American Journal of Epidemiology Vol. 145, No. 12: 1076-1088
Copyright © 1997 by The Johns Hopkins University School of Hygiene and Public Health
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Occupational Exposures and Amyotrophic Lateral Sclerosis. A Population-based Case-Control Study
1Department of Epidemiology, School of Public Health and Community Medicine, University of Washington Seattle, WA
2Department of Neurology, School of Medicine, University of Washington Seattle, WA
3Department of Health Research and Policy, School of Medicine, Stanford University Stanford, CA
4Department of Health Services, School of Public Health and Community Medicine, University of Washington Seattle, WA
5Department of Environ mental Health, School of Public Health and Community Medicine, University of Washington Seattle, WA
6Department of Biostatistics, School of Public Health and Community Medicine, University of Washington Seattle, WA
Reprint requests to Dr. W. T. Longstreth, Jr., Department of Neurology, University of Washington School of Medicine, Seattle, WA 98195-9775.
This population-based case-control study was conducted in three counties in western Washington State to evaluate associations between workplace exposures and the risk of amyotrophic lateral sclerosis (ALS). Cases (n = 174) were all newly diagnosed with ALS by neurologists during 1990–1994, and controls (n = 348), who were matched according to age (±5 years) and sex, were identified via random-digit dialing or Medicare enrollment files. Four industrial hygienists blindly assessed detailed lifetime job histories for exposures to metals, solvents, and agricultural chemicals. Case-control comparisons were made for jobs held between 15 years of age and 10 years prior to the cases' dates of diagnosis. After adjustment for age and education, ever exposure to agricultural chemicals was associated with ALS (odds ratio (OR) = 2.0, 95% confidence interval (CI) 1.1–3.5); this association was observed separately in men (OR = 2.4, 95% CI 1.2–4.8) but not in women (OR = 0.9, 95% CI 0.2–3.8). Among men, the odds ratio for low exposure to agricultural chemicals (below the median level for exposed controls) relative to no exposure was 1.5 (95% CI 0.4–5.3), and for high exposure, it was 2.8 (95% CI 1.3–6.1) (p for trend = 0.03). Similar analyses based on the panel's assessment of exposures to metals and solvents showed no associations. These findings suggest an association between ALS and agricultural chemicals in men. Am J Epidemiol 1997; 145: 1076-88.
agriculture; amyotrophic lateral sCIerosis; metals; occupational exposure; solvents
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