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.

中文翻译：

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一群农民及其配偶的农药使用和帕金森病事件。

背景

大量文献表明，一般农药的使用与帕金森病 (PD) 之间存在关联。然而，除了少数例外，人们对特定农药与PD之间的关联知之甚少。

客观的

我们在长达 20 多年的农业健康研究队列中，对 38,274 名农药施用者及其 27,836 名配偶的农药使用情况和 PD 事件进行了评估。

方法

我们使用了施用者和配偶在入组时曾经使用过 50 种特定农药的自我报告信息，并考虑了施用者在入组时和第一个 5 年随访期间报告的强度加权终生天数 (IWLD)。我们使用 Cox 回归估计了协变量调整风险比 (HR) 和 95% 置信区间 (CI)。我们还研究了头部受伤史和耐化学手套使用之间关联的异质性。

结果

共有 373 名施药者和 118 名配偶自我报告了医生诊断为 PD 的事件。曾经使用过杀虫剂特丁磷（HR：1.31，95%CI：1.02–1.68）和除草剂氟乐灵（HR：1.29，95%CI：0.99–1.70）和2,4,5-T（HR：1.57， 95% CI:1.21–2.04) 与 PD 风险升高相关。另一方面，二嗪农（HR：0.73，95％CI：0.58-0.94）和2,4,5-TP（HR：0.39，95％CI：0.25-0.62）与风险降低相关。我们观察到头部受伤和某些农药使用耐化学手套的使用关联存在异质性，那些报告有头部受伤史或不使用手套的人的风险更高。对于敌敌畏、氯菊酯（动物使用）和苯菌灵，IWLD 最高类别的施药器，PD 风险也有所升高。

结论

我们发现一些农药的局部放电风险增加的证据。我们的研究结果还表明，头部受伤的个体对农药相关帕金森病的敏感性更高，需要使用耐化学手套进行保护，尽管还需要进一步研究来了解头部受伤的影响。鉴于农药的广泛使用，对当前和新型农药（包括与 PD 相关的机制）的研究非常重要。