Cheshire William P, Tipton Philip W, Koga Shunsuke, Sekiya Hiroaki, Uitti Ryan J, Ross Owen A, Heckman Michael G, Sledge Hanna J, Dickson Dennis W
Division of Autonomic Neurology, Department of Neurology, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL, 32224, USA.
Division of Movement Disorders, Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.
Clin Auton Res. 2025 Jan 23. doi: 10.1007/s10286-025-01109-9.
This study examined occupational histories in multiple system atrophy to identify environmental associations of potential relevance to disease causation.
A total of 270 neuropathologically confirmed cases of multiple system atrophy obtained from the Mayo Clinic Brain Bank for neurodegenerative disorders in Jacksonville, Florida, were included in this case-control study. Demographic and disease information was collected from medical records. Information regarding occupational history was collected retrospectively from medical records and published obituaries. Proportions of employment by occupational sector were compared with US census data.
When comparing patients with US census data, significant differences were identified for education (15.2% versus 2.3%, P < 0.001), administration (14.8% versus 4.1%, P < 0.001), clerical (10.7% versus 5.5%, P = 0.001), petroleum industry (8.9% versus 5.6%, P = 0.024), metal industry (7.8% versus 3.0%, P < 0.001), electrical engineers and electricians (5.6% versus 0.4%, P < 0.001), civil or mechanical engineering (4.4% versus 0.2%, P < 0.001), real estate (4.4% versus 0.7%, P < 0.001), information technology (4.1% versus 1.8%, P = 0.011), woodworking (3.0% versus 0.03%, P < 0.001), writing or publishing (2.6% versus 0.3%, P < 0.001), law (2.2% versus 0.4%, P = 0.001), hairdressing (0.7% versus 0.1%, P = 0.03), and social work (0.7% versus 0.1%, P = 0.03).
The listed occupational categories were significantly overrepresented in our series of patients with multiple system atrophy as compared with population data. We hypothesize that these occupational associations may signify environmental exposures, increasing the disease risk in genetically susceptible individuals. We cannot exclude a potential selection bias in patients willing to donate their brains to an academic center to contribute to scientific knowledge.
本研究调查了多系统萎缩患者的职业史，以确定与疾病病因可能相关的环境因素。
本病例对照研究纳入了从佛罗里达州杰克逊维尔市梅奥诊所神经退行性疾病脑库获取的270例经神经病理学确诊的多系统萎缩病例。从医疗记录中收集人口统计学和疾病信息。关于职业史的信息通过回顾医疗记录和已发表的讣告进行收集。将各职业部门的就业比例与美国人口普查数据进行比较。
将患者与美国人口普查数据进行比较时，发现教育（15.2%对2.3%，P<0.001）、行政（14.8%对4.1%，P<0.001）、文书工作（10.7%对5.5%，P=0.001）、石油行业（8.9%对5.6%，P=0.024）、金属行业（7.8%对3.0%，P<0.001）、电气工程师和电工（5.6%对0.4%，P<0.001）、土木或机械工程（4.4%对0.2%，P<0.001）、房地产（4.4%对0.7%，P<0.001）、信息技术（4.1%对1.8%，P=0.011）、木工（3.0%对0.03%，P<0.001）、写作或出版（2.6%对0.3%，P<0.001）、法律（2.2%对0.4%，P=0.001）、美发（0.7%对0.1%，P=0.03）和社会工作（0.7%对0.1%，P=0.03）存在显著差异。
与总体数据相比，在我们的多系统萎缩患者系列中，所列职业类别明显过多。我们推测这些职业关联可能意味着环境暴露，增加了遗传易感个体的疾病风险。我们不能排除愿意将大脑捐赠给学术中心以促进科学知识的患者中存在潜在的选择偏倚。
