Geospatial analysis of individual-based Parkinson’s disease data supports a link with air pollution : A case-control study

Parkinsonism & Related Disorders, 83, 41‑48

Background: The etiology of Parkinson’s disease (PD) remains unknown. To approach the issue of PD’s risk factors from a new perspective, we hypothesized that coupling the geographic distribution of PD with spatial statistics may provide new insights into environmental epidemiology research. The aim of this case-control study was to examine the spatial dependence of PD prevalence in the Canton of Geneva, Switzerland (population =474,211). Methods: PD cases were identified through Geneva University Hospitals, private neurologists and nursing homes medical records (n =1115). Controls derived from a population-based study (n =12,614) and a comprehensive population census dataset (n =237,771). All individuals were geographically localized based on their place of residence. Spatial Getis-Ord Gi* statistics were used to identify clusters of high versus low disease prevalence. Confounder-adjustment was performed for age, sex, nationality and income. Tukey’s honestly significant dif-ference was used to determine whether nitrogen dioxide and particulate matters PM10 concentrations were different within PD hotspots, coldspots or neutral areas. Results: Confounder-adjustment greatly reduced greatly the spatial association. Characteristics of the geographic space influenced PD prevalence in 6% of patients. PD hotspots were concentrated in the urban centre. There was a significant difference in mean annual nitrogen dioxide and PM10 levels (+3.6 μg/m3 [p <0.001] and +0.63 μg/m3 [p <0.001] respectively) between PD hotspots and coldspots. Conclusion: PD prevalence exhibited a spatial dependence for a small but significant proportion of patients. A positive association was detected between PD clusters and air pollution. Our data emphasize the multifactorial nature of PD and support a link between PD and air pollution.

En savoir plus