Parkinson's disease and occupational exposures: a systematic literature review and meta-analyses by Gunnarsson L-G, Bodin L Contrary to previously published meta-analyses in this field, our meta-analyses are based only on studies fulfilling good standards of scientific quality. Thus the results of this review are not hampered by biases from studies of lower scientific quality and are also discussed in relation to today's knowledge of pathophysiological mechanisms for Parkinson's disease and Parkinsonism.
Affiliation
197Review Scand J Work Environ Health. 2017;43(3):197-209. doi:10.5271/sjweh.3641 Parkinson's disease and occupational exposures: a systematic literature review and meta-analyses GRADE guidelines were used to ensure high scientific quality, and reliable guidelines were applied to classify the papers. Of the 103 articles, 47 fulfilled good scientific standards while 56 were methodologically deficient and thus excluded from our meta-analyses.Results A total of 23 publications concerned work exposure to pesticides. The weighted relative risk estimate was 1.67 (95% confidence interval 1.42-1.97). A funnel plot and bias test indicated that some publication bias concerning smaller studies might have been present. The risk estimate was not influenced by study design (casecontrol, cohort, or cross-sectional study) or gender. Higher estimates were found when there was a hereditary taint or onset below age 60. Studies on exposure to metals or electromagnetic fields did not show increased risk.
ConclusionsUsing an elaborated quality protocol, there is now strong evidence that exposure to any pesticide involves a ≥50% increased risk for developing Parkinson's disease.