title: Protective glove use and hygiene habits modify the associations of specific pesticides with Parkinson's disease.
abstract: Pesticides have been associated with Parkinson's disease (PD), and protective gloves and workplace hygiene can reduce pesticide exposure. We assessed whether use of gloves and workplace hygiene modified associations between pesticides and PD. The Farming and Movement Evaluation (FAME) study is a nested case-control study within the Agricultural Health Study. Use of protective gloves, other PPE, and hygiene practices were determined by questionnaire (69 cases and 237 controls were included). We considered interactions of gloves and hygiene with ever-use of pesticides for all pesticides with ≥5 exposed and unexposed cases and controls in each glove-use stratum (paraquat, permethrin, rotenone, and trifluralin). 61% of respondents consistently used protective gloves and 87% consistently used ≥2 hygiene practices. Protective glove use modified the associations of paraquat and permethrin with PD: neither pesticide was associated with PD among protective glove users, while both pesticides were associated with PD among non-users (paraquat OR 3.9 [95% CI 1.3, 11.7], interaction p=0.15; permethrin OR 4.3 [95% CI 1.2, 15.6] interaction p=0.05). Rotenone was associated with PD regardless of glove use. Trifluralin was associated with PD among participants who used <2 hygiene practices (OR 5.5 [95% CI 1.1, 27.1]) but was not associated with PD among participants who used 2 or more practices (interaction p=0.02). Although sample size was limited in the FAME study, protective glove use and hygiene practices appeared to be important modifiers of the association between pesticides and PD and may reduce risk of PD associated with certain pesticides.
authors.affiliation: University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC, United States. Electronic address: furlongm@med.unc.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Furlong
authors.affiliation: San Francisco Veteran's Affairs Medical Center, Parkinson's Disease Research, Education and Clinical Center, San Francisco, CA, United States; The University of California at San Francisco School of Medicine, Department of Neurology, United States.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Tanner
authors.affiliation: The University of California at San Francisco School of Medicine, Department of Neurology, United States.
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Goldman
authors.affiliation: The Parkinson's Institute and Clinical Center, Sunnyvale, CA, United States.
authors.forename: Grace S
authors.initials: GS
authors.lastname: Bhudhikanok
authors.affiliation: National Cancer Institute, Occupational and Environmental Epidemiology Branch, United States.
authors.forename: Aaron
authors.initials: A
authors.lastname: Blair
authors.affiliation: Favaloro University, Institute of Neuroscience, Buenos Aires, Argentina.
authors.forename: Anabel
authors.initials: A
authors.lastname: Chade
authors.affiliation: The University of California at San Francisco School of Medicine, Department of Neurology, United States.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Comyns
authors.affiliation: North Carolina State University, Department of Biological Sciences, Raleigh, NC, United States.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.affiliation: University of Lubeck, Department of Psychiatry, Lubeck, Germany.
authors.forename: Meike
authors.initials: M
authors.lastname: Kasten
authors.affiliation: The University of California at San Francisco School of Medicine, Department of Neurology, United States.
authors.forename: Monica
authors.initials: M
authors.lastname: Korell
authors.affiliation: The Parkinson's Institute and Clinical Center, Sunnyvale, CA, United States.
authors.forename: J William
authors.initials: JW
authors.lastname: Langston
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Connie
authors.initials: C
authors.lastname: Marras
authors.affiliation: San Francisco Veteran's Affairs Medical Center, Parkinson's Disease Research, Education and Clinical Center, San Francisco, CA, United States; The University of California at San Francisco School of Medicine, Department of Neurology, United States.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Meng
authors.affiliation: Westat Inc., Durham, NC, United States.
authors.forename: Marie
authors.initials: M
authors.lastname: Richards
authors.affiliation: VA Pacific Islands Health Care System, Honolulu, HI, United States.
authors.forename: G Webster
authors.initials: GW
authors.lastname: Ross
authors.affiliation: National Institute of Environmental Health Sciences, Biostatistics Branch, Research Triangle Park, NC, United States.
authors.forename: David M
authors.initials: DM
authors.lastname: Umbach
authors.affiliation: National Institute of Environmental Health Sciences, Epidemiology Branch, Research Triangle Park, NC, United States.
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
authors.affiliation: National Institute of Environmental Health Sciences, Epidemiology Branch, Research Triangle Park, NC, United States.
authors.forename: Freya
authors.initials: F
authors.lastname: Kamel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000383:Agriculture; D016022:Case-Control Studies; D005260:Female; D017575:Gloves, Protective / Q000706:statistics & numerical data*; D006184:Habits; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control*; D016272:Occupational Health; D010269:Paraquat; D010300:Parkinson Disease / Q000453:epidemiology* / Q000209:etiology; D026023:Permethrin; D010575:Pesticides; D012306:Risk; D012402:Rotenone; D011795:Surveys and Questionnaires; D014274:Trifluralin; D017132:Workplace
chemical_list: D010575:Pesticides; D012402:Rotenone; D026023:Permethrin; D014274:Trifluralin; D010269:Paraquat
keywords: Movement disorders; Neurodegenerative diseases; Parkinson's disease; Personal protective equipment; Pesticides