Abstract
Parkinson disease is the second most prevalent neurodegenerative disease globally. Parkinson disease etiology is not fully understood, it is believed to be a multifactorial disease. Pesticide exposure is highlighted among the factors. Thus, this study analyzed the relationship between pesticide exposure and the development of Parkinson disease in Brazil via a systematic review. The review was conducted following the PRISMA methodology and PICOS process, using the PubMed, Web of Science, and Virtual Health Library databases. Inclusion criteria were observational studies, conducted in humans, focusing on the Brazilian population, and investigating the relationship between pesticide exposure and Parkinson disease development. Studies quality was evaluated using the Hawker checklist. A total of 85 publications were identified for eligibility and 12 studies were included in the qualitative synthesis. Regarding study quality, two showed poor, nine moderate, and only one presented high quality. Moreover, 11 studies indicated an association between pesticide exposure and increased occurrence of Parkinson disease in Brazilian people. Additionally, such association was more prevalent in the presence of the following factors: (i) single-nucleotide polymorphism IVS1-7 A→G of PINK1; (ii) variations in the gene and protein expressions of the enzyme glutathione S-transferase; (iii) occupational exposure; (iv) living in a non-urban area; (v) low schooling level, and (iv) being male. This study is the first to infer, via the systematization of observational studies conducted with the Brazilian population, the association between pesticide exposure and the occurrence of Parkinson disease in the country, evidencing the necessity of efficient public policies.