>> From WXXI News.

This is Connections.

I'm Evan Dawson.

Our connection this hour was made on the streets of London in the early 1800s.

A doctor had begun to notice something unusual.

He was seeing older men walking with stooped postures.

Some had tremors.

They shuffled their feet to this doctor.

It looked like a set of symptoms beyond just typical aging.

And so in 1817 he wrote an essay on the shaking palsy.

He was describing a disease that had not yet been identified officially.

That doctor's name was James Parkinson.

More than 200 years later, Parkinson's disease is well known, and yet it is often misunderstood.

In a new book, coauthor Dr.

Ray Dorsey makes the case that Parkinson's is not just an unlucky health break or the result of genetics alone.

Dorsey and colleagues argue that Parkinson's is utterly preventable, and it starts with the chemicals and products all around us.

The book includes a list of 25 actions that anyone can take to reduce their risk of getting Parkinson's.

The book explores specific environmental and chemical factors, even raising the question of how close your grocery store is in proximity to the nearest dry cleaner.

And the book includes endorsements from some lawmakers who are ready to take action to create a safer environment for everyone.

The authors want us to think of Parkinson's as a man made disease.

They want us to think about the chemicals we use as either necessary and beneficial or harmful, and unnecessary.

And I admit, I went looking for reviews from their colleagues in the field because I wondered if some of their colleagues found the book to be pushing too aggressively.

And really, all I have found is praise.

Let's get into what we can do, all of us, about Parkinson's disease.

My guest this hour is the coauthor of the Parkinson's Plan and the director of the center for the brain and the environment at Atria Research and Global Health Institute.

Dr.

Ray Dorsey, welcome back to Connections.

>> Thank you very much for having me, Evan.

I'm delighted to be with you.

>> And remind our listeners.

I mean, Rochester gets to claim you, Dr.

Dorsey.

This book is big around the world, but you're hours 100%.

>> I've lived in Rochester for 17 years and only recently moved to New York City.

I'm still a part time professor at the University of Rochester, where I was taught to think a little bit differently by my great and late mentor, IRA Shoulson, and, he said, don't always accept dogma.

And I think the dogma I was taught and that you alluded to was that Parkinson's disease was a natural consequence of aging.

Maybe genetics and bad luck.

And I increasingly think that Parkinson's disease is not a natural consequence of aging.

It's an unnatural consequence.

It's not inevitable.

It's preventable.

And I owe a lot of my thanks to Ivor Schultz and Carl Gebhardt, Bob Holloway and a lot of great colleagues at the University of Rochester.

>> The book is certainly packed with a lot of data, a lot of really good information.

But it is not just written for scientists or doctors, it really is written for the lay public.

It is available now, and I think it is a very, very important book.

And I said, Dr.

Dorsey, I kind of wanted to know if you have colleagues in the field who thought, well, this he's going a little too far here or this a little out there, I haven't found that.

Have you found any colleagues who've called you up to say, hey, great book, but this section or this recommendation, I don't know about that.

>> I think actually that the majority of my colleagues think we're a little bit out there Thomas Kuhn in the, in 1960s wrote this book called The Structure of Scientific Revolutions, and he said he wrote about.

He's a he was a physicist, and he became interested in the history of science.

And he said that scientists approach problems from a defined paradigm and the paradigm in which we're living right now is that of genetics, that in Francis Collins, a former director of NIH, said, if we identify all the genes out there as part of the Human Genome Project, we're going to find the underlying genetic causes for a wide range of common chronic diseases diabetes, hypertension.

And we uncovered a lot of information around genes.

But only 13% of Americans with Parkinson's disease carry any genetic cause or genetic risk factors for disease, said another way, 87% of Americans don't carry any known genetic cause or genetic risk factor.

I think we have found, I think to the surprise of me and to the surprise of my colleagues who maybe a little more resistant, the principal causes of Parkinson's do not lie within us.

They're not in our DNA.

They are outside of us.

They're in our environment.

They're in chemicals in our food, water and air.

>> There is a a comparison you make, and I'll let you make it more specifically than my recollection will have for listeners.

But I thought it was pretty profound where you say, if it's just a natural consequence of genetics and aging, if it's just something that will happen to people as they get older, in some percentage, then you would expect to see roughly similar rates in different communities, in different states, in different countries.

So if you're in Toronto or if you're in Nigeria, it should be roughly the same.

If it's just genetics, just aging, and yet you say you can point to places where it's five times higher or more, right?

>> Exactly.

So there is a consequence of aging.

If you adjusted for aging, the rates of disease should be uniform and they're not.

And to pick up on your point, the rates in in Toronto are five times higher than they are in Nigeria.

Areas of the world that are most industrialized, like the U.S.

and Canada, have the highest rates of disease areas of the world that are least industrialized, like sub-Saharan Africa, have the lowest rates in areas of the world undergoing the most rapid industrialization.

Like India and China had the fastest increasing rates of the disease.

And more generally.

To your point, when Dr.

Parkinson described the condition in 1817, he described six individuals with this disease.

200 years later, it's estimated that 6 million people had the disease.

How do you go from a disease that's not classified in the medical literature?

As Dr.

Parkinson said, affecting six individuals to the world's fastest growing brain disease, affecting over 6 million in the span of just two centuries.

Well, you know, genes don't change that much in that short period of time.

It's growing faster than aging than aging alone is growing far faster than Alzheimer's disease.

For example.

the only way you really get to this is changes in our environment, which are fueling the rise of disease, and therefore this disease is preventable.

And just one more thing on on aging, if you put a mouse into the laboratory at the University of Rochester and you just let it age, it will not spontaneously develop Parkinson's disease or for that matter, Alzheimer's.

The only reason that the only way that mouse will develop Parkinson's is if you either manipulate its genes or expose it to toxic chemicals.

>> and in a moment here, I'd like to kind of go through some of what I think is probably the part of the book that is going to immediately grab most people, which is 25 recommendations that literally anybody can do to reduce your risk of of getting Parkinson's, or if you have Parkinson's, to maybe slow its progression.

It's really, really useful.

We're going to talk about that in a moment.

And I hope Dr.

Dorsey doesn't think we're giving too much of the book away here.

But I think.

>> Give it away.

Give it all away, please.

>> Okay, let me try.

Let me try to offer some challenge to what you've said from maybe the parts of if there's criticism of the book, the parts that I'm aware of.

So for example, when you talk about sub-Saharan Africa having much lower rates than, for example, industrialized urban centers, I think some of the pushback might start with this.

There's more diagnosis happening in the urban centers because there's more health care, there's more treatment, there's more awareness in general.

And that that doesn't necessarily mean that there's less of a prevalence in places where we just can't check for it as much.

What do you say to that?

>> Yeah.

So if that were true, then we would be diagnosing all conditions better.

We'd be diagnosing Ms.. With ALS stroke, heart disease.

We'd be doing better and better.

and in fact, it's not terribly surprising.

Areas of the world like sub-Saharan Africa, which overall have worse health than, say, for the United, to the United States, they have a higher burden of most diseases, so they have a higher burden of stroke, for example, they have a higher burden of infectious diseases.

And so we actually Parkinson's actually stands out.

opposite is that countries that are most industrialized, that are wealthiest, that are generally the healthiest, have the highest rates of Parkinson's stroke, for example, is much more common in sub-Saharan Africa than the United States.

rates of stroke in the United States have decreased by 30% over the last 30 years.

And that's even though stroke is primarily diagnosed based on MRI machines.

And there are far, far more MRI machines hanging out in Rochester, New York, than in Lagos, Nigeria.

So we don't see this for other diseases.

It's it's unique and quite uniquely, but very Parkinson's is one of the few diseases where you see this.

>> Okay.

And maybe a parallel criticism.

And I by the way, I take that point maybe a parallel criticism would sound like this.

When you look at autism, there are pretty common misunderstandings that the lay public has.

When you look at the prevalence and the diagnosis of autism, because number one, the definition is expanded, the spectrum is expanded, and the way that it is diagnosed and examined has expanded.

So, you know, we don't know for sure if the rates of autism have really increased a lot at all over the years, especially because until recently it wasn't diagnosed at all.

So when you look at Parkinson's and you think of what James Parkinson was looking at in the streets of London in the early 1800s, he was seeing something that hadn't been diagnosed yet.

But is that an indication that the rates were much lower, or just that medical understanding was crude, unsophisticated?

>> Yeah.

if anyone who's seen someone with Parkinson's and untreated Parkinson's, it's not subtle.

I think it's really hard to imagine that people miss something.

And there are some rare ancient descriptions of the disease.

But part Dr.

Parkinson's himself said he knows people who are casually walking on the streets.

And he said this is a disease that's not been classified in the medical literature.

He's 61 years old.

He's a surgeon.

He writes this long essay and he's 61.

I think he's trying to tell us that I'm seeing something new, something disturbing, something that I haven't seen before.

And he goes in great length in his essay to say that tremors, long since been described, Smith and Jones all described it.

But this disease, with the stooped posture, shuffling gait, this is something new.

And then on autism.

So I took the train to New York City yesterday, and I read this book.

It's called In Harm's Way Toxic Threats to Child Development, and it talks about how chemicals in our environment are contributing to a wide range of childhood diseases.

I'm a pediatric neurologist, but I was trying to get educated and they highlighted that 2 in 1000 children in 2000, which is the year after I graduated medical school.

2 in 1000 children had autism.

Now it's 32 children in 1000, if not more, have autism.

how do you go from 2 to 32 in a short period of time?

Yes.

Our diagnostic criteria for autism, unlike Parkinson''s Disease, have changed and expanded.

But I think it's chemicals.

And in fact, some of the chemicals linked to autism are also linked to Parkinson's disease.

A study done published I think, last year showed that children with autism in Sweden had a four fold increased risk of developing Parkinson's as adults.

Many of these chemicals pesticides are neurotoxins.

That is how they kill insects.

They are designed to damage the nervous system of insects.

I think when you put chemicals in the environment that are designed to damage the nervous systems of insects, they might have untoward consequences, including damaging the nerve systems of children and adults and humans.

And I think this widespread use of these chemicals in our environment, increasing uses of these chemicals in our environment, are fueling the rise of brain diseases from autism to Alzheimer's.

>> When Silent Spring came out, I mean, that certainly is a massive landmark piece of literature that changed the country, changed how we think of pesticides and DDT.

Is this book in that category, Dr.

Dorsey, do you want it to be in that category?

>> Well, I think I think Rachel Carson's exactly right.

So she wasn't arguing against the use of pesticides like DDT, which she recognized prevented millions of people from getting malaria in World War II.

She was arguing against the indiscriminate use of pesticides.

some of your listeners are young enough to remember the DDT truck spraying, and kids would follow it much like an ice cream truck.

Only they were getting exposed to neurotoxins and in in Silent Spring, Rachel Carson wrote that new diseases were going to appear among farmers that would puzzle the doctors and the cities.

And I think Parkinson's disease is one of those new diseases that's been emerging in higher numbers that are puzzling all of us as to why this is happening.

I think she got it exactly right.

And, you know I think it's also worth noting that a lot of people who've been doing this work are women, including Dr.

Debbie Cory-slechta at the University of Rochester, who in 1998 showed that pesticide weedkiller called paraquat when exposed, when when she exposed laboratory animals to it, they developed the pathological features of Parkinson's disease, including tremor.

So we have, like University of Rochester, has this long history of identifying the health consequences to the environmental risks.

among us.

And I think Rachel Carson was exactly right in any tie between our book and Rachel Carson is about as high praise as you can get.

>> Are you worried about getting sued >>?

>> yeah.

I think any I think anyone doing research in the area that's detailing the risks of environmental chemicals, whether that's cigarettes, whether that's social media, whether that's opioids, whether that's lead.

has to be aware that this is this is what industry has done, is they attack they attack scientists.

And that's part of their script.

The script is old, it's tired, and it needs to be put to bed, and it only delays us from finding the truth and taking actions to prevent millions of people from suffering from autism.

Parkinson's disease, ALS, and other brain diseases.

>> Are you getting sued right now over this?

>> no.

not not to my knowledge.

Okay.

>> All right.

I'm not encouraging that.

I'm just kind of curious because.

>> Because because the book is bold.

>> I mean, the book is very direct.

So, so for listeners who are going, okay, well, Rachel Carson was talking about DDT.

What is Dr.

Dorsey talking about?

Can you be specific about the chemicals that you that worry you the most?

>> So there there are three major classes of chemicals that we focus the book on.

They're not the only three, but these are the three that we concern the most.

One are pesticides, certain pesticides.

Not all certain ones.

Paraquat is a weed killer.

It sprayed on vineyards in upstate New York, you know, 20 minutes from where you're sitting right now.

it kills the weeds that roundup does and has been used to commit homicide and suicide.

And it's been associated with 150% increased risk of developing Parkinson's among farmers.

And simply living or working near where paraquat is sprayed is associated with a doubling of the risk of the disease.

Over 50 countries, including China, have banned it, but the U.S.

has not, and it's sprayed in increasing amounts on fields of corn, cotton, soybeans and vineyards throughout New York State, including western New York and around the country.

That's one.

Another pesticide is called chlorpyrifos.

If you've ever had an apple, it's likely that Apple was sprayed with with chlorpyrifos.

One report suggests that over half of apple orchards were sprayed with chlorpyrifos.

This this pesticides and nerve toxin is estimated to have cost 26 million children, 16 million IQ points in the U.S.

alone.

It's also sprayed on utility poles, wooden fences and on golf courses.

And my colleague, Dr.

Brittany Krzyzanowski, published a paper earlier this year with her colleague, Dr.

Rodolfo.

Rodolfo Savica, at the Mayo Clinic.

The other Rochester, and found that people who lived within a mile of a golf course in Rochester, Minnesota, had a 126% increased risk of developing Parkinson's disease.

So I think pesticides are one major one.

The EPA actually banned chlorpyrifos in 2021 because of these health effects, especially on children.

But the manufacturer successfully sued to overturn that ban.

So chlorpyrifos, again is allowed to be sprayed on apples.

>> Is it your view that there are safe pesticides out there?

>> Oh, I think yes.

Look, look cars are safer.

Airplanes are safer than they were in the 1960s.

If we can develop safer cars and safer airplanes, we can certainly develop safer pesticides.

And we can stop indiscriminate use.

Like I found out writing the book, that pesticides are routinely sprayed on kids schools and playgrounds, pesticides, many of which are neurotoxins, are sprayed on kids schools and playgrounds.

And we wonder why 1 in 31 eight year olds in America have autism.

I think we're just not quite awake.

in the words of Susan Sontag from a writer and former late writer in New York City.

You know, we need to be serious.

We need to be passionate, and we need to wake up.

And if we wake up, we start realizing that we're indiscriminately spraying pesticides on kids schools and playgrounds.

Can golf courses use less toxic pesticides?

Can they spray less frequently?

Can they do the courtesy of notifying residents when they're spraying so people can close their windows and use air purifiers?

Or maybe they go out of town for that weekend so they're not exposed to these chemicals.

And even if you already have Parkinson's disease, there's a study suggesting that people who already have Parkinson's, who are exposed to pesticides, have a faster rate of progression.

So I think there are lots of things that we can do to modify the course of this thing.

And still use pesticides when appropriate to help with fruit production and kill weeds and the like.

but we don't need to be doing this on kids schools and playgrounds.

>> Would you ever be willing to live near a golf course or a dry cleaner?

>> so the dry cleaning is is really concerning.

Dr.

Caroline Tanner and her colleague, Dr.

Sam Goldman looked at twins from World War II and a twin who had hobby or occupational exposure to this very simple molecule, trichloroethylene had a 500% increased risk of developing Parkinson's disease.

in New York State.

It turns out that apartments above dry cleaners in Albany and New York City were found to have unsafe levels of this chemical.

And because the chemical loves fat, they even found it in when they opened the refrigerator doors in the apartments above in New York City, above dry cleaners, they found the chemical and the butter and the cheese in the refrigerator.

So I wouldn't want to live near a dry cleaner that's using perchloroethylene.

or perc.

especially site that's doing it on on premises.

No, I wouldn't want to do that.

and we found in Rochester alone in Monroe County there are over according to the Department of Environmental Conservation, over 100 contaminated sites in Rochester alone.

Monroe County that are contaminated with these dry cleaning chemicals, trichloroethylene and or perchloroethylene.

And no, I wouldn't want to live near these toxic sites, but there are four.

There are three in near 12 corners.

on Monroe Avenue.

there's one right near Monroe Avenue.

When it crosses the Erie Canal as the state Superfund site that had levels of trichloroethylene in its soil that were worse than that found at Camp Lejeune in North Carolina.

>> well, one of your recommendations, one of your 25 recommendations is to figure out how close your grocery store is to the nearest dry cleaner and for exactly for the reasons you just stated.

And I'm thinking of I'm thinking of Fairport Road and one of the maybe the original Wegmans, the small Wegmans on Fairport Road on 31 F so that is in a plaza that has a dry cleaner.

It also has a liquor store.

The liquor store is like two doors down from the dry cleaner and the the dry cleaner is across the plaza from the grocery store.

Is that too close for you?

>> So in Germany they found that grocery stores that were located next to dry cleaners when they went to the grocery store and they looked at the dairy products, they found the dry cleaning chemicals in the dairy products of them in Germany and now in Germany had their very strict laws about co-location.

>> But that was next door.

>> You said next door.

>> Oh, no, that was near.

I don't remember how near it was.

It was near and so they took they taken actions to prevent the co-location of dry cleaners and grocery stores in Washington state.

Elmar Diaz, a toxicologist working for the Washington State Department of Health, is concerned about the proximity of dry cleaners to daycare centers.

because the chemicals used in dry cleaning can spread from the dry cleaning site and go into nearby apartments or nearby buildings.

And he found 80 daycare centers near dry cleaners in Washington state and is taking actions to prevent the the harm from those dry cleaning chemicals affecting child care centers.

I think these are both prudent actions that we should be thinking about doing in Rochester, in New York State and New York City and around the country.

>> How about 100 a couple hundred yards across the plaza, though, is that is that enough of a barrier.

>> In trying to get me in trouble?

>> I'm just wondering.

>> I mean.

>> That's literally the Wegmans I went to for years.

>> so.

I, I think, you know, is is dry cleaning done on site?

So many dry cleaning stores are just storefronts.

I'll give you an example.

So after writing the book I realized that when I lived in Philadelphia, I lived in a high rise that was located above a dry cleaner.

And I was wondering, did I get exposed?

And did my children get exposed to dry cleaning chemicals?

We live in an apartment building in Philadelphia above a dry cleaner.

So I called the dry cleaner.

25 years after the fact and asked them if they did dry cleaning on site.

And so they told me no and they said that they had been, you know, sent the dry cleaning off site to be done and would just bring it.

They were just operating as a storefront.

So I think that would be the first question I would ask.

>> Okay.

so here's what we're going to do.

We're going to take our only break of the hour, and we're going to come back with Dr.

Ray Dorsey, who I'm not I really am not rea trying to get you in trouble here.

I think your book does enough of getting yourself in trouble.

and I think it's good trouble.

I think it's.

The book is called The Parkinson''s Plan, and it is not just written for families with people who have Parkinson's.

It's written for everybody in society to understand why the authors think Parkinson's is one of the fastest growing diseases in the world, and their contention is it is a man made disease.

It is not just a product of genetics or unluck or natural aging.

It is unnatural, it is preventable, and it should be prevented.

And we're going to talk about some of those 25 things that Dr.

Dorsey and his coauthor think we all can do.

On the other side of this only break of the hour.

Coming up in our second hour, we're joined by Jim Boscov of the department store Boscov's, a store that until recently, maybe you'd never heard of because they weren't in Rochester, but they just opened in Greece Ridge Mall at a time when a long list of other stores have been closing.

So how are they doing it?

How are they kind of rowing against the current there?

We're going to talk about what used to be the Black Friday madness and what's happening in retail today.

>> Support for your public radio station comes from our members and from Eastman Presents Welcoming Béla Fleck and the Flecktones jingle All the Way, a reunion tour featuring songs from the group's catalog along with a selection of jazz infused holiday classics.

Thursday, December 11th at Kodak Hall.

Tickets online at Eastman Theater, Dot.

>> This is Connections.

I'm Evan Dawson the reason I brought up Silent Spring earlier this hour is probably like a lot of Americans.

I remember that reading that in school.

I remember how important that work is.

Of course, for our country, probably for society.

And doctor Ray Dorsey my guest this hour, his book as as I approached this book, it really felt to me like this is either going to be in the category of Silent Spring or his colleagues or others will say, you know, it's a little too out there, but I think what we are hearing this hour is why Dr.

Dorsey and his colleagues have have decided to take this bold of a stand about the individual actions and the societal choices we are making that they feel are leading us into a lot, lot more Parkinson's disease that they find utterly unnecessary.

Listeners, if you've got questions, comments, it's 844295 talk.

It's toll free.

8442958255263 WXXI.

If you call from Rochester 2639994, email the program Connections at wxxi.org.

You can join the chat on YouTube if you're watching on the WXXI News YouTube channel.

Linda in Webster says since Parkinson's and Lewy body dementia both result from Lewy bodies in the brain, does the doctor think that there can?

Their conclusions are also related to cause and prevention of Lewy body dementia.

Dr.

Dorsey.

>> Yeah, so we talked about how, doctor, how Dr.

Parkinson described Parkinson's in 1817, the first major description of dementia with Lewy bodies is not till 1976 by a Japanese psychiatrist named Kenji Kosaka, who in 1984 asked, is this a new disease?

Question mark.

So I went back and I said, well, what was many people think that dementia with Lewy bodies begins in the gut.

And so I said, what was happening to the food supply and water supply in Japan in the 1950s, you know, years before someone would develop the symptoms.

And it turned out that after World War II, DDT was widely sprayed on rice paddies in Japan.

And because DDT is dissolves in fat they did studies measuring the fat concentration of DDT in Japanese men.

And that was what the study was done.

Absent in the 1920s, absent in the 1930s, starts rising in the 40s, 50s and 60s.

And in the lab, DDT damages the dopamine producing nerve cells that are lost in Parkinson's, and the ones that are lost and dementia with Lewy bodies.

And I get really concerned that your your, your guess has got it right that dementia with Lewy bodies might begin from toxicants, especially certain pesticides that we ingest, either through well water or perhaps food.

Well water has a tendency to be in rural areas, be contaminated from pesticides from nearby farms.

So yes, I get really, really concerned.

First major description dementia with Lewy bodies.

One of the most common causes of dementia in the United States after Alzheimer's disease, first descriptions not till 1976, Dr.

Kosaka said as far as I know, this is the first case report of parkinsonism and dementia.

The two major features of the disease.

>> Catherine wants to know what are the doctors thoughts about?

For example, a pizza place opening in a former dry cleaning laundromat.

So not active, a location that used to be a dry cleaner in a laundromat.

Does that.

Is there any evidence that there is residual possible concern about chemicals used on site?

There?

>> So the New York Department of Environmental Conservation has a website where you can see what sites are contaminated with trichloroethylene and perchloroethylene.

So I would look and see if that dry cleaner was known, is known to be contaminated.

If it's not known, you can do a neurologist, not an environmental scientist.

our friend Kevin Heldens, the environmental scientist.

You can test for these chemicals in the indoor air, just like you test for radon.

Lots of people have tested for radon for their homes in New York, in Rochester, to make sure that they're not getting exposed to a chemical that causes lung cancer.

Same testing approach for testing for radon.

You could test for a pizza parlor and make sure that these chemicals aren't there.

And if they are there, it's actually pretty easy to remove it.

It's just a remediation system that you put in for home radon remediation system.

About $2,000.

Not inexpensive, but not going to break the bank for most homeowners can be put in place and prevent exposure to these chemicals.

>> a lot of questions coming in.

I'm going to get through as much as we can with Dr.

Ray Dorsey.

Arielle on YouTube wants to know, is any dry cleaning safe?

Some local companies claim to use green earth cleaning process to deliver the safest and most environmentally responsible care for your garments, and Arielle says, is that just greenwashing?

Gobbledygook?

>> So I use a green dry cleaner in New York City.

I went around and found.

I looked to make sure that I find a dry cleaner that does not use Perchloroethylene.

It's abbreviated Perc.

In the industry.

And as far as I know, these green dry cleaners, their chemicals are are likely safer than that used in traditional dry cleaning.

>> Okay, Barbara, on line one on the phone.

Hey, Barbara from Webster.

Go ahead.

>> Yeah.

Hi.

I he mentioned that the apples are sprayed quite a bit with with the chemicals.

And my question is, if I remove the skin from the apple before I eat it, is that is that making it safer for me?

>> Dr.

Dorsey?

>> Yeah.

So everyone calls me Ray, by the way.

Everyone calls me Ray.

so the first recommendation in our Perkins 25 is to wash your produce.

Even your organic ones, because residues of, pesticides are found on 20% of common foods and water.

And washing your fruits and vegetables with water.

And I use a little bit of soap.

Some people use vinegar or salt.

Solutions can reduce your exposure to these toxicants.

And my understanding again I'm a neurologist, not a food expert, is that the chlorpyrifos is generally in the skin, so peeling off the skin, that would should be a helpful way to reduce exposure to chlorpyrifos.

Taking this from a neurologist, not a food expert.

>> Okay.

Barbara, thank you.

by the way your friend Yvonne Hilton does send this note who's been on this program before, and.

Hello, Yvonne.

She says folks listening in the area who might be interested in or need of education, support or care partner respite can reach out to the Rochester, Rochester Parkinson Network and you can learn more at Rock net dot rock net.

So thank you, Yvonne.

Continued.

success to Yvonne in building and Yvonne and Kevin and building this network and of support and information.

Patrick writes in to say if I, if I get my clothes dry cleaned, is that the same level of exposure as being located in a retail place next door to a dry cleaner?

How did dry cleaning chemicals end up in milk that is sealed from the outside world?

He's talking about the milk fats that you're talking about.

He's saying those.

>> Products are.

>> Sealed.

>> Yeah.

And so these these chemicals really, really small.

So it's many of your listeners know that water is made up of three atoms.

Trichloroethylene is made up of a whopping six.

So it got into the butter and the cheese I don't know if it's been in the milk.

but it's been in the butter and the cheese wrap is not as good for the butter and the cheese, but that's that's what the research has shown.

It's a really small molecule.

So you can imagine it's pretty easy to get through into environments.

And we clearly know that so I can't tell you about the relative contributions.

I, people used to ask me, you know, if I just get my clothes dry cleaned, is that going to cause Parkinson's?

And my initial answer was no, it'd be too little exposure.

And then someone contacted me and said that her husband was in a blue collar job.

And as part of that, had to wear a dry, clean uniform every day for 35 years and then got Parkinson's.

And then someone told me that she was fastidious and that in her apartment in Boston, where all her dry cleaned outfits still in the bag her boyfriend said that when he walked into her apartment, it smelled like a dry cleaner.

and she got Parkinson's.

And then there's one small, tiny study in Denmark that looked at different occupations.

Everything from accountants to teachers to farmers, and looked at what occupation had the highest rate of Parkinson's disease and the occupation that had the highest rate of Parkinson's, highest prevalence was female dry cleaning workers who had a 1,500% increased risk of developing Parkinson's.

Small study, to be sure.

but these clues are all around us.

So if you do get your dry cleaning from cleaning from a traditional dry cleaner, we'll try to find a green one.

But if you do it, you know, take the plastic off, air it out in your garage before bringing it into your home.

>> Debbie and Penfield wants to know should she avoid hiking on an abandoned golf course?

Dr.

Dorsey.

>> I tend to get most concerned about some level of chronic exposure.

Not one time exposure.

I get concerned about when the chemicals are in a closed environment.

or that they're frequently getting sprayed.

So we told you that living near farms that are sprayed with paraquat is associated with a doubling of your risk and living near a golf course, which golf course?

Which are some golf courses, are sprayed with 80 times as much pesticide per acre as a farm.

So I think it's chronic exposure over some period of time.

So walking on a golf course in the outside air that may have been previously sprayed, that would be not be as concerning, you know, some of the dog listeners and stuff like that may or may not want to have their dogs.

playing in that grass.

but I would be I think I would be less concerned about walking.

>> in a moment, we'll talk about that idea of 25 things we all can do.

But I should say the book is structured in a way that you can learn a lot here.

And there's it's called the Parkinson's plan.

There is a plan.

It's.

And we're not I'm looking at the list of calls and emails.

Dr.

Dorsey, we can't even get through everything.

But before I even get to the 25 recommendations, I do want to ask you briefly about part of your plan, which is to get access to the best treatment accessible for everybody.

So how is the current quality of treatment for existing Parkinson's cases?

>> Well, I mean, is anyone with Parkinson's will test?

It's difficult.

Only 9% of people with Parkinson's disease see a Parkinson's specialist.

It's likely a lot better in Rochester because the University of Rochester has some of the best Parkinson's specialists in the country, doctor Jamie Adams leads the division, and so people are able see Dr.

Adams and her colleagues are getting access to some of the best specialists in the country, if not the world.

But that said, you know, I've been visiting 30 cities around the country El Paso, Texas, Sioux Falls, South Dakota Medford, Oregon.

And one of the things that has really struck me is how poor of care people around the country are getting.

And I think people like me need to think what are better ways to bring care to patients instead of patients to care so that people who are suffering with the disease get access to the best care possible, possible because it makes a difference in your rate of your rate of progression of the disease.

>> Okay.

And how about the quality of drugs that are out there for Parkinson's?

>> I'm sorry I missed that last question.

>> Yeah.

The quality.

>> Of of drugs that are out there on the market right now for Parkinson's.

How is it.

>> So we've had no major therapeutic breakthrough on Parkinson's the last century.

We've gotten better ways of delivering the most effective medication for Parkinson's is a medication called levodopa, which replaces the dopamine that's lost.

And there are some new pumps that are coming out that will deliver that kind of like an insulin pump for diabetes, levodopa pump for people with Parkinson's.

I think that's promising.

And in chapters eight and nine, in the book, my colleague, Dr.

Michael tells you one of the most promising treatments in the near term, mid-term and long term.

But it's pretty clear, just as a general rule, that the status quo is not working.

if status quo were working, Parkinson's wouldn't be the world's fastest growing brain disease.

90% of people with Parkinson's would not would not be unable to access care from a Parkinson's specialist.

Parkinson's wouldn't be the 13th leading cause of death in the United States, and rising.

So in the book, we outline a new path to preventing and treating the disease.

>> okay.

My gosh, so many emails, doctor.

People are clearly interested here, Sean.

And Sean.

Fairport, I'll get your question coming up here because we're going to talk about food again.

Mary Lou and Irondequoit.

Does Rochester have a higher incidence of Parkinson's than other areas?

Is Kodak in any way responsible for emitting chemicals that contribute to Parkinson's?

>> so it appears that Rochester might be a little bit higher than the rest of the country.

one of the things that we really lack is high quality data on the number of new cases of people with Parkinson's disease.

My colleague, Dr.

Allison Willis, published a paper 2 or 3 years ago suggesting that the number of new cases of Parkinson's in the U.S.

is 50% higher than we previously thought, not 60,000 new cases a year, but 90,250 people today.

Americans will be diagnosed with Parkinson's.

And so we just really don't have the data that we need to have.

If you don't measure something, it's hard to manage it.

And right now, we're not measuring Parkinson's well enough to determine how what are the best steps to prevent it and how to identify clusters of the disease.

And in the book, we highlight some of the investigations of a cluster of the disease, including in downtown Rochester, associated with a former dry cleaning site.

If we look at and investigate these clusters, I think we get closer to identifying what the causes of the disease are.

Some of your listeners are historians of medicine, and that's how we found out what caused cholera, because John Snow in the 1800s found out that all the people dying of cholera in London were located around, were getting their water from a contaminated pump.

He put a lock on that pump, water pump, and people stopped dying of cholera.

I think we could do the same thing in Rochester around the country to identify where these clusters of the disease, where the chemicals that are causing what are the causes of the disease in these clusters and take action to prevent people from getting exposed to those chemicals.

>> See why emails to ask for clarity.

Are TCE and Perc still being used today?

Dr.?

>> Yeah.

Yes.

And so the EPA banned trichloroethylene and perchloroethylene in 2024. that calls for a phase out of those chemicals over the next ten years.

In 2025, a freeze on that ban was put in place.

And my understanding in perfect is that they're trying to modify this ban and perhaps provide some more exceptions.

Now because of Congressman Joe Morelli and others in New York State, trichloroethylene has been banned.

So New York State and Minnesota are the only two states in my knowledge to which trichloroethylene has been banned.

but perchloroethylene is still widely used in New York City and in New York State, including in dry cleaners.

To my knowledge.

>> I am trying to keep up as fast as I can because I have so much I want to get to, but there's so many.

Denise writes to say my grandmother dry cleaned most of her family clothes, including sometimes their underwear.

Both my grandma and grandpa got cancer, and my uncle, who lived with them forever, got Parkinson's.

Ken and East Rochester says please mention the misery our own government has caused our veterans with their chemical cocktail exposures.

I lost a friend ten years ago that went through hell the last few years of his life with Parkinson's and then multisystem atrophy, who was exposed as a serviceman, then had to fight tooth and nail for any assistance.

That's from East Rochester.

Anything you want to add there?

>> Just.

>> Yeah.

So dry cleaning in the book, we highlight the family Dave Toth and Patty Burnette both grew up in a family dry cleaning business in Rochester, New York.

Both developed Parkinson's disease, and their father may have also had Parkinson's.

So we tell their story.

veterans pay a disproportionate price of Parkinson's disease.

10% of Americans with Parkinson's are veterans.

Agent orange for Vietnam veterans, trichloroethylene.

For this next generation, the price of service should not be unnecessary.

Exposure to chemicals linked to Parkinson's disease.

The two protagonists of our book are two women who got Parkinson's after serving in the Air Force, including in Afghanistan.

And as I alluded to, I don't think it's just Parkinson's that is due to chemicals.

I think other Parkinsonian disorders could be tied to it and other brain disorders and more generally.

>> the stories of Jana Reed and Sarah Whittingham, I think, do a great service in helping your readers see that this is not just an old man's disease.

So as a reader, I appreciate that.

and, Ken, thank you for the email.

Alex has a two parter.

He says, first, what does your guest think about the direction that RFK is taking?

H-h HHS and has RFK said anything about Parkinson's?

>> So I think there's a movement in the in the public that chemicals in our food, water and air are fueling the rise of chronic diseases.

And I think that's right.

And I think Parkinson''s Disease is a poster child for it.

I think that the remedies that have been offered to date are not necessarily targeted on the most pressing concerns.

I think most people would probably sense that Tylenol is probably not the most important cause of autism.

I think.

>> Even any.

>> Cause of.

>> Yeah, yeah.

>> The.

>> Maha report, you know, identified pesticides as a major contributor to chronic disease among children, but his strategy report said that the solution the solution offered or a solution offered was more targeted spraying of pesticides.

I think we can do a lot better than that.

>> All right, Alex, thank you.

All right.

In the book, a section with 25 recommendations, the Parkinson's, 25 things we all can do.

And I'm just going we're going to try to fly through because we can't even get through everything here.

Number one, wash your produce.

Even if it's organic.

So we've talked about this on the on the show in the past with you Ray.

But let me also ask you this.

I washed blueberries yesterday at home.

I do not wash bell peppers.

Do I need to wash everything?

Corn, onions, bell peppers, everything.

>> So the Environmental working group at EWG has their dirty dozen and their clean 15 suggesting which which foods have the highest level of residues of their pesticides and which don't.

I essentially wash all my fruits and vegetables with water and a little bit of vegetable wash.

There are other solutions salt, vinegar and others that can be beneficial.

>> Okay, even the bell peppers.

Okay.

Mental note to self we eat a lot of bell pepper.

number two change your diet.

And just briefly on this one, what kind of diet doctor.

>> So diet Mediterranean diet high in fruits and vegetables.

Low in animal products has been associated with a decreased risk of Parkinson's and a slower rate of progression.

I really get concerned when you're eating a cow or dairy product.

You're not just eating the cow, you're eating what the cow ate.

And so many of these pesticides sprayed on feed, for example, are dissolved in fat.

And so they can concentrate in milk, for example, as they make their way up the food chain.

So I think getting organic meats and organic dairy products could be really advisable.

>> Number three.

>> Number three, we talked about make sure your grocery store is safe.

And that is just in regards to how close it is to things.

Places like dry cleaners.

Number four enjoy wine without pesticides.

Organic wine labeled as such.

It's not a huge category, but it's out there.

Dr.

Dorsey.

>> Yeah.

>> So my colleague Alexis Elbaz in France looked at pesticide use among vineyards in the south of France and found a near-perfect correlation between rates of Parkinson's and amount of pesticides.

And I think 17 different cantons in France, the equivalent of Consumer Reports in France, kosher found residues of pesticides in nearly every bottle of French wine that they tested.

Organic wines tend to have lower levels.

And so that's another way to reduce your exposure to these chemicals.

>> tell me a little bit about number five is about diabetes.

What do you want people to know.

>> So it's pretty clear that having a high blood glucose level is not good for brain diseases in general.

So if you have diabetes and manage it strictly because it may be able to slow your rate of progression of the disease.

>> Number six.

>> Is true for Alzheimer's.

>> Number six is have a cup of caffeinated coffee.

How about 3 or 4?

I don't know, it sounds.

>> Good.

>> So I'm not saying to drink.

Coffee.

If you don't drink I wouldn't say start it, but it turns out that caffeine might protect nerve cells from the damage of some of these toxins.

>> Okay.

Number seven, number seven is its own category.

That really is important.

It's farm safely.

And they have a lot to say about the importance of that.

It's the world's most common job.

So that's a big one.

Number eight check your.

Well so people think drinking water regulated.

But if you have a well not so.

So what do you want people to know about.

Well water.

>> you should put a water filter on your home right now if you, you know, have your house around the Finger Lakes and you're drinking well because private wells on your property are not regulated by the Safe Drinking Water Act and are prone to be contaminated in rural areas from pesticides on nearby farms and industrial areas from chemicals.

So you can test your wells.

There's a company called Simple Labs that have no financial interest in it that can test your wells, not just for the bacteria, which are routinely tested, but for pesticides in rural areas or industrial chemicals in urban areas.

>> again, can't get through all 25, but I'm just going to mention a few others that stand out.

And there's I mean, the whole list is important, but just roll up your windows and traffic.

That is a small thing that we could probably do even on a hot day.

Dr.. >> Yeah.

So at traffic related, air pollution has been associated with increased risk of Parkinson's and air pollution.

Really, I think is a huge contributor to Alzheimer's disease.

If you want to.

Yeah.

Don't breathe polluted air if you want to live a long, healthy life free of brain diseases.

>> and you mentioned things like exercise and sleep exercise is important for people with Parkinson's.

It's important for all of us.

It turns out that may play a role as well.

Yes.

>> Yes.

And sleep research by Dr.

Megan Neergaard who has a has an appointment at the University of Rochester, has shown that there's a system that called the Glymphatic Glymphatic system around your brain that flushes out toxicants.

And this flushing out might be accelerated during sleep.

>> I see producer Megan Mack yawning in there.

You need more sleep.

We all need more sleep.

It's important.

So we just scratched the surface here, doctor Dorsey.

what haven't we hit that?

You want to make sure listeners understand about this book and your research?

>> listen brain diseases are the world's leading source of disability.

For 99.9% of human history.

That's never been the case.

many of these brain diseases have only been recently described.

In the last two centuries.

Many of them are being fueled by chemicals in our food, water and air.

If we create a world with clean food, clean water, and clean air, we create a world where these diseases are increasingly rare instead of increasingly common.

And it's on us to do that.

>> I think where you're again, critics may step in and say this book is way too aggressive in its language.

When you talk about being within reach of a world where we don't see any new Parkinson's cases, that's where I think the critics will say, well, there's got to be some genetic component, or that is way too optimistic and too aggressive.

What would you say to that?

>> 1 in 31 children have autism.

The rates of ALS and brain cancer are increasing.

1 in 3 individuals who live to 85 will develop Alzheimer's disease.

Parkinson's is one of the world's fastest growing brain diseases.

If this doesn't sound enough alarm bells, I think we're being tone deaf.

It's incumbent upon us to take actions in our generation to create a world that's largely free of Parkinson's disease, where ALS, where Alzheimer's disease and autism are all increasingly rare.

Instead of increasingly common.

We've done this for polio, we've done this for typhus, we've done this for stroke.

30% less common than it was in 1990.

We can take actions to create a world where these diseases are increasingly less common, instead of increasingly common.

There are millions of Americans who are being affected by these diseases and these diseases.

In the words of Michael J. Fox, stuck.

And we need to wake up, be serious and be passionate and take action to prevent these diseases for future generations and for all generations to come.

>> One thing I will certainly take away from this book is the idea that Parkinson's is a man made disease, and that's a good place to end it.

Maybe for listeners who haven't thought about it that way, that's a helpful way to think about it.

Huh?

>> Yeah, and we can just like diseases come and go.

They are not permanent structures.

No one's dying.

No one in Rochester is dying of polio.

No one's dying of typhus.

No one's dying of yellow fever.

These are all diseases that we've successfully addressed in the past.

Diseases come and go.

It's time for us to say goodbye to Parkinson's.

>> The Parkinson''s Plan is the book that's out now.

Where do you want people to learn more information?

Dr.

Dorsey?

>> so you can get the book in your library on Amazon or wherever you'd like to get your book?

you can learn more about our work at PD planet.

If we didn't answer your question, you can just email me directly at info at PD, info at PD.

Org.

Our website.

We're doing a listening tour going around the country, including Rochester, New York.

to spread the word about the disease and answer all the questions from the Parkinson's community and beyond.

>> Come back sometime and talk to us about it.

Dr.. >> I will thank you very much, Evan, and thank you very much for having me again.

>> Dr.

Ray Dorsey, coauthor of The Parkinson's Plan.

More Connections coming up in a moment.

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