School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Am J Epidemiol. 2012 Aug 15;176(4):299-307. doi: 10.1093/aje/kws017. Epub 2012 Jul 12.
Mechanical stress producing head injury is associated with Parkinson's disease, suggesting that relations with other physical hazards such as whole-body vibration (WBV) should be tested. In this study, the authors evaluated the relation between occupational exposure to WBV and Parkinson's disease. A population-based case-control study with 403 cases and 405 controls was conducted in British Columbia, Canada, between 2001 and 2008. From detailed occupational histories and published measurements, metrics of occupational WBV exposure were constructed and tested for associations with Parkinson's disease using logistic regression and adjusting for age and sex first, and then also for smoking and history of head injury. While ever being occupationally exposed to WBV was inversely associated with Parkinson's disease (odds ratio = 0.67, 95% confidence interval: 0.48, 0.94), higher intensities had consistently elevated odds ratios, with a statistically significant effect being noted for intermediate intensities when exposures were restricted to the 10 years or more prior to diagnosis. Possible mechanisms of an inverse relation between low levels of WBV exposure and Parkinson's disease could include direct protective effects or correlation with other protective effects such as exercise. Higher intensities of WBV could result in micro-injury, leading to vascular or inflammatory pathology in susceptible neurons.
机械性头部外伤与帕金森病有关,这表明与其他物理危害(如全身振动(WBV))的关系应加以检验。在这项研究中,作者评估了职业性接触 WBV 与帕金森病之间的关系。2001 年至 2008 年期间,在加拿大不列颠哥伦比亚省进行了一项基于人群的病例对照研究,共纳入 403 例病例和 405 例对照。根据详细的职业史和已发表的测量结果,构建了职业性 WBV 暴露的指标,并使用逻辑回归对其与帕金森病的关系进行了检验,首先调整了年龄和性别,然后还调整了吸烟和头部外伤史。虽然职业性接触 WBV 与帕金森病呈负相关(比值比=0.67,95%置信区间:0.48,0.94),但较高的强度始终具有较高的比值比,当将暴露限制在诊断前 10 年或更长时间时,中等强度的暴露具有统计学意义。低水平 WBV 暴露与帕金森病之间呈负相关的可能机制可能包括直接保护作用或与其他保护作用(如运动)的相关性。较高强度的 WBV 可能导致微损伤,导致易感神经元的血管或炎症病理学。