Use of a VA Pharmacy Database to Screen for Areas at High Risk for Disease: Parkinson’s Disease and Exposure to Pesticides

Abstract

The purpose of this study was to assess whether pharmacy database information from US Department of Veterans Affairs (VA) medical centers could be used to screen for areas of higher Parkinson’s disease prevalence in patients exposed to pesticides. The authors used pharmacy data sets and compared the use of antiparkinsonian medications at 2 VA medical centers in California: one in Palo Alto, near the ocean, and one in Fresno, downwind from extensively farmed parts of the Central Valley. They found that patients at Fresno had higher odds ratios (1.5-1.8) for the use of Parkinson’s disease medications than patients at Palo Alto. These data are consistent with the observations of prior epidemiologic studies and suggest that VA pharmacy databases can prioritize locations for further epidemiologic research. However, a thorough exploration of alternative explanations is needed to reach definitive conclusions regarding the findings suggested by this method.

Keywords

pesticides pharmacy database Parkinson’s disease epidemiology

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References

1. Priyadarshi A , Khuder SA , Schaub EA , Shrivastava S . A metaanalysis of Parkinson’s disease and exposure to pesticides. Neurotoxicology 2000; 21(4):435-440.

2. Ritz B , Yu F . Parkinson’s disease mortality and pesticide exposure in California 1984-1994. Int J Epidemiol 2000; 29(2):323-329.

3. Giasson BI , Lee VM . A new link between pesticides and Parkinson’s disease. Nat Neurosci 2000; 3(12):1227-1228.

4. Checkoway H , Nelson LM . Epidemiologic approaches to the study of Parkinson’s disease etiology. Epidemiology 1999; 10(3):327-336.

5. Veldman BA , Wijn AM , Knoers N , et al. Genetic and environmental risk factors in Parkinson’s disease. Clin Neurol Neurosurg 1998; 100(1):15-26.