title: Exposure to hazardous air pollutants and the risk of amyotrophic lateral sclerosis.
abstract: BACKGROUND
  Amyotrophic lateral sclerosis (ALS) is a serious and rapidly fatal neurodegenerative disorder with an annual incidence of 1-2.6/100,000 persons. Few known risk factors exist although gene-environment interaction is suspected. We investigated the relationship between suspected neurotoxicant hazardous air pollutants (HAPs) exposure and ALS.
  
  
  METHODS
  A case-control study involving sporadic ALS cases (n = 51) and matched controls (n = 51) was conducted from 2008 to 2011. Geocoded residential addresses were linked to U.S. EPA NATA data (1999, 2002, and 2005) by census tract. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression.
  
  
  RESULTS
  Residential exposure to aromatic solvents significantly elevated the risk of ALS among cases compared to controls in 2002 (OR = 5.03, 95% CI: 1.29, 19.53) and 1999 (OR = 4.27, 95% CI: 1.09, 16.79) following adjustment for education, smoking, and other exposure groups. Metals, pesticides, and other HAPs were not associated with ALS.
  
  
  CONCLUSIONS
  A potential relationship is suggested between residential ambient air aromatic solvent exposure and risk of ALS in this study.
authors.affiliation: Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, 29425, USA. Electronic address: malek@musc.edu.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Malek
authors.affiliation: Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15219, USA. Electronic address: aab20@pitt.edu.
authors.forename: Aaron
authors.initials: A
authors.lastname: Barchowsky
authors.affiliation: Division of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, 85013, USA; Division of Neurobiology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, 85013, USA. Electronic address: Robert.Bowser@DignityHealth.org.
authors.forename: Robert
authors.initials: R
authors.lastname: Bowser
authors.affiliation: Department of Neurology, College of Medicine, Drexel University, Philadelphia, PA, 19107, USA. Electronic address: Terry.Heiman-Patterson@drexelmed.edu.
authors.forename: Terry
authors.initials: T
authors.lastname: Heiman-Patterson
authors.affiliation: Department of Pathology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA; Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, 15213, USA. Electronic address: lacomisd@upmc.edu.
authors.forename: David
authors.initials: D
authors.lastname: Lacomis
authors.affiliation: Department of Neurology, School of Medicine, Temple University, Philadelphia, PA, 19122, USA. Electronic address: sunnyrana@aol.com.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Rana
authors.affiliation: Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA. Electronic address: ayouk@pitt.edu.
authors.lastname: Ada Youk
authors.affiliation: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA. Electronic address: eot1@pitt.edu.
authors.forename: Evelyn O
authors.initials: EO
authors.lastname: Talbott
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000397:Air Pollution / Q000706:statistics & numerical data*; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology*; D016022:Case-Control Studies; D004781:Environmental Exposure / Q000032:analysis / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008670:Metals / Q000009:adverse effects; D008875:Middle Aged; D016017:Odds Ratio; D010575:Pesticides / Q000032:analysis / Q000633:toxicity; D012307:Risk Factors; D012997:Solvents
chemical_list: D000393:Air Pollutants; D008670:Metals; D010575:Pesticides; D012997:Solvents
keywords: Amyotrophic lateral sclerosis; Environmental exposures; Hazardous air pollutants; NATA; Risk factors