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From the Departments of Neurology (Drs. Racette, Tabbal, and Perlmutter, L. Good), Anatomy and Neurobiology (Dr. Perlmutter), and Internal Medicine (Division of General Medical Sciences) (Dr. Evanoff), American Parkinson Disease Association Advanced Center for Parkinson Research (Drs. Racette, Tabbal, and Perlmutter, L. Good), Mallinckrodt Institute of Radiology (Dr. Perlmutter), and Program in Physical Therapy (Dr. Perlmutter), Washington University School of Medicine, St. Louis, MO, and Institute for Neurodegenerative Disease (Dr. Jennings), New Haven, CT.
Address correspondence and reprint requests to Dr. B.A. Racette, Washington University School of Medicine, 660 S. Euclid Ave., Box 8111, St. Louis, MO 63110; e-mail: racetteb{at}neuro.wustl.edu
Objective: To estimate the prevalence of parkinsonism in welders in Alabama and to compare this prevalence with that in a general population sample.
Methods: The authors screened 1,423 welders from Alabama who were referred for medical–legal evaluation for Parkinson disease (PD). Standardized videotaped assessments using the Unified Parkinson’s Disease Rating Scale motor subsection 3 (UPDRS3) were obtained. Patients provided information regarding exposure to welding fumes and job titles. Job titles were matched with Department of Labor Standard Occupational Codes (SOCs). Diagnoses were assigned based on quantitative criteria for the diagnosis of PD using two thresholds for diagnosis. With use of the number of active welders in this screening with parkinsonism as the numerator and the age-adjusted number of welders in each SOC as the denominator, the prevalence of parkinsonism in Alabama welders was estimated using conservative assumptions and compared with general population data from Copiah County, MS.
Results: With use of conservative and liberal case definitions of parkinsonism, the estimated prevalence of parkinsonism among active male welders age 40 to 69 statewide was 977 to 1,336 cases/100,000 population. The prevalence of parkinsonism was higher among welders vs age-standardized data for the general population (prevalence ratio = 10.19, 95% CI 4.43 to 23.43).
Conclusion: The estimated prevalence of parkinsonism was higher within a sample of male Alabama welders vs the general population of male residents of Copiah County, MS.
Supported by NIH grants K23NS43351 and NS41509, the Greater St. Louis Chapter of the American Parkinson’s Disease Association, and the Welder Health Fund.
The Welder Health Fund was created by Gulf States Trial Attorneys to support medical–legal screening of welders for Parkinson disease. No author has taken any money personally related to this research.
Received April 7, 2004. Accepted in final form September 30, 2004.
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