Gardeners who use pesticides 'have higher Parkinson's risk'

Farmers and amateur gardeners who are exposed to pesticides run a higher risk of developing Parkinson's disease, researchers said yesterday.

Previous evidence that suggested an association with the disease was strengthened by the publication of research covering almost 3,000 people in five European countries.

Scientists found that heavy exposure to pesticides increased the chances of developing Parkinson's by almost 50 per cent.

The incurable disease is characterised by tremors, rigidity, shaking of the limbs and difficulty in walking. It is caused by the degeneration of nerve cells in the brain that send chemical messages to neurons controlling the muscles.

Around 120,000 people have Parkinson's in the UK - one in 500 of the population. Most are aged over 50.

The Geoparkinson study, funded by the European Commission, involved volunteers in Scotland, Italy, Sweden, Romania and Malta.

Researchers found that low-exposure pesticide users, such as amateur gardeners, were nine per cent more likely than non-users to develop Parkinson's. Farmers and other high-exposure users were 43 per cent more vulnerable.

"It considerably strengthens the case for pesticides being relevant to occupational risk of Parkinson's disease," said the principal investigator, Anthony Seaton, from the University of Aberdeen.

The research, reported in this week's New Scientist magazine, did not identify which pesticides were to blame.

The scientists also identified other, stronger risk factors. A family history of Parkinson's disease increased risk by 350 per cent, while being knocked unconscious raised it by 32 per cent.

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Mobile phone use in rural areas carries three times cancer risk

People who use mobile phones regularly in rural areas are three times more likely than city dwellers to suffer from brain tumours, a study has found. Scientists believe that rural users of mobile phones receive relatively large doses of microwave radiation from their handsets to compensate for the fact that base stations in the countryside are further apart than in the city.

The findings are based on a sample of 1,400 patients with brain cancer who were compared against 1,400 healthy people who had also been interviewed about their use of mobile phones.

But the scientists who carried out the research admitted that the overall number of cases involved was still small and that the findings do not prove that using mobile phones can cause brain tumours.

Professor Lennart Hardell, a cancer specialist at the University Hospital of Orebro in Sweden, said the results nevertheless point to a link between the dose of microwave radiation from a mobile and the risk of developing brain tumours.

'It's another piece of evidence, but of course we have to wait for further studies. This is a further step indicating that there is probably a problem and people should use the precautionary principle to limit their use of mobile phones, especially for children,' Professor Lennart said.

The study, published in the journal Occupational and Environmental Medicine, investigated more than 1,400 Swedes aged between 20 and 80 who had been diagnosed with a malignant or benign brain tumour between January 1997 and June 2000.

The scientists found no link between the probability of developing a tumour and the time spent on the phone, but they did find a link between the risk of brain cancer and place of residence " rural or urban.

Residents of rural areas who had been using a mobile digital phone for more than three years were three times more likely to be diagnosed with a brain tumour than those living in urban areas.

For those rural residents who had used a mobile digital phone for five years or more, the risk quadrupled compared to city dwellers. Yet the scientists found no such increased risk when they looked at older, analogue mobile phones.

Professor Hardell suggested the reason was that digital phones use a system called adaptive power control, which automatically boosts the power output of the handset signals when base stations are located further away.

Radiation emissions from a mobile phone handset can be 10 times higher in rural areas than in urban districts to compensate for the fact that base stations are located further apart, he said.

'With analogue phones the emissions are constant and we did not see this difference between rural and urban areas,' Professor Hardell said.

For malignant tumours the difference was even greater, with rural residents running an eightfold increase in risk compared to those living in urban areas.

But Professor Hardell said that the absolute numbers involved are small and said that the findings must be treated with caution until further, large-scale studies are completed.

'The message is that people should use hands-free sets and limit their phone calls if possible,' he said.

A spokesman for Britain's Health Protection Agency said that Professor Hardell's study was not designed to test the hypothesis that rural phone use is more dangerous than in the city.

'We do need to be precautionary about the use of mobile phones, especially by young children. We also need to be precautionary about this study, because other research has not found a clear link between mobile phone handsets and brain cancers,' he said.

'We should wait for the results of the Interphone study being carried out at the moment. It is a large study being carried out in 13 countries and should give a good indication of whether or not there is a real cancer risk from mobile phone use.'

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Foods rich in vitamin E may help to prevent Parkinson's disease

Olive oil, sunflower seeds, almonds, greens and other foods rich in vitamin E could help prevent Parkinson's disease, according to research published today.

Protection against Parkinson's is something of a holy grail according to Robert Meadowcroft, director of policy at the Parkinson's Disease Society, and so far it has been elusive.

But scientists in Canada and the USA say today that by combining all the studies there have been so far on vitamin E, they have concluded that moderate or high levels in the diet - but not as tablets - may help to protect the brain against the disease. Vitamin C and beta carotene, on the other hand, do not help.

Their work is published on line by the Lancet medical journal. Mayhar Etminan, an epidemiologist at the Royal Victoria hospital and Vancouver hospitals in Montreal, and colleagues say the effect is seen in people who have consistently eaten foods rich in vitamin E. There is no evidence that vitamin E supplements help.

They also say that well-designed clinical trials are needed to confirm their findings before doctors issue any dietary advice.

The researchers found eight studies of sufficient quality which contained data on the vitamin intake of populations and which also registered the numbers who had later been diagnosed with Parkinson's disease.

Some of the studies, taken individually, suggest vitamins are protective and some do not. But combined, they show a benefit for foods rich in vitamin E. This prevention was only effective before the onset of Parkinson's however, and did not help once it had been diagnosed.

There was no clear evidence that vitamin E in supplements was useful. "The role of supplemental vitamin E is not clear, but at least one study suggests that synthetic supplements do not confer the same benefit as dietary sources," they write.

They suggest that the form of vitamin E in food is different from the synthetic version in supplements and that the naturally occurring variety may penetrate to the brain more effectively.

They also say it is possible that the protective effect of sunflower seeds and olive oil may be connected with the lifestyles of those who consume them, which may be different from the lifestyles of those who take supplements.

The same could be true of vitamin C. Although it is the most potent antioxidant in blood and, therefore, might be thought to have an effect, it was possible that people who eat a lot of vitamin C-rich foods might be at greater risk of Parkinson's because of their lifestyle. "For example, intake of sweet foods, including fruit, which contain vitamin C, might be associated with Parkinson's disease risk," they say.

Mr Meadowcroft said the Parkinson's Disease Society advised people to eat a healthy, balanced diet, including olive oil, nuts, fresh green vegetables and salads. "We would now look for a further robust randomised clinical trial."

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Surgery for chronic back pain 'not the best option'

An operation to fuse a portion of the lower spine, which has been carried out for 90 years, might not be the best option for people with persistent and debilitating back pain - and is far more expensive than alternatives, researchers say today.

Up to 85% of the population suffers back pain at some point in their lives, and 10% have chronic back pain which interferes with their lives and has always been hard for doctors to cure.

It is a huge problem not only for individuals but for society as a whole, because of the amount of time people have to take off work, as well as the costs to the NHS. It is estimated to be responsible for the loss of close to 120m working days a year, and to have cost the UK pounds 1.6bn in 1998.

In the early years of the last century, surgeons began operating to try to relieve the pain of long-term sufferers by fusing the troublesome portion of the lower spine. About 1,000 operations are performed in the UK every year.

However, doubts began to be cast on the efficacy and advisability of the operation. A review by the respected Cochrane collaboration in 1999 could find no randomised controlled trials that had been carried out to justify surgery.

Because of this, the Medical Research Council funded a trial which would compare the results of patients randomly allocated either to surgery or to an intensive programme of physiotherapy and cognitive behaviour therapy - a form of psychological counselling.

The results of the trial, published today online by the British Medical Journal, suggest that surgery is no better than what the report's authors term "intensive rehabilitation". Since it is considerably more costly - pounds 7,830 per patient compared with pounds 4,526 in the rehabilitation group - the authors recommend that all patients should be offered rehabilitation first.

The trial was carried out on 349 patients who had suffered chronic back pain for at least a year. Roughly half - 176 patients - were allocated to surgery and the rest to rehabilitation. The rehabilitation patients received treatment and education five days a week for three weeks, which included general muscle strengthening and stabilising, as well as exercises for the spine, hydrotherapy and general cardiovascular exercise on equipment such as treadmills, rowing and cycling machines.

Both groups of patients improved, reporting less pain and more mobility. But Jeremy Fairbank, consultant orthopaedic surgeon at the Nuffield Orthopaedic Centre in Oxford, and colleagues found that there was little significant difference between them, although 38 rehabilitation patients went on to have surgery within two years.

Any advantage of surgery was small when the risks of operating were taken into account, they say.

Given its costs, they say spinal fusion surgery as a first-line therapy, before rehabilitation has been tried, seems not to be a cost-effective use of NHS resources, although they admit this could change if large numbers of patients still opt for surgery after the rehabilitation programme.

"Our results suggest that patients eligible for surgery should be offered this type of rehabilitation programme first, with strong support from the surgeon," said Mr Fairbank.

"We believe it is safer and cheaper than using surgery as the first line of treatment, when physiotherapy and alternative therapy have failed. This type of rehabilitation is well within the capacity of ordinary physiotherapy departments to deliver."

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İstanbul - 29.08.2005
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