Paris-Saclay University, Paris-Sud University, UVSQ, Center for Research in Epidemiology and Population Health (CESP), INSERM-U1018, Paul Brousse Hospital, Villejuif, France.
Santé Publique France, The French Public Health Agency, Direction Santé Environnement Travail, Saint-Maurice, France.
Environ Res. 2021 Jun;197:111161. doi: 10.1016/j.envres.2021.111161. Epub 2021 Apr 19.
BACKGROUND: Professional pesticides exposure is associated with PD risk, but it remains unclear whether specific products, which strongly depend on farming type, are specifically involved. We performed a nationwide ecological study to examine the association of pesticides expenditures for the main farming types with PD incidence in French farmers. METHODS: We used the French National Health Insurance database to identify incident PD cases in farmers (2010-2015). We combined data on pesticides expenditures with the agricultural census to compute pesticides expenditures for nine farming types in 2000 in 3571 French cantons. The association between pesticides expenditures and PD age/sex standardized incidence was examined using multilevel Poisson regression, adjusted for smoking, neurologists' density, and deprivation index. RESULTS: 10,282 incident PD cases were identified. Cantons with the highest pesticides expenditures for vineyards without designation of origin were characterized by 16% (95% CI = 6-28%) higher PD incidence (p-trend corrected for multiple testing = 0.006). This association was significant in men and older farmers. There was no association with pesticides expenditures for other farming types, including vineyards with designation of origin. CONCLUSIONS: PD incidence increased significantly with pesticides expenditures in vineyards without designation of origin characterized by high fungicide use. This result suggests that agricultural practices and pesticides used in these vineyards may play a role in PD and that farmers in these farms should benefit from preventive measures aiming at reducing exposure. Our study highlights the importance of considering farming type in studies on pesticides and PD and the usefulness of pesticides expenditures for exposure assessment.
背景:职业性农药暴露与 PD 风险相关,但具体产品(强烈依赖农业类型)是否具体参与仍不清楚。我们进行了一项全国性的生态学研究,以检验主要农业类型的农药支出与法国农民 PD 发病率之间的关系。
方法:我们使用法国国家健康保险数据库来确定农民中的 PD 病例(2010-2015 年)。我们将农药支出数据与农业普查相结合,计算了 2000 年 3571 个法国乡镇中 9 种农业类型的农药支出。使用多水平泊松回归,调整了吸烟、神经科医生密度和贫困指数,检验了农药支出与 PD 年龄/性别标准化发病率之间的关联。
结果:确定了 10282 例新发 PD 病例。没有原产地名称的葡萄园的农药支出最高的乡镇,PD 发病率高 16%(95%CI=6-28%,p-trend 经多次测试校正后为 0.006)。这种关联在男性和老年农民中更为显著。与其他农业类型(包括有原产地名称的葡萄园)的农药支出无关。
结论:没有原产地名称的葡萄园的 PD 发病率随着农药支出的增加而显著增加,这些葡萄园的杀菌剂使用量较高。这一结果表明,这些葡萄园的农业实践和使用的农药可能在 PD 中起作用,这些农场的农民应受益于旨在减少接触的预防措施。我们的研究强调了在农药和 PD 研究中考虑农业类型的重要性,以及使用农药支出进行暴露评估的有用性。
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