Priyadarshi A, Khuder S A, Schaub E A, Priyadarshi S S
Department of Public Health, Medical College of Ohio, Toledo, Ohio 43614-5809, USA.
Environ Res. 2001 Jun;86(2):122-7. doi: 10.1006/enrs.2001.4264.
The study aim was to examine the association between Parkinson's disease (PD) and exposure to environmental factors such as living in a rural area, well water use, farming, exposure to farm animals, or living on a farm, and pesticides. A series of metaanalyses of peer-reviewed studies were performed, using 16 studies for living in rural area, 18 studies for well water drinking, 11 studies for farming, and 14 studies for pesticides. Prior to the metaanalyses, all studies were reviewed and evaluated for heterogeneity and publication bias. Significant heterogeneity among studies was detected and combined odds ratio (OR) was calculated using the random and the fixed-effect models. The majority of the studies reported consistent elevation in the risk of PD with exposure to environmental factors such as rural living and farming. The combined OR for rural residence was 1.56 [95% confidence interval (95% CI) 1.18-2.07] for all the studies, and 2.17(95% CI 1.54-3.06) for studies performed in United States. The combined OR for well water use was 1.26 (95% CI 0.97-1.64) for all the studies, and 1.44(95% CI 0.92-2.24) for studies done in United States. The combined OR for farming, exposure to farm animals, or living on a farm was 1.42 (95% CI 1.05-1.91) for all studies, and 1.72(95% CI 1.20-2.46) for studies done in United States. The combined OR for pesticides exposure was 1.85(95% CI 1.31-2.60) for all studies, and 2.16(95% CI 1.95-2.39) for studies done in United States. Dose-response relationships could not be established due to the imprecise nature of the reported data. Our findings suggest that living in a rural area, drinking well water, farming, and exposure to pesticides may be a risk factor for developing PD.
该研究的目的是检验帕金森病(PD)与环境因素暴露之间的关联,这些环境因素包括生活在农村地区、使用井水、务农、接触农场动物或生活在农场以及接触杀虫剂。我们对同行评审的研究进行了一系列荟萃分析,其中关于生活在农村地区的研究有16项,关于饮用井水的研究有18项,关于务农的研究有11项,关于杀虫剂的研究有14项。在进行荟萃分析之前,对所有研究进行了审查,并评估了异质性和发表偏倚。检测到研究之间存在显著异质性,并使用随机效应模型和固定效应模型计算合并比值比(OR)。大多数研究报告称,接触农村生活和务农等环境因素会使患帕金森病的风险持续升高。所有研究中,农村居住的合并OR为1.56[95%置信区间(95%CI)1.18 - 2.07],在美国进行的研究中为2.17(95%CI 1.54 - 3.06)。所有研究中,使用井水的合并OR为1.26(95%CI 0.97 - 1.64),在美国进行的研究中为1.44(95%CI 0.92 - 2.24)。所有研究中,务农、接触农场动物或生活在农场的合并OR为1.42(95%CI 1.05 - 1.91),在美国进行的研究中为1.72(95%CI 1.20 - 2.46)。所有研究中,接触杀虫剂的合并OR为1.85(95%CI 1.31 - 2.60),在美国进行的研究中为2.16(95%CI 1.95 - 2.39)。由于报告数据的不精确性,无法建立剂量反应关系。我们的研究结果表明,生活在农村地区、饮用井水、务农和接触杀虫剂可能是患帕金森病的危险因素。