Department of Pathology, São Paulo State University (UNESP) , Botucatu , Brazil.
Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP) , São Paulo , Brazil.
J Toxicol Environ Health B Crit Rev. 2019;22(5-6):172-202. doi: 10.1080/10937404.2019.1659197. Epub 2019 Sep 2.
This investigation aimed to conduct a systematic review of the literature and meta-analysis to determine whether exposure to the herbicide paraquat was associated with the development of Parkinson's disease (PD). Observational studies that enrolled adults exposed to paraquat with PD as the outcome of interest were searched in the PubMed, Embase, LILACS, TOXNET, and Web of Science databases up to May 2019. Two authors independently selected relevant studies, extracted data, and assessed methodological quality. The evidence certainty was assessed by the GRADE approach, which served as basis for a tentative causality assessment, supplemented by the Bradford Hill criteria when necessary. Results from nine case-control studies indicated that PD occurrence was 25% higher in participants exposed to paraquat. The only cohort investigation included demonstrated a non-significant OR of 1.08. Results from subgroup analyses also indicated higher PD frequency in participants that were exposed to paraquat for longer periods or individuals co-exposed with paraquat and any other dithiocarbamate. Data indicate apositive association between exposure to paraquat and PD occurrence, but the weight-of-evidence does not enable one to assume an indisputable cause-effect relationship between these two conditions. Better designed studies are needed to increase confidence in results. : PROSPERO CRD42017069994.
本研究旨在通过系统综述和荟萃分析来确定接触除草剂百草枯是否与帕金森病（PD）的发生有关。我们在 PubMed、Embase、LILACS、TOXNET 和 Web of Science 数据库中检索了截至 2019 年 5 月，招募了接触百草枯且 PD 为研究结局的成年人的观察性研究。两位作者独立选择相关研究、提取数据并评估方法学质量。我们使用 GRADE 方法评估证据确定性，作为暂定因果关系评估的基础，并在必要时补充 Bradford Hill 标准。9 项病例对照研究的结果表明，接触百草枯的参与者中 PD 的发生率增加了 25%。唯一一项队列研究显示，OR 值为 1.08，无统计学意义。亚组分析的结果也表明，接触百草枯时间较长或同时接触百草枯和任何其他二硫代氨基甲酸盐的个体 PD 发生频率更高。数据表明接触百草枯与 PD 发生之间存在正相关，但现有证据尚不足以确定这两种情况之间存在不可争议的因果关系。需要更好设计的研究来提高对结果的信心。: PROSPERO CRD42017069994.
