Rates of amyotrophic lateral sclerosis (ALS) have been reported to be higher among US military veterans, who currently number more than 21 million, but the causal factor(s) has not been identified. We conducted a review to examine the weight of evidence for associations between military service, deployments, and exposures and ALS etiology and survival. Thirty articles or abstracts published through 2013 were reviewed. Although the current evidence suggests a positive association with ALS etiology, it is too limited to draw firm conclusions regarding associations between military service and ALS etiology or survival. Some evidence suggests that deployment to the 1990-1991 Persian Gulf War may be associated with ALS etiology, but there is currently no strong evidence that any particular military exposure is associated with ALS etiology. Future studies should address the limitations of previous ones, such as reliance on mortality as a surrogate for incidence, a dearth of survival analyses, lack of clinical data, low statistical power, and limited exposure assessment. The Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis (GENEVA) Study is one such study, but additional research is needed to determine whether military-related factors are associated with ALS and to assess potential prevention strategies.

中文翻译：

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与肌萎缩侧索硬化病因和生存相关的兵役、部署和暴露。

据报道，美国退伍军人中肌萎缩侧索硬化 (ALS) 的发病率较高，目前人数超过 2100 万，但尚未确定因果因素。我们进行了一项审查，以检查兵役、部署和暴露与 ALS 病因和生存之间关联的证据权重。对 2013 年发表的 30 篇文章或摘要进行了审查。尽管目前的证据表明与 ALS 病因存在正相关，但就兵役与 ALS 病因或生存之间的关联得出确切结论的范围太有限。一些证据表明，部署到 1990-1991 年的波斯湾战争可能与 ALS 病因有关，但目前没有强有力的证据表明任何特定的军事暴露与 ALS 病因有关。未来的研究应解决先前研究的局限性，例如依赖死亡率作为发病率的替代指标、缺乏生存分析、缺乏临床数据、低统计功效和有限的暴露评估。患有肌萎缩侧索硬化症 (GENEVA) 的退伍军人的基因和环境暴露研究就是这样的一项研究，但还需要更多的研究来确定军事相关因素是否与 ALS 相关并评估潜在的预防策略。