Fang Fang, Quinlan Patricia, Ye Weimin, Barber Marie K, Umbach David M, Sandler Dale P, Kamel Freya
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health/DHHS, Research Triangle Park, NC 27709, USA.
Environ Health Perspect. 2009 Sep;117(9):1387-92. doi: 10.1289/ehp.0900580. Epub 2009 May 11.
Occupation has been suggested to play a role in amyotrophic lateral sclerosis (ALS) etiology, but detailed information on the importance of specific workplace exposures is lacking.
Our aim was to assess the relationship between workplace exposures and the risk of ALS and to evaluate potential interactions between these exposures and smoking.
We conducted a case-control study in New England between 1993 and 1996, comprising 109 cases and 253 controls who completed a structured interview covering occupations and workplace exposures. Unconditional logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for ALS. Analyses were conducted among the entire study population and after stratification by smoking.
We observed a higher risk of ALS for construction workers excluding supervisors (OR = 2.9; 95% CI, 1.2-7.2) and precision metal workers (OR = 3.5; 95% CI, 1.2-10.5). Self-reported exposures to paint strippers; cutting, cooling, or lubricating oils; antifreeze or coolants; mineral or white spirits; and dry cleaning agents each appeared to be associated with a 60-90% higher risk. Specific chemicals related to a > 50% increase in risk of ALS included aliphatic chlorinated hydrocarbons, glycols, glycol ethers, and hexane. Relative risks associated with these workplace exposures and chemicals were greater among nonsmokers and persisted in mutually adjusted models.
Our data suggest that certain occupations and workplace exposures may be associated with increased risk of ALS. These results need to be confirmed in independent populations.
有研究表明职业在肌萎缩侧索硬化症（ALS）病因中起一定作用，但缺乏关于特定工作场所暴露重要性的详细信息。
我们的目的是评估工作场所暴露与ALS风险之间的关系，并评估这些暴露与吸烟之间的潜在相互作用。
1993年至1996年期间，我们在新英格兰地区进行了一项病例对照研究，包括109例病例和253例对照，他们完成了一项涵盖职业和工作场所暴露的结构化访谈。使用无条件逻辑回归模型估计ALS的比值比（OR）和95%置信区间（CI）。在整个研究人群中以及按吸烟情况分层后进行分析。
我们观察到，不包括主管的建筑工人（OR = 2.9；95%CI，1.2 - 7.2）和精密金属工人（OR = 3.5；95%CI，1.2 - 10.5）患ALS的风险更高。自我报告接触脱漆剂、切割、冷却或润滑油、防冻液或冷却液、矿物油或白酒精以及干洗剂似乎都与风险高60 - 90%相关。与ALS风险增加>50%相关的特定化学物质包括脂肪族氯代烃、二醇、二醇醚和己烷。这些工作场所暴露和化学物质与非吸烟者的相对风险更高，并且在相互调整模型中仍然存在。
我们的数据表明，某些职业和工作场所暴露可能与ALS风险增加有关。这些结果需要在独立人群中得到证实。
