title: Environmental and Occupational Exposures and Amyotrophic Lateral Sclerosis in New England.
abstract: Recent data provide support for the concept that potentially modifiable exposures are responsible for sporadic amyotrophic lateral sclerosis (ALS).
  
  
  
  To evaluate environmental and occupational exposures as risk factors for sporadic ALS.
  
  
  
  We performed a case-control study of ALS among residents of New England, USA. The analysis compared questionnaire responses from 295 patients with a confirmed ALS diagnosis to those of 225 controls without neurodegenerative illness.
  
  
  
  Self-reported job- or hobby-related exposure to one or more chemicals, such as pesticides, solvents, or heavy metals, increased the risk of ALS (adjusted OR 2.51; 95% CI 1.64-3.89). Industries with a higher toxicant exposure potential (construction, manufacturing, mechanical, military, or painting) were associated with an elevated occupational risk (adjusted OR 3.95; 95% CI 2.04-8.30). We also identified increases in the risk of ALS associated with frequent participation in water sports, particularly waterskiing (adjusted OR 3.89; 95% CI 1.97-8.44). Occupation and waterskiing both retained independent statistical significance in a composite model containing age, gender, and smoking status.
  
  
  
  Our study contributes to a growing body of literature implicating occupational- and hobby-related toxicant exposures in ALS etiology. These epidemiologic study results also provide motivation for future evaluation of water-body-related risk factors.
authors.affiliation: Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Angeline S
authors.initials: AS
authors.lastname: Andrew
authors.forename: Tracie A
authors.initials: TA
authors.lastname: Caller
authors.forename: Rup
authors.initials: R
authors.lastname: Tandan
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Duell
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Henegan
authors.forename: Nicholas C
authors.initials: NC
authors.lastname: Field
authors.forename: Walter G
authors.initials: WG
authors.lastname: Bradley
authors.forename: Elijah W
authors.initials: EW
authors.lastname: Stommel
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009511:New England; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors