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.
Occup Environ Med. 2019 Apr;76(4):208-214. doi: 10.1136/oemed-2018-105469. Epub 2019 Jan 31.
Previous research has indicated links between lead (Pb) exposure and increased risk of neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS). In this study, we evaluated the association between occupational Pb exposures and ALS.
ALS cases were ascertained through the Danish National Patient Registry from 1982 to 2013 and age and sex-matched to 100 controls. Using complete employment history since 1964 from the Danish Pension Fund, cumulative Pb exposure was estimated for each subject via a Danish job exposure matrix. Associations were evaluated using conditional logistic regression analyses and stratified by sex.
For men with >50% probability of exposure, there was an increase in odds of ALS for exposures in the 60th percentile or higher during any time 5 years prior to diagnosis (aOR: 1.35; 95% CI 1.04 to 1.76) and 10 years prior to diagnosis (aOR: 1.33; 95% CI 1.03 to 1.72). No significant associations were observed in women, and there were no linear trends seen for Pb exposures for either sex.
Our study indicates an association between consistently higher occupational Pb exposures and ALS. These findings support those of previously reported associations between ALS and specific occupations that commonly experience Pb exposure.
先前的研究表明，铅（Pb）暴露与神经退行性疾病（包括肌萎缩侧索硬化症，ALS）的风险增加之间存在关联。在这项研究中，我们评估了职业性 Pb 暴露与 ALS 之间的关联。
通过丹麦国家患者登记处，从 1982 年到 2013 年确定 ALS 病例，并与 100 名年龄和性别匹配的对照进行匹配。通过丹麦养老金基金中的完整就业历史（自 1964 年起），使用丹麦工作暴露矩阵，为每位受试者估算累积 Pb 暴露量。使用条件逻辑回归分析并按性别分层来评估关联。
对于暴露概率>50%的男性，在诊断前 5 年任何时间的第 60 百分位数或更高水平的暴露，ALS 的发病几率增加（OR：1.35；95%CI 1.04 至 1.76）和诊断前 10 年（OR：1.33；95%CI 1.03 至 1.72）。在女性中未观察到显著关联，并且对于两种性别，Pb 暴露均无线性趋势。
我们的研究表明，持续较高的职业性 Pb 暴露与 ALS 之间存在关联。这些发现支持先前报告的 ALS 与常见接触 Pb 的特定职业之间存在关联的结果。
