Nielsen Susan Searles, Warden Mark N, Sallmén Markku, Sainio Markku, Uuksulainen Sanni, Checkoway Harvey, Hublin Christer, Racette Brad A
Washington University School of Medicine in St. Louis, Department of Neurology, 660 S. Euclid Avenue, St. Louis, MO 63110, USA.
Finnish Institute of Occupational Health, PO Box 18, FI-00032 Tyoterveyslaitos, Arinatie 3 A, 00370 Helsinki, Finland.
Clin Park Relat Disord. 2021 Apr 20;4:100092. doi: 10.1016/j.prdoa.2021.100092. eCollection 2021.
Epidemiologic and toxicology studies suggest that exposure to various solvents, especially chlorinated hydrocarbon solvents, might increase Parkinson disease (PD) risk.
In a population-based case-control study in Finland, we examined whether occupations with potential for solvent exposures were associated with PD. We identified newly diagnosed cases age 45-84 from a nationwide medication reimbursement register in 1995-2014. From the population register, we randomly selected non-PD controls matched on sex, along with birth and diagnosis years (age). We included 11,757 cases and 23,236 controls with an occupation in the 1990 census, corresponding to age 40-60. We focused on 28 occupations with ≥ 5% probability of solvent exposure according to the Finnish Job Exposure Matrix. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) by logistic regression modeling, adjusting for age, sex, socioeconomic status, and smoking probability.
Similar proportions of cases (5.5%) and controls (5.6%) had an occupation with potential exposure to any solvents. However, all occupations with a point estimate above one, and all significantly or marginally significantly associated with PD (electronic/telecommunications worker [OR = 1.63, 95% CI 1.05-2.50], laboratory assistant [OR = 1.40, 95% CI 0.98-1.99], and machine/engine mechanic [OR = 1.23, 95% CI 0.99-1.52]) entailed potential for exposure to chlorinated hydrocarbon solvents, specifically. Secondary analyses indicated exposure to polycyclic aromatic hydrocarbons and some metals might contribute to the association for mechanics.
PD risk might be slightly increased in occupations with potential exposure to chlorinated hydrocarbon solvents. Confirmation is required in additional studies that adjust for other occupational exposures and smoking.
流行病学和毒理学研究表明，接触各种溶剂，尤其是氯代烃溶剂，可能会增加患帕金森病（PD）的风险。
在芬兰一项基于人群的病例对照研究中，我们调查了有可能接触溶剂的职业是否与帕金森病有关。我们从1995年至2014年全国药物报销登记册中确定了45至84岁新诊断的病例。从人口登记册中，我们随机选择了按性别以及出生和诊断年份（年龄）匹配的非帕金森病对照。我们纳入了1990年人口普查中有职业记录的11,757例病例和23,236例对照，年龄对应40至60岁。根据芬兰工作接触矩阵，我们重点关注了28种溶剂接触概率≥5%的职业。我们通过逻辑回归模型估计比值比（OR）和95%置信区间（CI），并对年龄、性别、社会经济地位和吸烟概率进行了调整。
病例（5.5%）和对照（5.6%）中具有接触任何溶剂潜在可能性的职业比例相似。然而，所有点估计值高于1且与帕金森病显著或边缘显著相关的职业（电子/电信工人[OR = 1.63，95% CI 1.05 - 2.50]、实验室助理[OR = 1.40，95% CI 0.98 - 1.99]以及机器/发动机机械师[OR = 1.23，95% CI 0.99 - 1.52]）特别涉及接触氯代烃溶剂的可能性。二次分析表明，接触多环芳烃和某些金属可能导致机械师与帕金森病之间的关联。
有可能接触氯代烃溶剂的职业中，帕金森病风险可能会略有增加。需要在针对其他职业接触和吸烟进行调整的更多研究中加以证实。
