Department of Environmental and Occupational Health, Drexel University, Philadelphia, Pennsylvania.
Department of Family Medicine and Public Health, University of California, San Diego, California.
Am J Ind Med. 2019 Sep;62(9):766-776. doi: 10.1002/ajim.23022. Epub 2019 Jul 22.
There is a lack of consistent study findings on associations between workplace exposures and the risk of Parkinson disease (PD) and a paucity of such data on women. We assessed PD risk among occupational groups to derive insights about potential occupation-specific exposures in a large cohort of women.
The Women's Health Initiative Observational Study (WHI-OS) is a prospective cohort that enrolled 91 627 postmenopausal women, 50 to 79 years of age, from 01 October 1993 through 31 December 1998, at 40 clinical centers across the United States, with average follow-up interval of 11 years. These women reported up to three paid jobs, held the longest since age 18; these jobs were coded and duration of employment calculated. We defined a case by self-report of doctor-diagnosed PD (at baseline or follow-up), death attributed to PD, or taking medication consistent with PD.
Among 2590 PD cases, we found evidence of excess risk among "counselors, social workers, and other community and social service specialists," and there was a suggestion of increased in risk among postsecondary teachers, and "building and grounds cleaning and maintenance" workers. There was also evidence of a deficit in risk among women who worked in sales. Results according to ever-employed and job duration were similar, except for evidence of excess risk among "health technologists and technicians" with more than 20 years of employment. Longer duration of life on a farm was associated with higher risk.
Our findings paint a largely reassuring picture of occupational risks for PD among US women.
目前缺乏关于工作场所暴露与帕金森病（PD）风险之间关联的一致性研究结果，并且针对女性的数据也很少。我们评估了职业群体中的 PD 风险，以期深入了解在这一大规模女性队列中潜在的特定职业暴露。
妇女健康倡议观察研究（WHI-OS）是一项前瞻性队列研究，于 1993 年 10 月 1 日至 1998 年 12 月 31 日期间在美国 40 个临床中心招募了 91627 名绝经后女性，年龄在 50 至 79 岁之间，平均随访时间为 11 年。这些女性报告了最多三份有报酬的工作，从 18 岁开始从事最长的工作；这些工作被编码，并计算了就业时间。我们通过自我报告的医生诊断的 PD（在基线或随访时）、归因于 PD 的死亡或服用与 PD 一致的药物来定义病例。
在 2590 例 PD 病例中，我们发现“顾问、社会工作者和其他社区和社会服务专家”的风险过高，并且在中学后教师和“建筑和场地清洁和维护”工人中存在风险增加的迹象。销售工作的女性风险也有降低的迹象。根据是否一直有工作和工作时间的结果相似，除了从事超过 20 年工作的“卫生技术人员和技师”风险过高的证据外。在农场的生活时间越长，风险越高。
我们的研究结果表明，美国女性患 PD 的职业风险总体上是令人安心的。
