title: Risk of Parkinson disease after organophosphate or carbamate poisoning.
abstract: OBJECTIVE
  Parkinson disease (PD) is a common neurodegenerative disease. The aim of this study was to evaluate the risk of PD in patients with organophosphate (OP) or carbamate (CM) poisoning by using the Taiwan National Health Insurance Research Database.
  
  
  METHODS
  We conducted a retrospective study involving a cohort of 45 594 patients (9128 patients with a history of OP or CM poisoning and 36 466 control patients) who were selected from the Taiwan National Health Insurance Research Database. The patients were observed for a maximum of 12 years to determine the rates of new-onset PD, and a Poisson regression model was used to identify the predictors of PD. The cumulative incidence of PD between the two cohorts was plotted through Kaplan-Meier analysis.
  
  
  RESULTS
  During the study period, the incidence rate ratio (IRR) of PD in the OP or CM poisoning patients was 1.36-fold [95% confidence interval (CI)=1.26-1.47] higher than that in the control patients in the multivariable model. The absolute incidence of PD was the highest for the group aged ≥75 years in both cohorts (77.4 vs 43.7 per 10 000 person-years). However, the age-specific relative risk was higher for the group aged <50 years (adjusted IRR=3.88; 95% CI=3.44-4.39).
  
  
  CONCLUSIONS
  Our results suggest that the likelihood of developing PD is greater in patients with OP or CM poisoning than in those without poisoning. OP or CM poisoning may be an independent risk factor for PD.
authors: Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.|Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan.
authors: C-S
authors: CS
authors: Chuang
authors: Department of Life Sciences, National Chung-Hsing University, Taichung, Taiwan.
authors: H-L
authors: HL
authors: Su
authors: College of Medicine, China Medical University, Taichung, Taiwan.|Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors: C-L
authors: CL
authors: Lin
authors: Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.|Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.|Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.
authors: C-H
authors: CH
authors: Kao
mesh_terms: D000328:Adult; D000368:Aged; D002219:Carbamates / Q000506:poisoning*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062025:Organophosphate Poisoning / Q000175:diagnosis* / Q000453:epidemiology*; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
chemical_list: D002219:Carbamates
keywords: National Health Insurance Research Database; Parkinson disease; carbamate; organophosphate