Screening for early detection of parkinsonism using a self-administered questionnaire: A cross-sectional epidemiologic study
•We report a cost effective screening option for manganese associated neurotoxicity.•Questionnaires validated against examination by a movement disorder specialist.•A screening questionnaire could be valuable in an occupational health program.•This could benefit remote workplaces unable to offer reg...
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| Veröffentlicht in: | Neurotoxicology (Park Forest South) 2014-12, Vol.45, p.232-237 |
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| creator | Lundin, Jessica I. Checkoway, Harvey Criswell, Susan R. Hobson, Angela J. Harris, Rachel C. Swisher, Laura M. Evanoff, Bradley A. Racette, Brad A. |
| description | •We report a cost effective screening option for manganese associated neurotoxicity.•Questionnaires validated against examination by a movement disorder specialist.•A screening questionnaire could be valuable in an occupational health program.•This could benefit remote workplaces unable to offer regular clinical examinations.•Identifying early signs is valuable to mitigate risk of irreversible neurotoxicity.
Manganese (Mn) is a common component of welding fume. Exposure to Mn fume has been associated with parkinsonism. A simple and reliable screening tool to evaluate Mn exposed workers for neurotoxic injury would have broad occupational health application.
This study investigated 490 occupational welders recruited from a trade union list. Subjects were examined by a movement disorders specialist using the Unified Parkinson Disease Rating Scale motor subsection 3 (UPDRS3). Parkinsonism, intermediate, and normal groups were defined as UPDRS3 score ≥15, 6–15, and |
| doi_str_mv | 10.1016/j.neuro.2013.08.010 |
| format | Article |
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Manganese (Mn) is a common component of welding fume. Exposure to Mn fume has been associated with parkinsonism. A simple and reliable screening tool to evaluate Mn exposed workers for neurotoxic injury would have broad occupational health application.
This study investigated 490 occupational welders recruited from a trade union list. Subjects were examined by a movement disorders specialist using the Unified Parkinson Disease Rating Scale motor subsection 3 (UPDRS3). Parkinsonism, intermediate, and normal groups were defined as UPDRS3 score ≥15, 6–15, and <6, respectively. Workers completed a health status questionnaire (PDQ39) and a Parkinson disease (PD) Symptoms Questionnaire. Areas under receiver operator curve (AUC) were analyzed based on these scores, adjusted for age, smoking, race, gender, and neurologist, using normal as the reference.
The AUC was 0.79 (95% confidence interval [CI]=0.73–0.84) for PDQ39 and 0.78 (95% CI=0.72–0.85) for PD Symptoms Questionnaire score. At 70% sensitivity, the specificity for PDQ39 score and PD Symptoms Questionnaire score for the prediction of parkinsonism was 73.1% and 80.1%, respectively.
These results suggest the questionnaires have reasonably good sensitivity and specificity to predict parkinsonism in Mn exposed workers. These questionnaires could be a valuable first step in a tiered screening approach for Mn exposed workers.</description><identifier>ISSN: 0161-813X</identifier><identifier>EISSN: 1872-9711</identifier><identifier>DOI: 10.1016/j.neuro.2013.08.010</identifier><identifier>PMID: 24035927</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Cross-Sectional Studies ; Early Diagnosis ; Epidemiology ; Female ; Health Status Indicators ; Humans ; Male ; Manganese ; Manganese Poisoning - complications ; Middle Aged ; Neurodegenerative disease ; Occupational Diseases - chemically induced ; Occupational Diseases - diagnosis ; Occupational Exposure ; Parkinson disease ; Parkinsonian Disorders - chemically induced ; Parkinsonian Disorders - diagnosis ; Parkinsonian Disorders - epidemiology ; Parkinsonism ; ROC Curve ; Surveys and Questionnaires ; Welding</subject><ispartof>Neurotoxicology (Park Forest South), 2014-12, Vol.45, p.232-237</ispartof><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><rights>2013 Elsevier B.V. All rights reserved. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c562t-e8233e740037dc4015bfb7b422aff6aa07d3043774f989f9657f354bdf3528003</citedby><cites>FETCH-LOGICAL-c562t-e8233e740037dc4015bfb7b422aff6aa07d3043774f989f9657f354bdf3528003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0161813X13001344$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24035927$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lundin, Jessica I.</creatorcontrib><creatorcontrib>Checkoway, Harvey</creatorcontrib><creatorcontrib>Criswell, Susan R.</creatorcontrib><creatorcontrib>Hobson, Angela J.</creatorcontrib><creatorcontrib>Harris, Rachel C.</creatorcontrib><creatorcontrib>Swisher, Laura M.</creatorcontrib><creatorcontrib>Evanoff, Bradley A.</creatorcontrib><creatorcontrib>Racette, Brad A.</creatorcontrib><title>Screening for early detection of parkinsonism using a self-administered questionnaire: A cross-sectional epidemiologic study</title><title>Neurotoxicology (Park Forest South)</title><addtitle>Neurotoxicology</addtitle><description>•We report a cost effective screening option for manganese associated neurotoxicity.•Questionnaires validated against examination by a movement disorder specialist.•A screening questionnaire could be valuable in an occupational health program.•This could benefit remote workplaces unable to offer regular clinical examinations.•Identifying early signs is valuable to mitigate risk of irreversible neurotoxicity.
Manganese (Mn) is a common component of welding fume. Exposure to Mn fume has been associated with parkinsonism. A simple and reliable screening tool to evaluate Mn exposed workers for neurotoxic injury would have broad occupational health application.
This study investigated 490 occupational welders recruited from a trade union list. Subjects were examined by a movement disorders specialist using the Unified Parkinson Disease Rating Scale motor subsection 3 (UPDRS3). Parkinsonism, intermediate, and normal groups were defined as UPDRS3 score ≥15, 6–15, and <6, respectively. Workers completed a health status questionnaire (PDQ39) and a Parkinson disease (PD) Symptoms Questionnaire. Areas under receiver operator curve (AUC) were analyzed based on these scores, adjusted for age, smoking, race, gender, and neurologist, using normal as the reference.
The AUC was 0.79 (95% confidence interval [CI]=0.73–0.84) for PDQ39 and 0.78 (95% CI=0.72–0.85) for PD Symptoms Questionnaire score. At 70% sensitivity, the specificity for PDQ39 score and PD Symptoms Questionnaire score for the prediction of parkinsonism was 73.1% and 80.1%, respectively.
These results suggest the questionnaires have reasonably good sensitivity and specificity to predict parkinsonism in Mn exposed workers. These questionnaires could be a valuable first step in a tiered screening approach for Mn exposed workers.</description><subject>Cross-Sectional Studies</subject><subject>Early Diagnosis</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health Status Indicators</subject><subject>Humans</subject><subject>Male</subject><subject>Manganese</subject><subject>Manganese Poisoning - complications</subject><subject>Middle Aged</subject><subject>Neurodegenerative disease</subject><subject>Occupational Diseases - chemically induced</subject><subject>Occupational Diseases - diagnosis</subject><subject>Occupational Exposure</subject><subject>Parkinson disease</subject><subject>Parkinsonian Disorders - chemically induced</subject><subject>Parkinsonian Disorders - diagnosis</subject><subject>Parkinsonian Disorders - epidemiology</subject><subject>Parkinsonism</subject><subject>ROC Curve</subject><subject>Surveys and Questionnaires</subject><subject>Welding</subject><issn>0161-813X</issn><issn>1872-9711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UV1rFDEUDaLYtfoLBMmjLzPmayYzgkIprRYKPrSCbyGT3KxZZ5I1mSks-OOb3a2lvviSQHLOufecg9BbSmpKaPthUwdYUqwZobwmXU0oeYZWtJOs6iWlz9GqoGjVUf7jBL3KeUMIbWTbv0QnTBDe9Eyu0J8bkwCCD2vsYsKg07jDFmYws48BR4e3Ov3yIcfg84SXvEdqnGF0lbaTL68zJLD49wJ5TwnaJ_iIz7BJMecqH4X0iGHrLUw-jnHtDc7zYnev0QunxwxvHu5T9P3y4vb8a3X97cvV-dl1ZZqWzRV0jHOQghAurRHFxeAGOQjGtHOt1kRaTgSXUri-613fNtLxRgy2nKwrrFP0-ai7XYYJrIEwJz2qbfKTTjsVtVf__gT_U63jneJ9I4ToisD7B4EUD0bV5LOBcdQB4pIVbYUs8TPRFig_Qg_-E7jHMZSofW9qow69qX1vinSqEAvr3dMNHzl_iyqAT0cAlJzuPCSVjYdgwJa4zaxs9P8dcA95ra5g</recordid><startdate>20141201</startdate><enddate>20141201</enddate><creator>Lundin, Jessica I.</creator><creator>Checkoway, Harvey</creator><creator>Criswell, Susan R.</creator><creator>Hobson, Angela J.</creator><creator>Harris, Rachel C.</creator><creator>Swisher, Laura M.</creator><creator>Evanoff, Bradley A.</creator><creator>Racette, Brad A.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7TK</scope><scope>7U2</scope><scope>7U7</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20141201</creationdate><title>Screening for early detection of parkinsonism using a self-administered questionnaire: A cross-sectional epidemiologic study</title><author>Lundin, Jessica I. ; Checkoway, Harvey ; Criswell, Susan R. ; Hobson, Angela J. ; Harris, Rachel C. ; Swisher, Laura M. ; Evanoff, Bradley A. ; Racette, Brad A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c562t-e8233e740037dc4015bfb7b422aff6aa07d3043774f989f9657f354bdf3528003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Cross-Sectional Studies</topic><topic>Early Diagnosis</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Health Status Indicators</topic><topic>Humans</topic><topic>Male</topic><topic>Manganese</topic><topic>Manganese Poisoning - complications</topic><topic>Middle Aged</topic><topic>Neurodegenerative disease</topic><topic>Occupational Diseases - chemically induced</topic><topic>Occupational Diseases - diagnosis</topic><topic>Occupational Exposure</topic><topic>Parkinson disease</topic><topic>Parkinsonian Disorders - chemically induced</topic><topic>Parkinsonian Disorders - diagnosis</topic><topic>Parkinsonian Disorders - epidemiology</topic><topic>Parkinsonism</topic><topic>ROC Curve</topic><topic>Surveys and Questionnaires</topic><topic>Welding</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lundin, Jessica I.</creatorcontrib><creatorcontrib>Checkoway, Harvey</creatorcontrib><creatorcontrib>Criswell, Susan R.</creatorcontrib><creatorcontrib>Hobson, Angela J.</creatorcontrib><creatorcontrib>Harris, Rachel C.</creatorcontrib><creatorcontrib>Swisher, Laura M.</creatorcontrib><creatorcontrib>Evanoff, Bradley A.</creatorcontrib><creatorcontrib>Racette, Brad A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Safety Science and Risk</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurotoxicology (Park Forest South)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lundin, Jessica I.</au><au>Checkoway, Harvey</au><au>Criswell, Susan R.</au><au>Hobson, Angela J.</au><au>Harris, Rachel C.</au><au>Swisher, Laura M.</au><au>Evanoff, Bradley A.</au><au>Racette, Brad A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Screening for early detection of parkinsonism using a self-administered questionnaire: A cross-sectional epidemiologic study</atitle><jtitle>Neurotoxicology (Park Forest South)</jtitle><addtitle>Neurotoxicology</addtitle><date>2014-12-01</date><risdate>2014</risdate><volume>45</volume><spage>232</spage><epage>237</epage><pages>232-237</pages><issn>0161-813X</issn><eissn>1872-9711</eissn><abstract>•We report a cost effective screening option for manganese associated neurotoxicity.•Questionnaires validated against examination by a movement disorder specialist.•A screening questionnaire could be valuable in an occupational health program.•This could benefit remote workplaces unable to offer regular clinical examinations.•Identifying early signs is valuable to mitigate risk of irreversible neurotoxicity.
Manganese (Mn) is a common component of welding fume. Exposure to Mn fume has been associated with parkinsonism. A simple and reliable screening tool to evaluate Mn exposed workers for neurotoxic injury would have broad occupational health application.
This study investigated 490 occupational welders recruited from a trade union list. Subjects were examined by a movement disorders specialist using the Unified Parkinson Disease Rating Scale motor subsection 3 (UPDRS3). Parkinsonism, intermediate, and normal groups were defined as UPDRS3 score ≥15, 6–15, and <6, respectively. Workers completed a health status questionnaire (PDQ39) and a Parkinson disease (PD) Symptoms Questionnaire. Areas under receiver operator curve (AUC) were analyzed based on these scores, adjusted for age, smoking, race, gender, and neurologist, using normal as the reference.
The AUC was 0.79 (95% confidence interval [CI]=0.73–0.84) for PDQ39 and 0.78 (95% CI=0.72–0.85) for PD Symptoms Questionnaire score. At 70% sensitivity, the specificity for PDQ39 score and PD Symptoms Questionnaire score for the prediction of parkinsonism was 73.1% and 80.1%, respectively.
These results suggest the questionnaires have reasonably good sensitivity and specificity to predict parkinsonism in Mn exposed workers. These questionnaires could be a valuable first step in a tiered screening approach for Mn exposed workers.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>24035927</pmid><doi>10.1016/j.neuro.2013.08.010</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Neurotoxicology (Park Forest South), 2014-12, Vol.45, p.232-237 |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Cross-Sectional Studies Early Diagnosis Epidemiology Female Health Status Indicators Humans Male Manganese Manganese Poisoning - complications Middle Aged Neurodegenerative disease Occupational Diseases - chemically induced Occupational Diseases - diagnosis Occupational Exposure Parkinson disease Parkinsonian Disorders - chemically induced Parkinsonian Disorders - diagnosis Parkinsonian Disorders - epidemiology Parkinsonism ROC Curve Surveys and Questionnaires Welding |
| title | Screening for early detection of parkinsonism using a self-administered questionnaire: A cross-sectional epidemiologic study |
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