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Parkinson's Disease in Ferrara, Italy, 1967 Through 1987

Parkinson's Disease in Ferrara, Italy, 1967 Through 1987 Abstract β Epidemiological surveys on Parkinson's disease that have been carried out in different parts of the world have suggested that the disease is uniformly distributed in white populations. The position with regard to the Mediterranean peoples is still controversial, because of the large variation of the frequencies observed in the different areas that have been investigated. We therefore studied the frequency of Parkinson's disease in the Local Health Service of Ferrara, northeastern Italy (mean population, 187 000). Based on 394 patients, the mean incidence per year for the period from 1967 through 1987 was 10.01/100 000. The incidence rate of Parkinson's disease among cases with early onset was found to be statistically higher in rural areas as compared with urban ones (6.32/100000 vs 3.11/100000). Moreover, the study revealed a significantly higher incidence rate among agricultural workers (20.6/100 000). These results would seem to give further support to the hypothesis of a possible causal role of environmental factors that are mainly linked to agriculture, most likely due to the continual exposure to toxic agents in this area. However, further studies, which are not exclusively epidemiological, are necessary before any conclusions may be drawn, because many confounding variables may account for the results from surveys of this type. References 1. Kurtzke JF. Neuroepidemiology . Ann Neurol . 1984;16:265-277.Crossref 2. Marttila RJ. Epidemiology . In: Koller WC, ed. Handbook of Parkinson's Disease . New York, NY: Marcel Dekker Inc; 1987:35-50. 3. Schoenberg BS. Descriptive epidemiology of Parkinson's disease: disease distribution and hypothesis formulation . Adv Neurol . 1987;45:277-283. 4. Rosati G, Granieri E, Pinna L, et al. The risk of Parkinson's disease in Mediterranean people . Neurology . 1980;30:250-255.Crossref 5. D'Alessandro R, Gamberini G, Granieri E, Benassi G, Naccarato S, Manzaroli D. Prevalence of Parkinson's disease in the republic of San Marino . Neurology . 1987;37:1679-1682.Crossref 6. Granieri E, Carreras M, Tola R, et al. Motor neuron disease in the province of Ferrara, Italy, in 1964-1982 . Neurology . 1988;38:1604-1608.Crossref 7. Bodmer WF. Population genetics of the HLA system: retrospect and prospect . In: Dausset J, Colombani J, eds. Histocompatibility Testing . Copenhagen, Denmark: Munksgaard International Publishers Ltd; 1972:611-677. 8. Koller W, O'Hara R, Weiner W, et al. Relationship of aging to Parkinson's disease . Adv Neurol . 1987;45;317-321. 9. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality . Neurology . 1967;17:427-442.Crossref 10. Marttila RJ, Rinne UK. Epidemiology of Parkinson's disease in Finland . Acta Neurol Scand . 1976;53:81-102.Crossref 11. Schoenberg BS, Anderson DW, Haerer AF. Prevalence of Parkinson's disease in the biracial population of Copiah County, Mississippi . Neurology . 1985;35:841-845.Crossref 12. Brewis M, Poskanzer DC, Rolland C, Miller H. Neurological disease in an English city . Acta Neurol Scand . 1966;42( (suppl 24) ):1-89. 13. Gudmundsson KRA. A clinical survey of Parkinsonism in Iceland . Acta Neurol Scand . 1967;43( (suppl 33) ):9-61.Crossref 14. Dupont E. Epidemiology of parkinsonism: the Parkinson investigation, Aarhus, Denmark . In: Worm-Petersen J, Bottcher J, eds. Symposium on Parkinsonism . Copenhagen, Denmark: Merck, Sharp & Dohme Publishers; 1977:65-75. 15. Chalmanov VN. Epidemiological studies of Parkinsonism in Sofia . Neuroepidemiology . 1986;5:171-177.Crossref 16. Kurland LT. Epidemiology: incidence, geographic distribution and genetic considerations . In: Field W, ed. Pathogenesis and Treatment on Parkinsonism . Springfield, Ill: Charles C Thomas Publisher; 1958:5-43. 17. Nobrega FT, Glattre E, Kurland LT, et al. Comments on the epidemiology of parkinsonism including prevalence and incidence statistics for Rochester, Minnesota, 1935-1966 . In: Barbeau A, Brunette JR, eds. Progress in Neuro-Genetics: Proceedings of the Second International Congress . Series No. 175. Princeton, NJ: Excerpta Medica; 1969:474-485. 18. Kessler II. Epidemiologic studies of Parkinson's disease, III: a community-based survey . Am J Epidemiol . 1972;96:242-254. 19. Rajput AH, Offord KP, Beard M, Kurland LT. Epidemiology of parkinsonism: incidence, classification and mortality . Ann Neurol . 1984;16:278-282.Crossref 20. Jenkins AC. Epidemiology of parkinsonism in Victoria . Med J Aust . 1966;2:496-502. 21. Pollok M, Hornabrook RW. The prevalence, natural history and dementia of Parkinson's disease . Brain . 1966;89:429-448.Crossref 22. Ashok PP, Radhakrishan K, Sridharan R, Mousa ME. Epidemiology of Parkinson's disease in Benghazi, North-East Libya . Clin Neurol Neurosurg . 1986;88:109-113.Crossref 23. Harada H, Mishikawa S, Takahashi K. Epidemiology of Parkinson's disease in a Japanese city . Arch Neurol . 1983;40:151-154.Crossref 24. Li S, Schoenberg BS, Wang C, et al. A prevalence survey of Parkinson's disease and other movement disorders in the People's Republic of China . Arch Neurol . 1985;42:655-657.Crossref 25. Langston JW, Ballard PA, Tetrud JW, Irwin I. Chronic parkinsonism in humans due to a product of meperidine-analogue synthesis . Science . 1983;219:979-980.Crossref 26. Langston JW. MPTP: insights into the etiology of Parkinson's disease . Eur Neurol . 1987;26:2-10.Crossref 27. Solomon H, D'Amato RJ. Predicting Parkinson's disease . Nature . 1985;317:198-199.Crossref 28. Amadori R, Zoli W, Ravaiolo A. Rischi da pesticidi: effetti tossici, mutageni, teratogeni, cancerogeni . Ambiente Risorse Salute . 1983;13:7-10. 29. Chiesura P, Fabbri L, Rossi A. Patologia da metalli . In: Crepet M, ed. Medicina del lavoro . Turin, Italy: Unione Tipografico-Editrice Torinese; 1979;12:578-579. 30. Barbeau A, Roy M, Bernier G, Campanella G, Paris S. Ecogenetics of Parkinson's disease: prevalence and environmental aspects in rural areas . Can J Neurol Sci . 1987;14:36-41. 31. Rajput AH, Uitti RJ, Stern W, Laverty W. Early onset of Parkinson's disease and childhood environment . Adv Neurol . 1987;45:295-297. 32. Tanner CM, Chen B, Wang WZ, et al. Environmental factors in the etiology of Parkinson's disease . Can J Neurol Sci . 1987;14:419-423. 33. Aquilonius SM, Hartvig P. Utilization of antiparkinsonian drugs in Sweden . Ups J Med Sci . 1986;43:93-97. 34. Lux WE, Kurtzke JF. Is Parkinson's disease acquired? evidence from a geographic comparison with multiple sclerosis . Neurology . 1987;37:467-471.Crossref 35. Jimenez-Jimenez FJ, Gonzales DM, Jimenez-Rolden S. Exposure to well water drinking and pesticides in Parkinson's disease: a case-control study from the southeast area of Madrid . In: Proceedings of the Ninth International Symposium on Parkinson's Disease: World Congress of Neurology . Jerusalem, Israel: Kenes Publishers; 1988:118. 36. Campanella G, Roy M, Masson H. Case-control study of Parkinson's disease in southern Quebec: exposure to metals and pesticides . In: Proceedings of the Ninth International Symposium on Parkinson's Disease: World Congress of Neurology . Jerusalem, Israel: Kenes Publishers; 1988:57. 37. Tanner CM. The role of environmental toxins in the etiology of Parkinson's disease . Trends Neurosci . 1989;12:49-54.Crossref 38. Koller W, Vetere-Overfield B, Gray C, et al. Environmental risk factors in Parkinson's disease . Neurology . 1990;40:1218-1221.Crossref 39. Bharucha NE, Stokes L, Schoenberg BS, et al. A case-control study of twin pairs discordant for Parkinson's disease: a search for environmental risk factors . Neurology . 1986;36:284-288.Crossref 40. Meador KJ, Meador MP, Loring DW, Feldman DS, Sethi KD. Neuroepidemiology of Parkinson's disease . Neurology . 1987;37( (suppl 1) ):120. 41. Zayed J, Ducic S, Campanella G, et al. Facteurs environmentaux dans l'étiologie de la maladie de Parkinson . Can J Neurol Sci . 1990;17:286-291. 42. Eldridge R, Rocca WA, Ince SE. Parkinson's disease: evidence against a toxic etiology and for an alternative theory . In: Markey SP, Castagnoli N, Trevor AJ, Kopin IJ, eds. MPTP: A Neurotoxin Producing a Parkinsonian Syndrome . Orlando, Fla: Academic Press Inc; 1986:355-367. 43. Calne DB, Langston JW. Aetiology of Parkinson's disease . Lancet . 1983;2:1457-1459.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

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References (45)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1991.00530200096026
Publisher site
See Article on Publisher Site

Abstract

Abstract β Epidemiological surveys on Parkinson's disease that have been carried out in different parts of the world have suggested that the disease is uniformly distributed in white populations. The position with regard to the Mediterranean peoples is still controversial, because of the large variation of the frequencies observed in the different areas that have been investigated. We therefore studied the frequency of Parkinson's disease in the Local Health Service of Ferrara, northeastern Italy (mean population, 187 000). Based on 394 patients, the mean incidence per year for the period from 1967 through 1987 was 10.01/100 000. The incidence rate of Parkinson's disease among cases with early onset was found to be statistically higher in rural areas as compared with urban ones (6.32/100000 vs 3.11/100000). Moreover, the study revealed a significantly higher incidence rate among agricultural workers (20.6/100 000). These results would seem to give further support to the hypothesis of a possible causal role of environmental factors that are mainly linked to agriculture, most likely due to the continual exposure to toxic agents in this area. However, further studies, which are not exclusively epidemiological, are necessary before any conclusions may be drawn, because many confounding variables may account for the results from surveys of this type. References 1. Kurtzke JF. Neuroepidemiology . Ann Neurol . 1984;16:265-277.Crossref 2. Marttila RJ. Epidemiology . In: Koller WC, ed. Handbook of Parkinson's Disease . New York, NY: Marcel Dekker Inc; 1987:35-50. 3. Schoenberg BS. Descriptive epidemiology of Parkinson's disease: disease distribution and hypothesis formulation . Adv Neurol . 1987;45:277-283. 4. Rosati G, Granieri E, Pinna L, et al. The risk of Parkinson's disease in Mediterranean people . Neurology . 1980;30:250-255.Crossref 5. D'Alessandro R, Gamberini G, Granieri E, Benassi G, Naccarato S, Manzaroli D. Prevalence of Parkinson's disease in the republic of San Marino . Neurology . 1987;37:1679-1682.Crossref 6. Granieri E, Carreras M, Tola R, et al. Motor neuron disease in the province of Ferrara, Italy, in 1964-1982 . Neurology . 1988;38:1604-1608.Crossref 7. Bodmer WF. Population genetics of the HLA system: retrospect and prospect . In: Dausset J, Colombani J, eds. Histocompatibility Testing . Copenhagen, Denmark: Munksgaard International Publishers Ltd; 1972:611-677. 8. Koller W, O'Hara R, Weiner W, et al. Relationship of aging to Parkinson's disease . Adv Neurol . 1987;45;317-321. 9. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality . Neurology . 1967;17:427-442.Crossref 10. Marttila RJ, Rinne UK. Epidemiology of Parkinson's disease in Finland . Acta Neurol Scand . 1976;53:81-102.Crossref 11. Schoenberg BS, Anderson DW, Haerer AF. Prevalence of Parkinson's disease in the biracial population of Copiah County, Mississippi . Neurology . 1985;35:841-845.Crossref 12. Brewis M, Poskanzer DC, Rolland C, Miller H. Neurological disease in an English city . Acta Neurol Scand . 1966;42( (suppl 24) ):1-89. 13. Gudmundsson KRA. A clinical survey of Parkinsonism in Iceland . Acta Neurol Scand . 1967;43( (suppl 33) ):9-61.Crossref 14. Dupont E. Epidemiology of parkinsonism: the Parkinson investigation, Aarhus, Denmark . In: Worm-Petersen J, Bottcher J, eds. Symposium on Parkinsonism . Copenhagen, Denmark: Merck, Sharp & Dohme Publishers; 1977:65-75. 15. Chalmanov VN. Epidemiological studies of Parkinsonism in Sofia . Neuroepidemiology . 1986;5:171-177.Crossref 16. Kurland LT. Epidemiology: incidence, geographic distribution and genetic considerations . In: Field W, ed. Pathogenesis and Treatment on Parkinsonism . Springfield, Ill: Charles C Thomas Publisher; 1958:5-43. 17. Nobrega FT, Glattre E, Kurland LT, et al. Comments on the epidemiology of parkinsonism including prevalence and incidence statistics for Rochester, Minnesota, 1935-1966 . In: Barbeau A, Brunette JR, eds. Progress in Neuro-Genetics: Proceedings of the Second International Congress . Series No. 175. Princeton, NJ: Excerpta Medica; 1969:474-485. 18. Kessler II. Epidemiologic studies of Parkinson's disease, III: a community-based survey . Am J Epidemiol . 1972;96:242-254. 19. Rajput AH, Offord KP, Beard M, Kurland LT. Epidemiology of parkinsonism: incidence, classification and mortality . Ann Neurol . 1984;16:278-282.Crossref 20. Jenkins AC. Epidemiology of parkinsonism in Victoria . Med J Aust . 1966;2:496-502. 21. Pollok M, Hornabrook RW. The prevalence, natural history and dementia of Parkinson's disease . Brain . 1966;89:429-448.Crossref 22. Ashok PP, Radhakrishan K, Sridharan R, Mousa ME. Epidemiology of Parkinson's disease in Benghazi, North-East Libya . Clin Neurol Neurosurg . 1986;88:109-113.Crossref 23. Harada H, Mishikawa S, Takahashi K. Epidemiology of Parkinson's disease in a Japanese city . Arch Neurol . 1983;40:151-154.Crossref 24. Li S, Schoenberg BS, Wang C, et al. A prevalence survey of Parkinson's disease and other movement disorders in the People's Republic of China . Arch Neurol . 1985;42:655-657.Crossref 25. Langston JW, Ballard PA, Tetrud JW, Irwin I. Chronic parkinsonism in humans due to a product of meperidine-analogue synthesis . Science . 1983;219:979-980.Crossref 26. Langston JW. MPTP: insights into the etiology of Parkinson's disease . Eur Neurol . 1987;26:2-10.Crossref 27. Solomon H, D'Amato RJ. Predicting Parkinson's disease . Nature . 1985;317:198-199.Crossref 28. Amadori R, Zoli W, Ravaiolo A. Rischi da pesticidi: effetti tossici, mutageni, teratogeni, cancerogeni . Ambiente Risorse Salute . 1983;13:7-10. 29. Chiesura P, Fabbri L, Rossi A. Patologia da metalli . In: Crepet M, ed. Medicina del lavoro . Turin, Italy: Unione Tipografico-Editrice Torinese; 1979;12:578-579. 30. Barbeau A, Roy M, Bernier G, Campanella G, Paris S. Ecogenetics of Parkinson's disease: prevalence and environmental aspects in rural areas . Can J Neurol Sci . 1987;14:36-41. 31. Rajput AH, Uitti RJ, Stern W, Laverty W. Early onset of Parkinson's disease and childhood environment . Adv Neurol . 1987;45:295-297. 32. Tanner CM, Chen B, Wang WZ, et al. Environmental factors in the etiology of Parkinson's disease . Can J Neurol Sci . 1987;14:419-423. 33. Aquilonius SM, Hartvig P. Utilization of antiparkinsonian drugs in Sweden . Ups J Med Sci . 1986;43:93-97. 34. Lux WE, Kurtzke JF. Is Parkinson's disease acquired? evidence from a geographic comparison with multiple sclerosis . Neurology . 1987;37:467-471.Crossref 35. Jimenez-Jimenez FJ, Gonzales DM, Jimenez-Rolden S. Exposure to well water drinking and pesticides in Parkinson's disease: a case-control study from the southeast area of Madrid . In: Proceedings of the Ninth International Symposium on Parkinson's Disease: World Congress of Neurology . Jerusalem, Israel: Kenes Publishers; 1988:118. 36. Campanella G, Roy M, Masson H. Case-control study of Parkinson's disease in southern Quebec: exposure to metals and pesticides . In: Proceedings of the Ninth International Symposium on Parkinson's Disease: World Congress of Neurology . Jerusalem, Israel: Kenes Publishers; 1988:57. 37. Tanner CM. The role of environmental toxins in the etiology of Parkinson's disease . Trends Neurosci . 1989;12:49-54.Crossref 38. Koller W, Vetere-Overfield B, Gray C, et al. Environmental risk factors in Parkinson's disease . Neurology . 1990;40:1218-1221.Crossref 39. Bharucha NE, Stokes L, Schoenberg BS, et al. A case-control study of twin pairs discordant for Parkinson's disease: a search for environmental risk factors . Neurology . 1986;36:284-288.Crossref 40. Meador KJ, Meador MP, Loring DW, Feldman DS, Sethi KD. Neuroepidemiology of Parkinson's disease . Neurology . 1987;37( (suppl 1) ):120. 41. Zayed J, Ducic S, Campanella G, et al. Facteurs environmentaux dans l'étiologie de la maladie de Parkinson . Can J Neurol Sci . 1990;17:286-291. 42. Eldridge R, Rocca WA, Ince SE. Parkinson's disease: evidence against a toxic etiology and for an alternative theory . In: Markey SP, Castagnoli N, Trevor AJ, Kopin IJ, eds. MPTP: A Neurotoxin Producing a Parkinsonian Syndrome . Orlando, Fla: Academic Press Inc; 1986:355-367. 43. Calne DB, Langston JW. Aetiology of Parkinson's disease . Lancet . 1983;2:1457-1459.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Aug 1, 1991

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