European Journal of Epidemiology

, Volume 26, Issue 7, pp 547–555

Parkinson’s disease risk from ambient exposure to pesticides

  • Anthony Wang
  • Sadie Costello
  • Myles Cockburn
  • Xinbo Zhang
  • Jeff Bronstein
  • Beate Ritz

DOI: 10.1007/s10654-011-9574-5

Cite this article as:
Wang, A., Costello, S., Cockburn, M. et al. Eur J Epidemiol (2011) 26: 547. doi:10.1007/s10654-011-9574-5


Due to the heavy and expanding agricultural use of neurotoxic pesticides suspected to affect dopaminergic neurons, it is imperative to closely examine the role of pesticides in the development of Parkinson’s disease (PD). We focus our investigation on pesticide use in California’s heavily agricultural central valley by utilizing a unique pesticide use reporting system. From 2001 to 2007, we enrolled 362 incident PD cases and 341 controls living in the Central Valley of California. Employing our geographic information system model, we estimated ambient exposures to the pesticides ziram, maneb, and paraquat at work places and residences from 1974 to 1999. At workplaces, combined exposure to ziram, maneb, and paraquat increased risk of PD three-fold (OR: 3.09; 95% CI: 1.69, 5.64) and combined exposure to ziram and paraquat, excluding maneb exposure, was associated with a 80% increase in risk (OR:1.82; 95% CI: 1.03, 3.21). Risk estimates for ambient workplace exposure were greater than for exposures at residences and were especially high for younger onset PD patients and when exposed in both locations. Our study is the first to implicate ziram in PD etiology. Combined ambient exposure to ziram and paraquat as well as combined ambient exposure to maneb and paraquat at both workplaces and residences increased PD risk substantially. Those exposed to ziram, maneb, and paraquat together experienced the greatest increase in PD risk. Our results suggest that pesticides affecting different mechanisms that contribute to dopaminergic neuron death may act together to increase the risk of PD considerably.


Case–control studyGeographic information systems (GIS)ParaquatParkinson’s diseasePesticideZiram



California department of pesticide regulation


Confidence interval


Geographic information system


Health insurance portability and accountability act


Odds ratio


Parkinson’s disease


Public land survey system


Pesticide use report


University of California Los Angeles


Ubiquitin proteasome system

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Anthony Wang
    • 1
  • Sadie Costello
    • 2
  • Myles Cockburn
    • 3
  • Xinbo Zhang
    • 3
  • Jeff Bronstein
    • 4
  • Beate Ritz
    • 5
    • 6
  1. 1.EpidemiologyUCLA School of Public HealthLos AngelesUSA
  2. 2.Environmental Health SciencesUC Berkeley School of Public HealthBerkeleyUSA
  3. 3.Preventive Medicine and GeographyUSC/Keck School of MedicineLos AngelesUSA
  4. 4.Neurology, UCLA School of MedicineLos AnglesUSA
  5. 5.Epidemiology, Environmental Health SciencesUCLA School of Public HealthLos AngelesUSA
  6. 6.NeurologyUCLA School of MedicineLos AngelesUSA