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Epidemiologic correlates of sporadic amyotrophic lateral sclerosis

Department of Neurology (Drs. Armon and Daube), the Section of Clinical Epidemiology (Dr. Kurland), and the Section of Biostatistics (Dr. O'Brien), Mayo Clinic and Mayo Foundation, Rochester, MN.

We evaluated 74 selected patients with amyotrophic lateral sclerosis (ALS) and 201 matched controls for risk factors for ALS by a case-control design and a sequential questionnaire/interview technique to quantitate biographic data. We analyzed occupational and recreational data only for 47 male patients and 47 corresponding patient controls; data for women were insufficient. We used nonparametric analyses to evaluate five primary comparisons of ALS patients with controls: (1) more hard physical labor, p not significant (NS); (2) greater frequency of neurodegenerative disease in family members, p NS; (3) greater exposure to lead, p <0.05; (4) more years lived in a rural community, p NS; and (5) more trauma or major surgery, p NS. Men with ALS had worked more frequently at blue-collar jobs (although not a statistically significant difference, p = 0.10) and at welding or soldering (p <0.01). These results suggest that there may be an association between ALS in men and exposure to lead vapor. The limited nature of the association favors a multifactorial etiologic mechanism of ALS.

Address correspondence and reprint requests to Dr. Leonard T. Kurland, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Supported in part by the Neuroepidemiologic Program Project Grant NS-17750 from the National Institute of Neurological Disorders and Stroke.

Presented in part at the 42nd annual meeting of the American Academy of Neurology, Miami Beach, FL, April 1990.

Received June 6, 1990. Accepted for publication in final form December 10, 1990.

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