2. Barbeau A., Roy M., Cloutier T., Plasse L., Paris S. Environmental and genetic factors in the etiology of Parkinson's disease. Adv Neurol. 1987;45:299–306. [PubMed] [Google Scholar]
  3. Bennett D. A., Beckett L. A., Murray A. M., Shannon K. M., Goetz C. G., Pilgrim D. M., Evans D. A. Prevalence of parkinsonian signs and associated mortality in a community population of older people. N Engl J Med. 1996 Jan 11;334(2):71–76. doi: 10.1056/NEJM199601113340202. [DOI] [PubMed] [Google Scholar]
  4. Bennett D. A., Shannon K. M., Beckett L. A., Goetz C. G., Wilson R. S. Metric properties of nurses' ratings of parkinsonian signs with a modified Unified Parkinson's Disease Rating Scale. Neurology. 1997 Dec;49(6):1580–1587. doi: 10.1212/wnl.49.6.1580. [DOI] [PubMed] [Google Scholar]
  5. Bhatt M. H., Elias M. A., Mankodi A. K. Acute and reversible parkinsonism due to organophosphate pesticide intoxication: five cases. Neurology. 1999 Apr 22;52(7):1467–1471. doi: 10.1212/wnl.52.7.1467. [DOI] [PubMed] [Google Scholar]
  6. Butterfield P. G., Valanis B. G., Spencer P. S., Lindeman C. A., Nutt J. G. Environmental antecedents of young-onset Parkinson's disease. Neurology. 1993 Jun;43(6):1150–1158. doi: 10.1212/wnl.43.6.1150. [DOI] [PubMed] [Google Scholar]
  7. De Michele G., Filla A., Volpe G., De Marco V., Gogliettino A., Ambrosio G., Marconi R., Castellano A. E., Campanella G. Environmental and genetic risk factors in Parkinson's disease: a case-control study in southern Italy. Mov Disord. 1996 Jan;11(1):17–23. doi: 10.1002/mds.870110105. [DOI] [PubMed] [Google Scholar]
  8. Ferraz H. B., Bertolucci P. H., Pereira J. S., Lima J. G., Andrade L. A. Chronic exposure to the fungicide maneb may produce symptoms and signs of CNS manganese intoxication. Neurology. 1988 Apr;38(4):550–553. doi: 10.1212/wnl.38.4.550. [DOI] [PubMed] [Google Scholar]
  9. Fleming L., Mann J. B., Bean J., Briggle T., Sanchez-Ramos J. R. Parkinson's disease and brain levels of organochlorine pesticides. Ann Neurol. 1994 Jul;36(1):100–103. doi: 10.1002/ana.410360119. [DOI] [PubMed] [Google Scholar]
  10. Golbe L. I., Farrell T. M., Davis P. H. Follow-up study of early-life protective and risk factors in Parkinson's disease. Mov Disord. 1990;5(1):66–70. doi: 10.1002/mds.870050116. [DOI] [PubMed] [Google Scholar]
  11. Gorell J. M., Johnson C. C., Rybicki B. A., Peterson E. L., Richardson R. J. The risk of Parkinson's disease with exposure to pesticides, farming, well water, and rural living. Neurology. 1998 May;50(5):1346–1350. doi: 10.1212/wnl.50.5.1346. [DOI] [PubMed] [Google Scholar]
  12. Gorell J. M., Rybicki B. A., Cole Johnson C., Peterson E. L. Occupational metal exposures and the risk of Parkinson's disease. Neuroepidemiology. 1999;18(6):303–308. doi: 10.1159/000026225. [DOI] [PubMed] [Google Scholar]
  13. Herishanu Y. O., Kordysh E., Goldsmith J. R. A case-referent study of extrapyramidal signs (preparkinsonism) in rural communities of Israel. Can J Neurol Sci. 1998 May;25(2):127–133. doi: 10.1017/s0317167100033734. [DOI] [PubMed] [Google Scholar]
  14. Hertzman C., Wiens M., Bowering D., Snow B., Calne D. Parkinson's disease: a case-control study of occupational and environmental risk factors. Am J Ind Med. 1990;17(3):349–355. doi: 10.1002/ajim.4700170307. [DOI] [PubMed] [Google Scholar]
  15. Hertzman C., Wiens M., Snow B., Kelly S., Calne D. A case-control study of Parkinson's disease in a horticultural region of British Columbia. Mov Disord. 1994 Jan;9(1):69–75. doi: 10.1002/mds.870090111. [DOI] [PubMed] [Google Scholar]
  16. Ho S. C., Woo J., Lee C. M. Epidemiologic study of Parkinson's disease in Hong Kong. Neurology. 1989 Oct;39(10):1314–1318. doi: 10.1212/wnl.39.10.1314. [DOI] [PubMed] [Google Scholar]
  17. Hubble J. P., Cao T., Hassanein R. E., Neuberger J. S., Koller W. C. Risk factors for Parkinson's disease. Neurology. 1993 Sep;43(9):1693–1697. doi: 10.1212/wnl.43.9.1693. [DOI] [PubMed] [Google Scholar]
  18. Koller W., Vetere-Overfield B., Gray C., Alexander C., Chin T., Dolezal J., Hassanein R., Tanner C. Environmental risk factors in Parkinson's disease. Neurology. 1990 Aug;40(8):1218–1221. doi: 10.1212/wnl.40.8.1218. [DOI] [PubMed] [Google Scholar]
  19. Kuopio A. M., Marttila R. J., Helenius H., Rinne U. K. Changing epidemiology of Parkinson's disease in southwestern Finland. Neurology. 1999 Jan 15;52(2):302–308. doi: 10.1212/wnl.52.2.302. [DOI] [PubMed] [Google Scholar]
  20. Langston J. W., Ballard P., Tetrud J. W., Irwin I. Chronic Parkinsonism in humans due to a product of meperidine-analog synthesis. Science. 1983 Feb 25;219(4587):979–980. doi: 10.1126/science.6823561. [DOI] [PubMed] [Google Scholar]
  21. Langston J. W., Irwin I., Ricaurte G. A. Neurotoxins, parkinsonism and Parkinson's disease. Pharmacol Ther. 1987;32(1):19–49. doi: 10.1016/0163-7258(87)90062-3. [DOI] [PubMed] [Google Scholar]
  22. Liou H. H., Tsai M. C., Chen C. J., Jeng J. S., Chang Y. C., Chen S. Y., Chen R. C. Environmental risk factors and Parkinson's disease: a case-control study in Taiwan. Neurology. 1997 Jun;48(6):1583–1588. doi: 10.1212/wnl.48.6.1583. [DOI] [PubMed] [Google Scholar]
  23. Morano A., Jiménez-Jiménez F. J., Molina J. A., Antolín M. A. Risk-factors for Parkinson's disease: case-control study in the province of Cáceres, Spain. Acta Neurol Scand. 1994 Mar;89(3):164–170. doi: 10.1111/j.1600-0404.1994.tb01655.x. [DOI] [PubMed] [Google Scholar]
  24. Morgante L., Rocca W. A., Di Rosa A. E., De Domenico P., Grigoletto F., Meneghini F., Reggio A., Savettieri G., Castiglione M. G., Patti F. Prevalence of Parkinson's disease and other types of parkinsonism: a door-to-door survey in three Sicilian municipalities. The Sicilian Neuro-Epidemiologic Study (SNES) Group. Neurology. 1992 Oct;42(10):1901–1907. doi: 10.1212/wnl.42.10.1901. [DOI] [PubMed] [Google Scholar]
  25. Rajput A. H., Uitti R. J., Stern W., Laverty W., O'Donnell K., O'Donnell D., Yuen W. K., Dua A. Geography, drinking water chemistry, pesticides and herbicides and the etiology of Parkinson's disease. Can J Neurol Sci. 1987 Aug;14(3 Suppl):414–418. doi: 10.1017/s0317167100037823. [DOI] [PubMed] [Google Scholar]
  26. Seidler A., Hellenbrand W., Robra B. P., Vieregge P., Nischan P., Joerg J., Oertel W. H., Ulm G., Schneider E. Possible environmental, occupational, and other etiologic factors for Parkinson's disease: a case-control study in Germany. Neurology. 1996 May;46(5):1275–1284. doi: 10.1212/wnl.46.5.1275. [DOI] [PubMed] [Google Scholar]
  27. Semchuk K. M., Love E. J., Lee R. G. Parkinson's disease and exposure to agricultural work and pesticide chemicals. Neurology. 1992 Jul;42(7):1328–1335. doi: 10.1212/wnl.42.7.1328. [DOI] [PubMed] [Google Scholar]
  28. Smargiassi A., Mutti A., De Rosa A., De Palma G., Negrotti A., Calzetti S. A case-control study of occupational and environmental risk factors for Parkinson's disease in the Emilia-Romagna region of Italy. Neurotoxicology. 1998 Aug-Oct;19(4-5):709–712. [PubMed] [Google Scholar]
  29. Stern M., Dulaney E., Gruber S. B., Golbe L., Bergen M., Hurtig H., Gollomp S., Stolley P. The epidemiology of Parkinson's disease. A case-control study of young-onset and old-onset patients. Arch Neurol. 1991 Sep;48(9):903–907. doi: 10.1001/archneur.1991.00530210029018. [DOI] [PubMed] [Google Scholar]
  30. Tanner C. M. Occupational and environmental causes of parkinsonism. Occup Med. 1992 Jul-Sep;7(3):503–513. [PubMed] [Google Scholar]
  31. Tanner C. M., Ottman R., Goldman S. M., Ellenberg J., Chan P., Mayeux R., Langston J. W. Parkinson disease in twins: an etiologic study. JAMA. 1999 Jan 27;281(4):341–346. doi: 10.1001/jama.281.4.341. [DOI] [PubMed] [Google Scholar]
  32. Thompson M. L., Myers J. E., Kriebel D. Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? Occup Environ Med. 1998 Apr;55(4):272–277. doi: 10.1136/oem.55.4.272. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Wong G. F., Gray C. S., Hassanein R. S., Koller W. C. Environmental risk factors in siblings with Parkinson's disease. Arch Neurol. 1991 Mar;48(3):287–289. doi: 10.1001/archneur.1991.00530150055018. [DOI] [PubMed] [Google Scholar]
  34. de Rijk M. C., Tzourio C., Breteler M. M., Dartigues J. F., Amaducci L., Lopez-Pousa S., Manubens-Bertran J. M., Alpérovitch A., Rocca W. A. Prevalence of parkinsonism and Parkinson's disease in Europe: the EUROPARKINSON Collaborative Study. European Community Concerted Action on the Epidemiology of Parkinson's disease. J Neurol Neurosurg Psychiatry. 1997 Jan;62(1):10–15. doi: 10.1136/jnnp.62.1.10. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES