Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta- Analyses

2018 · Harm · Moderate evidence

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HarmModerate evidencePaper 1993

Study snapshot

Publicationmanual · 2018

Study typemeta_analysis

Reported directionHarm

Evidence ratingModerate

Abstract

Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta- Analyses Gunnarsson LG, Bodin L. Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta-Analyses. Int J Environ Res Public Health. 2018 Oct 26;15(11). pii: E2371. doi: 10.3390/ijerph15112371. Abstract Objectives: We conducted a systematic literature review to identify studies fulfilling good scientific epidemiological standards for use in meta-analyses of occupational risk factors for amyotrophic lateral sclerosis (ALS). Methods: We identified 79 original publications on associations between work and ALS. The MOOSE (Meta- analysis Of Observational Studies in Epidemiology) and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) guidelines were used to ensure high scientific quality, and reliable protocols were applied to classify the articles. Thirty-seven articles fulfilled good scientific standards, while 42 were methodologically deficient and thus were excluded from our meta-analyses. Results: The weighted relative risks for the various occupational exposures were respectively; 1.29 (95% confidence interval (CI): 0.97⁻1.72; six articles) for heavy physical work, 3.98 (95% CI: 2.04⁻7.77; three articles) for professional sports, 1.45 (95% CI: 1.07⁻1.96; six articles) for metals, 1.19 (95% CI: 1.07⁻1.33; 10 articles) for chemicals, 1.18 (95% CI: 1.07⁻1.31; 16 articles) for electromagnetic fields or working with electricity, and 1.18 (95% CI: 1.05⁻1.34; four articles) for working as a nurse or physician. Conclusions: Meta-analyses based only on epidemiologic publications of good scientific quality show that the risk of ALS is statistically significantly elevated for occupational exposures to excessive physical work, chemicals (especially pesticides), metals (especially lead), and possibly also to electromagnetic fields and health care work. These results are not explained by publication bias. ncbi.nlm.nih.gov

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AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typemeta_analysis

Effect directionharm

PopulationNot supplied

Sample sizeNot supplied

ExposureNot supplied

Evidence strengthModerateConfidence: 74% · Peer reviewed: yes

Main findings

In meta-analyses restricted to 37 epidemiologic studies judged to have good scientific quality, occupational exposure to electromagnetic fields or working with electricity was associated with a weighted relative risk of 1.18 (95% CI: 1.07–1.31; 16 articles) for ALS. The authors conclude ALS risk is statistically significantly elevated for several occupational exposures and possibly also for electromagnetic fields and health care work, and state results are not explained by publication bias.

Outcomes measured

Amyotrophic lateral sclerosis (ALS) risk

Limitations

Population characteristics and total participant sample size not reported in the abstract
Exposure metrics (e.g., frequency, intensity, duration) for electromagnetic fields not specified
Meta-analysis includes observational studies; residual confounding and exposure misclassification cannot be assessed from the abstract
42 identified publications were excluded as methodologically deficient; criteria details not provided in the abstract

View raw extracted JSON

{
  "study_type": "meta_analysis",
  "exposure": {
    "band": null,
    "source": "occupational (electromagnetic fields or working with electricity)",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": null
  },
  "population": null,
  "sample_size": null,
  "outcomes": [
    "Amyotrophic lateral sclerosis (ALS) risk"
  ],
  "main_findings": "In meta-analyses restricted to 37 epidemiologic studies judged to have good scientific quality, occupational exposure to electromagnetic fields or working with electricity was associated with a weighted relative risk of 1.18 (95% CI: 1.07–1.31; 16 articles) for ALS. The authors conclude ALS risk is statistically significantly elevated for several occupational exposures and possibly also for electromagnetic fields and health care work, and state results are not explained by publication bias.",
  "effect_direction": "harm",
  "limitations": [
    "Population characteristics and total participant sample size not reported in the abstract",
    "Exposure metrics (e.g., frequency, intensity, duration) for electromagnetic fields not specified",
    "Meta-analysis includes observational studies; residual confounding and exposure misclassification cannot be assessed from the abstract",
    "42 identified publications were excluded as methodologically deficient; criteria details not provided in the abstract"
  ],
  "evidence_strength": "moderate",
  "confidence": 0.74,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "amyotrophic lateral sclerosis",
    "ALS",
    "occupational exposure",
    "electromagnetic fields",
    "electricity work",
    "systematic review",
    "meta-analysis",
    "MOOSE",
    "GRADE"
  ],
  "suggested_hubs": [
    {
      "slug": "occupational-exposure",
      "weight": 0.95,
      "reason": "Focuses on occupational risk factors for ALS, including electromagnetic fields/working with electricity."
    }
  ]
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.3390/ijerph15112371
PubMed: Not supplied

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