title: Association of cumulative lead exposure with Parkinson's disease.
abstract: BACKGROUND
  Research using reconstructed exposure histories has suggested an association between heavy metal exposures, including lead, and Parkinson's disease (PD), but the only study that used bone lead, a biomarker of cumulative lead exposure, found a nonsignificant increase in risk of PD with increasing bone lead.
  
  
  OBJECTIVE
  We sought to assess the association between bone lead and PD.
  
  
  METHODS
  Bone lead concentrations were measured using 109Cd excited K-shell X-ray fluorescence from 330 PD patients (216 men, 114 women) and 308 controls (172 men, 136 women) recruited from four clinics for movement disorders and general-community cohorts. Adjusted odds ratios (ORs) for PD were calculated using logistic regression.
  
  
  RESULTS
  The average age of cases and controls at bone lead measurement was 67 (SD = 10) and 69 (SD = 9) years of age, respectively. In primary analyses of cases and controls recruited from the same groups, compared with the lowest quartile of tibia lead, the OR for PD in the highest quartile was 3.21 [95% confidence interval (CI), 1.17-8.83]. Results were similar but slightly weaker in analyses restricted to cases and controls recruited from the movement disorders clinics only (fourth-quartile OR = 2.57; 95% CI, 1.11-5.93) or when we included controls recruited from sites that did not also contribute cases (fourth-quartile OR = 1.91; 95% CI, 1.01-3.60). We found no association with patella bone lead.
  
  
  CONCLUSIONS
  These findings, using an objective biological marker of cumulative lead exposure among typical PD patients seen in our movement disorders clinics, strengthen the evidence that cumulative exposure to lead increases the risk of PD.
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02215, USA. mweissko@hsph.harvard.edu
authors.forename: Marc G
authors.initials: MG
authors.lastname: Weisskopf
authors.forename: Jennifer
authors.initials: J
authors.lastname: Weuve
authors.forename: Huiling
authors.initials: H
authors.lastname: Nie
authors.forename: Marie-Helene
authors.initials: MH
authors.lastname: Saint-Hilaire
authors.forename: Lewis
authors.initials: L
authors.lastname: Sudarsky
authors.forename: David K
authors.initials: DK
authors.lastname: Simon
authors.forename: Bonnie
authors.initials: B
authors.lastname: Hersh
authors.forename: Joel
authors.initials: J
authors.lastname: Schwartz
authors.forename: Robert O
authors.initials: RO
authors.lastname: Wright
authors.forename: Howard
authors.initials: H
authors.lastname: Hu
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D004781:Environmental Exposure / Q000032:analysis / Q000706:statistics & numerical data*; D004785:Environmental Pollutants / Q000378:metabolism*; D005260:Female; D006801:Humans; D007854:Lead / Q000378:metabolism*; D016015:Logistic Models; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D010300:Parkinson Disease / Q000453:epidemiology* / Q000378:metabolism; D010329:Patella / Q000378:metabolism; D013052:Spectrometry, X-Ray Emission; D013977:Tibia / Q000378:metabolism
chemical_list: D015415:Biomarkers; D004785:Environmental Pollutants; D007854:Lead
references.citation: Neurotoxicology. 1997;18(3):673-88
references.pmid: 9339816
references.citation: Gerontologist. 1966 Dec;6(4):179-84
references.pmid: 5342911
references.citation: JAMA. 1999 Jan 27;281(4):341-6
references.pmid: 9929087
references.citation: Toxicol Lett. 2001 Sep 15;123(2-3):217-26
references.pmid: 11641049
references.citation: Am J Epidemiol. 2009 Jan 1;169(1):1-8
references.pmid: 18845552
references.citation: Phys Med Biol. 1994 Dec;39(12):2263-71
references.pmid: 15551552
references.citation: Brain Res. 1981 Jun 1;213(2):397-404
references.pmid: 7248763
references.citation: Toxicology. 1979 Mar-Apr;12(3):343-9
references.pmid: 494315
references.citation: Curr Opin Neurol. 2008 Aug;21(4):454-60
references.pmid: 18607207
references.citation: Environ Health Perspect. 1998 Jan;106(1):1-8
references.pmid: 9417769
references.citation: Neurology. 1997 Mar;48(3):650-8
references.pmid: 9065542
references.citation: Toxicology. 1984 Oct;33(1):81-90
references.pmid: 6495347
references.citation: Parkinsonism Relat Disord. 2002 Jun;8(5):297-309
references.pmid: 15177059
references.citation: Neurotoxicology. 1992 Fall;13(3):625-35
references.pmid: 1361980
references.citation: Med Phys. 2000 Jan;27(1):119-23
references.pmid: 10659745
references.citation: Toxicol Appl Pharmacol. 1986 Jun 30;84(2):400-11
references.pmid: 3715885
references.citation: J Neural Transm Suppl. 1995;46:183-7
references.pmid: 8821054
references.citation: Annu Rev Psychol. 2009;60:549-76
references.pmid: 18652544
references.citation: Environ Health Perspect. 2006 Dec;114(12):1872-6
references.pmid: 17185278
references.citation: Ann Neurol. 2003;53 Suppl 3:S26-36; discussion S36-8
references.pmid: 12666096
references.citation: Mol Cell Biochem. 1997 Oct;175(1-2):137-41
references.pmid: 9350044
references.citation: Basic Life Sci. 1990;55:287-92
references.pmid: 2088281
references.citation: J Int Med Res. 2007 Jan-Feb;35(1):159-63
references.pmid: 17408069
references.citation: Arch Environ Health. 1990 Nov-Dec;45(6):335-41
references.pmid: 2270952
references.citation: Neuroepidemiology. 1995;14(2):72-81
references.pmid: 7891817
references.citation: J Neurol Neurosurg Psychiatry. 1992 Mar;55(3):181-4
references.pmid: 1564476
references.citation: Eur J Epidemiol. 2003;18(12):1133-42
references.pmid: 14758870
references.citation: Neurotoxicology. 2001 Apr;22(2):259-69
references.pmid: 11405257
references.citation: Epidemiology. 2007 Jan;18(1):59-66
references.pmid: 17130688
references.citation: Neurology. 1998 Jun;50(6):1885-6
references.pmid: 9633752
references.citation: Curr Top Med Chem. 2001 Dec;1(6):529-39
references.pmid: 11895129
references.citation: Am J Epidemiol. 1997 Oct 1;146(7):586-91
references.pmid: 9326437
references.citation: Ann Neurol. 2002 Sep;52(3):276-84
references.pmid: 12205639
references.citation: Parkinsonism Relat Disord. 2009 Jun;15(5):339-46
references.pmid: 19346153