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Case Reports
. 2021 Feb 5:33:e6.
doi: 10.35371/aoem.2021.33.e6. eCollection 2021.

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

Yangwoo Kim  1   2 , Inah Kim  3 , Jung-Min Sung  4 , Jaechul Song  1   3
Affiliations
Case Reports

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

Yangwoo Kim et al. Ann Occup Environ Med. .

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.

Keywords: Occupational exposure, Farmers; Parkinson disease; Pesticides.

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Conflict of interest statement

Competing interests: The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1. Patient transverse T2 magnetic resonance imaging results. The swallow-tail sign (red arrow) was absent.
Fig. 2
Fig. 2. Patient single-photon emission computed tomography images. There was asymmetrical uptake in the caudate nucleus (white arrows).
Fig. 3
Fig. 3. Patient positron emission tomography-computed tomography images. The comma-shape deteriorated to an oval-shape.
See this image and copyright information in PMC

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