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Associations of welding and manganese exposure with Parkinson disease: review and meta-analysis.

Authors
Mortimer-JA; Borenstein-AR; Nelson-LM
Source
Neurology 2012 Sep; 79(11):1174-1180
NIOSHTIC No.
20041900
Abstract
OBJECTIVE: To examine associations of welding and manganese exposure with Parkinson disease (PD) using meta-analyses of data from cohort, case-control, and mortality studies. METHODS: Epidemiologic studies related to welding or manganese exposure and PD were identified in a PubMed search, article references, published reviews, and abstracts. Inclusion criteria were 1) cohort, case-control, or mortality study with relative risk (RR), odds ratio (OR), or mortality OR (MOR) and 95 confidence intervals (95% CI); 2) RR, OR, and MOR matched or adjusted for age and sex; 3) valid study design and analysis. When participants of a study were a subgroup of those in a larger study, only results of the larger study were included to assure independence of datasets. Pooled RR/OR estimates and 95% CIs were obtained using random effects models; heterogeneity of study effects were evaluated using the Q statistic and I(2) index in fixed effect models. RESULTS: Thirteen studies met inclusion criteria for the welding meta-analysis and 3 studies for the manganese exposure meta-analysis. The pooled RR for the association between welding and PD for all study designs was 0.86 (95% CI 0.80-0.92), with absence of between-study heterogeneity (I(2) = 0.0). Effect measures for cohort, case-control, and mortality studies were similar (0.91, 0.82, 0.87). For the association between manganese exposure and PD, the pooled OR was 0.76 (95% CI 0.41-1.42). CONCLUSIONS: Welding and manganese exposure are not associated with increased PD risk. Possible explanations for the inverse association between welding and PD include confounding by smoking, healthy worker effect, and hormesis.
Keywords
Welding; Manganese-compounds; Exposure-levels; Humans; Men; Women; Epidemiology; Risk-factors; Age-groups; Statistical-analysis; Smoking; Etiology; Toxic-effects; Neuromuscular-function
CODEN
NEURAI
CAS No.
7439-96-5
Publication Date
20120911
Document Type
Journal Article
Email Address
jmortime@health.usf.edu
Funding Type
Grant
Fiscal Year
2012
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R21-OH-009914; B20130124
Issue of Publication
11
ISSN
0028-3878
Source Name
Neurology
State
CA; FL
Performing Organization
Stanford University
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