Abstract

Epidemiological studies have reported an increased risk of Parkinson’s disease (PD) in farmers, especially in those exposed to pesticides, but no clear conclusion can be drawn on the type of use, duration or latency associated with an effect. In the French prospective agricultural cohort AGRICAN, we assessed associations between agricultural and pesticide exposures, including their duration, and the risk of PD. Self-reported doctor-diagnosed PD and history of life-time exposure to 13 crops and 5 types of animals and pesticide use were collected at enrollment (2005–2011) among 181,842 participants affiliated to the French agriculture health assurance scheme (77% having worked on a farm, 23% who did not). Associations between agricultural/pesticide use and PD were estimated by logistic regression adjusted for sex, age, education, smoking status and alcohol consumption. PD was reported by 1 732 subjects (1.2%). Significant higher risk of PD was found for 3 types of animals (swine, horses, and poultry) and 7 crops (corn, peas, beet, rape, fruit-growing, potatoes and vegetables): odds ratios [OR] = 1.19 (horses) to 1.46 (peas). Pesticide exposure (E) was significantly associated with PD in all the animals and crops studied except tobacco (OR = 1.31 (cattle) to 1.83 (horses)) with a significant dose related-relationship with duration of exposure on cattle, swine, horses, poultry, vineyards and rape (P-trend < 0.05). Associations were more pronounced in farm-workers than in farm-owners. Our work suggested that the risk of PD was increased in almost all French agricultural activities, especially in subjects exposed to pesticides on vineyards and rape and to insecticides on cattle, swine, horses and poultry. Further analyses will explore class of pesticides suspected to increase PD risk (such as dithiocarbamates) using the crop-exposure matrix PESTIMAT.