Occupation and risk of parkinsonism: a multicenter case-control study.

Abstract

BACKGROUND:

We examined risk of parkinsonism in occupations (agriculture, education, health care, welding, and mining) and toxicant exposures (solvents and pesticides) putatively associated with parkinsonism.

OBJECTIVE:

To investigate occupations, specific job tasks, or exposures and risk of parkinsonism and clinical subtypes.

DESIGN:

Case-control.

SETTING:

Eight movement disorders centers in North America.

PARTICIPANTS:

Inclusion criteria were parkinsonism (>or=2 cardinal signs), diagnosis within 8 years of recruitment (to minimize survival bias), and ability to participate in detailed telephone interviews. Control subjects were primarily nonblood relatives or acquaintances of patients.

MAIN OUTCOME MEASURES:

This multicenter case-control study compared lifelong occupational and job task histories to determine associations with parkinsonism and certain clinical subtypes (postural instability and gait difficulty and age at diagnosis <or=50 years).

RESULTS:

Findings in 519 cases and 511 controls were analyzed. Work in agriculture, education, health care, or welding was not associated with increased risk of parkinsonism. Unexpected increased risks associated with legal, construction and extraction, or religious occupations were not maintained after adjustment for duration. Risk of parkinsonism increased with pesticide use (odds ratio, 1.90; 95% confidence interval, 1.12-3.21), use of any of 8 pesticides mechanistically associated with experimental parkinsonism (2.20; 1.02-4.75), and use of 2,4-dichlorophenoxyacetic acid (2.59; 1.03-6.48). None of the specific occupations, job tasks, or task-related exposures were associated with younger age at diagnosis (<or=50 years). Ever working in business and finance, legal occupations, construction and extraction, or transportation and material moving was associated with postural instability and gait difficulty subtype of parkinsonism. Tobacco use was inversely associated with parkinsonism risk.

CONCLUSION:

The association of disease risk with pesticides support a toxicant-induced cause of parkinsonism.

• Authors: Caroline M Tanner, G Webster Ross, Sarah A Jewell, Robert A Hauser, Joseph Jankovic, Stewart A Factor, Susan Bressman, Amanda Deligtisch, Connie Marras, Kelly E Lyons, Grace S Bhudhikanok, Diana F Roucoux, Cheryl Meng, Robert D Abbott, J William Langston
• Journal: Archives of neurology (Arch Neurol) Vol. 66 Issue 9 Pg. 1106-13 (Sep 2009) ISSN: 1538-3687 [Electronic] United States
• PMID: 19752299 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Neurotoxins
• Pesticides
• Solvents
• 2,4-Dichlorophenoxyacetic Acid

Topics

• 2,4-Dichlorophenoxyacetic Acid (adverse effects)
• Adult
• Age Distribution
• Age Factors
• Aged
• Aged, 80 and over
• Case-Control Studies
• Dyskinesia, Drug-Induced (epidemiology, physiopathology)
• Female
• Gait Disorders, Neurologic (chemically induced, epidemiology, physiopathology)
• Humans
• Male
• Middle Aged
• Neurotoxins (adverse effects, classification)
• Occupational Diseases (epidemiology)
• Occupational Exposure (statistics & numerical data)
• Parkinson Disease (epidemiology)
• Pesticides (adverse effects)
• Risk Factors
• Solvents (adverse effects)