title: Head injuries and Parkinson's disease in a case-control study.
abstract: BACKGROUND
  Head injury is a hypothesised risk factor for Parkinson's disease, but there is a knowledge gap concerning the potential effect of injury circumstances (eg, work-related injuries) on risk. The objective of this study is to address this gap while addressing issues of recall bias and potential for reverse causation by prediagnosis symptoms.
  
  
  METHODS
  We conducted a population based case-control study of Parkinson's disease in British Columbia, Canada (403 cases, 405 controls). Interviews queried injury history; whether injuries occurred at work, in a motor vehicle accident or during sports. Participants were also asked to report their suspicions about the causes of Parkinson's disease to provide an indicator of potential recall bias. Associations were estimated with logistic regression, adjusted for age, sex and smoking history.
  
  
  RESULTS
  Associations were strongest for injuries involving concussion (OR: 2.08, 95% CI 1.30 to 3.33) and unconsciousness (OR: 2.64, 95% CI 1.39 to 5.03). Effects remained for injuries that occurred long before diagnosis and after adjustment for suspicion of head injury as a cause of Parkinson's disease. Injuries that occurred at work were consistently associated with stronger ORs, although small numbers meant that estimates were not statistically significant.
  
  
  CONCLUSIONS
  This study adds to the body of literature suggesting a link between head injury and Parkinson's disease and indicates further scrutiny of workplace incurred head injuries is warranted.
authors.affiliation: School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada.
authors.forename: M Anne
authors.initials: MA
authors.lastname: Harris
authors.forename: Hui
authors.initials: H
authors.lastname: Shen
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Marion
authors.forename: Joseph K C
authors.initials: JK
authors.lastname: Tsui
authors.forename: Kay
authors.initials: K
authors.lastname: Teschke
mesh_terms: D000328:Adult; D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D016022:Case-Control Studies; D006259:Craniocerebral Trauma / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors