Paraquat and Parkinson's disease: an overview of the epidemiology and a review of two recent studies.
OBJECTIVE
This paper reviews and evaluates two recent epidemiologic studies focused on pesticides, and in particular, paraquat as a cause of PD. Both studies are derived primarily from the Agricultural Health Study (AHS). A review and evaluation is also provided on the AHS and several additional studies of paraquat and PD.


METHODS
The methods used to design and conduct the studies and analyze the data are described and evaluated.


RESULTS
Studies were inadequately designed and often underpowered with very few exposed individuals. They were not population-based, failed to distinguish incident from prevalent cases, relied on multiple comparisons, and may have reported results selectively. The results across the studies are inconsistent.


CONCLUSIONS
The inherent difficulties of studying Parkinson's disease in relation to paraquat or other pesticides are well illustrated by these studies. A conclusion regarding these relationships cannot be reached based on the current literature. Further research with higher methodological standards is needed to reach a definitive conclusion.
Exponent, Inc., Menlo Park, CA 94025, United States. jmandel@exponent.com
J S
JS
Mandel
H-O
HO
Adami
P
P
Cole
D016022:Case-Control Studies; D006540:Herbicides / Q000633:toxicity*; D010269:Paraquat / Q000633:toxicity*; D010300:Parkinson Disease / Q000453:epidemiology / Q000209:etiology*; D010575:Pesticides / Q000633:toxicity
D006540:Herbicides; D010575:Pesticides; D010269:Paraquat