Département des Sciences Neurologiques, Centre Hospitalier Universitaire de Québec, Québec City, Québec, Canada.
Faculté de médecine, Université Laval, Québec City, Québec, Canada.
Can J Neurol Sci. 2019 Nov;46(6):711-716. doi: 10.1017/cjn.2019.248.
The age-at-onset (AAO) of Parkinson's disease (PD) is thought to be influenced by environmental factors and polygenic predispositions. Professional exposures to pesticides and toxic metals were shown to be associated with an earlier onset in small sample studies.
The aim of this study was to confirm the association between professional exposures to pesticides and toxic metals and the AAO of PD, on a larger cohort of patients, defined with a clinic-based ascertainment scheme.
We used an incident cohort of 290 patients recruited through three designated movement disorder clinics in the province of Quebec, Canada. Patients completed a detailed questionnaire regarding professional exposures to pesticides and toxic metals. We compared the AAO in patients without prior professional exposure (N = 170) and those with exposure to pesticides (N = 53) or toxic metals through welding (N = 30). We further subdivided patients exposed to pesticides according to the frequency and proximity of their contacts.
Patients with prior exposure to pesticides (AAO = 54.74 years) or toxic metals (54.27 years) had a significantly earlier AAO compared to the control group (59.26 years) (p = 0.003). In those exposed to pesticides, closer (p = 0.03) and more frequent (p = 0.02) contacts were negatively correlated with AAO.
Exposure to pesticides and toxic metals were both associated with an earlier onset of PD, an effect that was greater with higher levels of exposure, both in terms of frequency and proximity.
帕金森病(PD)的发病年龄(AAO)被认为受到环境因素和多基因易感性的影响。小样本研究表明,职业性接触农药和有毒金属与发病年龄提前有关。
本研究旨在通过基于临床的确定方案,在更大的患者队列中证实职业性接触农药和有毒金属与 PD 的 AAO 之间的关联。
我们使用了一个由 290 名患者组成的发病队列,这些患者是通过加拿大魁北克省的三个指定运动障碍诊所招募的。患者完成了一份关于职业性接触农药和有毒金属的详细问卷。我们比较了无职业性接触史(N=170)、接触农药(N=53)或通过焊接接触有毒金属(N=30)的患者的 AAO。我们进一步根据接触的频率和距离将接触农药的患者细分。
接触过农药(AAO=54.74 岁)或有毒金属(54.27 岁)的患者的 AAO 明显早于对照组(59.26 岁)(p=0.003)。在接触农药的患者中,更接近(p=0.03)和更频繁(p=0.02)的接触与 AAO 呈负相关。
接触农药和有毒金属均与 PD 的发病年龄提前有关,接触的频率和距离越高,这种影响越大。