Brouwer Maartje, Koeman Tom, van den Brandt Piet A, Kromhout Hans, Schouten Leo J, Peters Susan, Huss Anke, Vermeulen Roel
Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
Department of Epidemiology, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Occup Environ Med. 2015 Jun;72(6):448-55. doi: 10.1136/oemed-2014-102209. Epub 2015 Feb 23.
We investigated the association between six occupational exposures (ie, pesticides, solvents, metals, diesel motor emissions (DME), extremely low frequency magnetic fields (ELF-MF) and electric shocks) and Parkinson's disease (PD) mortality in a large population-based prospective cohort study.
The Netherlands Cohort Study on diet and cancer enrolled 58,279 men and 62,573 women aged 55-69 years in 1986. Participants were followed up for cause-specific mortality over 17.3 years, until December 2003, resulting in 402 male and 207 female PD deaths. Following a case-cohort design, a subcohort of 5,000 participants was randomly sampled from the complete cohort. Information on occupational history and potential confounders was collected at baseline. Job-exposure matrices were applied to assign occupational exposures. Associations with PD mortality were evaluated using Cox regression.
Among men, elevated HRs were observed for exposure to pesticides (eg, ever high exposed, HR 1.27, 95% CI 0.86 to 1.88) and ever high exposed to ELF-MF (HR 1.54, 95% CI 1.00 to 2.36). No association with exposure duration or trend in cumulative exposure was observed for any of the occupational exposures. Results among women were unstable due to small numbers of high-exposed women.
Associations with PD mortality were observed for occupational exposure to pesticides and ELF-MF. However, the weight given to these findings is limited by the absence of a monotonic trend with either duration or cumulative exposure. No associations were found between PD mortality and occupational exposure to solvents, metals, DME or electric shocks.
在一项基于人群的大型前瞻性队列研究中，我们调查了六种职业暴露（即农药、溶剂、金属、柴油发动机排放物（DME）、极低频磁场（ELF-MF）和电击）与帕金森病（PD）死亡率之间的关联。
1986年，荷兰饮食与癌症队列研究纳入了58279名男性和62573名年龄在55至69岁之间的女性。对参与者进行了17.3年的特定病因死亡率随访，直至2003年12月，导致402例男性和207例女性PD死亡。按照病例队列设计，从整个队列中随机抽取了5000名参与者作为一个子队列。在基线时收集了职业史和潜在混杂因素的信息。应用工作暴露矩阵来确定职业暴露。使用Cox回归评估与PD死亡率的关联。
在男性中，观察到接触农药（例如，曾经高暴露，风险比[HR] 1.27，95%置信区间[CI] 0.86至1.88）和曾经高暴露于ELF-MF（HR 1.54，95% CI 1.00至2.36）的HR升高。对于任何职业暴露，均未观察到与暴露持续时间或累积暴露趋势的关联。由于高暴露女性数量较少，女性的结果不稳定。
观察到职业接触农药和ELF-MF与PD死亡率存在关联。然而，由于在暴露持续时间或累积暴露方面缺乏单调趋势，这些发现的权重有限。未发现PD死亡率与职业接触溶剂、金属、DME或电击之间存在关联。
