Translation of UIPP document
“Q/R et messages clés sur l’inscription de la maladie de Parkinson
(MP) provoquée par les pesticides au tableau des maladies
professionelles en agriculture)
July 2012
Q&A and key messages on the listing of Parkinson’s
Disease (PD) caused by pesticides in the table of
agricultural occupational diseases
Replaces and cancels the document on the decree of 16 05 2012
The tables of occupational diseases concerning agriculture have been completed
through the decree n°2012-665 of 4 May 2012 by the new table (n°58) “Parkinson’s
Disease caused by pesticides”.
“Table n° 58 – Parkinsons’s Disease caused by pesticides (1)
DESIGNATION OF THE DISEASE
TIMELINE
INDICATIVE LIST OF MAIN TASKS
susceptible to cause the disease
Parkinson’s Disease confirmed by an
examination conducted by neurologist.
1 year
(provided
there is an
exposure of 10
years)
Tasks generally exposing to pesticides:
- Handling or use of these products,
through contact or inhalation;
- Through contact with crops, surfaces,
treated
animals
or
during
the
maintenance of machinery/equipment
used to apply pesticides
(1) The term “pesticides” concerns agricultural and amenity products, as well as
biocides and veterinary parasite treatments, whether these products are authorised or
not at the moment of the request.
Why a listing on the occupational disease tables?
After several requests of recognition as “occupational disease”, the regional
committees for the recognition of occupational diseases (CRRMP – Comité Régional
de Reconnaissance des Maladies Professionelles) have made different decisions on
a case-by-case basis. This resulted in unfair manners of dealing with dossiers of
patients in similar situations.
In order to remedy that situation the COSMAP (Supreme Commission of
occupational diseases in agriculture – Commission Supérieure des Maladies
Professionelles en Agriculture) has taken over the dossier at national level. Two
options were possible for an equitable treatment of each dossier with regard to
Parkinson’s Disease in agriculture:
 The formulation of a national recommendation to the CRRMP
 The listing on the table of occupational diseases
The decision to list on the table of occupational diseases has been taken after a
vote1 within the COSMAP (following a compromise of social consensus), “to ensure
the compensation of exposed employed workers and farm managers concerned by
the disease”. It was also convened that the listing conditions on this table would be
reviewed within 5 years.
It shall be noted that the state counsellor made the remark on a former meeting2 of
the COSMAP: “for a judge, the presumption resulting from the report established by
experts would be sufficient to conclude on the causality link”. In other words, in case
of doubt on the cause-effect link the judge would logically decide in favour of the sick
person requesting compensation.
How to read the table?
Designation of the disease: Parkinson’s Disease
The diagnosis of the disease is complex, it must be conducted by a physician
specialised in neurology.
Timeline to be considered: 1 year (provided the exposure was 10 years). This means
that the maximum time between the last exposure and the risk of the disease at the
1st medical observation is 1 year AND the minimum exposure time is 10 years.
Indicative list of main tasks: as indicated by the name this list is of indicative
character. In other words, other, similar tasks can be considered too.
Why the term “pesticides” in the table?
In the table the term “pesticide” refers to agricultural and amenity products, as well as
biocides and veterinary products used to treat parasites; whether they are
authorised/on the market or not at the time of the request.
1
2
2
Footnote missing in original document
See minutes of the COSMAP meeting of 1 June 2011
Epidemiological studies conducted in France or internationally in the agricultural
domain usually cover very diverse applications/uses and exposure conditions, which
are rarely described in detail. Very often these are covered by a simple question
such as “have you been exposed to pesticides?”.
As a consequence, the COSMAP has decided to link Parkinson’s disease to
“pesticides” in general, without any detail on chemical family or individual molecules.
“The recurring difficulties to document correctly with necessary detail the exposure of
populations to pesticides result in bias and/or difficulties to interpret results”.3
“[The identification of a substance] in the occurrence of Parkinson’s disease is often difficult.
Under these conditions the establishment of evidence of a dose-response relationship
remains limited”4.
Is there a causality link between Parkinson’s Disease and pesticides?
No. According to the report presented to the COSMAP, “if the data generated in
epidemiological studies indicated a link between the exposure to pesticides and the
occurrence of Parkinson’s Disease, and if these various mechanistic studies confirm
the biological plausibility of a chemical induction of the disease, they remain
insufficient to establish with certitude this causal relationship.”5
The mail of the ministry of agriculture (15 June 2012) to UIPP emphasises: “{The
ministry} does not conclude on the causal link between pesticides and
Parkinson’s Disease, but will add to the dossier all elements/epidemiological data
indicating the existence of a link between exposure to pesticides and the
occurrence of the Parkinson’s disease, and that these various mechanistic studies
confirm the biological plausibility of a chemical induction of the disease.”
If there is no causality link between Parkinson’s Disease and pesticides
why does the decree refer to it?
Indeed, the Decree of 4 May 2012 in it paragraph “Note”6 specifies that “Table n°58
{…} has been created given the knowledge in humans allowing the establishment of
a causality link between the Parkinson’s Disease and pesticides”.
From a strictly scientific point of view this statement is not exact. It would have been
more correct to write: “It (the table) has been created based on the knowledge
concerning humans allowing to suspect a link between Parkinson’s disease and
pesticides.”
Key messages from UIPP
3
See minutes of the COSMAP meeting of 1 June 2011
See minutes of the COSMAP meeting of 1 June 2011
5 Report on the revision or set up of a table of occupational diseases on the use of pesticides
– the case of neurodegenerative diseases. Pr Gérard Lasfargues, March 2010
6 footnote?
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3
Concerning the listing of Parkinson’s Disease caused by pesticides on the
table of occupational diseases

UIPP understands that farmers organize themselves to have their difficulties
of having their diseases taken in charge recognised.

UIPP regrets the excessive generalization to all pesticides, which have
different functions, belong to different chemical families with very different
modes of action.

UIPP reminds that those cases of Parkinson’s Disease that could be caused
by pesticides reflect the exposure, the products, and the uses that have not
ceased to evolve over the past 50 years: Today’s agriculture is no longer the
agriculture of the 1960’s. Since 50 years, industry and public authorities
based on the development of scientific knowledge have continuously worked
to improve product profiles in terms of safety and support of good use
practices.

UIPP reminds that to date, there is no sufficient proof to confirm a causal link
between the exposure to PPPs and the Parkinson’s Disease. “The origin of
Parkinson’s Disease remains difficult to understand but is likely to be
multifactorial, associating environmental and genetic characteristics”
(report of Prof Lasfargues COSMAP, March 2010).

In any case it is critical to maintain the research on the long-term effects of
exposure to PPPs but also to work on the exposure reduction while handling
PPPs.
On the prevention of risks for farmers:

UIPP reminds that user safety is part of the authorisation procedure prior to
marketing. However, this safety depends on the correct handling as defined
in the authorisation and on the label.

To date, the MSA notes the insufficient awareness on chemical risks on the
field. Indeed, user safety is not always within the user’s priorities. Getting the
message across on risk prevention often implies changing current practices.
For example, in terms of protection, the MSA emphasises that protection
measures are not sufficiently taken into account: only 52% of users declare
putting on gloves to prepare their mixes or when they fill their tanks (Report
Phyt’attitude 1997-2007): http://www.msa.fr Phyt’attitude.
UIPP’s and UIPP member’s actions to reduce user exposure
1. Product improvement, thanks to research and development
o Improvement of toxicological profiles and of marketed molecules (improved
safety: lower dosage/ha and improved toxicological profiles/ADI)
o Development of product formulation: hydrosoluble bags, micro-encapsulation,
progressive disappearance of wettable powders, reduction and ceasing of the
use of solvents where possible…
o Improved packaging: anti-splashing devices, no caps when possible
o Better readability of labels
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2. Raising awareness with farmers on good practices
o Since several years UIPP has established awareness raising initiatives
(School for Good Phytopharmaceutical Practices, River Basins, Training…):
15,000 farmers already trained.
o Awareness raising campaigns with regard to risks linked to pesticides (“Hand”
campaign (“Main”, in French).
o Certain member companies also work on the field, analyse situations of most
important exposures, in close cooperation with ergotoxicologists, tackling
chemical risks during work (e.g. Improvement solutions for back sprayers
etc.)
3. Observation and contribution to epidemiological studies
o Scientific observation of epidemiological projects and studies describing the
interactions between exposure to phytopharmaceutical products and health
issues.
o On certain health issues UIPP provides data on the use of these products
with certain French epidemiological groups, such as the GRECAN (Groupe
Régional d’Etudes sur le cancer/Calvados – Regional group of cancer
studies) and within the Agrican framework. These will help to better
understand cancer risk factors in the French agricultural environment.
To know more:

Conditions for the recognition of an occupational disease (see UIPP document
“Occupational Health and PPP 0712”)

The state of knowledge on Parkinson Disease (see UIPP document “Parkinson
disease and PPP nov 2010")
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