Håkansson Niclas, Gustavsson Per, Johansen Christoffer, Floderus Birgitta
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Epidemiology. 2003 Jul;14(4):420-6; discussion 427-8. doi: 10.1097/01.EDE.0000078446.76859.c9.
Previous work has suggested an increase in risk of amyotrophic lateral sclerosis (ALS) and Alzheimer's disease among workers exposed to extremely low-frequency magnetic fields (ELF-MF). We evaluated the relation between ELF-MF from occupational exposures and mortality from neurodegenerative diseases.
The study was based on a cohort of Swedish engineering industry workers, comprising 537,692 men and 180,529 women. The cohort was matched against the 3 most recent censuses and The Causes of Death Registry. Levels of ELF-MF exposure were obtained by linking occupation according to the censuses to a job exposure matrix. We used 4 levels of exposure and considered both the primary and contributing causes of death, 1985-96.
The risk of Alzheimer's disease as primary or contributing cause of death increased with increasing exposure to ELF-MF among both men and women, with a relative risk (RR) of 4.0 and a 95% confidence interval (95% CI) of 1.4-11.7 in the highest exposure group for both sexes combined. There was a RR of 2.2 (95% CI: 1.0-4.7) for ALS in the highest exposure group with the suggestion of an exposure-response relationship. No evidence of increased risk was seen for Parkinson's disease or multiple sclerosis.
The findings support previous observations of an increased risk of Alzheimer's disease and ALS among employees occupationally exposed to ELF-MF. Further studies based on morbidity data are warranted.
先前的研究表明,暴露于极低频磁场(ELF-MF)的工人患肌萎缩侧索硬化症(ALS)和阿尔茨海默病的风险增加。我们评估了职业暴露的ELF-MF与神经退行性疾病死亡率之间的关系。
该研究基于一组瑞典工程行业工人,包括537,692名男性和180,529名女性。该队列与最近的3次人口普查和死亡原因登记处进行了匹配。通过根据人口普查将职业与工作暴露矩阵联系起来,获得ELF-MF暴露水平。我们使用了4个暴露水平,并考虑了1985 - 1996年的主要和次要死亡原因。
阿尔茨海默病作为主要或次要死亡原因的风险在男性和女性中均随着ELF-MF暴露的增加而增加,在最高暴露组中,两性合并的相对风险(RR)为4.0,95%置信区间(95%CI)为1.4 - 11.7。在最高暴露组中,ALS的RR为2.2(95%CI:1.0 - 4.7),提示存在暴露 - 反应关系。未发现帕金森病或多发性硬化症风险增加的证据。
这些发现支持了先前关于职业暴露于ELF-MF的员工中阿尔茨海默病和ALS风险增加的观察结果。有必要基于发病率数据进行进一步研究。