Kamel Freya, Umbach David M, Munsat Theodore L, Shefner Jeremy M, Hu Howard, Sandler Dale P
National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
Epidemiology. 2002 May;13(3):311-9. doi: 10.1097/00001648-200205000-00012.
Previous interview-based studies have suggested that exposure to neurotoxicants including metals might be related to ALS.
We evaluated the relation of lead exposure to ALS, using both biological measures and interviews, in a case-control study conducted in New England from 1993 to 1996. Cases (N = 109) were recruited at two hospitals in Boston, MA. Population controls (N = 256) identified by random-digit dialing were frequency-matched to cases by age, sex, and region of residence within New England.
Risk of ALS was associated with self-reported occupational exposure to lead (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 1.1-3.3), with a dose response for lifetime days of lead exposure. Blood and bone lead levels were measured in most cases (N = 107) and in a subset of controls (N = 41). Risk of ALS was associated with elevations in both blood and bone lead levels. ORs were 1.9 (95% CI = 1.4-2.6) for each microg/dl increase in blood lead, 3.6 (95% CI = 0.6-20.6) for each unit increase in log-transformed patella lead, and 2.3 (95% CI = 0.4-14.5) for each unit increase in log-transformed tibia lead.
These results are consistent with previous reports and suggest a potential role for lead exposure in the etiology of ALS.
先前基于访谈的研究表明，接触包括金属在内的神经毒物可能与肌萎缩侧索硬化症（ALS）有关。
在1993年至1996年于新英格兰地区进行的一项病例对照研究中，我们使用生物学测量和访谈评估了铅暴露与ALS之间的关系。病例（N = 109）在马萨诸塞州波士顿的两家医院招募。通过随机数字拨号确定的人群对照（N = 256）按年龄、性别和新英格兰地区居住区域与病例进行频率匹配。
ALS风险与自我报告的职业性铅暴露相关（比值比[OR] = 1.9；95%置信区间[CI] = 1.1 - 3.3），且与终生铅暴露天数存在剂量反应关系。在大多数病例（N = 107）和一部分对照（N = 41）中测量了血铅和骨铅水平。ALS风险与血铅和骨铅水平升高均相关。血铅每增加1微克/分升，OR为1.9（95% CI = 1.4 - 2.6）；髌骨铅对数转换值每增加1个单位，OR为3.6（95% CI = 0.6 - 20.6）；胫骨铅对数转换值每增加1个单位，OR为2.3（95% CI = 0.4 - 14.5）。
这些结果与先前的报告一致，并表明铅暴露在ALS病因学中可能发挥作用。
