title: Whole-body lifetime occupational lead exposure and risk of Parkinson's disease.
abstract: BACKGROUND
  Several epidemiologic studies have suggested an association between Parkinson's disease (PD) and exposure to heavy metals using subjective exposure measurements.
  
  
  OBJECTIVE
  We investigated the association between objective chronic occupational lead exposure and the risk of PD.
  
  
  METHODS
  We enrolled 121 PD patients and 414 age, sex, and race, frequency-matched controls in a case-control study. As an indicator of chronic Pb exposure, we measured concentrations of tibial and calcaneal bone Pb stores using 109Cadmium excited K-series X-ray fluorescence. As an indicator of recent exposure, we measured blood Pb concentration. We collected occupational data on participants from 18 years of age until the age at enrollment, and an industrial hygienist determined the duration and intensity of environmental Pb exposure. We employed physiologically based pharmacokinetic modeling to combine these data, and we estimated wholebody lifetime Pb exposures for each individual. Logistic regression analysis produced estimates of PD risk by quartile of lifetime Pb exposure.
  
  
  RESULTS
  Risk of PD was elevated by > 2-fold [odds ratio = 2.27 (95% confidence interval, 1.13-4.55); p = 0.021] for individuals in the highest quartile for lifetime lead exposure relative to the lowest quartile, adjusting for age, sex, race, smoking history, and coffee and alcohol consumption. The associated risk of PD for the second and third quartiles were elevated but not statistically significant at the alpha = 0.05 level.
  
  
  CONCLUSIONS
  These results provide an objective measure of chronic Pb exposure and confirm our earlier findings that occupational exposure to Pb is a risk factor for PD.
authors.affiliation: Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, MI 48202, USA. scoon1@hfhs.org
authors.forename: Steven
authors.initials: S
authors.lastname: Coon
authors.forename: Azadeh
authors.initials: A
authors.lastname: Stark
authors.forename: Edward
authors.initials: E
authors.lastname: Peterson
authors.forename: Aime
authors.initials: A
authors.lastname: Gloi
authors.forename: Gene
authors.initials: G
authors.lastname: Kortsha
authors.forename: Joel
authors.initials: J
authors.lastname: Pounds
authors.forename: David
authors.initials: D
authors.lastname: Chettle
authors.forename: Jay
authors.initials: J
authors.lastname: Gorell
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007854:Lead / Q000032:analysis* / Q000097:blood; D016015:Logistic Models; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis* / Q000706:statistics & numerical data; D010302:Parkinson Disease, Secondary / Q000139:chemically induced* / Q000453:epidemiology; D012307:Risk Factors; D017678:Sex Distribution
chemical_list: D007854:Lead