Narayan Shilpa, Liew Zeyan, Bronstein Jeff M, Ritz Beate
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles (UCLA), 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA.
Department of Neurology, School of Medicine, UCLA, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA.
Environ Int. 2017 Oct;107:266-273. doi: 10.1016/j.envint.2017.04.010. Epub 2017 Aug 2.
To study the influence of occupational pesticide use on Parkinson's disease (PD) in a population with information on various occupational, residential, and household sources of pesticide exposure.
In a population-based case control study in Central California, we used structured interviews to collect occupational history details including pesticide use in jobs, duration of use, product names, and personal protective equipment use from 360 PD cases and 827 controls. We linked reported products to California's pesticide product label database and identified pesticide active ingredients and occupational use by chemical class including fungicides, insecticides, and herbicides. Employing unconditional logistic regression, we estimated odds ratios and 95% confidence intervals for PD and occupational pesticide use.
Ever occupational use of carbamates increased risk of PD by 455%, while organophosphorus (OP) and organochlorine (OC) pesticide use doubled risk. PD risk increased 110-211% with ever occupational use of fungicides, herbicides, and insecticides. Using any pesticide occupationally for >10years doubled the risk of PD compared with no occupational pesticide use. Surprisingly, we estimated higher risks among those reporting use of personal protective equipment (PPE).
Our findings provide additional evidence that occupational pesticide exposures increase PD risk. This was the case even after controlling for other sources of pesticide exposure. Specifically, risk increased with occupational use of carbamates, OPs, and OCs, as well as of fungicides, herbicides, or insecticides. Interestingly, some types of PPE use may not provide adequate protection during pesticide applications.
在一个具有各种职业、居住和家庭农药接触信息的人群中，研究职业性农药使用对帕金森病（PD）的影响。
在加利福尼亚中部进行的一项基于人群的病例对照研究中，我们采用结构化访谈从360例PD患者和827名对照中收集职业史细节，包括工作中农药使用情况、使用持续时间、产品名称以及个人防护装备使用情况。我们将报告的产品与加利福尼亚州的农药产品标签数据库相关联，并确定农药活性成分以及按化学类别（包括杀菌剂、杀虫剂和除草剂）划分的职业用途。采用无条件逻辑回归，我们估计了PD与职业性农药使用的比值比和95%置信区间。
曾经职业性使用氨基甲酸盐类农药使患PD的风险增加455%，而使用有机磷（OP）和有机氯（OC）农药使风险增加一倍。曾经职业性使用杀菌剂、除草剂和杀虫剂使PD风险增加110 - 211%。与未进行职业性农药使用相比，职业性使用任何农药超过10年使患PD的风险增加一倍。令人惊讶的是，我们估计报告使用个人防护装备（PPE）的人群风险更高。
我们的研究结果提供了更多证据表明职业性农药接触会增加患PD的风险。即使在控制了其他农药接触源之后也是如此。具体而言，职业性使用氨基甲酸盐类、有机磷类和有机氯类农药以及杀菌剂、除草剂或杀虫剂会增加风险。有趣的是，某些类型的个人防护装备在农药施用期间可能无法提供充分的保护。
