281 Occupations and Parkinson’s disease in a population-based case-control study
该研究在加拿大不列颠哥伦比亚省通过病例对照设计，分析了403例帕金森病患者和405例对照的职业史，发现社会科学、法律和图书馆职业以及农业和园艺职业与帕金森病风险显著升高相关。
<h3>Objectives</h3> Despite mounting evidence on epidemiological risk factors, Parkinson’s disease (PD) incidence remains largely unexplained. The purpose of this study was to test associations between occupations and PD to complement analyses of occupational exposures. <h3>Methods</h3> We used a population-based case-control design in British Columbia, Canada, including 403 cases (users of antiparkinsonian medication) and 405 controls (from the provincial health insurance register, frequency matched on age and sex). Job histories were collected using structured questionnaires querying all jobs held since age 16. Odds ratios were calculated for associations between PD and occupational categories using unconditional logistic regression, adjusting for age, sex, and smoking. <h3>Results</h3> Significantly elevated risks were found for social science, law and library jobs (OR 1.82; 95% CI 1.01 - 3.29); and farming and horticulture jobs (OR 2.03; 95% CI 1.10 - 3.74). Nonsignificantly elevated risks were found for gas station jobs (OR 2.55; 95% CI 0.84 - 7.72); welders (OR 2.98; 95% CI 0.78 - 11.40); and drivers of heavy equipment (OR 1.95; 95% CI 0.66 - 5.81). Reduced risks were found for management and administration jobs (OR 0.70; 95% CI 0.49 - 0.99); other health care jobs (OR 0.44; 95% CI 0.20 - 0.99); repairers (OR 0.49; 95% CI 0.22 - 1.09); and electricians (OR 0.46; 95% CI 0.17 - 1.26). <h3>Conclusions</h3> Increased risks for social science jobs could be related to numbers of people contacted in a day and risk of infections. Severe influenza was associated with increased risk of PD but number of people contacted was not. Elevated risks for farmers are typically attributed to pesticide exposure, however our pesticide analyses did not support this attribution. Other exposures of interest for farmers could include animal contact, influenza, head injuries, and vibration from heavy equipment, all associated with PD in our study.