A population-based case-control study found an association between residential proximity to golf courses and an increased risk of Parkinson's disease. The greatest risk was observed among individuals living within 1 to 3 miles of a golf course, particularly those residing in water service areas with vulnerable groundwater systems.
The study identified 419 incident cases of Parkinson's disease (PD) in Olmsted County, Minnesota, from 1991 to 2015, using the Rochester Epidemiology Project. These were matched by age and sex to 5,113 controls from a 27-county region in southern Minnesota and western Wisconsin. Investigators evaluated the risk of PD in relation to distance from 139 golf courses and municipal water service area characteristics, adjusting for age, sex, race and ethnicity, household income, urban/rural classification, and health care utilization.
Living within 1 mile of a golf course was associated with 2.26 times the risk of PD compared with living more than 6 miles away. A dose-response pattern was observed, with increased risks at 1 to 2 miles, 2 to 3 miles, and 3 to 6 miles, relative to those living more than 6 miles away.
Secondary analyses focused on water service area characteristics. Individuals receiving tap water from groundwater-based service areas with a golf course had nearly twice the risk of PD compared with those in groundwater service areas without golf courses and a 49% higher risk compared with those using private wells.
Notably, residents in vulnerable groundwater regions with a golf course had an 82% greater risk of PD compared with those in nonvulnerable regions with a golf course and a 92% greater risk compared with those in water service areas without a golf course.
The investigators proposed two potential exposure pathways: pesticide-contaminated groundwater and airborne pesticide drift. They noted that 86.6% of the patients with PD lived in groundwater service areas, and that the association between PD and golf course proximity remained even after adjusting for groundwater vulnerability—particularly in urban areas, suggesting a possible airborne contribution.
Pesticides historically applied to golf courses include compounds associated with PD, such as organophosphates, chlorpyrifos, methylchlorophenoxypropionic acid (MCPP), 2,4-dichlorophenoxyacetic acid (2,4-D), maneb, and organochlorines. Experimental evidence has shown that paraquat and rotenone can induce PD-like neurodegeneration through mechanisms such as oxidative stress and mitochondrial dysfunction.
Disclosures can be found in the published study.
Source: JAMA Network Open