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Golf Links to Parkinson's Disease?

Monday February 04, 2013

Dr. Douglas Fields

Huffington Post - In a letter published in the journal Annals of Neurology, neurologists Margaret Parrish and Robert Gardner suggest a link between Parkinson's disease and golf. Of 26 patients with Parkinson's disorder that they collected for their small study of the disease, it turned out that 19 of them lived on or within two miles of a golf course. A coincidence perhaps, given the higher probability of golf courses in communities favored by senior citizens? The data suggest otherwise: "Sixteen of the 19 patients resided down-wind of a golf course," the researchers noted. Of the other three patients with Parkinson's living up-wind of a golf course, two of them had "additional golf course exposure."

Such a small study proves nothing, but it may be an intriguing clue to tracking down the cause of this debilitating disease. Parkinson's disease results from the death of specific neurons deep in the brain, in a region called the substantia nigra. These neurons use the neurotransmitter dopamine to communicate, and when enough of them die, voluntary movement becomes halting or frozen.

One way to kill these neurons is by ingesting certain toxic substances. MPTP, a contaminant in an illegal morphine-like street drug, turns unfortunate drug addicts into a Parkinson's patient overnight. For some reason, this toxic substance specifically attacks the neurons that are lost in Parkinson's disease, raising the possibility that other toxic substances in the environment might do the same thing.

Another recent study by neurologists at Washington University School of Medicine in St. Louis published in the Journal of Neurotoxicology documents an alarming increase in risk of Parkinson's disorder associated with welding. An astonishing 15.6 percent of 811 shipyard welders in the study developed Parkinson's disorder, compared with none in the control group of 59 union workers from the same area who had no welding exposure. (The incidence of Parkinson's disorder in the general population in the United States is approximately 0.4 percent.) The toxin responsible is manganese, a heavy metal released in welding fumes.

Manganese is also a component in sprays applied to promote healthy green turf by supporting grass growth and inhibiting fungal disease, but there are many other toxic substances used on golf courses known to cause Parkinson's disease, notably pesticides and weed killers. Paraquat, rotenone, maneb and other organophosphates have been linked to Parkinson's disease in several studies, as well as many solvents used in the sprays.

This, Parrish and Gardner suspect, is the reason for the high number of people living down-wind of golf courses developing Parkinson's, and they cite a recent study by Samuel Goldman and colleagues published in the same journal to buttress their suspicion. This study of 99 twins (to control for genetic risks for the disease) found that solvents present in the air and ground water increase the risk of Parkinson's disease; notably trichloroethylene, perchloroethylene and carbon tetrachloride. Genetic predisposition is an important factor, but a Japanese study published in Experimental Neurobiology in 2012 concluded that interactions between a person's genetics and environmental exposures to substances linked to Parkinson's contribute more to the risk of acquiring the disorder than does either genetic risk or exposure to environmental toxins individually.

So if you are thinking of retiring near the links, you might want to pick a plot up wind and avoid welding without a proper respirator. That same Japanese study also identified some environmental exposures that reduced the risk of Parkinson's: notably, drinking coffee and smoking. Perhaps this explains the peculiar urge for duffers to light up a stogie on the back nine. That habit, though, could cost you some other serious health-related penalty strokes.

References:

Tsuboi, Y. (2012) Environmental-genetic interactions in the pathogenesis of Parkinson's disease. Experimental Neurobiology, 21, 123-128.

Goldman, S.M. et al., (2012) Solvent exposures in Parkinson disease risk in twins. Ann. Neurol. 71, 776-784.

Racette, B.A. et al. (2012) Increased risk of parkinsonism associated with welding exposure. Neurotoxicology 33, 1356-61.

Parrish, M. and Gardner R.E. (2012) Is living downwind of a golf course a risk factor for Parkinsonism? Ann. Neurol. 72, 983-4.

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