Parkinson’s disease is complex, involving both genetic and environmental factors, including air pollution and other chemical exposures.  In particular, pesticide exposure has been linked to an increased risk of Parkinson’s. While commonly only used in rural, relatively unpopulated areas, some areas are treated with pesticides in urban, populated areas, including golf courses. Although golf courses are frequently treated with pesticides, there are a lack of epidemiology data exploring the relationship of risk of Parkinson’s disease to living in proximity to a golf course. 

Using data from the Rochester Epidemiology Project, researchers explored the relationship between proximity to golf courses and Parkinson’s disease. To do this, researchers examined patients with Parkinson’s in Olmstead County, Minnesota from 1991 to 2015. Parkinson’s diagnoses, identified using health insurance claims codes, were confirmed by a movement disorder specialist, including the recorded date of symptom onset. Researchers recorded the distance from each subject’s home address to a golf course, determined whether the home’s water supply came from vulnerable groundwater resources, surface water resources, or private wells, and identified whether or not those water service areas contained a golf course. 

The results, published in JAMA Network Open, included 419 patients with Parkinson’s (61% male, median age at diagnosis: 73) and 5113 age- and sex-matched controls (60% male, median age at diagnosis: 72) were identified in the cohort. Median distance to a golf course was 1.72 miles for those with Parkinson’s, while the median distance was 1.98 miles for controls. When modeled linearly, the odds for Parkinson’s decreased by 9% (adjusted OR: 0.91; 95% CI: 0.85-0.98) for each mile of distance from a golf course up to 18 miles. Categorical analysis showed that those living within one mile of a golf course were 126% more likely to be diagnosed with Parkinson’s than those living six or more miles from a golf course (adjusted OR: 2.26; 95% CI: 1.09-4.70).

While proximity to a golf course is correlated with higher probability of Parkinson’s onset, source of tap water is also a concern.  Tap water that comes from a service area that contains a golf course leads to a 96% increase in Parkinson’s risk compared to a service area without a golf course (adjusted OR: 1.96; 95% CI: 1.20-3.23). When compared to private wells, service areas with golf courses are at 49% greater risk (adjusted OR: 1.49; 95% CI: 1.05-2.13).  Those whose tap water came from a service area containing a golf course in a vulnerable region, meaning that pollutants can easily transmit to groundwater, were 82% more likely to be diagnosed with Parkinson’s compared to those in a nonvulnerable area with a golf course (adjusted OR: 1.82; 95% CI: 1.09-3.03) and 92% more likely to be diagnosed with Parkinson’s than individuals living in water service areas that did not contain a golf course (adjusted OR: 1.92; 95% CI: 1.06-3.45). Intriguingly, adjusting for groundwater vulnerability did not change the observed association between Parkinson’s risk and proximity to a golf course, strongly suggesting that airborne exposure is a separate, powerful driver of risk to groundwater mediated risk.

While the authors note that population density could contribute to increases in air pollutant exposure, the association between Parkinson’s disease and golf courses, whether through ground water or airborne exposure, appears to be robust based on this initial analysis.

The study results help frame the risk and the potential influence of golf courses to public health via airborne or tap water exposure to pesticides. Authors state that further risk mitigation to manage the risk of Parkinson’s disease: “Public health policies to reduce the risk of groundwater contamination and airborne exposure from pesticides on golf courses may help reduce risk of PD in nearby neighborhoods.”