title: An association between organophosphate pesticides exposure and Parkinsonism amongst people in an agricultural area in Ubon Ratchathani Province, Thailand.
abstract: BACKGROUND
  Parkinson's disease (PD) is a ubiquitous disease. However, PDs prevalence in the population of agricultural communities lacks understanding and there has been no epidemiological study on the association between pesticides exposure factors and risk for PD.
  
  
  OBJECTIVE
  To investigate the potential association between organophosphate pesticides exposure and Parkinsonism by using a screening questionnaire in agricultural areas.
  
  
  METHODS
  Ninety elderly people living in agricultural areas participated in a cross-sectional study conducted at Tambon Hua-Rua Health Promoting Hospital in April 2014. Screening questionnaires for Parkinson's disease, Test-mate ChE (Model 400) for blood cholinesterase (ChE) levels of both blood enzymes erythrocyte cholinesterase (AChE), and plasma cholinesterase (PChE) were used as measurement tools. Descriptive statistics for frequencies and percentage distributions were used primarily to summarize and describe the data. Sensitivity, specificity, positive and negative predictive values were calculated.
  
  
  RESULTS
  The age range of the participants was 50 to 59 years old, with an average age of 53.9±2.87 years. The majority of the participants were female (62.2%), 82.2% of respondents were farmers. Most of participants (76.7%) reported that they applied insecticides in their farms. Ninety persons participated and completed the 11-item questionnaire. Of these, 17 (18.9%) felt that they lost balance when turning or that they needed to take a few steps to turn right around and 16.7% of participants indicated that they felt the need to move slowly or stiffly. The study found the prevalence of abnormal AChE levels was 28.9% (95%CI=19.81-39.40) and 17.8% of PChE levels (95%CI=10.52-27.26). To predict Parkinsonism, AChE, and PChE level, with a cutoff score of 5 or higher there had to be a sensitivity of 0.31, specificity of 1.00, positive predictive value (PPV) of 1.00 and negative predictive value (NPV) of 0.78 for AChE. While PChE, the score value of 5 or more had a sensitivity of 0.19, specificity of 0.93, PPV of 0.38 and NPV of 0.84.
  
  
  CONCLUSIONS
  This study described an association between pesticides exposure and Parkinsonism. The questionnaire appears to be useful for Thai agriculturists as a screening tool for Parkinsonism and cholinesterase levels regarding to pesticides exposure.
authors: College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
authors: Saowanee
authors: S
authors: Norkaew
authors: College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.|Department of Preventive & Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors: Somrat
authors: S
authors: Lertmaharit
authors: College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
authors: Wachiraporn
authors: W
authors: Wilaiwan
authors: College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.|Thai Fogarty ITREOH Center, Chulalongkorn University, Bangkok, Thailand.
authors: Wattasit
authors: W
authors: Siriwong
authors: School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, USA.
authors: Héctor Maldonado
authors: HM
authors: Pérez
authors: Thai Fogarty ITREOH Center, Chulalongkorn University, Bangkok, Thailand.|School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, USA.
authors: Mark G
authors: MG
authors: Robson
mesh_terms: D000382:Agricultural Workers' Diseases / Q000139:chemically induced* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004785:Environmental Pollutants / Q000633:toxicity*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D062025:Organophosphate Poisoning / Q000453:epidemiology / Q000209:etiology*; D009943:Organophosphorus Compounds / Q000633:toxicity*; D010300:Parkinson Disease / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology
chemical_list: D004785:Environmental Pollutants; D009943:Organophosphorus Compounds