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British Medical Bulletin Advance Access originally published online on January 22, 2007
British Medical Bulletin 2006 79-80(1):219-231; doi:10.1093/bmb/ldl018
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Parkinson's disease and pesticide exposures

Finlay D. Dick*

Department of Environmental and Occupational Medicine, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Aberdeenshire, UK

* Correspondence to: Finlay D. Dick, Department of Environmental and Occupational Medicine, Liberty Safe Work Research Centre, Foresterhill Road, Aberdeen, Aberdeenshire AB25 2ZP, UK. E-mail: f.dick{at}abdn.ac.uk

Introduction: Idiopathic Parkinson's disease (PD) is a neurodegenerative disorder in which loss of dopaminergic neurons in the basal ganglia leads to tremor, bradykinesia, rigidity and postural instability.

Methods: Literature search using Medline with keywords ‘Parkinson's disease’ and ‘pesticides’, limited to English, was undertaken, supplemented by articles from the author's files.

Results: Many studies have found an association between pesticides and PD, but no one agent has been consistently identified. Those implicated include organochlorine insecticides, maneb and paraquat. One meta-analysis of pesticide exposure and PD found an almost doubling of risk in those exposed. Associations with specific agents may be confounded by exposure to other pesticides, making it difficult to identify the causative agent.

Conclusions: The available evidence indicates that pesticides are associated with PD, but further research is needed to identify long-term biomarkers of exposure, improve methods for estimating pesticide-exposure and undertake prospective cohort studies of pesticide-exposed workers.

Keywords: Parkinson's disease • parkinsonism • pesticides

Accepted for publication December 4, 2006.


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