Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Environmental Toxins Associated with ALS

JAMA Neurol; ePub 2016 May 9; Su, et al

Persistent environmental pollutants measured in blood were significantly associated with amyotrophic lateral sclerosis (ALS) and may represent modifiable ALS disease risk factors, according to a recent study. Researchers conducted a case-control study between 2011 and 2014 at a tertiary referral center for ALS. Cases were patients diagnosed as having definite, probably, probable with laboratory support, or possible ALS; controls were excluded if they were diagnosed as having ALS or another neurodegenerative condition or if they had a family history of ALS in a first- or second-degree blood relative. Participants included 156 cases (mean age, 60.5 [11.1] years; 61.5% male) and 128 controls (mean age, 60.4 [9.4] years; 57.8% male). Researchers found:

• Reported pesticide exposure in the cumulative exposure window was significantly associated with ALS.

• Military service was also associated with ALS in 2 time windows (exposure ever happened in entire occupational history; exposure ever happened 10 to 30 years ago).

• A multivariable model of measured persistent environmental pollutants in the blood, representing cumulative occupational and residential exposure, showed increased odds of ALS for 2 organochlorine pesticides (OCPs), 2 polychlorinated biphenyls (PCBs), and 1 brominated flame retardant (BFR).

Citation: Su FC, Goutman SA, Chernyak S, et al. Association of environmental toxins with amyotrophic lateral sclerosis. [Published online ahead of print May 9, 2016]. JAMA Neurol. doi:10.1001/jamaneurol.2016.0594.

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