Screening for early detection of parkinsonism using a self-administered questionnaire: A cross-sectional epidemiologic study

Jessica I. Lundin, Harvey Checkoway, Susan R. Criswell, Angela J. Hobson, Rachel C. Harris, Laura M. Swisher, Bradley A. Evanoff, Brad A. Racette

Research output: Contribution to journalArticle

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)232-237
Number of pages6
JournalNeuroToxicology
Volume45
DOIs
StatePublished - Dec 1 2014

Keywords

  • Epidemiology
  • Manganese
  • Neurodegenerative disease
  • Occupational exposure
  • Parkinson disease
  • Parkinsonism

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