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Occupational exposure in parkinsonian disorders: a 43-year prospective cohort study in men.

ABSTRACT: Several occupations and occupational exposures have been investigated for associations with Parkinson's disease. Common findings are increased risk associated with pesticide exposure and no association between Parkinson's disease and welding.We explored the association between a broad range of possible occupational risk factors and Parkinson's disease as well as Parkinson's disease plus other forms of Parkinsonism (referred to as Parkinsonian disorders), using prospectively collected data in the population-based Swedish Twin Registry. A cohort of 14,169 Swedish men was followed for up to 43 years. We identified 234 Parkinsonian disorder cases including 204 Parkinson's disease cases with complete data. We assessed exposure to 14 chemical and biological compounds through a job exposure matrix. Hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, smoking, and education were used to estimate the relative risk of disease associated with exposure.Exposure to inorganic dust was associated with increased risk of Parkinson's disease and Parkinsonian disorders, HR 1.6 (95% CI 1.1-2.4) and 1.5 (1.0-2.2) respectively. There was no association between Parkinson's disease or Parkinsonian disorders and occupational exposure to pesticides, welding smoke, metal dust, wood dust, animal handling, stone and concrete dust, chrome and nickel dust, quartz dust, organic dust, oil, asbestos, organic solvents and irritating gas.Inorganic dust should be explored further as a potential risk factor for Parkinson's disease. Occupational exposure to pesticides and twelve other compounds explored in this study may not be associated with risk of Parkinson's disease in Swedish men.

SUBMITTER: Feldman AL

PROVIDER: S-EPMC3200471 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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Occupational exposure in parkinsonian disorders: a 43-year prospective cohort study in men.

Feldman Adina L AL Johansson Anna L V AL Nise Gun G Gatz Margaret M Pedersen Nancy L NL Wirdefeldt Karin K

Parkinsonism & related disorders 20110705 9

<h4>Background</h4>Several occupations and occupational exposures have been investigated for associations with Parkinson's disease. Common findings are increased risk associated with pesticide exposure and no association between Parkinson's disease and welding.<h4>Methods</h4>We explored the association between a broad range of possible occupational risk factors and Parkinson's disease as well as Parkinson's disease plus other forms of Parkinsonism (referred to as Parkinsonian disorders), using ...[more]

PMID: 21733735

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Project description:IntroductionAlthough fluoroscopically guided procedures involve a considerably high dose of radiation, few studies have investigated the effects of radiation on medical workers involved in interventional fluoroscopy procedures. Previous research remains in the early stages and has not reached a level comparable with other occupational studies thus far. Furthermore, the study of radiation workers provides an opportunity to estimate health risks at low doses and dose rates of ionising radiation. Therefore, the objectives of this study are (1) to initiate a prospective cohort study by conducting a baseline survey among medical radiation workers who involve interventional fluoroscopy procedures and (2) to assess the effect of occupational radiation exposure and on the overall health status through an in-depth cross-sectional study.Methods and analysisIntervention medical workers in Korea will be enrolled by using a self-administered questionnaire survey, and the survey data will be linked with radiation dosimetry data, National Health Insurance claims data, cancer registry and mortality data. After merging these data, the radiation organ dose, lifetime attributable risk due to cancer and the risk per unit dose will be estimated. For the cross-sectional study, approximately 100 intervention radiology department workers will be investigated for blood tests, clinical examinations such as ultrasonography (thyroid and carotid artery scan) and lens opacity, the validation of badge dose and biodosimetry.Ethics and disseminationThis study was reviewed and approved by the institutional review board of Korea University (KU-IRB-12-12-A-1). All participants will provide written informed consent prior to enrolment. The findings of the study will be disseminated through peer-reviewed scientific journals, conference presentations, and a report will be submitted to the relevant public health authorities in the Korea Centers for Disease Control and Prevention to help with the development of appropriate research and management policies.

Project description:BackgroundAntipsychotic drugs remain the mainstay of schizophrenia treatment; however, their effectiveness has been questioned, and it is not possible to predict the response to a specific antipsychotic drug in an individual patient. Thus, it is important to compare the effectiveness of the various antipsychotics and search for possible response predictors.AimTo investigate the effectiveness of antipsychotic drugs, we examined response trajectories and predictors for belonging to different trajectory groups.MethodsThe Bergen-Stavanger-Innsbruck-Trondheim (BeSt InTro) trial compared the effectiveness of three atypical antipsychotics-amisulpride, aripiprazole, and olanzapine-in a prospective, semirandomized, rater-blind, head-to-head design. Adult participants with a schizophrenia spectrum disorder diagnosis, according to international classification of diseases, Tenth Revision (ICD-10) F20-29, were included. Participants were followed for a period of 12 mo, with assessments at baseline; after one, three and six weeks; and after three, six, nine and 12 mo. A latent class mixed model was fitted to our data. The three-trajectory model based on the Positive and Negative Syndrome Scale (PANSS) total score reduction was found to have adequate fit, and the study drugs, as well as various demographic and clinical parameters, were tested as predictors for belonging to the different trajectory groups.ResultsOverall, 144 participants were included, and 41% completed the 12-mo study period. The largest trajectory group, consisting of 74% of participants, showed a PANSS total score reduction of 59% from baseline to 12 mo (Good response group). A trajectory group comprising 13% of participants had their PANSS total score reduced by 82.5% at 12 mo (Strong response group), while the last response trajectory group comprising 13% of the participants had a PANSS total score reduction of 13.6% (Slight response group). The largest part of the total reduction for the Good and Strong response groups occurred at six weeks of treatment, amounting to 45% and 48% reductions from baseline, respectively. The use of amisulpride predicted belonging to the Strong response group, while unemployment, depression, and negative psychotic symptoms at baseline increased the chance of belonging to the Slight response group, indicating a poor response to antipsychotic drug treatment.ConclusionMost of the participants (87%) had a good outcome after one year. Amisulpride users, more often than aripiprazole and olanzapine users, belonged to the response trajectory group with a strong response.

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Dataset Information

Occupational exposure in parkinsonian disorders: a 43-year prospective cohort study in men.

Publications

Occupational exposure in parkinsonian disorders: a 43-year prospective cohort study in men.

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