Association between essential tremor and blood lead concentration

Elan D. Louis; Eva C. Jurewicz; LaKeisha Applegate; Pam Factor-Litvak; Michael Parides; Leslie Andrews; Vesna N. Slavkovich; Joseph Graziano; Spencer Carroll; Andrew Todd

Association between essential tremor and blood lead concentration
Louis, Elan D.
Jurewicz, Eva C.
Applegate, LaKeisha
Factor-Litvak, Pam
Parides, Michael
Andrews, Leslie
Slavkovich, Vesna N.
Graziano, Joseph
Carroll, Spencer
Todd, Andrew
Center for Parkinson's Disease and Other Movement Disorders
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Environmental Health Perspectives
Lead is a ubiquitous toxicant that causes tremor and cerebellar damage. Essential tremor (ET) is a highly prevalent neurologic disease associated with cerebellar involvement. Although environmental toxicants may play a role in ET etiology and their identification is a critical step in disease prevention, these toxicants have received little attention. Our objective was to test the hypothesis that ET is associated with lead exposure. Therefore, blood lead (BPb) concentrations were measured and a lifetime occupational history was assessed in ET patients and in controls. We frequency matched 100 ET patients and 143 controls on age, sex, and ethnicity. BPb concentrations were analyzed using graphite furnace atomic absorption spectrophotometry. A lifetime occupational history was reviewed by an industrial hygienist. BPb concentrations were higher in ET patients than in controls (mean ± SD, 3.3 ± 2.4 and 2.6 ± 1.6 µg/dL, respectively; median, 2.7 and 2.3 µg/dL; p = 0.038). In a logistic regression model, BPb concentration was associated with diagnosis [control vs. ET patient, odds ratio (OR) per unit increase = 1.21; 95% confidence interval (CI), 1.05-1.39; p = 0.007]. BPb concentration was associated with diagnosis (OR per unit increase = 1.19; 95% CI, 1.03-1.37; p = 0.02) after adjusting for potential confounders. Prevalence of lifetime occupational lead exposure was similar in ET patients and controls. We report an association between BPb concentration and ET. Determining whether this association is due to increased exposure to lead or a difference in lead kinetics in ET patients requires further investigation.
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Elan D. Louis, Eva C. Jurewicz, LaKeisha Applegate, Pam Factor-Litvak, Michael Parides, Leslie Andrews, Vesna N. Slavkovich, Joseph Graziano, Spencer Carroll, Andrew Todd, , Association between essential tremor and blood lead concentration, Columbia University Academic Commons, .

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