Parkinson's Disease In Finland Research Articles

The Incidence and Outcomes of Head Injuries in People with and without Parkinson's Disease.

Fall-related injuries are a major health concern among people with Parkinson's disease (PD). We compared the incidence and post-injury mortality of head injuries and traumatic brain injury (TBI) among persons with and without PD. This register-based study was conducted on the FINPARK cohort which includes 22 189 persons who were diagnosed with PD in Finland 1996-2015. We excluded persons with a previous head injury, leaving 20 514 persons with PD. For each person with PD, 1-7 matching persons without PD and previous head injury were identified with respect to age, sex and residence. The Cox proportional hazard model was used to estimate hazard ratios for head injury. A logistic regression model was used to compare mortality. Persons with PD had 2.16-fold (95% CI 2.06-2.26) risk of all head injuries and 1.97-fold (95% CI 1.84-2.10) risk of TBI after adjustment for age, sex and comorbidities. Persons with PD had a higher one-year mortality after any type of head injury (adjusted odds ratio [aOR] 1.44 95% CI 1.28-1.62), TBI (aOR 1.33 95% CI 1.14-1.57) or non-TBI head injury (aOR 1.72 95% CI 1.42-2.07) than persons without PD. The higher risk of mortality was observed six months after TBI and one month after non-TBI injury in persons with PD. Persons with PD and head injury also had a higher one-year mortality than persons with PD and without head injury. Persons with PD have a higher risk of head injury and a higher post-injury mortality than persons without PD.

Solvent exposed occupations and risk of Parkinson disease in Finland

IntroductionEpidemiologic and toxicology studies suggest that exposure to various solvents, especially chlorinated hydrocarbon solvents, might increase Parkinson disease (PD) risk. MethodsIn a population-based case-control study in Finland, we examined whether occupations with potential for solvent exposures were associated with PD. We identified newly diagnosed cases age 45–84 from a nationwide medication reimbursement register in 1995–2014. From the population register, we randomly selected non-PD controls matched on sex, along with birth and diagnosis years (age). We included 11,757 cases and 23,236 controls with an occupation in the 1990 census, corresponding to age 40–60. We focused on 28 occupations with ≥ 5% probability of solvent exposure according to the Finnish Job Exposure Matrix. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) by logistic regression modeling, adjusting for age, sex, socioeconomic status, and smoking probability. ResultsSimilar proportions of cases (5.5%) and controls (5.6%) had an occupation with potential exposure to any solvents. However, all occupations with a point estimate above one, and all significantly or marginally significantly associated with PD (electronic/telecommunications worker [OR = 1.63, 95% CI 1.05–2.50], laboratory assistant [OR = 1.40, 95% CI 0.98–1.99], and machine/engine mechanic [OR = 1.23, 95% CI 0.99–1.52]) entailed potential for exposure to chlorinated hydrocarbon solvents, specifically. Secondary analyses indicated exposure to polycyclic aromatic hydrocarbons and some metals might contribute to the association for mechanics. ConclusionPD risk might be slightly increased in occupations with potential exposure to chlorinated hydrocarbon solvents. Confirmation is required in additional studies that adjust for other occupational exposures and smoking.

Antibiotic exposure and risk of Parkinson's disease in Finland: A nationwide case-control study.

Gut microbiota alterations have been found in prodromal and established Parkinson's disease (PD). Antibiotic exposure can have long-term effects on the composition of human intestinal microbiota, but a potential connection between antibiotic exposure and risk of PD has not been studied previously. To evaluate the impact of antibiotic exposure on the risk of PD in a nationwide, register-based, case-control study. We identified all patients who were diagnosed with PD in Finland during the years 1998 to 2014. Information was obtained on individual purchases of orally administered antibiotics during the years 1993 to 2014. We assessed the association between prior antibiotic exposure and PD using conditional logistic regression. The study population consisted of 13,976 PD cases and 40,697 controls. The strongest connection with PD risk was found for oral exposure to macrolides and lincosamides (adjusted odds ratio up to 1.416; 95% confidence interval, 1.053-1.904). After correction for multiple comparisons, exposure to antianaerobics and tetracyclines 10 to 15 years before the index date, sulfonamides and trimethoprim 1 to 5 years before the index date, and antifungal medications 1 to 5 years before the index date were positively associated with PD risk. In post hoc analyses, further positive associations were found for broad-spectrum antibiotics. Exposure to certain types of oral antibiotics seems to be associated with an elevated risk of PD with a delay that is consistent with the proposed duration of a prodromal period. The pattern of associations supports the hypothesis that effects on gut microbiota could link antibiotics to PD, but further studies are needed to confirm this. © 2019 International Parkinson and Movement Disorder Society.

Risk of Parkinson disease in agricultural occupations in Finland

Introduction Prior epidemiologic studies indicate that agricultural work and occupational exposure to pesticides may increase risk of Parkinson disease (PD). Findings may vary by country as well as by type and degree of agricultural exposures. We therefore studied whether work in agriculture, forestry, and fishing is related to the risk of PD in Finland. Methods We constructed a population-based case-control study of incident PD in Finland using a medication register maintained by the Social Insurance Institution of Finland, along with the Population Information System, which includes census records for all Finnish residents. PD cases were diagnosed (first approved to receive symptomatic therapy for PD) between 1995–2014. We randomly selected two controls per case from the general population while matching on diagnosis year, birth year (1930–1950), and sex. Individual occupational census data from 1990, allowing for a minimum of four years of exposure lagging, was used to define occupation. We included 36,398 economically active subjects (12,204 PD cases and 24,194 controls). We linked the data on occupation in 1990 to the Finnish Job Exposure Matrix (FINJEM) to identify potential for occupational exposure to pesticides and other FINJEM agents. We estimated matching variable adjusted odds ratios (ORs) and more fully adjusted odds ratios (aOR), and 95% confidence intervals (CIs) using logistic regression while respectively adjusting for matching variables only, or also for socioeconomic status and any environmental tobacco smoke at work (ETSW). Environmental tobacco smoke, including ETSW, appears to be inversely associated with PD, while socioeconomic status is likely associated with active tobacco smoking, which is well established as strongly inversely associated with PD. Results In total, 1797 PD cases (14.7%) and 3224 controls (13.3%) were working in agricultural occupations in 1990, suggesting a modestly increased risk of PD (OR 1.12; CI: 1.05–1.19 and aOR 1.13; CI: 1.03–1.24). The majority were farmers or doing any type of managerial work in agriculture (1529 PD cases, 2692 controls, aOR 1.17; CI: 1.05–1.30). We also observed a greater PD risk among workers in agriculture, horticulture and animal husbandry (147 PD cases, 260 controls, aOR 1.18; CI: 0.96–1.46). In contrast, there was no indication of a greater risk of PD in other agricultural occupational groups: aOR 0.67; CI: 0.37–1.19 for “fishermen/fish farmers” (15 PD cases, 48 controls) and aOR 0.98; CI: 0.77–1.24 for “forestry workers/lumberjacks” (106 PD cases, 224 controls). Exposure to insecticides, herbicides and fungicides were highly correlated with agricultural occupations, and yielded ORs relatively similar to the overall estimate for agricultural occupation. Conclusion We observed a modest positive association between agricultural occupations and PD in Finland. However, it is possible that this association at least in part is related to a known relatively low prevalence of active tobacco smoking among most agricultural workers in Finland outside of fishing and forestry as compared to the general population.