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Occupational exposure to pesticides and endotoxin and Parkinson disease in the Netherlands
  1. Marianne van der Mark1,
  2. Roel Vermeulen1,2,
  3. Peter C G Nijssen3,4,
  4. Wim M Mulleners5,
  5. Antonetta M G Sas6,
  6. Teus van Laar7,
  7. Maartje Brouwer1,
  8. Anke Huss1,
  9. Hans Kromhout1
  1. 1Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
  2. 2Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  3. 3St Elisabeth Hospital Tilburg, Tilburg, The Netherlands
  4. 4TweeSteden Hospital Tilburg, Tilburg, The Netherlands
  5. 5Canisius-Wilhelmina Hospital Nijmegen, Nijmegen, The Netherlands
  6. 6Vlietland Hospital Schiedam, Schiedam, The Netherlands
  7. 7University Medical Center Groningen, Groningen, The Netherlands
  1. Correspondence to Marianne van der Mark, Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, PO Box 80.178, Utrecht 3508 TD, The Netherlands; m.vandermark{at}uu.nl

Abstract

Objectives Previous research has indicated that occupational exposure to pesticides and possibly airborne endotoxin may increase the risk of developing Parkinson disease (PD). We studied the associations of PD with occupational exposure to pesticides, specifically to the functional subclasses insecticides, herbicides and fungicides, and to airborne endotoxin. In addition we evaluated specific pesticides (active ingredients) previously associated with PD.

Methods We used data from a hospital-based case–control study, including 444 patients with PD and 876 age and sex matched controls. Exposures to pesticides from application and re-entry work were estimated with the ALOHA+job-exposure matrix and with an exposure algorithm based on self-reported information on pesticide use. To assess exposure to specific active ingredients a crop-exposure matrix was developed. Endotoxin exposure was estimated with the DOM job-exposure matrix.

Results The results showed almost no significant associations. However, ORs were elevated in the higher exposure categories for pesticides in general, insecticides, herbicides and fungicides, and below unity for endotoxin exposure. The analyses on specific active ingredients showed a significant association of PD risk with the fungicide benomyl.

Conclusions This study did not provide evidence for a relation between pesticide exposure and PD. However, the consistently elevated ORs in the higher exposure categories suggest that a positive association may exist. The possible association with the active ingredient benomyl requires follow-up in other studies. This study did not provide support for a possible association between endotoxin exposure and PD.

Keywords
  • Parkinson disease
  • pesticides
  • endotoxins

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