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Freya Kamel, Ph.D.

Chronic Disease Epidemiology Group

Freya Kamel, Ph.D.
Freya Kamel, Ph.D.
Staff Scientist – Chronic Disease Epidemiology, Adjunct member - Aging and Neuroepidemiology Group
Tel (919) 541-1581
Fax (919) 541-2511
P.O. Box 12233
Mail Drop A3-05
Research Triangle Park, North Carolina 27709
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NIH Study Finds Two Pesticides Associated with Parkinson's Disease

Kamel, Freya, Ph.D.

Freya Kamel, Ph.D.,
Staff Scientist
Chronic Disease Epidemiology Group

Research interests for Freya Kamel, Ph.D., focus on environmental determinants of neurologic dysfunction and disease, in particular, neurodegenerative disease.


Kamel and her colleagues conducted a case-control study of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, to study the role of exposure to lead and other neurotoxicants in this disease (Kamel et al., 2002). Occupational exposure to lead was associated with a two-fold increase in ALS risk. Both blood and bone lead levels were also elevated in ALS cases compared to population controls. However, neither residential nor recreational exposure to lead was related to ALS. Analyses of the role of genetic susceptibility suggested that polymorphisms in the gene for ?-aminolevulinic acid dehydratase were associated with increased risk of ALS (Kamel et al., 2003). Thus, both genetic susceptibility and exposure to environmental neurotoxicants increase risk of ALS.


Another study examined the relationship of farmwork-related exposures to subclinical neurobehavioral deficits in farmworkers. In this community-based study, farmworkers in central Florida were recruited with the assistance of the Farmworkers Association of Florida, a local advocacy group. Farm work was associated with deficits in neurobehavioral performance reflecting cognitive and psychomotor function (Kamel et al., 2003). Longer duration of farm work was associated with worse performance. Deficits related to the duration of work experience were seen in former as well as current farmworkers, and decreased performance was related to chronic exposure even in the absence of a history of pesticide poisoning. Thus, long-term experience of farm work is associated with measurable deficits in cognitive and psychomotor function.


Kamel participated in work on the Agricultural Health Study (AHS), a large cohort study of licensed pesticide applicators and their spouses in Iowa and North Carolina. Using data from the AHS, Kamel found that use of fungicides and organochlorine insecticides was associated with increased risk of retinal degeneration, the leading cause of blindness in adults (Kamel e NTP Report on Carcinogens t al., 2000). Another analysis found that prevalence of neurologic symptoms was related to moderate levels of exposure to organophosphate and organochlorine insecticides and fumigants (Kamel et al., 2005).


The AHS is the setting for a nested case-control study of pesticide exposure and Parkinson's disease called the Farming and Movement Evaluation or FAME Study. In collaboration with Caroline Tanner, M.D., Ph.D., at The Parkinson's Institute, FAME investigated the relationship of Parkinson's disease to pesticides and other farm-related exposures in a population with a well-documented history of pesticide exposure. The study also evaluated the role of other environmental neurotoxicants, lifestyle variables and genetic susceptibility. Enrollment of participants in the study began in 2002 and was completed in 2006.


Kamel also serves as an epidemiology resource for the National Toxicology Program (NTP)  . She has participated in the review of agents and exposure circumstances nominated for listing in the NTP Report on Carcinogens  , including alcoholic beverage consumption, beryllium, diesel exhaust particulates, dioxins, environmental tobacco smoke, heterocyclic amines, nickel, silica, solar and ultraviolet radiation, sunbeds, steroidal estrogens, sulfuric acid mists, tamoxifen, trichloroethylene and wood dust.


Kamel received a B.A. in mathematics from Brandeis University and a Ph.D. in biological sciences from SUNY-Binghamton. She did research in neuroendocrinology as a postdoctoral fellow at The Rockefeller University and then as an assistant professor at The Rockefeller University and the University of Wisconsin. She received an M.P.H. in epidemiology from the University of North Carolina at Chapel Hill. She joined the Epidemiology Branch at NIEHS in 1989, and currently serves as an epidemiologic consultant for the National Toxicology Program, an associate editor of the American Journal of Epidemiology, and a member of the editorial board of Environmental Health Perspectives.


  • Agricultural Health Study (AHS)
    ("/Rhythmyx/assembler/render?sys_contentid=35054&sys_revision=4&sys_variantid=639&sys_context=0&sys_authtype=0&sys_siteid=&sys_folderid=" sys_dependentvariantid="639" sys_dependentid="35054" inlinetype="rxhyperlink" rxinlineslot="103" sys_dependentid="35054" sys_siteid="" sys_folderid="")The AHS explores potential causes of cancer and other diseases among farmers, their families and commercial pesticide applicators.

  • Amyotrophic Lateral Sclerosis (ALS) Study
    ("/Rhythmyx/assembler/render?sys_contentid=35070&sys_revision=1&sys_variantid=639&sys_context=0&sys_authtype=0&sys_siteid=&sys_folderid=" sys_dependentvariantid="639" sys_dependentid="35070" inlinetype="rxhyperlink" rxinlineslot="103" sys_dependentid="35070" sys_siteid="" sys_folderid="")The ALS Study explores potential associations of ALS with exposure to lead and other neurotoxins, lifestyle factors and genetic polymorphisms affecting neurologic function or lead metabolism.

  • Farming and Movement Evaluation (FAME) Study
    ("/Rhythmyx/assembler/render?sys_contentid=35471&sys_revision=1&sys_variantid=639&sys_context=0&sys_authtype=0&sys_siteid=&sys_folderid=" sys_dependentvariantid="639" sys_dependentid="35471" inlinetype="rxhyperlink" rxinlineslot="103" sys_dependentid="35471" sys_siteid="" sys_folderid="")The FAME Study examines the relationship between Parkinson's disease and exposure to pesticides, other neurotoxicants and soil pathogens. The study also examines the connection between the illness and lifestyle factors, skin melanin and polymorphisms in genes involved in xenobiotic metabolism, dopaminergic neurotransmission or xenobiotic-specific membrane transport.

  • Farmworkers Health Study
    ("/Rhythmyx/assembler/render?sys_contentid=35483&sys_revision=1&sys_variantid=639&sys_context=0&sys_authtype=0&sys_siteid=&sys_folderid=" sys_dependentvariantid="639" sys_dependentid="35483" inlinetype="rxhyperlink" rxinlineslot="103" sys_dependentid="35483" sys_siteid="" sys_folderid="")The Farmworkers Health Study examines the association of long-term pesticide exposure in farmworkers with deficits in cognitive and psychomotor function.

Selected Publications

  1. Kamel F, Umbach DM, Munsat TL, Shefner JM, Hu H, and Sandler DP. Lead exposure and amyotrophic lateral sclerosis. Epidemiology 13:311-319, 2002. [Abstract ( ]
  2. Kamel F, Umbach DM, Lehman TA, Park LP, Munsat TL, Shefner JM, Sandler DP, Hu H, Taylor JA. Amyotrophic lateral sclerosis, lead, and genetic susceptibility: polymorphisms in the delta-aminolevulinic acid dehydratase and vitamin D receptor genes. Environ Health Perspect 111: 1335-9, 2003.   [Abstract ( ] [Full Text ( ] [PDF ( ]
  3. Kamel F, Rowland AS, Park LP, Anger WK, Baird DD, Gladen BC, Moreno T, Stallone L, Sandler DP. Neurobehavioral performance and work experience in Florida farmworkers. Environ Health Perspect 111: 1765-72, 2003. [Abstract ( ] [Full Text ( ] [PDF ( ]
  4. Kamel F, Engel LS, Gladen BC, Hoppin JA, Alavanja MCR, Sandler DP. Neurologic symptoms in licensed private pesticide applicators in the Agricultural Health Study. Environ Health Perspect 113: 877-882, 2005. [Abstract ( ] [Full Text ( ] [PDF ( ]
  5. Kamel F, Tanner CM, Umbach DM, Hoppin JA, Alavanja MCR, Blair A, Comyns K, Goldman SM, Korell M, Langston JW, Ross GW, Sandler DP. Pesticide exposure and self-reported Parkinson’s disease in the Agricultural Health Study. Amer J Epidemiol 165(4): 364-74, 2007. [Abstract ( ]
  6. Chen H , Richards M , Sandler DP , Umbach DM , Kamel F. Head injury and amyotrophic lateral sclerosis. American Journal of Epidemiology. 7: 810-816, 2007. [Abstract ( ]
  7. Kamel F, Umbach DM, Stallone L, Richards M, Hu H, Sandler DP. Association of lead exposure with survival in Amyotrophic Lateral Sclerosis (ALS). Neurology 116(7):943-947, 2008. [Abstract ( ]
  8. Crawford JM, Hoppin JA, Alavanja MCR, Blair A, Sandler DP, Kamel F. Hearing loss in licensed pesticide applicators. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 50(7):817-826, 2008. [Abstract ( ]
  9. Fang F, Kamel F, Sandler DP, Sparén P, Ye W. Maternal age, exposure to siblings and risk of amyotrophic lateral sclerosis. American Journal of Epidemiology 167(11):1281-1286, 2008. [Abstract ( ]
  10. Beseler CL, Stallones L, Hoppin JA, Alavanja MC, Blair A, Keefe T, Kamel F. Depression and pesticide exposures among private pesticide applicators enrolled in the Agricultural Health Study. Environmental Health Perspectives 116(12):1713-1719, 2008. [Abstract ( ]
  11. Fang F, Quinlan P, Ye WM, Barber MK, Umbach DM, Sandler DP, Kamel F. Workplace exposures and the risk of amyotrophic lateral sclerosis. Environmental health perspectives 117(9):1387-1392, 2009.  [Abstract ( ]
  12. Bronstein J, Carvey P, Chen H, Cory-Slechta D, DiMonte D, Duda J, English P, Goldman S, Grate S, Hansen J, Hoppin J, Jewell S, Kamel F, Koroshetz W, Langston JW, Logroscino G, Nelson L, Ravina B, Rocca W, Ross GW, Schettler T, Schwarzschild M, Scott B, Seegal R, Singleton A, Steenland K, Tanner CM, Van Den Eeden S, Weisskopf M. Meeting report: consensus statement-Parkinson's disease and the environment: collaborative on health and the environment and Parkinson's Action Network (CHE PAN) conference 26-28 June 2007. Environmental health perspectives 117(1):117-121, 2009. [Abstract ( ]
  13. Fang F, Kamel F, Lichtenstein P, Bellocco R, Sparén P, Sandler DP, Ye W. Familial risk of amyotrophic lateral sclerosis. Annals of neurology 66(1):94-99, 2009. [Abstract ( ]
  14. Fang F, Kwee LC, Allen KD, Umbach DM, Ye W, Watson M, Keller J, Oddone EZ, Sandler DP, Schmidt S, Kamel F. Association between blood lead and the risk of amyotrophic lateral sclerosis. American journal of epidemiology 2010 171(10):1126-1133.  [Abstract ( ]
  15. Goldner WS, Sandler DP, Yu F, Hoppin JA, Kamel F, LeVan TD. Pesticide use and thyroid disease among women in the Agricultural Health Study. American journal of epidemiology 171(4):455-464, 2010. [Abstract ( ]
  16. Fang F, Xu Q, Park Y, Huang X, Hollenbeck A, Blair A, Schatzkin A, Kamel F, Chen H: Depression and the subsequent risk of Parkinson’s disease in the NIH-AARP Diet and Health Study. Movement disorders: official journal of the Movement Disorder Society 25(9):1157-62, 2010. [Abstract ( ]
  17. Waggoner JK, Kullman GJ, Henneberger PK, Umbach DM, Blair A, Alavanja MCR, Kamel F, Lynch CF, Knott C, London SJ, Hines CJ, Thomas KW, Sandler DP, Lubin JH, Beane Freeman LE, Hoppin JA. Mortality in the agricultural health study: 1993-2007. American journal of epidemiology 173(1):71-83, 2011. [Abstract ( ]
  18. Blair A, Thomas K, Coble J, Sandler DP, Hines CJ, Lynch CF, Knott C, Purdue MP, Zahm SH, Alavanja MC, Dosemeci M, Kamel F, Hoppin JA, Freeman LB, Lubin JH. Impact of pesticide exposure misclassification on estimates of relative risks in the Agricultural Health Study. Occupational and Environmental Medicine 68(7):537-541, 2011. [Abstract ( ]
  19. Tanner CM, Kamel F, Ross GW , Hoppin JA , Goldman SM, Korell M, Marras C, Bhudhikanok GS, Kasten M, Chade A, Comyns K, Richards M, Meng C, Priestley B, Fernandez HH, Cambi F, Umbach DM, Blair A, Sandler DP, Langston JW. Rotenone, Paraquat and Parkinson's Disease. Environmental health perspectives 119(6):866-872, 2011. [Abstract ( ]
  20. Hines CJ, Deddens JA, Coble J, Kamel F, Alavanja MCR. Determinants of Captan Air and Dermal Exposures among Orchard Pesticide Applicators in the Agricultural Health Study. Annals of Occupational Hygiene 55(6):620-633, 2011. [Abstract ( ]  
  21. Beard JD, Umbach DM, Hoppin JA, Richards M, Alavanja MC, Blair A, Sandler DP, Kamel F. Suicide and Pesticide Use among Pesticide Applicators and Their Spouses in the Agricultural Health Study. Environmental health perspectives 119(11):1610-5, 2011. [Abstract ( ]
  22. Popat RA, Van Den Eeden SK, Tanner CM, Kamel F, Umbach DM, Marder K, Mayeux R, Ritz B, Ross GW, Petrovich H, Topol B, McGuire V, Costello S, Manthripragada AD, Southwick A, Myers RM, Nelson LM. Coffee, ADORA2A, and CYP1A2: the caffeine connection in Parkinson's disease. European journal of neurology  18(5):756-65, 2011. [Abstract ( ]
  23. McGuire V, Van Den Eeden SK, Tanner CM, Kamel F, Umbach DM, Marder K, Mayeux R, Ritz B, Ross GW, Petrovitch H, Topol B, Popat RA, Costello S, Manthripragada AD, Southwick A, Myers RM , Nelson LM, Nelson L. Association of DRD2 and DRD3 polymorphisms with Parkinson's disease in a multiethnic consortium. Journal of the neurological sciences 307(1-2):22-29, 2011. [Abstract ( ]
  24. Davis MF, Kamel F, Hoppin JA, Alavanja MCR, Freeman LB, Gray GC, Nelson K, Silbergeld E. Neurologic symptoms associated with raising poultry and swine among participants in the Agricultural Health Study. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 53(2):190-195, 2011.  [Abstract ( ]
  25. Starks SE, Gerr F, Kamel F, Lynch CF, Alavanja MC, Sandler DP, Hoppin JA. High pesticide exposure events and central nervous system function among pesticide applicators in the Agricultural Health Study. Int Arch Occup Environ Health 85(5):505-515, 2012. [Abstract ( ]
  26. Goldman SM, Kamel F, Ross GW, Jelell SA, Bhudhikanok GS, Umbach D, Marras C, Hauser RA, Jankovic J, Factor SA, Bressman S, Lyons KE, Meng C, Korell M, Roucoux DF, Hoppin JA, Sandler DP, Langston JW, Tanner CM. Head injury, alpha-synuclein Rep1 and Parkinson's disease. Annals of neurology 2012 71(1):40-8. [Abstract ( ]
  27. Starks SE, Hoppin JA, Kamel F, Lynch CF, Jones MP, Alavanja MC, Sandler DP, Gerr F. Peripheral Nervous System Function and Organophosphate Pesticide Use among Licensed Pesticide Applicators in the Agricultural Health Study. Environmental health perspectives. 120(4):515-20, 2012. [Abstract ( ]
  28. Kamel F, Umbach DM, Bedlack RS, Richards M, Watson M, Alavanja MC, Blair A, Hoppin JA, Schmidt S, Sandler DP. Pesticide exposure and amyotrophic lateral sclerosis. Neurotoxicology 33(3):457-62, 2012. [Abstract ( ]
  29. Hoppin JA, Long S, Umbach DM, Lubin JH, Starks SE, Gerr F, Thomas K, Hines CJ, Weichenthal S, Kamel F, Koutros S, Alavanja M, Beane Freeman LE, Sandler DP. Lifetime organophosphorous insecticide use among private pesticide applicators in the Agricultural Health Study. Journal of exposure science & environmental epidemiology  22(6):584-92, 2012. [Abstract ( ]
  30. Vegosen L, Davis MF, Silbergeld E, Breysse PN, Agnew J, Gray G, Freeman LB, Kamel F. Neurologic symptoms associated with cattle farming in the Agricultural Health Study. Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 54(10):1253-8, 2012. [Abstract ( ]
  31. Goldman SM, Kamel F, Ross GW, Bhudhikanok GS, Hoppin JA, Korell M, Marras C, Meng C, Umbach DM, Kasten M, Chade AR, Comyns K, Richards MB, Sandler DP, Blair A, Langston JW, Tanner CM. Genetic modification of the association of paraquat and Parkinson's disease. Movement disorders 27(13):1652-8, 2012.  [Abstract ( ]
  32. Fang F, Umbach DM, Xu Z, Ye W, Sandler DP, Taylor JA, Kamel F. No association between DNA repair gene XRCC1 and amyotrophic lateral sclerosis. Neurobiology of aging 33(5):1015.e25-1015.e26, 2012.  [Abstract ( ]
  33. Waggoner JK, Henneberger PK, Kullman GJ, Umbach DM, Kamel F, Beane Freeman LE, Alavanja MC, Sandler DP, Hoppin JA. Pesticide use and fatal injury among farmers in the Agricultural Health Study. International archives of occupational and environmental health 86(2):177-187, 2013. [Abstract ( ]
  34. Pinkerton LE, Hein MJ, Meyers A, Kamel F. Assessment of ALS mortality in a cohort of formaldehyde-exposed garment. Amyotrophic lateral sclerosis: official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases 14(5-6):353-355, 2013.  [Abstract ( ]
  35. Beard JD, Hoppin JA, Richards M, Alavanja MC, Blair A, Sandler DP, Kamel F. Pesticide exposure and self-reported incident depression among wives in the Agricultural Health Study. Environmental research  126():31-42, 2013. [Abstract ( ]
  36. Kamel F, Goldman SM, Umbach DM, Chen H, Richardson G, Barber MR, Meng C, Marras C, Korell M, Kasten M, Hoppin JA, Comyns K, Chade A, Blair A, Bhudhikanok GS, Webster Ross G, William Langston J, Sandler DP, Tanner CM. Dietary fat intake, pesticide use, and Parkinson's disease. Parkinsonism & related disorders 20(1):82-87, 2014. [Abstract ( ]

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