Parkinsonism Signs and Symptoms in Agricultural Pesticide Handlers in Washington State

Authors

Susan Searles Nielsen, Department of Neurology , Washington University School of Medicine , St. Louis , Missouri , USA.
Shu-Ching Hu, Department of Neurology, School of Medicine , University of Washington , Seattle , Washington , USA.
Harvey Checkoway, Department of Family Medicine and Public Health , University of California San Diego , La Jolla , California , USA.
Maria Negrete, Department of Environmental and Occupational Health Sciences, School of Public Health , University of Washington , Seattle , Washington , USA.
Pablo Palmández, Department of Environmental and Occupational Health Sciences, School of Public Health , University of Washington , Seattle , Washington , USA.
Theresa Bordianu, Department of Environmental and Occupational Health Sciences, School of Public Health , University of Washington , Seattle , Washington , USA.
Brad A. Racette, Department of Neurology , Washington University School of Medicine , St. Louis , Missouri , USA.
Christopher D. Simpson, Department of Environmental and Occupational Health Sciences, School of Public Health , University of Washington , Seattle , Washington , USA.

Document Type

Article

Abstract

OBJECTIVES: Examine associations between pesticide exposure and signs or symptoms of parkinsonism. METHODS: Prior to the 2014 pesticide spray season, the authors examined 38 active pesticide handlers aged 35 to 65 (median: 43.5) who participated in the State of Washington's cholinesterase monitoring program in the Yakima Valley, where cholinesterase-inhibiting insecticides are applied in fruit orchards. A movement disorder specialist assessed the workers using the Unified Parkinson's Disease Rating Scale (UPDRS) motor subscore 3 (UPDRS3). Participants also self-reported work and medical histories, including the UPDRS activities of daily living subscore 2 (UPDRS2). The authors explored the relation between these scores and lifetime occupational pesticide exposure while accounting for age. RESULTS: All participants were Hispanic men born in Mexico who had worked in agriculture for 4 to 43 years (median: 21 years, including 11 years applying pesticides, mostly in the United States). Ten participants (26%) reported difficulty with one or more UPDRS2 activities of daily living (maximum = 2), and nine (24%) had a UPDRS3 >0 (maximum = 10). The most common symptom and sign, respectively, were excess saliva (n = 6) and action tremor (n = 5). UPDRS2 and UPDRS3 scores were unrelated to the number of years applying pesticides, but UPDRS3, especially action tremor, was positively associated with living on or by a farm. CONCLUSIONS: Symptoms and signs of parkinsonism were absent to mild in this small sample of active workers who apply cholinesterase-inhibiting insecticides in Washington State, USA. Future studies should be larger and examine older, retired workers with greater cumulative exposure to agricultural pesticides at work and home, including other types of agricultural pesticides.

Medical Subject Headings

Adolescent; Adult; Aged; Agricultural Workers' Diseases (diagnosis, ethnology, etiology); Agriculture; Child; Child, Preschool; Farmers; Female; Humans; Male; Mexico; Middle Aged; Occupational Exposure (adverse effects); Parkinsonian Disorders (diagnosis, ethnology, etiology); Pesticides (economics, toxicity); Washington (ethnology); Workforce; Young Adult

Publication Date

1-1-2017

Publication Title

Journal of agromedicine

E-ISSN

1545-0813

Volume

22

Issue

3

First Page

215

Last Page

221

PubMed ID

28418778

Digital Object Identifier (DOI)

10.1080/1059924X.2017.1317684

Recommended Citation

Searles Nielsen, Susan; Hu, Shu-Ching; Checkoway, Harvey; Negrete, Maria; Palmández, Pablo; Bordianu, Theresa; Racette, Brad A.; and Simpson, Christopher D., "Parkinsonism Signs and Symptoms in Agricultural Pesticide Handlers in Washington State" (2017). Neurology. 1158.
https://scholar.barrowneuro.org/neurology/1158