Krzyzanowski Brittany, Mullan Aidan F, Dorsey E Ray, Chirag Sai Shivani, Turcano Pierpaolo, Camerucci Emanuele, Bower James H, Savica Rodolfo
Department of Neurology, Barrow Neurological Institute, Phoenix, Arizona.
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
JAMA Netw Open. 2025 May 1;8(5):e259198. doi: 10.1001/jamanetworkopen.2025.9198.
The role of pesticide exposure from golf courses in Parkinson disease (PD) risk remains unclear.
To assess whether proximity to golf courses is associated with increased PD risk and to use information on groundwater vulnerability and municipal well locations to investigate drinking water contamination as a potential route of exposure.
DESIGN, SETTING, AND PARTICIPANTS: This case-control study included patients with incident PD and matched controls from the Rochester Epidemiology Project from 1991 to 2015. Data were analyzed between June and August 2024.
Distance to golf courses, living in water service areas with a golf course, living in water service areas in vulnerable groundwater regions, living in water service areas with shallow municipal wells, and living in water service areas with a municipal well on a golf course.
Risk of incident PD. All models adjusted for age, sex, race and ethnicity, year of index, median household income, and urban or rural category.
A total of 419 incident PD cases were identified (median [IQR] age, 73 [65-80] years; 257 male [61.3%]) with 5113 matched controls (median [IQR] age, 72 [65-79] years; 3043 male [59.5%]; 4504 White [88.1%]). After adjusting for patient demographics and neighborhood characteristics, living within 1 mile of a golf course was associated with 126% increased odds of developing PD compared with individuals living more than 6 miles away from a golf course (adjusted odds ratio [aOR], 2.26; 95% CI, 1.09-4.70). Individuals living within water service areas with a golf course had nearly double the odds of PD compared with individuals in water service areas without golf courses (aOR, 1.96; 95% CI, 1.20-3.23) and 49% greater odds compared with individuals with private wells (aOR, 1.49; 95% CI, 1.05-2.13). Additionally, individuals living in water service areas with a golf course in vulnerable groundwater regions had 82% greater odds of developing PD compared with those in nonvulnerable groundwater regions (aOR, 1.82; 95% CI, 1.09-3.03).
In this population-based case-control study, the greatest risk of PD was found within 1 to 3 miles of a golf course and risk generally decreased with distance. Associations with the largest effect sizes were in water service areas with a golf course and in vulnerable ground water regions.
高尔夫球场农药暴露在帕金森病（PD）风险中的作用仍不明确。
评估居住在靠近高尔夫球场的地方是否与PD风险增加相关，并利用地下水脆弱性和市政水井位置信息调查饮用水污染作为潜在暴露途径。
设计、设置和参与者：这项病例对照研究纳入了1991年至2015年罗切斯特流行病学项目中的新发PD患者及匹配的对照。数据于2024年6月至8月进行分析。
到高尔夫球场的距离、居住在有高尔夫球场的供水区域、居住在地下水脆弱区域的供水区域、居住在有浅市政水井的供水区域以及居住在高尔夫球场上有市政水井的供水区域。
新发PD的风险。所有模型均对年龄、性别、种族和民族、索引年份、家庭收入中位数以及城市或农村类别进行了调整。
共确定了419例新发PD病例（年龄中位数[四分位间距]，73[65 - 80]岁；男性257例[61.3%]），匹配对照5113例（年龄中位数[四分位间距]，72[65 - 79]岁；男性3043例[59.5%]；白人4504例[88.1%]）。在对患者人口统计学和邻里特征进行调整后，与居住在距离高尔夫球场超过6英里的个体相比，居住在距离高尔夫球场1英里范围内患PD的几率增加了126%（调整后的优势比[aOR]，2.26；95%置信区间[CI]，1.09 - 4.70）。与没有高尔夫球场的供水区域的个体相比，居住在有高尔夫球场的供水区域的个体患PD的几率几乎翻倍（aOR，1.96；95%CI，1.20 - 3.23），与有私人水井的个体相比几率高49%（aOR，1.49；95%CI，1.05 - 2.13）。此外，与非脆弱地下水区域的个体相比，居住在地下水脆弱区域且有高尔夫球场的供水区域的个体患PD的几率高82%（aOR，1.82；95%CI，1.09 - 3.03）。
在这项基于人群的病例对照研究中，发现距离高尔夫球场1至3英里范围内患PD的风险最高，且风险一般随距离增加而降低。效应量最大的关联存在于有高尔夫球场的供水区域和脆弱地下水区域。
