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Int Arch Occup Environ Health

Title:		Associations of self-reported occupational exposures and settings to ALS: a case-control study
Author(s):		Goutman SA; Boss J; Godwin C; Mukherjee B; Feldman EL; Batterman SA;
Address:		"Department of Neurology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109-5223, USA. sgoutman@med.umich.edu. NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, USA. sgoutman@med.umich.edu. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA. Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA. Department of Neurology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109-5223, USA. NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, USA"
Journal Title:		Int Arch Occup Environ Health
Year:		2022
Volume:		20220520
Issue:		7
Page Number:		1567 - 1586
DOI:		10.1007/s00420-022-01874-4
ISSN/ISBN:		1432-1246 (Electronic) 0340-0131 (Print) 0340-0131 (Linking)
Abstract:		"BACKGROUND: Environmental exposures contribute to the pathogenesis of amyotrophic lateral sclerosis (ALS), a fatal and progressive neurological disease. Identification of these exposures is important for targeted screening and risk factor modification. OBJECTIVE: To identify occupational exposures that are associated with a higher risk of ALS using both survey and standard occupational classification (SOC) coding procedures, and to highlight how exposure surveys can complement SOC coding. METHODS: ALS participants and neurologically healthy controls recruited in Michigan completed a detailed exposure assessment on their four most recent and longest held occupations. Exposure scores were generated from the exposure survey, and occupations were assigned to SOC codes by experienced exposure scientists. RESULTS: This study included 381 ALS and 272 control participants. ALS participants reported higher duration-adjusted occupational exposure to particulate matter (OR = 1.45, 95% CI 1.19-1.78, p < 0.001), volatile organic compounds (OR = 1.22, 95% CI 1.02-1.45, p = 0.029), metals (OR = 1.48, 95% CI 1.21-1.82, p < 0.001), and combustion and diesel exhaust pollutants (OR = 1.20, 95% CI 1.01-1.43, p = 0.041) prior to ALS diagnosis, when adjusted for sex, age, and military service compared to controls. In multivariable models, only occupational exposure to metals remained significant risk (OR = 1.56, 95% CI 1.11-2.20, p = 0.011), although in an adaptive elastic net model, particulate matter (OR = 1.203), pesticides (OR = 1.015), and metals (1.334) were all selected as risk factors. Work in SOC code 'Production Occupations' was associated with a higher ALS risk. SOC codes 'Building and Grounds Cleaning and Maintenance Occupations', 'Construction and Extraction Occupations', 'Installation, Maintenance, and Repair Occupations', and 'Production Occupations' were all associated with a higher exposure to metals as determined using survey data. DISCUSSION: Occupational exposure to particulate matter, volatile organic compounds, metals, pesticides, and combustion and diesel exhaust and employment in 'Production Occupations' was associated with an increased ALS risk in this cohort"
Keywords:		*Amyotrophic Lateral Sclerosis Case-Control Studies Humans Metals *Occupational Exposure Particulate Matter *Pesticides Risk Factors Self Report Vehicle Emissions *Volatile Organic Compounds Amyotrophic lateral sclerosis Exposome Occupation;
Notes:		"MedlineGoutman, Stephen A Boss, Jonathan Godwin, Christopher Mukherjee, Bhramar Feldman, Eva L Batterman, Stuart A eng R01 TS000289/TS/ATSDR CDC HHS/ R01 ES030049/ES/NIEHS NIH HHS/ P30 ES017885/ES/NIEHS NIH HHS/ K23 ES027221/ES/NIEHS NIH HHS/ Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S. Germany 2022/05/21 Int Arch Occup Environ Health. 2022 Sep; 95(7):1567-1586. doi: 10.1007/s00420-022-01874-4. Epub 2022 May 20"