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丹麦队列研究职业与肌萎缩侧索硬化症。

Study of occupation and amyotrophic lateral sclerosis in a Danish cohort.

机构信息

Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

出版信息

Occup Environ Med. 2018 Sep;75(9):630-638. doi: 10.1136/oemed-2018-105110. Epub 2018 Jun 25.

Abstract

OBJECTIVES

Several manuscripts have proposed associations between amyotrophic lateral sclerosis (ALS) and occupational toxicant exposures-not to mention physical activity and trauma/injury. Some have also reported associations in investigations of specific occupations. Using data from a prospective Danish cohort study, we investigated the association between employment in certain industries and ALS diagnosis.

METHODS

We identified 1826 ALS cases who were 25 years old or less in 1964 and diagnosed from 1982 to 2013 from the Danish National Patient Registry then matched 100 population controls to each case based on birth year and sex. Demographic data were linked to the Danish Pension Fund to determine occupation history. Conditional logistic regression models were adjusted for socioeconomic status, marital status and residential location at the index date.

RESULTS

There was an increase in odds of ALS among men who worked in agriculture, hunting, forestry or fishing (adjusted OR (aOR)=1.21; 95% CI 1.02 to 1.45). There was also a positive association for men employed in construction (aOR=1.21; 95% CI 1.05 to 1.39). In women, a protective association was seen with employment in the cleaning industry (aOR=0.69; 95% CI 0.52 to 0.93).

CONCLUSIONS

Our study shows various occupations with exposure to toxicants, such as diesel exhaust and lead, and strenuous physical activity associated with increased odds of ALS in men. Future studies should have a particular focus on gathering detailed information on physical exertion and toxicant exposures specific to certain job tasks.

摘要

目的

有几篇文献提出肌萎缩侧索硬化症(ALS)与职业性毒物暴露之间存在关联-更不用说体力活动和创伤/损伤了。有些研究还报告了特定职业的调查结果存在关联。利用来自丹麦前瞻性队列研究的数据,我们调查了某些行业的就业与 ALS 诊断之间的关系。

方法

我们从丹麦国家患者登记处确定了 1982 年至 2013 年期间 1826 名年龄在 25 岁或以下的 ALS 病例,然后根据出生年份和性别与每位病例匹配了 100 名人群对照。人口统计学数据与丹麦养老金基金相关联,以确定职业史。条件逻辑回归模型调整了社会经济地位、婚姻状况和索引日期的居住地点。

结果

在从事农业、狩猎、林业或渔业的男性中,ALS 的发病几率增加(调整后的比值比(aOR)=1.21;95%CI 1.02 至 1.45)。在从事建筑工作的男性中,也存在阳性关联(aOR=1.21;95%CI 1.05 至 1.39)。在女性中,从事清洁行业与 ALS 的发病几率较低相关(aOR=0.69;95%CI 0.52 至 0.93)。

结论

我们的研究表明,暴露于毒物(如柴油废气和铅)和剧烈体力活动的各种职业与男性 ALS 发病几率增加有关。未来的研究应特别关注收集特定工作任务的体力消耗和毒物暴露的详细信息。

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