||The association between Arsenic in well water and Parkinson's Disease in Taiwan
||Institute of Environmental and Occupational Health
degenerative neurological diseases
我們使用台灣健保資料庫收集2005年到2009年疾病代碼為332.0 或332.1並且使用藥物治療的病人.井水砷濃度則是採用台灣環保署針對台灣242鄉鎮井水所做的分析,依濃度高低分為2組。 我們使用SAS9.3軟體來進行分析，找出飲用井水中砷的濃度和帕金森氏症之間的相關性，並找出有無年齡和性別的差異。我們的結果顯示，巴金森氏症盛行率為每年十萬分之226人，發生率為每年十萬分之41.8人．男性得到巴金森氏症的機率比女性高．隨著年齡增加，得到巴金森氏症的機率越高，其中70-80歲為最高峰。而砷濃度較高地區的居民得到巴金森氏症的相對風險是其他地區居民的1.4倍，而95%信賴區間為(0.9-2.0)，接近統計上的意義。
introduction: Parkinson's disease (PD) is the second most common progressive neurodegenerative disease in Taiwan. It is associated with the desecration of dopamine-generated neurons in the substantial nigra in the brain, but actual etiology remains unknown. Some animal studies found that arsenic can pass through the blood brain barrier, aggregate in the substantia nigra area, and inhibit the synthesis and release of dopamine. Therefore, exposure to arsenic may be related to the occurrence of PD, but few epidemiological data are available on this issue. We conduct a study to evaluate the association between arsenic exposure through drinking water and the occurrence of PD in Taiwan.
Methods: We used the National Health Insurance Research Database to identify patients with PD from 2005 to 2009 and defined cases as those who had ICD-9-CM codes 332.0 or 332.1 among the diagnoses and received prescription of medicine for PD. Arsenic exposure was assessed using the survey of well water in 243 villages conducted by the Taiwanese government. We compare the occurrence of PD between villages within and outside the endemic areas of arsenic exposure to evaluate the association between the arsenic level in drinking water and the PD after adjusting for gender and age.
Results: The prevalence of PD was 226/100,000 and the incidence of PD was 41.8/100,000. Men had higher prevalence than women, and the peak age of late-type PD was 70-80 years old. The relative risk of people living in the endemic areas of arsenic exposure was 1.4 compared to those who did not live in the areas, and the 95% confidence interval was 0.9-2.0, indicating a marginal statistical significance.
Conclusion: People living in the endemic areas of arsenic exposure from drinking water had a higher risk of developing PD, but the increase did not reach statistical significance.
Table of Contents 6
Chapter 1 Introduction 7
Chapter 2 Literature Review 9
2-1 Parkinson’s disease epidemiology 9
2-2 The mechanism of Parkinson’s Disease 10
2-3 The etiology of Parkinson’s disease 11
2-4 The treatment of Parkinson’s disease 11
2-5 The Arsenic Toxicity 12
Chapter 3 The Purpose of this study 15
Chapter 4 Methods and Materials 16
Chapter 5 Results 19
Chapter 6 Discussion 23
Chapter 7 Conclusion 25
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