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Association of Parkinson’s disease with industry sectors: a French nationwide incidence study

  • NEURO-EPIDEMIOLOGY
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Abstract

In order to identify working environments at risk for Parkinson’s disease (PD), we investigated the relation between the importance of industry sectors, used as a surrogate for occupational exposures, and PD incidence in French cantons. The number of incident PD cases (2010–2014) in 3689 cantons of metropolitan France was determined using drug claims from French National Health Insurance databases. The proportions of workers in 38 industry sectors in 2006 were calculated for each canton. Associations between the proportions of workers in industry sectors and PD age/sex-standardized incidence ratios were examined using incidence rate ratios (IRR) and 95% confidence intervals (CI) estimated with multilevel negative binomial regressions with a random intercept at the canton-level and adjusted for smoking, deprivation index, and density of neurologists. We then used two-step semi-Bayes hierarchical regression (HR) to include prior information about exposure to pesticides, metals, and solvents in each industry sector. We identified 112,625 incident cases. PD incidence was higher in areas characterized by high proportions of workers in “Agriculture, forestry and fishing” (IRRHR = 1.042; CI 95% = 1.014–1.070; p-TrendHR = 0.004), “Manufacture of textiles, wearing apparel, leather and related products” (IRRHR = 1.024; CI 95% = 1.005–1.044; p-TrendHR = 0.010), and “Manufacture of basic metals and fabricated metal products, except machinery and equipment” (IRRHR = 1.024; CI 95% = 1.003–1.046; p-TrendHR = 0.071). This nationwide study, based on a comprehensive analysis of industry sectors, shows significant associations between high proportions of workers in specific industry sectors (agriculture, metallurgy, textile) and PD incidence that may be targeted in further epidemiological studies to replicate and better understand these associations.

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Author contribution

TV participated in the design of the research, carried out the statistical analyses, interpreted the results, and wrote the first draft of the paper manuscript. FM participated in the design of the research, interpreted the results, and provided the estimations on the number of incident cases based on the SNIIRAM data. AE participated in the design of the research and interpreted the results. SK provided data on the adjustment variables. YS and NF provided data on occupational exposure in the industry sectors. All contributors reviewed the manuscript and provided valuable comments.

Funding

TV benefits from a doctoral grant delivered by the French Ministry of Higher Education and Research.

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Authors and Affiliations

  1. Santé publique France, 12 Rue du Val d’Osne, 94410, Saint-Maurice, France

    Tim Vlaar, Yannick Schwaab, Nadine Fréry, Alexis Elbaz & Frédéric Moisan

  2. Université Paris-Sud, UVSQ, CESP, INSERM, Université Paris-Saclay, Villejuif, France

    Tim Vlaar, Sofiane Kab & Alexis Elbaz

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  1. Tim Vlaar
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Correspondence to Frédéric Moisan.

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Vlaar, T., Kab, S., Schwaab, Y. et al. Association of Parkinson’s disease with industry sectors: a French nationwide incidence study. Eur J Epidemiol 33, 1101–1111 (2018). https://doi.org/10.1007/s10654-018-0399-3

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