Risk of Parkinson Disease Associated with Solvent Exposures in Finland

描述（由申请人提供）：帕金森病（PD）是一种老年人常见病，具有较高的发病率和早期死亡率。PD的病因在很大程度上是未知的，但最近在小群体中的研究表明职业暴露于神经毒性溶剂。在更大的研究中证明两者之间的关系将提供减少接触从而减少疾病风险的机会。鉴于缺乏任何明确的药物治疗来减缓疾病进展，这一点尤为重要。此外，由于溶剂是美国城市地区常见的环境空气和水污染物，因此预防措施将不仅限于油漆工、机械师、金属工人和塑料工人等高暴露工人。本研究利用芬兰的现有数据，通过一项大规模、高效构建、基于人群的研究，调查职业性溶剂暴露与PD事件之间的关系。芬兰是进行以下研究的理想国家，因为其低迁移/移民，全民医疗保健，神经科医生对PD的诊断，以及患者对治疗计划的高依从性。在这项研究中，我们将芬兰国家人口登记处与国家综合卫生保健数据库联系起来，以确定PD事件病例和高度合适的对照组，以及所有受试者的丰富协变量数据。我们将进一步将这些数据与来自芬兰人口普查和国家养老金数据库的个人层面的职业数据联系起来，然后使用经过验证的芬兰工作暴露矩阵（FINJEM）估计职业溶剂暴露。这些芬兰数据库已广泛用于调查许多其他疾病的职业风险因素，包括癌症和冠心病，但仍需用于调查PD或其他神经退行性疾病相关的职业风险。本提案中的调查人员和机构非常适合进行拟议的研究，代表芬兰职业卫生研究所（FIOH）的主要职业卫生专家以及华盛顿大学和华盛顿大学之间建立良好的职业流行病学研究合作。

DESCRIPTION (provided by applicant): Parkinson disease (PD) is a common disease of the elderly associated with substantial morbidity and early mortality. The causes of PD are largely unknown, but recent studies in small cohorts have implicated occupational exposure to neurotoxic solvents. Demonstrating a relation in a larger study would provide an opportunity to reduce exposures and hence disease risk. This is particularly important given the lack of any definitive pharmacotherapy to slow disease progression. Moreover, prevention would not be limited to workers with high exposures such as painters, mechanics, metal workers and plastic workers, since solvents are common environmental air and water pollutants in urban areas of the US. This proposal investigates the relation between occupational solvent exposure and incident PD in a large and efficiently-constructed, population-based study using existing data in Finland. Finland is an ideal country in which to conduct the studies described below due to low migration/immigration, universal health care, PD diagnoses made by neurologists, and high patient compliance with treatment plans. For this study, we will link the Finnish national population registry to the national comprehensive health care database to identify incident PD cases and a highly suitable comparison group, along with a wealth of covariate data for all subjects. We will further link these data with individual-level occupational data from the Finnish census and national pension database, and then estimate occupational solvent exposure, using the validated Finnish Job-Exposure Matrix (FINJEM). These Finnish databases have been used extensively to investigate occupational risk factors for many other diseases, including cancer and coronary heart disease, but remain to be used to investigate occupational risks associated with PD or other neurodegenerative diseases. The investigators and institutions in this proposal are ideally suited to perform the proposed study, representing the leading occupational health experts from the Finnish Institute of Occupational Health (FIOH) and well-established occupational epidemiology research collaboration between Washington University and the University of Washington.