Association of cumulative lead exposure with Parkinson's disease.
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.
Weisskopf
Marc G
MG
Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02215, USA. mweissko@hsph.harvard.edu
Weuve
Jennifer
J
Nie
Huiling
H
Saint-Hilaire
Marie-Helene
MH
Sudarsky
Lewis
L
Simon
David K
DK
Hersh
Bonnie
B
Schwartz
Joel
J
Wright
Robert O
RO
Hu
Howard
H
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
D015415:Biomarkers; D004785:Environmental Pollutants; D007854:Lead
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