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Am J Epidemiol. 2019 Jan 10. doi: 10.1093/aje/kwy287. [Epub ahead of print]

Electric Shock and Extremely Low-Frequency Magnetic Field Exposure and the Risk of ALS: Euro-MOTOR.

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Department of Neurology, University Medical Center Utrecht, Utrecht, the Netherlands.
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
Rita Levi Montalcini Department of Neuroscience, University of Torino, Torino, Italy.
Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy.
Unit of Neurodegenerative Diseases, Department of Clinical Research in Neurology, University of Bari "Aldo Moro", Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy.
Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland.


We explored the association between occupational exposure to extremely low-frequency magnetic fields (ELF-MF) and electric shocks and the risk of amyotrophic lateral sclerosis (ALS) in a pooled case-control study (Euro-MOTOR) from three European countries. ALS patients and population-based controls were recruited in Ireland, Italy and the Netherlands between 2010 and 2015. Lifetime occupational and lifestyle histories were obtained using structured questionnaires. We applied previously developed job-exposure matrices assigning exposure to ELF-MF and potential for electric shocks. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression for either exposure to ELF-MF or electric shocks, adjusted for age, sex, center, education, smoking and alcohol, and adjustment was made for the respective other exposure. Complete occupational histories and information on confounding variables were available for 1,323 clinically confirmed ALS cases and 2,704 controls. Both ever exposure above background to ELF-MF (OR = 1.16, 95% CI: 1.01, 1.33) and ever potential above background for electric shocks (OR = 1.23, 95% CI: 1.05, 1.43) were associated with ALS. Adjustment for the respective other exposure resulted in similar risk estimates. Heterogeneity in risks across centers was significant for both exposures. Our findings support a possible independent association between occupational exposure to ELF-MF and electric shocks and the risk of ALS.


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