Abstract
Objective: To determine the relative contribution of various risk factors to the development
of Parkinson's disease (PD). Methods: Ten variables that were independently associated with PD in a health system population-based
case-control study of epidemiological risk factors for the disease were jointly assessed.
Stepwise logistic regression, adjusted for sex, race and age was used to develop a
multiple variate model that best predicted the presence of PD. The population attributable
risk was estimated for each variable in the final model, as well as for all factors
together. Results: The 10 initial variables included >20 years occupational exposure to manganese or
to copper, individually; >20 years joint occupational exposure to either lead and
copper, copper and iron, or lead and iron; a positive family history of PD in first-
or second-degree relatives; occupational exposure to insecticides or herbicides; occupational
exposure to farming; and smoking. Logistic regression resulted in a final model that
included >20 years joint occupational exposure to lead and copper (p=0.009; population attributable risk [PAR]=3.9%), occupational exposure to insecticides
(p=0.002; PAR=8.1%), a positive family history of PD in first- and second-degree relatives
(p=0.001; PAR=12.4%), and smoking ≤30 pack-years or not smoking (p=0.005; PAR=41.4%). All four variables combined had a PAR=54.1%. Conclusions: Our final model of PD risk suggests that occupational, environmental lifestyle and,
likely, genetic factors, individually and collectively, play a significant role in
the etiology of the disease. Clearly, additional risk factors remain to be determined
through future research.
Keywords
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Article info
Publication history
Accepted:
September 24,
2003
Received in revised form:
August 26,
2003
Received:
January 27,
2003
Identification
Copyright
© 2003 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
