意大利艾米利亚-罗马涅地区帕金森病职业与环境危险因素的病例对照研究。
A case-control study of occupational and environmental risk factors for Parkinson's disease in the Emilia-Romagna region of Italy.
作者信息
Smargiassi A, Mutti A, De Rosa A, De Palma G, Negrotti A, Calzetti S
机构信息
Dept. of Clinical Medicine, Nephrology and Health Sciences, University of Parma, Italy.
出版信息
Neurotoxicology. 1998 Aug-Oct;19(4-5):709-12.
A questionnaire-based case-control study was carried out on 86 patients with neurologist-confirmed idiopathic Parkinson's disease (PD) and 86 controls similar in sex and age. The control group was recruited in outpatient specialist centers of the same University Hospital (glaucoma, psoriasis vulgaris, essential arterial hypertension and renal diseases). Exposure was defined as occupational or residential contact with a given factor for at least 10 consecutive years prior to the onset of PD. Smoking habits were defined by exclusion of those subjects who never smoked. The following risk factors were identified: cranial trauma (OR: 2.88; 95% CI: 0.98-8.49), well water use (OR: 2.78; 95% CI: 1.46-5.28) and occupational exposure to industrial chemicals (OR: 2.13; 95% CI: 1.16-3.91). Among industrial chemicals, only organic solvents were identified as significant risk factors for PD (O.R. : 2.78, 95% C.I. : 1.23-6.26). Whereas no exposure to neurotoxic metals occurred among controls, making the assessment of the O.R. impossible, exposure pesticides and herbicides was similar in the two groups (O.R. : 1.15; 95% C. : 0.56-2-36). Smoking habits was negatively associated with PD (OR: 0.41; 95% CI: 0.22-0.75), confirming the "protective" role of tobacco smoking suggested by many studies. As a whole, these results support the role of environmental factors in the etiology of PD.
对86例经神经科医生确诊的特发性帕金森病(PD)患者和86例年龄及性别匹配的对照者进行了一项基于问卷的病例对照研究。对照组在同一大学医院的门诊专科中心招募(青光眼、寻常型银屑病、原发性动脉高血压和肾病患者)。暴露定义为在帕金森病发病前连续至少10年与特定因素有职业或居住接触。吸烟习惯通过排除从不吸烟的受试者来定义。确定了以下危险因素:颅脑外伤(比值比:2.88;95%置信区间:0.98 - 8.49)、使用井水(比值比:2.78;95%置信区间:1.46 - 5.28)和职业接触工业化学品(比值比:2.13;95%置信区间:1.16 - 3.91)。在工业化学品中,仅有机溶剂被确定为帕金森病的显著危险因素(比值比:2.78,95%置信区间:1.23 - 6.26)。虽然对照组中未发生神经毒性金属暴露,使得无法评估比值比,但两组中农药和除草剂暴露情况相似(比值比:1.15;95%置信区间:0.56 - 2.36)。吸烟习惯与帕金森病呈负相关(比值比:0.41;95%置信区间:0.22 - 0.75),证实了许多研究表明的吸烟的“保护”作用。总体而言,这些结果支持环境因素在帕金森病病因学中的作用。