Objective: We used types of farming as a proxy for pesticide exposure and investigated its association with Parkinson’s disease (PD) prevalence/incidence in the entire French population. We hypothesized that persons living in French regions with more crops that require more pesticides would be at higher risk of PD.

Background: Most studies on the pesticide-PD association are on the role of occupational exposure. Whether non-occupational pesticide exposure is also associated with PD is an important question, as it would increase the burden of PD attributable to pesticides.

Methods: We identified prevalent (2010) and incident (2010-2012) PD cases from French National Health Insurance databases. The density of 18 types of crops and animals were defined at the canton of residence level (1988 French agricultural census). We examined the association between PD rates and types of farming using multivariable multilevel Poisson regression with a random intercept per canton, adjusted for smoking and rurality (proportion of agricultural land). Interactions with gender and age were investigated. Clusters of cantons with similar agricultural characteristics were defined using the k-means algorithm.

Results: We identified 136,011 prevalent (2010) and 69,010 incident (2010-2012) PD cases. Rurality was associated with higher PD rates (P<0.001). Cantons with higher density of vineyards displayed the strongest independent association with incidence (RR_{top/bottom quartile}=1.11, 95% CI=1.06-1.16; P_trend=0.003) and prevalence (RR_{top/bottom quartile}=1.07, 95% CI=1.03-1.11; P_trend=0.002) of PD. This association was similar in men and women and stronger in older (≥75 years) than younger persons (P<0.001). A weaker positive association was observed with other crops (permanent crops, industrial crops, cereals, fresh vegetables in greenhouses) and animals (cattle, goats, pigs). Persons living in 638 cantons forming the cluster with the highest presence of vineyards had 12% higher incidence (P<0.001) and 5% higher prevalence (P=0.002) of PD.

Conclusions: In France, vineyards rank among the crops that require most intense use of pesticides, in particular insecticides and fungicides. Our results suggest that persons who live in regions with farming requiring high levels of pesticide use are at higher risk of PD; environmental pesticide exposure is a possible explanation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/types-of-farming-and-prevalence-and-incidence-of-parkinsons-disease-french-nationwide-study/