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