APPENDIX II-AX:Ascherio, et al, Article: "Pesticide Exposure and Risk of

Parkinsonísn's Disease,". Annals of Neurology; July 2006;

(DOI: 10.1002/ana.20904)


This appendix is copied from:‑bin/abstract/112660877/ABSTRACT


Pesticide exposure and risk for Parkinson's disease

Alberto Ascherio, MD, DrPH 1 2 *, Honglei Chen, MD, PhD 3, Marc G. Weisskopf, PhD 1, Eilis O'Reilly, MSc 1, Marjorie L. McCullough, ScD 4, Eugenia E. Calle, PhD 4, Michael A. Schwarzschild, MD, PhD 5, Michael J. Thun, MD 4

1Department of Nutrition, Harvard School of Public Health, Boston, MA
2Department of Epidemiology, Harvard School of Public Health, Boston, MA
3Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC
4Epidemiology and Surveillance Research Department, American Cancer Society, Atlanta, GA
5Department of Neurology, Massachusetts General Hospital, Boston, MA

email: Alberto Ascherio (

*Correspondence to Alberto Ascherio, Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115

Funded by:
 Michael J. Fox Foundation
 Kinetic Foundation
 National Institute of Environmental Health Sciences; Grant Number: ES10804




Chronic, low-dose exposure to pesticides is suspected to increase the risk for Parkinson's disease (PD), but data are inconclusive.


We prospectively examined whether individuals exposed to pesticides have higher risk for PD than those not exposed. The study population comprised participants in the Cancer Prevention Study II Nutrition Cohort, a longitudinal investigation of US men and women initiated in 1992 by the American Cancer Society. Follow-up surveys were conducted in 1997, 1999, and 2001. The 143,325 individuals who returned the 2001 survey and did not have a diagnosis or symptoms of PD at baseline (1992) were included in the analyses.


Exposure to pesticides was reported by 7,864 participants (5.7%), including 1,956 farmers, ranchers, or fishermen. Individuals exposed to pesticides had a 70% higher incidence of PD than those not exposed (adjusted relative risk, 1.7; 95% confidence interval, 1.2-2.3; p = 0.002). The relative risk for pesticide exposure was similar in farmers and nonfarmers. No relation was found between risk for PD and exposure to asbestos, chemical/acids/solvents, coal or stone dust, or eight other occupational exposures.


These data support the hypothesis that exposure to pesticides may increase risk for PD. Future studies should seek to identify the specific chemicals responsible for this association. Ann Neurol 2006

Received: 25 January 2006; Accepted: 28 April 2006