title: Parkinson's disease mortality and pesticide exposure in California 1984-1994.
abstract: BACKGROUND
  In the last two decades reports from different countries emerged associating pesticide and herbicide use with Parkinson's disease (PD). California growers use approximately 250 million pounds of pesticides annually, about a quarter of all pesticides used in the US.
  
  
  METHODS
  We employed a proportional odds mortality design to compare all cases of PD recorded as underlying (1984-1994) or associated causes (1984-1993) of death occurring in California with all deaths from ischaemic heart disease (ICD-9 410-414) during the same period. Based on pesticide use report data we classified California counties into several pesticide use categories. Agricultural census data allowed us to create measures of percentage of land per county treated with pesticides. Employing logistic regression models we estimated the effect of pesticide use controlling for age, gender, race, birthplace, year of deaths, and education.
  
  
  RESULTS
  Mortality from PD as the underlying cause of death was higher in agricultural pesticide-use counties than in non-use counties. A dose response was observed for insecticide use per county land treated when using 1982 agricultural census data, but not for amounts of restricted pesticides used or length of residency in a country prior to death.
  
  
  CONCLUSIONS
  Our data show an increased PD mortality in California counties using agricultural pesticides. Unless all of our measures of county pesticide use are surrogates for other risk factors more prevalent in pesticide use counties, it seems important to target this prevalent exposure in rural California in future studies that use improved case finding mechanisms and collect pesticide exposure data for individuals.
authors.affiliation: Department of Epidemiology, Center for Occupational and Environmental Health, School of Public Health, UCLA, Los Angeles, CA 90095-1772, USA.
authors.forename: B
authors.initials: B
authors.lastname: Ritz
authors.forename: F
authors.initials: F
authors.lastname: Yu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016573:Agrochemicals / Q000009:adverse effects*; D002140:California / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000401:mortality; D009784:Occupational Diseases / Q000139:chemically induced / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D010300:Parkinson Disease / Q000401:mortality*; D010302:Parkinson Disease, Secondary / Q000139:chemically induced*; D010575:Pesticides / Q000009:adverse effects*; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012424:Rural Population; D015996:Survival Rate
chemical_list: D016573:Agrochemicals; D010575:Pesticides