Abstract Details

Title Environmental and Occupational Risk Factors for ALS: A Nested Case Control Study

Topic General Neurology

Presentation(s) S21 - Neuroepidemiology (4:06 PM-4:18 PM)

Poster/Presentation
Number 004

Objective

We investigated the association between environmental and occupational exposures including air pollution (AP) and ALS mortality among post-menopausal women within the Women's Health Initiative (WHI) Clinical Trial and Observational Study.

Background The etiology of ALS is largely unknown with only 5-10% of cases familial. Most recently, investigators have explored the relationship of air pollutants especially particulates (PM) and pesticides as risk factors for ALS.

Design/Methods Within the WHI cohort of 161,808 post-menopausal women aged 51-69 recruited in 1993-1998, a nested case-control study was performed among 256 women who died of ALS and 10 controls per case matched on year of birth and enrollment, follow-up time, and U.S. Census region. Environmental/occupational risk factors included military history, farm work/residence, and residential AP exposure estimates. We used available USEPA Air Quality System data and national-scale, log-normal, ordinary kriging for ozone and PM₁₀, PM_2.5, and coarse PM (PM_2.5_–₁₀); and modeled NOx; NO₂; SO₂ at 5, 7.5 & 10 years. Odds ratios (OR, 95% CIs) were estimated using conditional logistic regression controlling for smoking, education, and physical activity.

Results Participants had a mean ±SD age of 64.0±6.4 and most were white race/ethnicity (90.5). Fifty-two percent of cases were ever-smokers compared to 48.7% of controls. Average energy expenditure from hard/strenuous exercise (MET-hours/week) was 4.2±8.5 and 3.4±7.5 respectively. Preliminary analysis revealed an association for PM_2.5_–₁₀ for 7.5 yrs average exposure was noted, OR: 1.07 (95% CI: 1.00-1.14) after adjustment for education, ever-smoking and physical activity. No associations were observed for the remaining pollutants. Within the observational arm of the cohort (n=93,676) cases had higher odds of ever living/working on a farm than controls (adjusted OR=1.59, 95% CI: 1.09-2.31).

Conclusions This is the first study to examine ambient AP and other environmental and occupational exposures in relation to ALS risk in a large cohort of women who died of ALS.

Authors/Disclosures
PRESENTER	No disclosure on file
Angela M. Malek, PhD (Medical University of South Carolina, Department of Public Health Sciences)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
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	No disclosure on file
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