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Parkinson's disease in a worker exposed to insecticides at a greenhouse

김양우, 김인아, 성정민, 송재철,
소속 상세정보
김양우 ( Kim Yang-Woo ) - Hanyang University Hospital Department of Occupational and Environmental Medicine
김인아 ( Kim In-Ah ) - Hanyang University College of Medicine Department of Occupational and Environmental Medicine
성정민 ( Sung Jung-Min ) - Korea Occupational Safety and Health Agency Occupational Safety and Health Research Institute
송재철 ( Song Jae-Chul ) - Hanyang University Hospital Department of Occupational and Environmental Medicine

Abstract


Background: Parkinson's disease (PD) is a rare, neurodegenerative disease with various occupational and environmental risk factors. Exposure to specific pesticides contributes significantly to the incidence of PD. However, it is difficult to measure the level of pesticide exposure in workers. This study presents the first case recognized the work-relatedness between PD and pesticide exposure.

Case presentation: A 68-year-old male was diagnosed with PD after working with pesticides at a tomato greenhouse for 12 years and 5 months. From the results of a field study, it was reasonable to assume that the patient had been exposed to a significant level of various insecticides. In the present report, we described the first accepted case of work-relatedness between PD and exposure to pesticides. The evaluation was conducted using the following steps: we ruled out other possible risk factors including additional occupational history and personal risk factors, we assessed the work environment, surveyed possible exposures, found proper epidemiological evidence, and calculated the probability of causation. The work-relatedness was determined through the review of epidemiological evidence and estimation of exposure situation and level, and biological plausibility. We also decided work-relatedness based on the exposure of PD related pesticides with identified biologically plausible and the presumption that the exposure level would be high due to the working process.

Conclusions: In this case, the field study and epidemiological results supported the work-relatedness of PD and exposure to pesticides. Moreover, the results of previous studies have confirmed a causal relationship between exposure to pesticides and PD.

키워드

Parkinson disease; Pesticides; Occupational exposure, Farmers

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