Advocacy on Environmental Risk Factors of PD esp in LMICs

The risk of developing PD as a result of exposure to pesticides or other toxic chemicals in our environment is not restricted to those with occupational exposure but is also increased for individuals living in the immediate vicinity of farmlands and rural communities. This is important especially for us in Africa where we have more rural communities; where ‘illegal’ mining is polluting our water bodies and where personal protective wear is not easily available or uncomfortable to wear due to our weather.

Internationally applied procedures to test for potential neurotoxic effects of any existing pesticide is barely done and rarely do we hear of potentially hazardous combination of pesticides replaced by safer alternatives in Africa. The regulatory bodies appear not to be working.

I know there are several studies ongoing assessing this risk in Africans but am coming from the angle of risk prevention or reduction.

As clinicians and researchers how do we make our voices heard and how do we influence policies concerning pesticides and heavy metal use? considering my African context

I guess am asking, where do I start from and how do I go about it?

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Here in Brazil the same thing happens frequently. Being a country mostly dependent on rural byproducts, pesticide use is widespread. Pesticides itself aren’t necessary the problem in all cases, however, a lot of different hazardous pesticides are approved here, also farmers here tend to use a lot of even more hazardous unnaproved pesticides and frequently do not adhere to the safety procedures required, boosting the exposure to both the workers and the enviornment. I think that is the same case for heavy metals.

Regarding your question on what we should do, I do not have expertise in the field of politics, however, I have a little exposure to this topic as my fianceè is a family phyiscian devoted to the study of Planetary Health, an area of research that studies the health of human civilization and the natural systems on which it depends. She has previously organized and contributed substantially to a local initiative that forbid a new coal mine and plant to be created near our city, aside from other local and international contributions. I’ve shown her your topic and discussed about it. These are possible suggestions:

1 - Produce a clear Health Impact Assessment study alongside environmental impact studies. When talking about pesticide use among farming communities, for example, elaborate on documents that could clearly indicate the possible health impacts associated with that activity, such as PD or other neurodegenerative diseases. This topic is deeply discussed and a framework on conducting this study can be found at the WHO webiste (link here)

2 - Provide storytelling to sensitive the media and local communities. Evaluated a patient or a group of patients with PD with previous exposure to pesticides or heavy metals? Spread it. Make it reach the local population that is mostly affected by it, social media and the conventional media.

3 - Join forces. No one can solve all the world problems alone. You need to develop a trusting and devoted community that aims to really address this issue. Look for other physicians and researchers in your area and colaborate on this with a clear objective in mind. One example would be to look for medical societies to join forces. Click here for an excellent article on this matter. From what I know, MJFF itself is very interested in this topic, however, I do not know if there is an active working party on this. If this exists, you could join them (or other global institutons) and ask for support.

4 - Provide a framework for a just transition. People do not expose themselves to these toxic materials because they want, but mostly because they need it. For them, it is a matter of survival. I think regulatory measures or environmental proposals are less inclined to be followed if this issue is not addresed. I think a definitive solution for the problem also revolves around providing alternative income sources for those populations, teaching them new and lucrative agricultural techniques that do not require those materials or any other kind of measure that effectivelly also addresses the economical need associated. There are some cases on this on the Planetary Alliance website (link), specifically case 3 (link)

5 - Gather scientific evidence. A lot of different prestigious journals have articles addressing the issue. Look for them and have them with you. Here are some: Glyphosate and neurotoxicity — a call for scientific renewal (link), The Emerging Evidence of the Parkinson Pandemic (this one is catchy, even though it has recently been challenged - link), Pesticide exposure and risk of Alzheimer’s disease: a systematic review and meta-analysis (link) and The inadequacy of current pesticide regulations for protecting brain health: the case of glyphosate and Parkinson’s disease (link)

Our voices on this topic matter. A lot. Health professionals are trusted and have an important role to play in this topic. (link)

To finish my reply, here goes an image from a very interesting article that summarises some key aspects on dealing with this matter. This article was published in The Lancet Planetary Health and is called “Targeted change making for a healthy recovery” (link)

image

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Honestly your response has given me so much clarity and direction
Truly grateful

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Very interesting topic, thank you @Vidash for raising and @danieltds for your many thoughts :slight_smile:

MJFF has definitely been interested in both understanding environmental risk factors and also advocating for/participating in efforts to reduce exposure in the first place (long-standing efforts to ban paraquat come to mind): What’s the Environment Got to Do with Parkinson’s Research?.

One thing that I’ve noticed on the link above is an automated form for reaching out to lawmakers, and @Vidash , I wonder if you know of any institutions involved in these sorts of lobbying/outreach efforts? I also wonder if there are ways we can perhaps share scaffolding or models for conducting outreach if that is of interest (just a thought, not sure it’s feasible or helpful, but I know from my PD registry work that we’ll do things like share model legislation, so each state doesn’t have to draft a new law over and over…).

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