Parkinson's Disease Progression and Exposure to Contaminated Water at Camp Lejeune.

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY Movement Disorders Pub Date : 2024-07-11 DOI:10.1002/mds.29922

Samuel M Goldman, Frances M Weaver, Beverly Gonzalez, Kevin T Stroupe, Lishan Cao, Kalea Colletta, Ethan G Brown, Caroline M Tanner

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Abstract

Background: We recently reported an increased risk of Parkinson's disease (PD) in service members who resided at Marine Base Camp Lejeune, North Carolina, when water supplies were contaminated with trichloroethylene and other volatile organic compounds (VOCs). Prior studies suggest that environmental exposures may affect PD phenotype or progression, but this has not been reported for VOCs.

Objective: The objective of this study was to test whether PD progression is faster in individuals exposed to VOCs in water at Camp Lejeune.

Methods: A cohort of 172,128 marines residing at Camp Lejeune between 1975 and 1985 was previously assembled. We identified individuals with PD in Veterans Health Administration and Medicare databases between 2000 and 2021. Using estimates derived by the US Agency for Toxic Substances and Disease Registry, we classified individuals as exposed or unexposed to VOCs in residential water. We used Kaplan-Meier and Cox regression models to test differences between exposed and unexposed groups in the time from PD diagnosis until psychosis, fracture, fall, or death.

Results: Among 270 persons with PD, 177 (65.6%) were exposed to VOCs in residential water. Median cumulative exposure was 4970 μg/L-months, >50-fold the permissible level. Time until psychosis, fracture, and fall were all shorter in the exposed group, with adjusted hazard ratios (HRs) exceeding 2: psychosis HR, 2.19 (95% confidence interval [CI]: 0.99-4.83); fracture HR, 2.44 (95% CI: 0.91-6.55); and fall HR, 2.64 (95% CI: 0.97-7.21). A significant dose response was observed for time to fall (P trend, 0.032). No differences were observed for time until death.

Conclusions: PD progression may be faster in persons exposed to trichloroethylene and other VOCs in water decades earlier. © 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

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帕金森病的进展与接触勒让军营的污染水。

背景：我们最近报告称，当水源受到三氯乙烯和其他挥发性有机化合物（VOC）污染时，居住在北卡罗来纳州勒让营海军陆战队基地的军人罹患帕金森病（PD）的风险增加。先前的研究表明，环境暴露可能会影响帕金森氏症的表型或进展，但尚未有关于 VOCs 的报道：本研究的目的是检测暴露于 Lejeune 营水中挥发性有机化合物的人是否会加速帕金森氏症的发展：方法：以前曾收集了 1975 年至 1985 年期间居住在 Lejeune 营的 172 128 名海军陆战队员。我们在退伍军人健康管理局和医疗保险数据库中找到了 2000 年至 2021 年期间患有帕金森病的患者。利用美国有毒物质和疾病登记署的估计值，我们将个人分为暴露于或未暴露于住宅用水中的挥发性有机化合物。我们使用 Kaplan-Meier 和 Cox 回归模型来检验暴露组和未暴露组在从确诊帕金森病到精神病、骨折、跌倒或死亡的时间上的差异：在270名帕金森氏症患者中，有177人（65.6%）暴露于住宅用水中的挥发性有机化合物。累积暴露量中位数为4970微克/升-月，超过允许水平的50倍。在暴露组中，患精神病、骨折和跌倒的时间都较短，调整后的危险比（HRs）超过 2：患精神病的危险比为 2.19（95% 置信区间 [CI]：0.99-4.83）；骨折的危险比为 2.44（95% 置信区间 [CI]：0.91-6.55）；跌倒的危险比为 2.64（95% 置信区间 [CI]：0.97-7.21）。在跌倒时间方面观察到了明显的剂量反应（P 趋势，0.032）。在死亡时间上没有观察到差异：结论：早几十年接触水中的三氯乙烯和其他挥发性有机化合物的人可能会加速帕金森病的发展。© 2024 The Author(s).运动障碍》由 Wiley Periodicals LLC 代表国际帕金森和运动障碍协会出版。本文由美国政府雇员撰写，其作品在美国属于公共领域。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.