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NEUROLOGY 1980;30:453
© 1980 American Academy of Neurology

Epidemiology of amyotrophic lateral sclerosis

1. A case-control comparison based on ALS deaths

John F. Kurtzke, M.D and Gilbert W. Beebe, Ph.D.

Departments of Neurology and Community Medicine. Georgetown University School of Medicine, and the Neurology Service, Veterans Administration Medical Center, Washington, DC (Dr. Kurtzke), and the Medical Follow-up Agency, National Academy of sciences-National Research Council, Washington, DC (Dr. Beebe).

Deaths coded to amyotrophic lateral sclerosis (ALS) for the years 1963 to 1967 among U.S. males were matched against military files to identify 504 World War II veterans. Military controls for these 504 men were matched for year of birth, date of entry into military service, and branch of service. Hospital records of 37 representative deaths coded as ALS among veterans were reviewed, and 36 were accepted as definite ALS. Military records were abstracted for information about preservice demographic and other factors, the physical examination for entry into service, and the medical history and factors characterizing the military career during World War II.

There was a deficit of blacks with ALS, which did not attain statistical significance (p = 0.08). Several differences in preservice occupations were found: Truck drivers and "operatives" were in excess. There was no significant difference between ALS cases and controls in aggregate scores on sports activity before service, although baseball was more often listed by the ALS cases than by controls. The ALS patients significantly more often gave histories of trauma or surgical operations before service, and during service had a significant excess of hospitalizations for trauma and in particular for fractures of the limbs.

Address correspondence and reprint requests to Dr. Kurtzke. Neurology Service, VAMC, Washington, DC 20422.

This study was supported by the National Institute of Neurological and Communicative Disorders and Stroke under Contracts PH-43-64 44, Task Order No. 62. and NO1-NS-5-2315, and by the Veterans Administration.

Presented at the annual meeting of the Society for Epidemiologic Research, Seattle, WA, June 1977

Accepted for publication September 4, 1979.




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