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Military service and related risk factors for amyotrophic lateral sclerosis.
- Source :
-
Acta neurologica Scandinavica [Acta Neurol Scand] 2021 Jan; Vol. 143 (1), pp. 39-50. Date of Electronic Publication: 2020 Oct 12. - Publication Year :
- 2021
-
Abstract
- Background: The cause of amyotrophic lateral sclerosis (ALS) is unknown, but occupations have been explored as a potential proxy measure of risk. There is a substantial body of literature connecting military service to ALS. We aimed to summarize and assess the quality of this evidence.<br />Methods: Systematic review of the literature, including observational studies which explored one of the following exposures: general military service (army, air force, marines, or navy); or specific exposures associated with military service measured among military personnel. The outcome of interest was ALS incidence, which could include onset, diagnosis, or death from ALS.<br />Results: A total of 2642 articles were screened. Following exclusion, 19 articles remained for inclusion in the systematic review, including 1 meta-analysis and 18 original observational studies. Most studies were of moderate quality. In general, the relationship between military service was suggestive of an increased risk, particularly among Gulf War and WWII veterans. Exposure to pesticides (including Agent Orange) certain chemicals (exhaust, burning agents), heavy metals, and head trauma appeared to increase the risk of ALS among military personnel.<br />Conclusions: There is a possible association between military service and the subsequent development of ALS; however, the evidence was limited. Studies were generally hindered by small sample sizes and inadequate follow-up time. Future studies should endeavor to objectively measure specific exposures, or combinations thereof, associated with military service, as this will be of vital importance in implementing preventative strategies into military organizations.<br /> (© 2020 The Authors. Acta Neurologica Scandinavica published by John Wiley & Sons Ltd.)
- Subjects :
- Amyotrophic Lateral Sclerosis chemically induced
Amyotrophic Lateral Sclerosis diagnosis
Case-Control Studies
Craniocerebral Trauma diagnosis
Craniocerebral Trauma epidemiology
Female
Humans
Male
Metals, Heavy adverse effects
Pesticides adverse effects
Risk Factors
War-Related Injuries diagnosis
Amyotrophic Lateral Sclerosis epidemiology
Environmental Exposure adverse effects
Military Personnel
Veterans
War-Related Injuries epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0404
- Volume :
- 143
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Acta neurologica Scandinavica
- Publication Type :
- Academic Journal
- Accession number :
- 32905613
- Full Text :
- https://doi.org/10.1111/ane.13345