Objective: To examine the association of exposure to categories of pesticides (H-I-F) with PD incidence in the French general population.

Background: Environmental exposure to pesticides has been associated with Parkinson’s disease (PD), but it is unclear whether specific categories of pesticides (herbicides-H, insecticides-I, fungicides-F) are more particularly involved.

Method: Incident PD cases were identified using a validated algorithm based on drug claims (2010-2014)[1]. We distinguished the non-agricultural from the agricultural population. Pesticides exposure was determined using crop-exposure matrices (CEM)[2] that describe exposure to H-I-F by region and time for 5 crops (straw cereals, grain corn, corn fodder, potatoes, vineyards) since 1960. CEMs provide annual probabilities of exposure to H-I-F and number of applications. CEMs were combined with data from the agricultural censuses (1988-2000). Of 3,689 French cantons (mean area~150km²), 3,537 had at least 1 of 5 crops (representing 74% of all French agricultural area). For each canton, we estimated PD age/sex standardized incidence and the proportion of the area devoted to the 5 crops for which H-I-F were applied. We examined their association using multivariable multilevel negative binomial regression with a random intercept per canton, adjusted for the total area of the 5 crops, the agricultural area without these crops, and the area of the cantons, as well as smoking, deprivation index, and neurologists’ density.

Results: We identified 112,625 incident PD cases in the French population (median number of cases per canton=19, interquartile range-IQR=11-34) of whom 74,476 belonged to the non-agricultural population (median=12, IQR=5-23). In the general population, PD incidence was 7.3% (95% CI=3.6-11.1%) higher in cantons with the highest (top quintile) exposure to F compared to those in the lowest in 1988; a similar pattern was observed for the non-agricultural population (8.7%, 95% IC=4.6-13.1). There was no association for exposure to H and I. Results were consistent in 2000.

Conclusion: PD incidence was higher in cantons with the highest proportion of agricultural land treated with F. The next step will be to examine the role of chemical families and active substances available in the CEMs.

References: 1. Moisan, F., et al., Prediction model of Parkinson’s disease based on antiparkinsonian drug claims. Am J Epidemiol, 2011. 174(3): p. 354-63. 2. Spinosi, J. and J. Févotte, Le programme Matphyto. Matrices cultures-expositions aux produits phytosanitaires. Saint-Maurice (Fra) : Institut de veille sanitaire, 2008: p. 16p.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-of-environmental-exposure-to-herbicides-fungicides-and-insecticides-used-in-agriculture-with-incidence-of-parkinsons-disease-in-the-french-general-population/