Occupational exposure and amyotrophic lateral sclerosis in a prospective cohort

Occup Environ Med. 2017 Aug;74(8):578-585. doi: 10.1136/oemed-2016-103780. Epub 2017 Mar 29.

Abstract

Objective: To prospectively study suspected occupational risk factors for amyotrophic lateral sclerosis (ALS).

Methods: For this case-cohort analysis within the prospective Netherlands Cohort Study, 58 279 men and 62 573 women aged 55-69 years at enrolment in 1986 were followed up for 17.3 years on ALS mortality. Information on occupational history and potential confounders were collected at baseline through a self-administered questionnaire and entered for a random subcohort (2092 men and 2074 women) and ALS deaths (76 men and 60 women). Occupational exposure to solvents, pesticides, metals, extremely low frequency magnetic fields (ELF-MFs) and electrical shocks was estimated by means of job exposure matrices (JEMs). Associations between ever/never occupationally exposed and cumulative exposure and ALS mortality were analysed by gender using Cox regression.

Results: Occupational exposure to ELF-MF showed a possible association with ALS mortality among men: HR for ever holding a job with high exposure versus background 2.19 (95% (CI): 1.02 to 4.73) and HR for the highest tertile of cumulative exposure versus background 1.93 (95% CI 1.05 to 3.55).

Interpretation: These results strengthen the evidence suggesting a positive association between ELF-MF exposure and ALS. We did not replicate earlier positive findings for other occupational exposures.

Keywords: Amyotrophic Lateral Sclerosis; Electromagnetic fields; metals; occupation; pesticides.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Amyotrophic Lateral Sclerosis / epidemiology
  • Amyotrophic Lateral Sclerosis / etiology*
  • Electromagnetic Fields / adverse effects*
  • Female
  • Humans
  • Male
  • Metals / adverse effects
  • Middle Aged
  • Netherlands / epidemiology
  • Occupational Diseases / epidemiology
  • Occupational Diseases / etiology*
  • Occupational Exposure / adverse effects*
  • Pesticides / adverse effects
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Sex Distribution
  • Solvents / adverse effects
  • Surveys and Questionnaires

Substances

  • Metals
  • Pesticides
  • Solvents