Petrovitch Helen, Ross G Webster, Abbott Robert D, Sanderson Wayne T, Sharp Dan S, Tanner Caroline M, Masaki Kamal H, Blanchette Patricia L, Popper Jordan S, Foley Daniel, Launer Lenore, White Lon R
Department of Medicine, University of Hawaii John A. Burns School of Medicine, USA.
Arch Neurol. 2002 Nov;59(11):1787-92. doi: 10.1001/archneur.59.11.1787.
Parkinson disease (PD) has an unknown cause; however, convincing evidence is emerging that indicates pesticides can selectively injure the dopaminergic system in laboratory animals. Retrospective studies in humans demonstrate a link between exposure to agricultural lifestyle factors and PD.
To determine whether working on a plantation in Hawaii and exposure to pesticides are associated with an increased risk of PD decades later.
Prospective cohort study based on the island of Oahu, Hawaii, with 30 years of follow-up. Years of work on a plantation were assessed by questionnaire at study enrollment in 1965. Self-reported information on pesticide exposure was collected at a separate examination 6 years later.
Participants were 7986 Japanese American men born between 1900 and 1919 who were enrolled in the longitudinal Honolulu Heart Program.
Incident PD was determined by medical record review or by an examination conducted by a study neurologist at a later date.
During follow-up, 116 men developed PD. Age-adjusted incidence increased significantly among men who worked more than 10 years on a plantation. The relative risk of PD was 1.0 (95% confidence interval, 0.6-1.6), 1.7 (95% confidence interval, 0.8-3.7), and 1.9 (95% confidence interval, 1.0-3.5) for men who worked on a plantation 1 to 10 years, 11 to 20 years, and more than 20 years compared with men who never did plantation work (P =.006, test for trend). Age-adjusted incidence of PD was higher in men exposed to pesticides than in men not exposed to pesticides although this was not statistically significant (P =.10, test for trend).
These longitudinal observations regarding plantation work in Hawaii support case-control studies suggesting that exposure to pesticides increases the risk of PD.
帕金森病（PD）病因不明；然而，越来越多的确凿证据表明，杀虫剂可在实验动物中选择性损伤多巴胺能系统。对人类的回顾性研究表明，接触农业生活方式因素与帕金森病之间存在联系。
确定在夏威夷种植园工作以及接触杀虫剂是否与数十年后患帕金森病的风险增加有关。
基于夏威夷瓦胡岛的前瞻性队列研究，随访30年。1965年研究入组时通过问卷评估在种植园工作的年限。6年后在另一次检查中收集关于杀虫剂接触的自我报告信息。
参与者为7986名1900年至1919年出生的日裔美国男性，他们参加了檀香山心脏纵向研究项目。
通过病历审查或研究神经科医生后来进行的检查确定帕金森病发病情况。
随访期间，116名男性患帕金森病。在种植园工作超过10年的男性中，年龄调整后的发病率显著增加。与从未在种植园工作的男性相比，在种植园工作1至10年、11至20年以及超过20年的男性患帕金森病的相对风险分别为1.0（95%置信区间，0.6 - 1.6）、1.7（95%置信区间，0.8 - 3.7）和1.9（95%置信区间，1.0 - 3.5）（趋势检验P = 0.006）。接触杀虫剂的男性中帕金森病的年龄调整发病率高于未接触杀虫剂的男性，尽管这在统计学上无显著差异（趋势检验P = 0.10）。
这些关于夏威夷种植园工作的纵向观察结果支持病例对照研究，表明接触杀虫剂会增加患帕金森病的风险。
