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European Centre for Disease Prevention and Control.

In 1984 we made the first observation of a correlation between early age exposure to rural environment (and drinking well water) and development of idiopathic Parkinson's disease (IPD). 13 These findings were subsequently confirmed elsewhere (Barbeau, 1985 ; 25 Tanner, 1985 26 ). Analysis of all early age onset IPD (EPD) cases born and raised in Saskatchewan revealed that 20 of 22 had exclusively rural exposure during the first 15 years of life. This distribution was significantly different from the general population (p = 0.0141). Further study of the EPD group included sampling and metal analysis of childhood sources of drinking water in 18 cases and 36 age and sex-matched controls. Water collected from the two groups was analyzed for 23 metals (including 7 elements implicated in the etiology of IPD). There was no difference in the metal composition of the water between the two groups. 17 Finally, a review of herbicide and pesticide use in Saskatchewan agriculture was undertaken to determine if there was an increased incidence of EPD following utilization of any particular chemical. No increase was found in the incidence of EPD with the introduction of any pesticide or herbicide, including Paraquat, for agricultural use. We conclude that there is a strong correlation between early age rural environmental exposure and development of IPD. We believe well water is a likely vehicle for the causal agent, but neither water metal concentration nor any of the herbicides and pesticides used in Saskatchewan agriculture are related to the cause. RESUME: Etiologie de la maladie de Parkinson et site geographique, qualite chimique de l'eau potable, pesticides et herbicides. En 1984, nous avons rapporte pour la premiere fois l'obervation d'une correlation entre une exposition a un environnement rural dans le jeune age (et l'absorption d'eau provenant de puits) et le developpement de la maladie de Parkinson idiopathique (MPI). 13 Ces constatations ont ete confirmees subsequemment ailleurs (Barbeau, 1985; 25 Tanner, 1985 26 ). Une analyse de tous les cas de MPI a debut precoce qui sont nes et ont ete eleves en Saskatchewan a revele que 20 de ces 22 cas ont ete exposes a un environnement exclusivement rural pendant les 15 premieres annees de leur vie. Cette distribution etait significativement differente de la population en general (p = 0.0141). Une etude plus poussee du groupe de MPI comportait un echantillonnage des sources d'approvisionnement en eau potable utilisees dans leur enfance chez 18 des cas ainsi que chez 36 controles apparies pour l'age et le sexe et l'analyse des metaux contenus dans ces echantillons, soit 23 metaux dont 7 elements deja mis en cause dans l'etiologie de la MPI. II n'existait pas de difference dans la composition en metaux de l'eau entre les deux groupes.

In February 2015, an outbreak of recently acquired HIV infections among people who inject drugs (PWID) was identified in Dublin, following similar outbreaks in Greece and Romania in 2011. We compared drug and risk behaviours among 15 HIV cases and 39 controls. Injecting a synthetic cathinone, snow blow, was associated with recent HIV infection (AOR: 49; p=0.003). Prevention and control efforts are underway among PWID in Dublin, but may also be needed elsewhere in Europe.

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