Details:

Alternative Title:
Amyotroph Lateral Scler Frontotemporal Degener
Personal Author:
Wang, Te-Wei ; Wuu, Joanne ; Cooley, Anne ; Yeh, Tian-Shin ; Benatar, Michael ; ... More +
Wang, Te-Wei ; Wuu, Joanne ; Cooley, Anne ; Yeh, Tian-Shin ; Benatar, Michael ; Weisskopf, Marc Less -
Description:
Objective:

Lead exposure has been hypothesised to increase the risk of ALS, but only two studies have examined the association with ALS survival, and with inconsistent results. The use of occupational history to assess lead exposure can avoid reverse causation that may occur in epidemiologic analyses that use biomarkers of lead exposure collected after ALS onset.

Methods:

We evaluated the relationship of occupational lead exposure to ALS survival among 135 cases from an international ALS cohort that included deep phenotyping, careful follow-up, and questionnaires to quantify participants’ occupation history. ALS patients were recruited in 2015–2019. We determined occupational lead exposure using a job-exposure matrix. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for survival using Cox proportional hazard analysis with adjustment for covariates.

Results:

135 ALS patients completed the environmental questionnaires, among whom 38 reached a survival endpoint (death or permanent assisted ventilation). The median survival was 48.3 months (25th – 75th percentile, 30.9–74.1). Older patients and those with initial symptom other than limb onset had shorter survival time. There were 36 ALS cases with occupational lead exposure. After adjusting for age, sex, site of onset, smoking, and military service, lead exposure was associated with an HR of 3.26 (95%CI 1.28–8.28). Results with adjustment for subsets of these covariates were similar.

Conclusions:

These results suggest that lead exposure prior to onset of ALS is associated with shorter survival following onset of ALS, and this association is independent of other prognostic factors.


Subjects:
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Amyotrophic Lateral Sclerosis Lead Occupational Exposure Proportional Hazards Models Risk Factors Smoking
Source:
Amyotroph Lateral Scler Frontotemporal Degener. 24(1-2):100-107
Pubmed ID:
35400246
Pubmed Central ID:
PMC9547984
Document Type:
Journal Article
Funding:
P30 ES000002/ES/NIEHS NIH HHSUnited States/ ; R01 TS000244/TS/ATSDR CDC HHSUnited States/ ; U54 NS092091/NS/NINDS NIH HHSUnited States/
P30 ES000002/ES/NIEHS NIH HHSUnited States/ ; R01 TS000244/TS/ATSDR CDC HHSUnited States/ ; U54 NS092091/NS/NINDS NIH HHSUnited States/ Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:c24f22764595af690c3da0102efa4bd16302149f3dda061961ba8e9c661e2c05
File Type:

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