Occupational lead exposure and survival with amyotrophic lateral sclerosis

Te Wei Wang, Joanne Wuu, Anne Cooley, Tian Shin Yeh, Michael Benatar, Marc Weisskopf

研究成果: 雜誌貢獻文章同行評審

4 引文 斯高帕斯(Scopus)

摘要

Objective: Lead exposure has been hypothesized to increase the risk of ALS, but only two studies have examined the association with ALS survival, and with inconsistent results. The use of occupational history to assess lead exposure can avoid reverse causation that may occur in epidemiologic analyses that use biomarkers of lead exposure collected after ALS onset. Methods: We evaluated the relationship of occupational lead exposure to ALS survival among 135 cases from an international ALS cohort that included deep phenotyping, careful follow-up, and questionnaires to quantify participants’ occupation history. ALS patients were recruited in 2015–2019. We determined occupational lead exposure using a job-exposure matrix. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for survival using Cox proportional hazard analysis with adjustment for covariates. Results: A total of 135 ALS patients completed the environmental questionnaires, among whom 38 reached a survival endpoint (death or permanent assisted ventilation). The median survival was 48.3 months (25th–75th percentile, 30.9–74.1). Older patients and those with initial symptom other than limb onset had shorter survival time. There were 36 ALS cases with occupational lead exposure. After adjusting for age, sex, site of onset, smoking, and military service, lead exposure was associated with an HR of 3.26 (95%CI 1.28–8.28). Results with adjustment for subsets of these covariates were similar. Conclusions: These results suggest that lead exposure prior to onset of ALS is associated with shorter survival following onset of ALS, and this association is independent of other prognostic factors.

原文英語
頁(從 - 到)100-107
頁數8
期刊Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
24
發行號1-2
DOIs
出版狀態接受/付印 - 2022
對外發佈

ASJC Scopus subject areas

  • 神經內科
  • 神經病學(臨床)

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