ABSTRACT
The perception and concern of a risk of Parkinson’s disease (PD) associated with rural exposures was not considered until the nding of chemically generated acute PD by a garage labmade street narcotic metabolite (1-methyl-4-phenyl-1,2,3,6tetrahydropyridine [MPTP]) in the early 1980s [1,2]. Because of this chemical’s resemblance to certain common herbicides, the essence of the investigations of “rural” exposure or “well water” use is as a proxy measure for deleterious chemicals. Since the initial broad stroke studies, we have moved from using that proxy exposure to see if the association exists to looking directly at the specic chemicals that MPTP story leads us to believe represent the underlying risk. Even more recently, difculty in arriving at clear results from studies of pesticide exposure has led the PD research community to an interest in pesticide-gene interactions, but not further explorations of other agricultural exposures. Most likely we are correct in this that there really is no more to the story than the farming chemical or chemicals that are hazardous to dopaminergic brain cells, but since so many researchers have put so much effort into examining everything about farming and rural living, it seems wasteful not to look a little deeper and consider a little more the other possibilities. A few of those other possibilities are discussed in the course of reviewing the history of this literature, but there really is comparatively little work on rural exposures other than pesticides. Just to list them, some of the other possibilities include diet and occupational chemicals other than pesticides-i.e., such things as heavy metals, sawdust, engine fumes, paints, and zoonotic infectious agent exposures from farm animals. Farmers often have ample opportunity for exposure to all of these, and given that many farmers nd it nancially necessary to take supplementary jobs in the local area, they then
have opportunity for more exposure to the types of industry, often quite dirty, commonly seen in rural areas.
