Neurotoxicology. 2012 May 21. [Epub ahead of print]
Freire C, Koifman S.
Source
National
School of Public Health, Oswaldo Cruz Foundation, 21041-210 Rio de
Janeiro, RJ, Brazil; Laboratory of Medical Investigations, San Cecilio
University Hospital, University of Granada, 18071 Granada, Spain.
Abstract
It
has been suggested that exposure to pesticides might be involved in the
etiology of Parkinson's disease (PD). We conducted an updated
systematic review of the epidemiologic literature over the past decade
on the relationship between pesticide exposure and PD, using the
MEDLINE database. Despite methodological differences, a significantly
increased PD risk was observed in 13 out of 23 case-control studies
that considered overall exposure to pesticides (risk estimates of
1.1-2.4) and in 10 out of 12 studies using other research designs (risk
estimates of 2 or higher). Various studies found stronger associations
in genetically susceptible individuals. Among a growing number of
studies on the effects of exposure to specific pesticides (n=20), an
increased PD risk has been associated with insecticides, especially
chlorpyrifos and organochlorines, in six studies (odds ratios of
1.8-4.4), and with the herbicide paraquat, the fungicide maneb or the
combination of both. Findings considerably strengthen the evidence that
exposure to pesticides in well water may contribute to PD, whereas
studies of farming and rural residence found inconsistent or little
association with the disease. Taken together, this comprehensive set of
results suggests that the hypothesis of an association between
pesticide exposure and PD cannot be ruled out. However, inadequate data
on consistent responses to exposure hinder the establishment of a
causal relationship with PD. Given the extensive worldwide use of many
pesticides, further studies are warranted in larger populations that
include detailed quantitative data on exposure and determination of
genetic polymorphisms.
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