职业性接触锰、铜、铅、铁、汞和锌与帕金森病风险

Occupational exposure to manganese, copper, lead, iron, mercury and zinc and the risk of Parkinson's disease.

作者信息

Gorell J M, Johnson C C, Rybicki B A, Peterson E L, Kortsha G X, Brown G G, Richardson R J

机构信息

Department of Neurology, Henry Ford Health System, Detroit, Michigan 48202, USA.

出版信息

Neurotoxicology. 1999 Apr-Jun;20(2-3):239-47.

DOI:
Abstract

A population-based case-control study was conducted in the Henry Ford Health System (HFHS) in metropolitan Detroit to assess occupational exposures to manganese, copper, lead, iron, mercury and zinc as risk factors for Parkinson's disease (PD). Non-demented men and women 50 years of age who were receiving primary medical care at HFHS were recruited, and concurrently enrolled cases (n = 144) and controls (n = 464) were frequency-matched for sex, race and age (+/- 5 years). A risk factor questionnaire, administered by trained interviewers, inquired about every job held by each subject for 6 months from age 18 onward, including a detailed assessment of actual job tasks, tools and environment. An experienced industrial hygienist, blinded to subjects' case-control status, used these data to rate every job as exposed or not exposed to one or more of the metals of interest. Adjusting for sex, race, age and smoking status, 20 years of occupational exposure to any metal was not associated with PD. However, more than 20 years exposure to manganese (Odds Ratio [OR] = 10.61, 95% Confidence Interval [CI] = 1.06, 105.83) or copper (OR = 2.49, 95% CI = 1.06,5.89) was associated with PD. Occupational exposure for > 20 years to combinations of lead-copper (OR = 5.24, 95% CI = 1.59, 17.21), lead-iron (OR = 2.83, 95% CI = 1.07,7.50), and iron-copper (OR = 3.69, 95% CI = 1.40,9.71) was also associated with the disease. No association of occupational exposure to iron, mercury or zinc with PD was found. A lack of statistical power precluded analyses of metal combinations for those with a low prevalence of exposure (i.e., manganese, mercury and zinc). Our findings suggest that chronic occupational exposure to manganese or copper, individually, or to dual combinations of lead, iron and copper, is associated with PD.

摘要

在底特律都会区的亨利·福特健康系统(HFHS)开展了一项基于人群的病例对照研究,以评估职业性接触锰、铜、铅、铁、汞和锌作为帕金森病(PD)风险因素的情况。招募了在HFHS接受初级医疗护理的50岁非痴呆男性和女性,同时纳入的病例(n = 144)和对照(n = 464)按性别、种族和年龄(±5岁)进行频率匹配。由经过培训的访谈员管理的风险因素问卷询问了每位受试者从18岁起从事6个月以上的每份工作,包括对实际工作任务、工具和环境的详细评估。一位经验丰富的工业卫生学家在不知道受试者病例对照状态的情况下,利用这些数据将每份工作评定为接触或未接触一种或多种感兴趣的金属。在对性别、种族、年龄和吸烟状况进行调整后,20年的任何金属职业接触与PD均无关联。然而,超过20年的锰接触(比值比[OR] = 10.61,95%置信区间[CI] = 1.06,105.83)或铜接触(OR = 2.49,95% CI = 1.06,5.89)与PD相关。超过20年的铅 - 铜组合(OR = 5.24,95% CI = 1.59,17.21)、铅 - 铁组合(OR = 2.83,95% CI = 1.07,7.50)和铁 - 铜组合(OR = 3.69,95% CI = 1.40,9.71)的职业接触也与该疾病相关。未发现职业性接触铁、汞或锌与PD有关联。由于缺乏统计学效力,无法对接触患病率较低的金属(即锰、汞和锌)的组合进行分析。我们的研究结果表明,长期职业性接触锰或铜,单独接触或铅、铁和铜的双重组合接触,均与PD有关。

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