Environmental determinants of Parkinson’s disease and attributable burden in Latin America

  1. Daniel Teixeira-dos-Santos
  2. Henry Mauricio Chaparro-Solano
  3. Juan Felipe Duarte-Zambrano
  4. Thiago Leal
  5. Miguel Inca-Martinez
  6. Emily Waldo
  7. Alastair Noyce
  8. Dario Sergio Adamec
  9. Emilia Mabel Gatto
  10. Bruno Lopes Santos-Lobato
  11. Juliana dos Santos Duarte
  12. Francisco Eduardo Costa Cardoso
  13. Grace Helena Letro
  14. Gonzalo Arboleda
  15. Jorge Orozco
  16. Beatriz Muñoz Ospina
  17. Paola Medina-Cordero
  18. Pedro Chana-Cuevas
  19. Ximena Pizarro-Correa
  20. Philippe Salles
  21. David Aguillon
  22. David Pineda
  23. Susana Lissette Peña Martínez
  24. Tatiana Ascencio
  25. Maria Valentina Müller
  26. Marcelo Merello
  27. Florencia Nicole Wainberg
  28. Pedro Braga-Neto
  29. Deborah Rangel
  30. Marcela Susana Tela
  31. Evelin Álvarez-Herrera
  32. Mayela Rodríguez-Violante
  33. Amin Cervantes-Arriaga
  34. Daniel Martinez-Ramirez
  35. Artur Schuh
  36. Carlos Rieder
  37. Mario Cornejo-Olivas
  38. Cintia Armas
  39. Julia Rios-Pinto
  40. Angel Medina-Colque
  41. Koni Mejia-Rojas
  42. Angel Viñuela
  43. Ana Lucia Rosso
  44. Marcelo Kauffman
  45. Vitor Tumas
  46. Gabriel Vilela
  47. Vanderci Borges
  48. Cesar Avila
  49. Patricio Olguín
  50. Alicia Colombo
  51. Juan Cristobal Nuñez
  52. Samuel Jorquera
  53. Elias Fernandez-Toledo
  54. Alejandra Lázaro-Figueroa
  55. Juan Manuel Esquivias-Farías
  56. Ingrid Estrada-Bellmann
  57. Paula Reyes-Pérez
  58. Alejandra Medina-Rivera
  59. Sarael Alcauter
  60. María Teresa Muñoz-Quezada
  61. Ignacio Mata
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Abstract

We investigated environmental determinants of Parkinson’s disease (PD) and their attributable burden in a case-control study of 9,887 participants from nine Latin American countries. Logistic regression adjusted for age, sex, and country estimated associations, and population attributable fractions (PAFs) were calculated for modifiable risk factors. Weekly caffeine consumption (adjusted odds ratio [aOR] 0.77, p  < 0.0001) and tobacco use for ≥ 5 years (aOR 0.83, p  = 0.0009) were inversely associated with PD, whereas severe head trauma (aOR 1.35), occupational pesticide exposure (aOR 1.42), occupational metal exposure (aOR 1.29), rural living (aOR 1.60), and well water consumption (aOR 1.22) increased PD risk (all p  < 0.05). Dose-response relationships were observed. The joint PAF was 13.7% (95% CI 9.8–17.3), with higher estimates in El Salvador, Brazil, Colombia, men, and individuals younger than 60 years. Sensitivity and lag analyses yielded consistent results.

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