Occupational exposure and amyotrophic lateral sclerosis in a prospective cohort

2017 · Mixed · Moderate evidence

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MixedModerate evidencePaper 2300

Study snapshot

Publicationmanual · 2017

Study typecohort

Reported directionMixed

Evidence ratingModerate

Abstract

Occupational exposure and amyotrophic lateral sclerosis in a prospective cohort Koeman T, Slottje P, Schouten LJ, Peters S, Huss A, Veldink JH, Kromhout H, van den Brandt PA, Vermeulen R. Occupational exposure and amyotrophic lateral sclerosis in a prospective cohort. Occup Environ Med. 2017 Mar 29. pii: oemed-2016-103780. doi: 10.1136/oemed-2016-103780. Abstract OBJECTIVE: To prospectively study suspected occupational risk factors for amyotrophic lateral sclerosis (ALS). METHODS: For this case-cohort analysis within the prospective Netherlands Cohort Study, 58 279 men and 62 573 women aged 55-69 years at enrollment in 1986 were followed up for 17.3 years on ALS mortality. Information on occupational history and potential confounders were collected at baseline through a self- administered questionnaire and entered for a random subcohort (2092 men and 2074 women) and ALS deaths (76 men and 60 women). Occupational exposure to solvents, pesticides, metals, extremely low frequency magnetic fields (ELF-MFs) and electrical shocks was estimated by means of job exposure matrices (JEMs). Associations between ever/never occupationally exposed and cumulative exposure and ALS mortality were analysed by gender using Cox regression. RESULTS: Occupational exposure to ELF-MF showed a possible association with ALS mortality among men: HR for ever holding a job with high exposure versus background 2.19 (95% (CI): 1.02 to 4.73) and HR for the highest tertile of cumulative exposure versus background 1.93 (95% CI 1.05 to 3.55). INTERPRETATION: These results strengthen the evidence suggesting a positive association between ELF-MF exposure and ALS. We did not replicate earlier positive findings for other occupational exposures. ncbi.nlm.nih.gov

Machine Enhanced Logic

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 typecohort

Effect directionmixed

PopulationMen and women aged 55–69 years at enrollment (1986) in the Netherlands Cohort Study

Sample size120852

ExposureELF · Follow-up 17.3 years; exposure assessed from occupational history at baseline

Evidence strengthModerateConfidence: 78% · Peer reviewed: yes

Main findings

In this case-cohort analysis, occupational exposure to extremely low frequency magnetic fields (ELF-MFs) showed a possible association with ALS mortality among men (HR 2.19, 95% CI 1.02 to 4.73 for ever holding a job with high exposure vs background; HR 1.93, 95% CI 1.05 to 3.55 for highest tertile of cumulative exposure vs background). The study did not replicate earlier positive findings for other occupational exposures (solvents, pesticides, metals, electrical shocks).

Outcomes measured

ALS mortality

Limitations

Outcome was ALS mortality (not incidence)
Exposure estimated using job exposure matrices (JEMs) based on baseline occupational history
Case-cohort sampling (random subcohort plus ALS deaths)

View raw extracted JSON

{
  "study_type": "cohort",
  "exposure": {
    "band": "ELF",
    "source": "occupational",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": "Follow-up 17.3 years; exposure assessed from occupational history at baseline"
  },
  "population": "Men and women aged 55–69 years at enrollment (1986) in the Netherlands Cohort Study",
  "sample_size": 120852,
  "outcomes": [
    "ALS mortality"
  ],
  "main_findings": "In this case-cohort analysis, occupational exposure to extremely low frequency magnetic fields (ELF-MFs) showed a possible association with ALS mortality among men (HR 2.19, 95% CI 1.02 to 4.73 for ever holding a job with high exposure vs background; HR 1.93, 95% CI 1.05 to 3.55 for highest tertile of cumulative exposure vs background). The study did not replicate earlier positive findings for other occupational exposures (solvents, pesticides, metals, electrical shocks).",
  "effect_direction": "mixed",
  "limitations": [
    "Outcome was ALS mortality (not incidence)",
    "Exposure estimated using job exposure matrices (JEMs) based on baseline occupational history",
    "Case-cohort sampling (random subcohort plus ALS deaths)"
  ],
  "evidence_strength": "moderate",
  "confidence": 0.78,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "amyotrophic lateral sclerosis",
    "ALS mortality",
    "occupational exposure",
    "extremely low frequency magnetic fields",
    "ELF-MF",
    "job exposure matrix",
    "case-cohort",
    "Cox regression",
    "Netherlands Cohort Study"
  ],
  "suggested_hubs": [
    {
      "slug": "occupational-exposure",
      "weight": 0.95,
      "reason": "Study evaluates occupational exposures including ELF magnetic fields using job exposure matrices in a prospective cohort."
    }
  ]
}

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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: 10.1136/oemed-2016-103780
PubMed: Not supplied

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