An epidemiologic investigation of amyotrophic lateral sclerosis in Jefferson County, Missouri, 1998-2002.
Amyotrophic lateral sclerosis (ALS) cases diagnosed between 1998 and 2002 were identified to study ALS prevalence and spatial clustering in Jefferson County, Missouri, where an active lead smelter is located. The study used the El Escorial criteria for ALS diagnosis, the capture-recapture analysis for ALS case ascertainment, and the spatial scan statistic for cluster analysis. The estimated crude prevalence of ALS in Jefferson County was 3.9 per 100,000 population (95% CI, 1.7-7.7) at the time point on December 31, 2002. After age-adjustment to the 2002 U.S. population, the prevalence was 4.2 per 100,000 (95% CI, 1.9-6.6). This prevalence estimate was comparable to recent prevalence estimates from Western Europe. A small but significant cluster (p=0.04) was detected around the smelter area. An ALS registry utilizing outpatient, inpatient, and death certificate data is needed to provide comprehensive information for ALS case ascertainment. Etiologic studies are needed to assess whether living in proximity to a lead smelter is associated with the development of ALS.
Turabelidze
George
G
Missouri Department of Health and Senior Services, Jefferson City, MO 63103, USA. George.Turabelidze@dhss.mo.gov
Zhu
Bao-Ping
BP
Schootman
Mario
M
Malone
Joseph L
JL
Horowitz
Steven
S
Weidinger
Joseph
J
Williamson
Dhelia
D
Simoes
Eduardo
E
D000328:Adult; D017677:Age Distribution; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008923:Missouri / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017678:Sex Distribution