Kim Yangwoo, Kim Inah, Sung Jung-Min, Song Jaechul
Department of Occupational and Environmental Medicine, Hanyang University Hospital, Seoul, Korea.
Department of Public Health Science, Graduate School of Public Health, Institute of Health and Environment, Seoul National University, Seoul, Korea.
Ann Occup Environ Med. 2021 Feb 5;33:e6. doi: 10.35371/aoem.2021.33.e6. eCollection 2021.
Parkinson's disease (PD) is a rare, neurodegenerative disease with various occupational and environmental risk factors. Exposure to specific pesticides contributes significantly to the incidence of PD. However, it is difficult to measure the level of pesticide exposure in workers. This study presents the first case recognized the work-relatedness between PD and pesticide exposure.
A 68-year-old male was diagnosed with PD after working with pesticides at a tomato greenhouse for 12 years and 5 months. From the results of a field study, it was reasonable to assume that the patient had been exposed to a significant level of various insecticides. In the present report, we described the first accepted case of work-relatedness between PD and exposure to pesticides. The evaluation was conducted using the following steps: we ruled out other possible risk factors including additional occupational history and personal risk factors, we assessed the work environment, surveyed possible exposures, found proper epidemiological evidence, and calculated the probability of causation. The work-relatedness was determined through the review of epidemiological evidence and estimation of exposure situation and level, and biological plausibility. We also decided work-relatedness based on the exposure of PD related pesticides with identified biologically plausible and the presumption that the exposure level would be high due to the working process.
In this case, the field study and epidemiological results supported the work-relatedness of PD and exposure to pesticides. Moreover, the results of previous studies have confirmed a causal relationship between exposure to pesticides and PD.
帕金森病（PD）是一种罕见的神经退行性疾病，存在多种职业和环境风险因素。接触特定农药对PD的发病率有显著影响。然而，测量工人的农药接触水平较为困难。本研究首次确认了PD与农药接触之间的职业相关性。
一名68岁男性在番茄温室从事农药相关工作12年零5个月后被诊断为PD。根据现场研究结果，合理推测该患者接触了大量多种杀虫剂。在本报告中，我们描述了首例被认可的PD与农药接触职业相关性病例。评估按以下步骤进行：我们排除了包括其他职业史和个人风险因素在内的其他可能风险因素，评估了工作环境，调查了可能的接触情况，找到了适当的流行病学证据，并计算了因果关系概率。通过审查流行病学证据、估计接触情况和水平以及生物学合理性来确定职业相关性。我们还基于接触已确定具有生物学合理性的与PD相关农药以及因工作过程导致接触水平较高的推测来判定职业相关性。
在该病例中，现场研究和流行病学结果支持了PD与农药接触的职业相关性。此外，先前研究结果已证实农药接触与PD之间存在因果关系。
