Professional exposure to pesticides and Parkinson disease
Identifieur interne : 000353 ( Main/Corpus ); précédent : 000352; suivant : 000354Professional exposure to pesticides and Parkinson disease
Auteurs : Alexis Elbaz ; Jacqueline Clavel ; Paul J. Rathouz ; Frédéric Moisan ; Jean-Philippe Galanaud ; Bernard Delemotte ; Annick Alpérovitch ; Christophe TzourioSource :
- Annals of Neurology [ 0364-5134 ] ; 2009-10.
Abstract
Objective: We studied the relation between Parkinson disease (PD) and professional exposure to pesticides in a community‐based case‐control study conducted in a population characterized by a high prevalence of exposure. Our objective was to investigate the role of specific pesticide families and to perform dose‐effect analyses. Methods: PD cases (n = 224) from the Mutualité Sociale Agricole (France) were matched to 557 controls free of PD affiliated with the same health insurance. Pesticide exposure was assessed using a 2‐phase procedure, including a case‐by‐case expert evaluation. Analyses of the relation between PD and professional exposure to pesticides were first performed overall and by broad category (insecticides, fungicides, herbicides). Analyses of 29 pesticide families defined based on a chemical classification were restricted to men. Multiple imputation was used to impute missing values of pesticide families. Data were analyzed using conditional logistic regression, both using a complete‐case and an imputed dataset. Results: We found a positive association between PD and overall professional pesticide use (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.1–3.1), with a dose‐effect relation for the number of years of use (p = 0.01). In men, insecticides were associated with PD (OR = 2.2, 95% CI = 1.1–4.3), in particular organochlorine insecticides (OR = 2.4, 95% CI = 1.2–5.0). These associations were stronger in men with older onset PD than in those with younger onset PD, and were characterized by a dose‐effect relation in the former group. Interpretation: Our results support an association between PD and professional pesticide exposure, and show that some pesticides (ie, organochlorine insecticides) may be more particularly involved. Ann Neurol 2009;66:494–504
Url:
DOI: 10.1002/ana.21717
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Rathouz</name><affiliation><mods:affiliation>Department of Health Studies, University of Chicago, Chicago, IL</mods:affiliation></affiliation></author><author><name sortKey="Moisan, Frederic" sort="Moisan, Frederic" uniqKey="Moisan F" first="Frédéric" last="Moisan">Frédéric Moisan</name><affiliation><mods:affiliation>INSERM, U708, Paris, France</mods:affiliation></affiliation><affiliation><mods:affiliation>UPMC, Univ Paris 06, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Galanaud, Jean Hilippe" sort="Galanaud, Jean Hilippe" uniqKey="Galanaud J" first="Jean-Philippe" last="Galanaud">Jean-Philippe Galanaud</name><affiliation><mods:affiliation>INSERM, U708, Paris, France</mods:affiliation></affiliation><affiliation><mods:affiliation>UPMC, Univ Paris 06, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Delemotte, Bernard" sort="Delemotte, Bernard" uniqKey="Delemotte B" first="Bernard" last="Delemotte">Bernard Delemotte</name><affiliation><mods:affiliation>Mutualité Sociale Agricole, Bagnolet, France</mods:affiliation></affiliation></author><author><name sortKey="Alperovitch, Annick" sort="Alperovitch, Annick" uniqKey="Alperovitch A" first="Annick" last="Alpérovitch">Annick Alpérovitch</name><affiliation><mods:affiliation>INSERM, U708, Paris, France</mods:affiliation></affiliation><affiliation><mods:affiliation>UPMC, Univ Paris 06, Paris, France</mods:affiliation></affiliation></author><author><name sortKey="Tzourio, Christophe" sort="Tzourio, Christophe" uniqKey="Tzourio C" first="Christophe" last="Tzourio">Christophe Tzourio</name><affiliation><mods:affiliation>INSERM, U708, Paris, France</mods:affiliation></affiliation><affiliation><mods:affiliation>UPMC, Univ Paris 06, Paris, France</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of Neurology</title><title level="j" type="abbrev">Ann Neurol.</title><idno type="ISSN">0364-5134</idno><idno type="eISSN">1531-8249</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-10">2009-10</date><biblScope unit="volume">66</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="494">494</biblScope><biblScope unit="page" to="504">504</biblScope></imprint><idno type="ISSN">0364-5134</idno></series><idno type="istex">80A003FEED147605130B49003FBB3D593BF89233</idno><idno type="DOI">10.1002/ana.21717</idno><idno type="ArticleID">ANA21717</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0364-5134</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: We studied the relation between Parkinson disease (PD) and professional exposure to pesticides in a community‐based case‐control study conducted in a population characterized by a high prevalence of exposure. Our objective was to investigate the role of specific pesticide families and to perform dose‐effect analyses. Methods: PD cases (n = 224) from the Mutualité Sociale Agricole (France) were matched to 557 controls free of PD affiliated with the same health insurance. Pesticide exposure was assessed using a 2‐phase procedure, including a case‐by‐case expert evaluation. Analyses of the relation between PD and professional exposure to pesticides were first performed overall and by broad category (insecticides, fungicides, herbicides). Analyses of 29 pesticide families defined based on a chemical classification were restricted to men. Multiple imputation was used to impute missing values of pesticide families. Data were analyzed using conditional logistic regression, both using a complete‐case and an imputed dataset. Results: We found a positive association between PD and overall professional pesticide use (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.1–3.1), with a dose‐effect relation for the number of years of use (p = 0.01). In men, insecticides were associated with PD (OR = 2.2, 95% CI = 1.1–4.3), in particular organochlorine insecticides (OR = 2.4, 95% CI = 1.2–5.0). These associations were stronger in men with older onset PD than in those with younger onset PD, and were characterized by a dose‐effect relation in the former group. Interpretation: Our results support an association between PD and professional pesticide exposure, and show that some pesticides (ie, organochlorine insecticides) may be more particularly involved. Ann Neurol 2009;66:494–504</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Alexis Elbaz MD, PhD</name><affiliations><json:string>INSERM, U708, Paris, France</json:string><json:string>UPMC, Univ Paris 06, Paris, France</json:string><json:string>Département santé‐travail, Institut de Veille Sanitaire, Saint‐Maurice, France</json:string></affiliations></json:item><json:item><name>Jacqueline Clavel MD, PhD</name><affiliations><json:string>INSERM, U754, Villejuif, France</json:string><json:string>Univ Paris 11, Villejuif, France</json:string></affiliations></json:item><json:item><name>Paul J. Rathouz PhD</name><affiliations><json:string>Department of Health Studies, University of Chicago, Chicago, IL</json:string></affiliations></json:item><json:item><name>Frédéric Moisan MSc</name><affiliations><json:string>INSERM, U708, Paris, France</json:string><json:string>UPMC, Univ Paris 06, Paris, France</json:string></affiliations></json:item><json:item><name>Jean‐Philippe Galanaud MD</name><affiliations><json:string>INSERM, U708, Paris, France</json:string><json:string>UPMC, Univ Paris 06, Paris, France</json:string></affiliations></json:item><json:item><name>Bernard Delemotte MD</name><affiliations><json:string>Mutualité Sociale Agricole, Bagnolet, France</json:string></affiliations></json:item><json:item><name>Annick Alpérovitch MSc, MD</name><affiliations><json:string>INSERM, U708, Paris, France</json:string><json:string>UPMC, Univ Paris 06, Paris, France</json:string></affiliations></json:item><json:item><name>Christophe Tzourio MD, PhD</name><affiliations><json:string>INSERM, U708, Paris, France</json:string><json:string>UPMC, Univ Paris 06, Paris, France</json:string></affiliations></json:item></author><articleId><json:string>ANA21717</json:string></articleId><language><json:string>eng</json:string></language><abstract>Objective: We studied the relation between Parkinson disease (PD) and professional exposure to pesticides in a community‐based case‐control study conducted in a population characterized by a high prevalence of exposure. Our objective was to investigate the role of specific pesticide families and to perform dose‐effect analyses. Methods: PD cases (n = 224) from the Mutualité Sociale Agricole (France) were matched to 557 controls free of PD affiliated with the same health insurance. Pesticide exposure was assessed using a 2‐phase procedure, including a case‐by‐case expert evaluation. Analyses of the relation between PD and professional exposure to pesticides were first performed overall and by broad category (insecticides, fungicides, herbicides). Analyses of 29 pesticide families defined based on a chemical classification were restricted to men. Multiple imputation was used to impute missing values of pesticide families. Data were analyzed using conditional logistic regression, both using a complete‐case and an imputed dataset. Results: We found a positive association between PD and overall professional pesticide use (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.1–3.1), with a dose‐effect relation for the number of years of use (p = 0.01). In men, insecticides were associated with PD (OR = 2.2, 95% CI = 1.1–4.3), in particular organochlorine insecticides (OR = 2.4, 95% CI = 1.2–5.0). These associations were stronger in men with older onset PD than in those with younger onset PD, and were characterized by a dose‐effect relation in the former group. Interpretation: Our results support an association between PD and professional pesticide exposure, and show that some pesticides (ie, organochlorine insecticides) may be more particularly involved. 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PhD</roleName><note type="correspondence"><p>Correspondence: Inserm, U708, Hôpital de la Salpêtrière, 47 boulevard de l'Hôpital, 75651 Paris Cedex 13, France</p></note><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation><affiliation>Département santé‐travail, Institut de Veille Sanitaire, Saint‐Maurice, France</affiliation></author><author><persName><forename type="first">Jacqueline</forename><surname>Clavel</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>INSERM, U754, Villejuif, France</affiliation><affiliation>Univ Paris 11, Villejuif, France</affiliation></author><author><persName><forename type="first">Paul J.</forename><surname>Rathouz</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Health Studies, University of Chicago, Chicago, IL</affiliation></author><author><persName><forename type="first">Frédéric</forename><surname>Moisan</surname></persName><roleName type="degree">MSc</roleName><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation></author><author><persName><forename type="first">Jean‐Philippe</forename><surname>Galanaud</surname></persName><roleName type="degree">MD</roleName><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation></author><author><persName><forename type="first">Bernard</forename><surname>Delemotte</surname></persName><roleName type="degree">MD</roleName><affiliation>Mutualité Sociale Agricole, Bagnolet, France</affiliation></author><author><persName><forename type="first">Annick</forename><surname>Alpérovitch</surname></persName><roleName type="degree">MSc, MD</roleName><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation></author><author><persName><forename type="first">Christophe</forename><surname>Tzourio</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation></author></analytic><monogr><title level="j">Annals of Neurology</title><title level="j" type="abbrev">Ann Neurol.</title><idno type="pISSN">0364-5134</idno><idno type="eISSN">1531-8249</idno><idno type="DOI">10.1002/(ISSN)1531-8249</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-10"></date><biblScope unit="volume">66</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="494">494</biblScope><biblScope unit="page" to="504">504</biblScope></imprint></monogr><idno type="istex">80A003FEED147605130B49003FBB3D593BF89233</idno><idno type="DOI">10.1002/ana.21717</idno><idno 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Our objective was to investigate the role of specific pesticide families and to perform dose‐effect analyses. Methods: PD cases (n = 224) from the Mutualité Sociale Agricole (France) were matched to 557 controls free of PD affiliated with the same health insurance. Pesticide exposure was assessed using a 2‐phase procedure, including a case‐by‐case expert evaluation. Analyses of the relation between PD and professional exposure to pesticides were first performed overall and by broad category (insecticides, fungicides, herbicides). Analyses of 29 pesticide families defined based on a chemical classification were restricted to men. Multiple imputation was used to impute missing values of pesticide families. Data were analyzed using conditional logistic regression, both using a complete‐case and an imputed dataset. Results: We found a positive association between PD and overall professional pesticide use (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.1–3.1), with a dose‐effect relation for the number of years of use (p = 0.01). In men, insecticides were associated with PD (OR = 2.2, 95% CI = 1.1–4.3), in particular organochlorine insecticides (OR = 2.4, 95% CI = 1.2–5.0). These associations were stronger in men with older onset PD than in those with younger onset PD, and were characterized by a dose‐effect relation in the former group. Interpretation: Our results support an association between PD and professional pesticide exposure, and show that some pesticides (ie, organochlorine insecticides) may be more particularly involved. 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corresponding="yes"><personName><givenNames>Alexis</givenNames><familyName>Elbaz</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email>alexis.elbaz@upmc.fr</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af4 #af5"><personName><givenNames>Jacqueline</givenNames><familyName>Clavel</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af6"><personName><givenNames>Paul J.</givenNames><familyName>Rathouz</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Frédéric</givenNames><familyName>Moisan</familyName><degrees>MSc</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Jean‐Philippe</givenNames><familyName>Galanaud</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af7"><personName><givenNames>Bernard</givenNames><familyName>Delemotte</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Annick</givenNames><familyName>Alpérovitch</familyName><degrees>MSc, MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Christophe</givenNames><familyName>Tzourio</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="FR" type="organization"><unparsedAffiliation>INSERM, U708, Paris, France</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="FR" type="organization"><unparsedAffiliation>UPMC, Univ Paris 06, Paris, France</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="FR" type="organization"><unparsedAffiliation>Département santé‐travail, Institut de Veille Sanitaire, Saint‐Maurice, France</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="FR" type="organization"><unparsedAffiliation>INSERM, U754, Villejuif, France</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="FR" type="organization"><unparsedAffiliation>Univ Paris 11, Villejuif, France</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="US" type="organization"><unparsedAffiliation>Department of Health Studies, University of Chicago, Chicago, IL</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="FR" type="organization"><unparsedAffiliation>Mutualité Sociale Agricole, Bagnolet, France</unparsedAffiliation></affiliation></affiliationGroup><fundingInfo><fundingAgency>Institut National de la Santé et de la Recherche Médicale</fundingAgency></fundingInfo><fundingInfo><fundingAgency>MSA</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Agence Nationale de la Recherche</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Agence Française de Sécurité Sanitaire de l'Environnement et du Travail</fundingAgency></fundingInfo><fundingInfo><fundingAgency>French Ministry of the Environment</fundingAgency></fundingInfo><fundingInfo><fundingAgency>France Parkinson</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Ministère de l'enseignement supérieur et de la recherche</fundingAgency></fundingInfo><supportingInformation><p> Additional Supporting Information may be found in the online version of this article. </p><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:03645134:media:ana21717:ANA_21717_Appendix"></mediaResource><caption>Tables</caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Objective</title><p>We studied the relation between Parkinson disease (PD) and professional exposure to pesticides in a community‐based case‐control study conducted in a population characterized by a high prevalence of exposure. Our objective was to investigate the role of specific pesticide families and to perform dose‐effect analyses.</p></section><section xml:id="abs1-2"><title type="main">Methods</title><p>PD cases (n = 224) from the Mutualité Sociale Agricole (France) were matched to 557 controls free of PD affiliated with the same health insurance. Pesticide exposure was assessed using a 2‐phase procedure, including a case‐by‐case expert evaluation. Analyses of the relation between PD and professional exposure to pesticides were first performed overall and by broad category (insecticides, fungicides, herbicides). Analyses of 29 pesticide families defined based on a chemical classification were restricted to men. Multiple imputation was used to impute missing values of pesticide families. Data were analyzed using conditional logistic regression, both using a complete‐case and an imputed dataset.</p></section><section xml:id="abs1-3"><title type="main">Results</title><p>We found a positive association between PD and overall professional pesticide use (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.1–3.1), with a dose‐effect relation for the number of years of use (<i>p</i> = 0.01). In men, insecticides were associated with PD (OR = 2.2, 95% CI = 1.1–4.3), in particular organochlorine insecticides (OR = 2.4, 95% CI = 1.2–5.0). These associations were stronger in men with older onset PD than in those with younger onset PD, and were characterized by a dose‐effect relation in the former group.</p></section><section xml:id="abs1-4"><title type="main">Interpretation</title><p>Our results support an association between PD and professional pesticide exposure, and show that some pesticides (ie, organochlorine insecticides) may be more particularly involved. Ann Neurol 2009;66:494–504</p></section></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: Nothing to report.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Professional exposure to pesticides and Parkinson disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Professional Pesticide Exposure and PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Professional exposure to pesticides and Parkinson disease</title></titleInfo><name type="personal"><namePart type="given">Alexis</namePart><namePart type="family">Elbaz</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation><affiliation>Département santé‐travail, Institut de Veille Sanitaire, Saint‐Maurice, France</affiliation><description>Correspondence: Inserm, U708, Hôpital de la Salpêtrière, 47 boulevard de l'Hôpital, 75651 Paris Cedex 13, France</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jacqueline</namePart><namePart type="family">Clavel</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>INSERM, U754, Villejuif, France</affiliation><affiliation>Univ Paris 11, Villejuif, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Paul J.</namePart><namePart type="family">Rathouz</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Health Studies, University of Chicago, Chicago, IL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Frédéric</namePart><namePart type="family">Moisan</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jean‐Philippe</namePart><namePart type="family">Galanaud</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bernard</namePart><namePart type="family">Delemotte</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Mutualité Sociale Agricole, Bagnolet, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Annick</namePart><namePart type="family">Alpérovitch</namePart><namePart type="termsOfAddress">MSc, MD</namePart><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Christophe</namePart><namePart type="family">Tzourio</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>INSERM, U708, Paris, France</affiliation><affiliation>UPMC, Univ Paris 06, Paris, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2009-10</dateIssued><dateCaptured encoding="w3cdtf">2008-11-07</dateCaptured><dateValid encoding="w3cdtf">2009-03-20</dateValid><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">3</extent><extent unit="references">44</extent><extent unit="words">7256</extent></physicalDescription><abstract lang="en">Objective: We studied the relation between Parkinson disease (PD) and professional exposure to pesticides in a community‐based case‐control study conducted in a population characterized by a high prevalence of exposure. Our objective was to investigate the role of specific pesticide families and to perform dose‐effect analyses. Methods: PD cases (n = 224) from the Mutualité Sociale Agricole (France) were matched to 557 controls free of PD affiliated with the same health insurance. Pesticide exposure was assessed using a 2‐phase procedure, including a case‐by‐case expert evaluation. Analyses of the relation between PD and professional exposure to pesticides were first performed overall and by broad category (insecticides, fungicides, herbicides). Analyses of 29 pesticide families defined based on a chemical classification were restricted to men. Multiple imputation was used to impute missing values of pesticide families. Data were analyzed using conditional logistic regression, both using a complete‐case and an imputed dataset. Results: We found a positive association between PD and overall professional pesticide use (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.1–3.1), with a dose‐effect relation for the number of years of use (p = 0.01). In men, insecticides were associated with PD (OR = 2.2, 95% CI = 1.1–4.3), in particular organochlorine insecticides (OR = 2.4, 95% CI = 1.2–5.0). These associations were stronger in men with older onset PD than in those with younger onset PD, and were characterized by a dose‐effect relation in the former group. Interpretation: Our results support an association between PD and professional pesticide exposure, and show that some pesticides (ie, organochlorine insecticides) may be more particularly involved. Ann Neurol 2009;66:494–504</abstract><note type="content">*Potential conflict of interest: Nothing to report.</note><note type="funding">Institut National de la Santé et de la Recherche Médicale</note><note type="funding">MSA</note><note type="funding">Agence Nationale de la Recherche</note><note type="funding">Agence Française de Sécurité Sanitaire de l'Environnement et du Travail</note><note type="funding">French Ministry of the Environment</note><note type="funding">France Parkinson</note><note type="funding">Ministère de l'enseignement supérieur et de la recherche</note><relatedItem type="host"><titleInfo><title>Annals of Neurology</title></titleInfo><titleInfo type="abbreviated"><title>Ann Neurol.</title></titleInfo><genre type="Journal">journal</genre><note type="content"> Additional Supporting Information may be found in the online version of this article.Supporting Info Item: Tables - </note><subject><genre>article category</genre><topic>Original Article</topic></subject><identifier type="ISSN">0364-5134</identifier><identifier type="eISSN">1531-8249</identifier><identifier type="DOI">10.1002/(ISSN)1531-8249</identifier><identifier type="PublisherID">ANA</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>66</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>494</start><end>504</end><total>11</total></extent></part></relatedItem><identifier type="istex">80A003FEED147605130B49003FBB3D593BF89233</identifier><identifier type="DOI">10.1002/ana.21717</identifier><identifier type="ArticleID">ANA21717</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2009 American Neurological Association</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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