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Amyotroph Lateral Scler Frontotemporal Degener

Title:		Occupational history associates with ALS survival and onset segment
Author(s):		Goutman SA; Boss J; Godwin C; Mukherjee B; Feldman EL; Batterman SA;
Address:		"Department of Neurology, University of Michigan, Ann Arbor, MI, USA. NeuroNetwork for Emerging Therapies, University of Michigan, Ann Arbor, MI, USA. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA, and. Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA"
Journal Title:		Amyotroph Lateral Scler Frontotemporal Degener
Year:		2023
Volume:		20221003
Issue:		3-Apr
Page Number:		219 - 229
DOI:		10.1080/21678421.2022.2127324
ISSN/ISBN:		2167-9223 (Electronic) 2167-8421 (Print) 2167-8421 (Linking)
Abstract:		"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"
Keywords:		Male Humans Female *Amyotrophic Lateral Sclerosis/diagnosis/epidemiology/etiology Risk Factors Prospective Studies *Occupational Exposure/adverse effects *Military Personnel Amyotrophic lateral sclerosis occupation phenotype survival;
Notes:		"MedlineGoutman, Stephen A Boss, Jonathan Godwin, Christopher Mukherjee, Bhramar Feldman, Eva L Batterman, Stuart A eng R01 TS000289/TS/ATSDR CDC HHS/ R01TS000289/ACL/ACL HHS/ K23 ES027221/ES/NIEHS NIH HHS/ R01 ES030049/ES/NIEHS NIH HHS/ P30 ES017885/ES/NIEHS NIH HHS/ R01 NS127188/NS/NINDS NIH HHS/ Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S. England 2022/10/05 Amyotroph Lateral Scler Frontotemporal Degener. 2023 May; 24(3-4):219-229. doi: 10.1080/21678421.2022.2127324. Epub 2022 Oct 3"