Objective: To determine whether welders exhibit Parkinsonian-like motor balance phenotypes by projecting clinical balance scores into Hoehn and Yahr severity space using a PD-trained predictive model.

Background: Chronic occupational exposure to welding fumes has been associated with secondary parkinsonism and motor dysfunction. However, welders lack a structured clinical framework for quantifying motor severity. Parkinson’s disease (PD) motor impairment is systematically classified using Hoehn and Yahr (HY) staging, providing a validated reference severity scale.

Method: In this exploratory cross-sectional study, 15 patients with clinically staged PD (HY 1-4) and 16 experienced male welders without a PD diagnosis were evaluated. Balance performance was assessed using the Berg Balance Scale (BBS), Mini-BESTest, and Falls Efficacy Scale (FES). Random Forest–based classification models were trained exclusively on PD data and validated using leave-one-out cross-validation (LOOCV). A weighted aggregation model (Model 5), incorporating F1-macro–based weights, was applied to project welders into HY-like severity stages.

Results: The aggregated PD-trained model projected 75% of welders into Stage I and 25% into Stage III severity space. No welders were projected into advanced stages (IV–V). These projections reflect balance phenotype similarity within a PD-derived severity framework rather than clinical diagnosis.

Conclusion: This study introduces a structured mapping framework for situating occupational motor balance phenotypes within a validated neurodegenerative severity reference model. The observed partial overlap with early PD stages suggests potential occupational motor vulnerability and supports longitudinal investigation of motor trajectories in exposed workers. Future studies integrating MDS-UPDRS, blood manganese biomarkers, and neuroimaging will validate projections and establish biological correlates of severity.

References: Kwakye GF, Paoliello MM, Mukhopadhyay S, Bowman AB, Aschner M. Manganese-Induced Parkinsonism and Parkinson’s Disease: Shared and Distinguishable Features. Int J Environ Res Public Health. 2015 Jul 6;12(7):7519-40. doi: 10.3390/ijerph120707519. PMID: 26154659; PMCID: PMC4515672.

Andruska, K.M., Racette, B.A. Neuromythology of Manganism. Curr Epidemiol Rep 2, 143–148 (2015). https://doi.org/10.1007/s40471-015-0040-x

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-clinical-mapping-framework-for-motor-balance-impairment-in-welders-projected-against-parkinson-disease-severity-stages/