205455 Amyotrophic Lateral Sclerosis (ALS) in Western Pennsylvania (W.Pa) (2008-2009): Examining the Role of Gender and Age at Onset

Sunday, November 8, 2009

Angela Malek Bazaco, MPH , Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
Evelyn O. Talbott, DrPH, MPH , Department of Epidemiology, Director-University of Pittsburgh Center of Excellence in Environmental Public Health Tracking, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA
David Lacomis, MD , Department of Neurology, University of Pittsburgh, Pittsburgh, PA
Robert Bowser, PhD , Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
Sandeep S. Rana, MD , Neuroscience Center, Allegheny General Hospital, Pittsburgh, PA
Judy Rager , Graduate School of Public Health- Dept of Epidemiology, University of Pittsburg Academic Partner of Excellence in EPHT, Pittsburg, PA
Background: ALS is a rare disease. The global incidence is 1-2 per 100,000. No treatment exists to prevent or reverse this devastating disease. Median survival is 2-4 years. The etiology is unknown although environmental/occupational risk factors are thought to play a role. W.Pa is suitable for studying ALS due to its occupational diversity and strong coal and steel industry. This case-series will investigate personal, occupational and environmental ALS risk factors.

Methods: A descriptive analysis was conducted. Matched controls will be obtained. A SMR (Standardized Mortality Ratio) ratio was calculated comparing ALS deaths with Pa deaths for 2006-2008. GIS (Geographic information systems) techniques will relate proximity of subjects' residences to toxic waste sites and landfill areas.

Results: Seventy-six cases were identified, 44 males and 32 females (1.4:1). Fourteen reside in the city of Pittsburgh. Mean age of onset is 58.4 + 12.3 (males) and 64.7 + 13.0 (females) (p=0.037). The sample is 97% Caucasian. The SMR showed a significantly elevated rate for Beaver County (SMR=1.48, 95%, CI=103.6, 204.8) and nearly significant for Allegheny County (SMR=113.9, 95%, CI=98.1, 131.5) compared to Pa.

Conclusions: This case-series confirmed the increased male:female ratio and the male decreased mean age of onset that may reflect a reduced latency due to increases in personal and/or environmental/occupational exposures in men. A comparison of females will determine if cases have "non-traditional" exposures more reflective of male experiences.

Implications for public health: Case-control designs permit within gender and racial comparisons and may shed light on important risk factors for ALS.

Learning Objectives:
1. Define Amyotrophic Lateral Sclerosis (ALS). 2. List potential risk factors for ALS. 3. Compare gender differences for ALS cases.

Keywords: Environmental Exposures, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualitifed to be an abstract author on this work because I am responsible for coordinating the study as well as interviewing the majority of participants. This study is being conducted as part of my doctoral dissertation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.