Betemps E J, Buncher C R
University of Cincinnati College of Nursing and Health, OH 45221.
Int J Epidemiol. 1993 Oct;22(5):898-904. doi: 10.1093/ije/22.5.898.
A proportional mortality study was conducted to determine if state of birth is a risk factor associated with motor neurone disease (MND) and Parkinson's disease (PD) using US death certificate information for 1981. State of birth was used as a surrogate variable for location of early childhood environment. A gradient of risk by geographical area in the US was found for MND and PD. Cerebral vascular accident (CVA) deaths served as a comparison group. Multiple sclerosis (MS) deaths were analysed to validate the methods used. A geographical relationship between latitude proportional mortality ratios for MND, PD and MS by state of birth, and a geographical relationship between latitude and proportional mortality ratios for MND and MS by state of birth were found. Statistical modelling was used to compare the deaths from MND, PD, MS, CVA to all other deaths in the US by state of birth. The resulting models were evaluated to determine if any individual states were not well represented by the model for each disease. As predicted, no pattern was evident for CVA. The geographical gradient observed for MS was as predicted by other studies. The geographical pattern found for MND has a northwest to southeast gradient and the pattern found for PD has a west to east gradient.
开展了一项比例死亡率研究，利用1981年美国死亡证明信息来确定出生州是否为与运动神经元病（MND）和帕金森病（PD）相关的风险因素。出生州被用作儿童早期环境所在地的替代变量。在美国发现了MND和PD按地理区域划分的风险梯度。脑血管意外（CVA）死亡用作对照组。对多发性硬化症（MS）死亡进行分析以验证所使用的方法。发现了按出生州划分的MND、PD和MS的纬度比例死亡率之间的地理关系，以及按出生州划分的MND和MS的纬度与比例死亡率之间的地理关系。使用统计模型按出生州比较美国MND、PD、MS、CVA与所有其他死亡情况。对所得模型进行评估，以确定每种疾病的模型是否未充分体现任何个别州的情况。正如所预测的，CVA没有明显模式。MS观察到的地理梯度与其他研究预测的一致。MND发现的地理模式呈西北向东南梯度，PD发现的模式呈西向东梯度。
