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作者信息

Ferraro Ottavia Eleonora, Guido Davide, Zambianchi Roberto, Lanfranchi Simone, Oddone Enrico, Villani Simona

机构信息

Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Italy.

出版信息

Med Lav. 2018 Dec 20;109(6):420-434. doi: 10.23749/mdl.v110i6.7215.

Abstract

UNLABELLED

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BACKGROUND

: Neurological and neurodegenerative diseases are multifactorial and their causes are not well understood yet. Among the relevant risk factors, pesticides and the productive activities in which they are used are included.

OBJECTIVES

: To evaluate the association of mortality from neurological diseases within the Province of Pavia (Italy) with the agricultural activities, as a proxy of pesticides exposure.

METHODS

: Population data for 2012 were provided by the local health unit (ATS) and by the registry office of the Regional Health Service. Spatial analyses were carried out by both a classical and Bayesian approach, to obtain a mortality map of the relative risk for neurological diseases in the Province of Pavia. Spatial distribution of main agricultural activities within the same territory, used as proxy of pesticides use, was made possible by data from the Geoportale Territoriale of the Lombardy region. Finally, a comparison between spatial distribution of mortality from neurological diseases and spatial distribution of main agricultural activities has been conducted.

RESULTS

: Mortality for neurological diseases in the Province of Pavia in 2012 was 4.41 for men and 6.53 for women per 10,000 subjects living in this area. Female mortality for neurological diseases showed a cluster in the Oltrepò district, where viticulture and fruit/horticulture are more common than elsewhere. More precisely, Bayesian relative risk (RR) had higher values in comparison with the median RR of the Province (100.8), with a posterior probability (PP) between 0.75 and 0.95 (not significant). Similarly, mortality for Parkinson’s disease in women showed RR greater than the median value of the Province (100.6), with PP between 0.25 and 0.75 (not significant).

CONCLUSIONS

: Notwithstanding the ecological nature of the study, our results suggest the need to further investigate the possible link between pesticides exposure or related activities and neurological and neurodegenerative diseases, particularly Parkinson’s disease. An ad hoc study on a random sample of the population living in the Province of Pavia, with the collection of individual data by means of standardized questionnaire, would allow to control for biases usually present when an ecological study design is applied.

摘要

未标注

背景

神经和神经退行性疾病是多因素导致的,其病因尚未完全明确。相关风险因素包括农药及其使用的生产活动。

目的

评估意大利帕维亚省神经疾病死亡率与农业活动之间的关联,以此作为农药暴露的指标。

方法

2012年的人口数据由当地卫生部门(ATS)和地区卫生服务登记处提供。采用经典方法和贝叶斯方法进行空间分析,以绘制帕维亚省神经疾病相对风险死亡率地图。通过伦巴第地区地理门户的数据,得以了解同一地区主要农业活动的空间分布,以此作为农药使用的指标。最后,对神经疾病死亡率的空间分布与主要农业活动的空间分布进行了比较。

结果

2012年帕维亚省每10000名居民中,男性神经疾病死亡率为4.41,女性为6.53。女性神经疾病死亡率在奥尔特雷波区呈现聚集现象,该地区葡萄种植以及水果/园艺种植比其他地区更为普遍。更确切地说,与该省中位数相对风险(RR)(100.8)相比,贝叶斯相对风险值更高,后验概率(PP)在0.75至0.95之间(无显著性差异)。同样,女性帕金森病死亡率的RR大于该省中位数(100.6),PP在0.25至0.75之间(无显著性差异)。

结论

尽管本研究具有生态学性质,但我们的结果表明有必要进一步调查农药暴露或相关活动与神经和神经退行性疾病,特别是帕金森病之间的可能联系。对居住在帕维亚省的人群进行随机抽样的专项研究,并通过标准化问卷收集个体数据,将有助于控制应用生态学研究设计时通常存在的偏差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c252/7682186/8ae2b1f39e0e/MDL-109-420-g001.jpg

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