Association between essential tremor and blood lead concentration

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

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1707-1711
Number of pages5
JournalEnvironmental health perspectives
Issue number14
StatePublished - Nov 2003
Externally publishedYes


  • Epidemiology
  • Essential tremor
  • Etiology
  • Lead
  • Occupational exposure

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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