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Occupation and parkinsonism in three movement disorders clinics

From the University of California, San Francisco; The Parkinson's Institute, Sunnyvale, CA; Mt. Sinai School of Medicine, New York, NY; and University of Alabama School of Medicine, Birmingham.

Address correspondence and reprint requests to Dr. Samuel M. Goldman, The Parkinson's Institute, 1170 Morse Avenue, Sunnyvale, CA 94089; e-mail: sgoldman{at}thepi.org

Background: Few occupational risk factors for Parkinson disease (PD) have been identified. Healthcare, teaching, and farming have been associated with increased risk, while welding has been proposed to accelerate age at PD onset. The aim of the present study was to investigate occupational associations with PD or parkinsonism drawing from three different movement disorders clinics.

Methods: Medical records of 2,249 consecutive patients with PD or parkinsonism from specialty clinics in Sunnyvale, CA, New York, NY, and Atlanta, GA, were reviewed for primary lifetime occupation. Job frequencies were compared with Department of Labor regional statistics. PD diagnosis age and risk of diagnosis 50 were determined for each job.

Results: Physicians/dentists, farmers, and teachers were significantly more common than expected among PD patients, as were lawyers, scientists, and religion-related jobs. Computer programmers had a younger age at PD diagnosis, and risk of diagnosis 50 was greater in computer programmers and technicians.

Conclusions: Consistent with prior studies, healthcare, teaching, and farming were common occupations in Parkinson disease (PD) patients, but welders were not over-represented. Even though several occupations were associated with younger age at PD diagnosis, these results may reflect biases inherent in specialty clinic surveys, including over-representation of younger, employed, and insured patients. Carefully designed analytic studies utilizing appropriate control populations will be required to test hypotheses regarding occupation and PD risk.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the November 8 issue to find the title link for this article.

This article was previously published in electronic format as an Expedited E-Pub on September 14, 2005, at www.neurology.org.

Supported by an unrestricted grant from the welding industry legal defense fund, a group of current and former manufacturers of welding consumables.

Disclosure: S.M. Goldman, MD, MPH, has provided legal testimony on behalf of General Electric Corporation, and has received personal compensation in excess of $10,000. C.W. Olanow, MD, has provided legal testimony on behalf of welding consumable manufacturers, and has received personal compensation in excess of $10,000. C.M. Tanner, MD, PhD, R.L. Watts, MD, and J.W. Langston, MD, have received consulting honoraria from welding product manufacturers. The corporate sponsor had no role in the design or conduct of the study, or in the collection, management, analysis, or interpretation of the data presented in this manuscript. The corporate sponsor had no role in the preparation, review, or approval of the manuscript.

Received December 16, 2004. Accepted in final form July 25, 2005.

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