Occupational History Associates with ALS Survival and Onset Segment

Details

• Personal Author:
  Batterman SA ; Boss J ; Feldman EL ; Godwin C ; Goutman SA ; Mukherjee B
• Description:
  Objective: To identify associations between occupational settings and self-reported occupational exposures on amyotrophic lateral sclerosis (ALS) survival and phenotypes. Methods: All patients seen in the University of Michigan Pranger ALS Clinic were invited to complete an exposure assessment querying past occupations and exposures. Standard occupational classification (SOC) codes for each job and the severity of various exposure types were derived. Cox proportional hazards models associated all-cause mortality with occupational settings and the self-reported exposures after adjusting for sex, diagnosis age, revised El Escorial criteria, onset segment, revised ALS Functional Rating Scale (ALSFRS-R), and time from symptom onset to diagnosis. Multinomial logistic regression models with three categories, adjusted for age, assessed the association between occupational settings and exposures to onset segment. Results: Among the 378 ALS participants (median age, 64.7 years; 54.4% male), poorer survival was associated with work in SOC code "Production Occupations" and marginally with work in "Military Occupation"; poor survival associated with self-reported occupational pesticide exposure in adjusted models. Among onset segments: cervical onset was associated with ALS participants having ever worked in "Buildings and Grounds Cleaning and Maintenance Occupations," "Construction and Extraction Occupations," and "Production Occupations"; bulbar onset with self-reported occupational exposure to radiation; and cervical onset with exposure to particulate matter, volatile organic compounds, metals, combustion and diesel exhaust, electromagnetic radiation, and radiation. Conclusion: Occupational settings and self-reported exposures influence ALS survival and onset segment. Further studies are needed to explore and understand these relationships, most advantageously using prospective cohorts and detailed ALS registries. [Description provided by NIOSH]
• Subjects:
  Epidemiology Mortality Occupational Exposure Occupational Health Safety
• Keywords:
  Author Keywords: Amyotrophic Lateral Sclerosis Exposure Assessment Mortality Data Neurological Diseases Occupation Occupational Exposure Occupations Phenotype Survival Survival Rate
• ISSN:
  2167-8421
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  219-229
• Volume:
  24
• Issue:
  3
• NIOSHTIC Number:
  nn:20070720
• Citation:
  Amyotroph Lateral Scler Frontotemporal Degener 2023 May; 24(3-4):219-229
• Contact Point Address:
  Stephen A. Goutman, Department of Neurology, 1500 E Medical Center Dr, Ann Arbor, MI48109-5223, USA
• Email:
  sgoutman@med.umich.edu
• Federal Fiscal Year:
  2023
• Performing Organization:
  University of Michigan, Ann Arbor
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:494a770fcee875d9048c66ae10b8fca0009eea467c38c09f2c7b662dc85ab7f72c64ff435b12a5d48c6b9c29319a022dc7547cb36e48ac47999ebc379cc10f84
• Download URL:
  https://stacks.cdc.gov/view/cdc/208892/cdc_208892_DS1.pdf
• File Type:
  [PDF - 1.15 MB ]