{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T00:29:38Z","timestamp":1793838578335,"version":"4.6.1"},"reference-count":56,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Neurol"],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:sec id=\"ab-noi230025-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>An increased risk of Parkinson disease (PD) has been associated with exposure to the solvent trichloroethylene (TCE), but data are limited. Millions of people in the US and worldwide are exposed to TCE in air, food, and water.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230025-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To test whether the risk of PD is higher in veterans who served at Marine Corps Base Camp Lejeune, whose water supply was contaminated with TCE and other volatile organic compounds (VOCs), compared with veterans who did not serve on that base.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230025-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>\n                      This population-based cohort study examined the risk for PD among all Marines and Navy personnel who resided at Camp Lejeune, North Carolina (contaminated water) (n\u2009=\u2009172\u202f128), or Camp Pendleton, California (uncontaminated water) (n\u2009=\u2009168\u202f361), for at least 3 months between 1975 and 1985, with follow-up from January 1, 1997, until February 17, 2021. Veterans Health Administration and Medicare databases were searched for\n                      <jats:italic>International Classification of Diseases<\/jats:italic>\n                      diagnostic codes for PD or other forms of parkinsonism and related medications and for diagnostic codes indicative of prodromal disease. Parkinson disease diagnoses were confirmed by medical record review.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230025-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Water supplies at Camp Lejeune were contaminated with several VOCs. Levels were highest for TCE, with monthly median values greater than 70-fold the permissible amount.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230025-8\">\n                    <jats:title>Main Outcome and Measures<\/jats:title>\n                    <jats:p>Risk of PD in former residents of Camp Lejeune relative to residents of Camp Pendleton. In those without PD or another form of parkinsonism, the risk of being diagnosed with features of prodromal PD were assessed individually and cumulatively using likelihood ratio tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230025-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Health data were available for 158\u202f122 veterans (46.4%). Demographic characteristics were similar between Camp Lejeune (5.3% women, 94.7% men; mean [SD] attained age of 59.64 [4.43] years; 29.7% Black, 6.0% Hispanic, 67.6% White; and 2.7% other race and ethnicity) and Camp Pendleton (3.8% women, 96.2% men; mean [SD] age, 59.80 [4.62] years; 23.4% Black, 9.4% Hispanic, 71.1% White, and 5.5% other race and ethnicity). A total of 430 veterans had PD, with 279 from Camp Lejeune (prevalence, 0.33%) and 151 from Camp Pendleton (prevalence, 0.21%). In multivariable models, Camp Lejeune veterans had a 70% higher risk of PD (odds ratio, 1.70; 95% CI, 1.39-2.07;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001). No excess risk was found for other forms of neurodegenerative parkinsonism. Camp Lejeune veterans also had a significantly increased risk of prodromal PD diagnoses, including tremor, anxiety, and erectile dysfunction, and higher cumulative prodromal risk scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-noi230025-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>The study\u2019s findings suggest that the risk of PD is higher in persons exposed to TCE and other VOCs in water 4 decades ago. Millions worldwide have been and continue to be exposed to this ubiquitous environmental contaminant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaneurol.2023.1168","type":"journal-article","created":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T11:34:29Z","timestamp":1684150469000},"page":"673","source":"Crossref","is-referenced-by-count":87,"title":["Risk of Parkinson Disease Among Service Members at Marine Corps Base Camp Lejeune"],"prefix":"10.1001","volume":"80","author":[{"given":"Samuel M.","family":"Goldman","sequence":"first","affiliation":[{"name":"Division of Occupational and Environmental Medicine, University of California, San Francisco"},{"name":"San Francisco Veterans Affairs Health Care System, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances M.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Center of Innovation for Complex Chronic Healthcare, Hines Veterans Affairs Hospital, 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