title: Occupational exposures and Parkinson's disease mortality in a prospective Dutch cohort.
abstract: OBJECTIVE
  We investigated the association between six occupational exposures (ie, pesticides, solvents, metals, diesel motor emissions (DME), extremely low frequency magnetic fields (ELF-MF) and electric shocks) and Parkinson's disease (PD) mortality in a large population-based prospective cohort study.
  
  
  METHODS
  The Netherlands Cohort Study on diet and cancer enrolled 58,279 men and 62,573 women aged 55-69 years in 1986. Participants were followed up for cause-specific mortality over 17.3 years, until December 2003, resulting in 402 male and 207 female PD deaths. Following a case-cohort design, a subcohort of 5,000 participants was randomly sampled from the complete cohort. Information on occupational history and potential confounders was collected at baseline. Job-exposure matrices were applied to assign occupational exposures. Associations with PD mortality were evaluated using Cox regression.
  
  
  RESULTS
  Among men, elevated HRs were observed for exposure to pesticides (eg, ever high exposed, HR 1.27, 95% CI 0.86 to 1.88) and ever high exposed to ELF-MF (HR 1.54, 95% CI 1.00 to 2.36). No association with exposure duration or trend in cumulative exposure was observed for any of the occupational exposures. Results among women were unstable due to small numbers of high-exposed women.
  
  
  CONCLUSIONS
  Associations with PD mortality were observed for occupational exposure to pesticides and ELF-MF. However, the weight given to these findings is limited by the absence of a monotonic trend with either duration or cumulative exposure. No associations were found between PD mortality and occupational exposure to solvents, metals, DME or electric shocks.
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Maartje
authors.initials: M
authors.lastname: Brouwer
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Koeman
authors.affiliation: Department of Epidemiology, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.affiliation: Department of Epidemiology, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schouten
authors.affiliation: Department of Occupational Respiratory Epidemiology, School of Population Health, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Peters
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Anke
authors.initials: A
authors.lastname: Huss
authors.affiliation: Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands Julius Centre for Public Health Sciences and Primary Care, Utrecht University Medical Centre, Utrecht, The Netherlands.
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
mesh_terms: D000368:Aged; D004560:Electricity / Q000009:adverse effects; D005260:Female; D006801:Humans; D060526:Magnetic Fields / Q000009:adverse effects; D008297:Male; D008670:Metals / Q000633:toxicity; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D010300:Parkinson Disease / Q000209:etiology / Q000401:mortality*; D010575:Pesticides / Q000633:toxicity; D011446:Prospective Studies; D012307:Risk Factors; D001335:Vehicle Emissions / Q000633:toxicity
chemical_list: D008670:Metals; D010575:Pesticides; D001335:Vehicle Emissions
keywords: Occupational exposure; Parkinson's Disease; Prospective cohort study