Lifetime occupation, education, smoking, and risk of ALS
Abstract
Objective: To investigate the association between cigarette smoking, level of education, occupation, and the occurrence of sporadic amyotrophic lateral sclerosis (ALS).
Methods: A total of 364 patients and 392 controls completed a questionnaire covering smoking habits, level of education, and occupational history. Main occupations were coded according to the International Standard Classification of Occupations and compared between patients and controls.
Results: The univariate analysis showed an increased risk of developing ALS among current cigarette smokers (OR = 1.7; 95% CI = 1.1 to 2.6; p = 0.01), those with a low level of education (elementary school) (OR = 2.2; 95% CI = 1.2 to 3.8; p < 0.01), and among women whose main occupation was classified as crafts and related trades workers (OR = 8.4; 95% CI = 1.0 to 70.1; p = 0.05). Multivariate analysis (with covariates age, smoking, education, and occupation) showed an increased risk for current smokers of cigarettes (OR = 1.6; 95% CI = 1.0 to 2.5; p = 0.04).
Conclusions: Occupation, education, and cigarette smoking are risk factors for amyotrophic lateral sclerosis, but only smoking appeared independently associated.
GLOSSARY: ALS = amyotrophic lateral sclerosis; ILO = International Labor Organization; ISCO = International Standard Classification of Occupations; JEM = job-exposure matrix.
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REFERENCES
1.
Rowland LP, Shneider NA. Amyotrophic lateral sclerosis. N Engl J Med 2001;344:1688–1700.
2.
Brown RH Jr. Amyotrophic lateral sclerosis. Insights from genetics. Arch Neurol 1997;54:1246–1250.
3.
Slowik A, Tomik B, Wolkow PP, et al. Paraoxonase gene polymorphisms and sporadic ALS. Neurology 2006;67:766–770.
4.
Saeed M, Siddique N, Hung WY, et al. Paraoxonase cluster polymorphisms are associated with sporadic ALS. Neurology 2006;67:771–776.
5.
Frigerio R, Elbaz A, Sanft KR, et al. Education and occupations preceding Parkinson disease: a population-based case-control study. Neurology 2005;65:1575–1583.
6.
Chio A, Benzi G, Dossena M, Mutani R, Mora G. Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players. Brain 2005;128(Pt 3):472–476.
7.
Belli S, Vanacore N. Proportionate mortality of Italian soccer players: is amyotrophic lateral sclerosis an occupational disease? Eur J Epidemiol 2005;20:237–242.
8.
Weisskopf MG, O’Reilly EJ, McCullough ML, et al. Prospective study of military service and mortality from ALS. Neurology 2005;64:32–37.
9.
Weisskopf MG, McCullough ML, Morozova N, Calle EE, Thun MJ, Ascherio A. Prospective study of occupation and amyotrophic lateral sclerosis mortality. Am J Epidemiol 2005;162:1146–1152.
10.
Haley RW. Excess incidence of ALS in young Gulf War veterans. Neurology 2003;61:750–756.
11.
Gunnarsson LG, Lindberg G, Soderfeldt B, Axelson O. Amyotrophic lateral sclerosis in Sweden in relation to occupation. Acta Neurol Scand 1991;83:394–398.
12.
Park RM, Schulte PA, Bowman JD, et al. Potential occupational risks for neurodegenerative diseases. Am J Ind Med 2005;48:63–77.
13.
Schulte PA, Burnett CA, Boeniger MF, Johnson J. Neurodegenerative diseases: occupational occurrence and potential risk factors, 1982 through 1991. Am J Public Health 1996;86:1281–1288.
14.
Armon C. An evidence-based medicine approach to the evaluation of the role of exogenous risk factors in sporadic amyotrophic lateral sclerosis. Neuroepidemiology 2003;22:217–228.
15.
Brooks BR. El Escorial World Federation of Neurology criteria for the diagnosis of amyotrophic lateral sclerosis. Subcommittee on Motor Neuron Diseases/Amyotrophic Lateral Sclerosis of the World Federation of Neurology Research Group on Neuromuscular Diseases and the El Escorial “Clinical limits of amyotrophic lateral sclerosis” workshop contributors. J Neurol Sci 1994;124 suppl:96–107.
16.
Veldink JH, Kalmijn S, Groeneveld GJ, Titulaer MJ, Wokke JH, Van den Berg LH. Physical activity and the association with sporadic ALS. Neurology 2005;64:241–245.
17.
Traynor BJ, Codd MB, Corr B, Forde C, Frost E, Hardiman OM. Clinical features of amyotrophic lateral sclerosis according to the El Escorial and Airlie House diagnostic criteria: a population-based study. Arch Neurol 2000;57:1171–1176.
18.
Beghi E, Millul A, Micheli A, Vitelli E, Logroscino G. Incidence of ALS in Lombardy, Italy. Neurology 2007;68:141–145.
19.
Nelson LM, McGuire V, Longstreth WT Jr, Matkin C. Population-based case-control study of amyotrophic lateral sclerosis in western Washington State. I. Cigarette smoking and alcohol consumption. Am J Epidemiol 2000;151:156–163.
20.
Weisskopf MG, McCullough ML, Calle EE, Thun MJ, Cudkowicz M, Ascherio A. Prospective study of cigarette smoking and amyotrophic lateral sclerosis. Am J Epidemiol 2004;160:26–33.
21.
Kamel F, Umbach DM, Munsat TL, Shefner JM, Sandler DP. Association of cigarette smoking with amyotrophic lateral sclerosis. Neuroepidemiology 1999;18:194–202.
22.
Chancellor AM, Slattery JM, Fraser H, Warlow CP. Risk factors for motor neuron disease: a case-control study based on patients from the Scottish Motor Neuron Disease Register. J Neurol Neurosurg Psychiatry 1993;56:1200–1206.
23.
Granieri E, Carreras M, Tola R, et al. Motor neuron disease in the province of Ferrara, Italy, in 1964–1982. Neurology 1988;38:1604–1608.
24.
Bharucha NE, Schoenberg BS, Raven RH, Pickle LW, Byar DP, Mason TJ. Geographic distribution of motor neuron disease and correlation with possible etiologic factors. Neurology 1983;33:911–915.
25.
Bracco L, Antuono P, Amaducci L. Study of epidemiological and etiological factors of amyotrophic lateral sclerosis in the province of Florence, Italy. Acta Neurol Scand 1979;60:112–124.
26.
Minkler M, Fuller-Thomson E, Guralnik JM. Gradient of disability across the socioeconomic spectrum in the United States. N Engl J Med 2006;355:695–703.
27.
Beretta S, Carri MT, Beghi E, Chio A, Ferrarese C. The sinister side of Italian soccer. Lancet Neurol 2003;2:656–657.
28.
Beghi E, Morrison KE. ALS and military service. Neurology 2005;64:6–7.
29.
Davanipour Z, Sobel E, Bowman JD, Qian Z, Will AD. Amyotrophic lateral sclerosis and occupational exposure to electromagnetic fields. Bioelectromagnetics 1997;18:28–35.
30.
Feychting M, Jonsson F, Pedersen NL, Ahlbom A. Occupational magnetic field exposure and neurodegenerative disease. Epidemiology 2003;14:413–419.
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Published online: October 8, 2007
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