Studies of occupational solvent exposures and amyotrophic lateral sclerosis (ALS) have been conflicting. We conducted a population-based case-control study of mixed occupational solvent exposures and ALS. Using the Danish National Patient Registry, we identified ALS cases in Denmark from 1982 to 2013, and matched them to 100 controls based on sex and birth year. We estimated cumulative exposures to solvents (benzene, methylene chloride, toluene, trichloroethylene, perchloroethylene, and 1,1,1-trichloroethane) via job exposure matrices and applied them to occupational history from the Danish Pension Fund. Sex-stratified conditional logistic regression analyses revealed higher adjusted odds of ALS for men with exposure to benzene (aOR = 1.20; 95% CI 1.02, 1.41) and methylene chloride (aOR = 1.23; 95% CI 1.07, 1.42). We used weighted quantile sum regression to explore combined solvent exposures and risk of ALS in exposed subjects and found increased odds of 26 to 28% in all exposure lag periods for every one-unit increase in the mixture index in men. Weights of methylene chloride predominated the mixture index in all lag periods. Our study suggests an increased risk of ALS in men exposed to multiple solvents, with the greatest influence being from methylene chloride. These findings highlight the need to utilize mixtures analysis when considering co-occurring exposures.

中文翻译：

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溶剂暴露和肌萎缩侧索硬化症的混合方法：丹麦的一项基于人群的研究。


关于职业溶剂暴露和肌萎缩侧索硬化症 (ALS) 的研究一直相互矛盾。我们对混合职业溶剂暴露和 ALS 进行了一项基于人群的病例对照研究。我们利用丹麦国家患者登记处，确定了 1982 年至 2013 年丹麦的 ALS 病例，并根据性别和出生年份将其与 100 名对照者进行匹配。我们通过工作暴露矩阵估算了溶剂（苯、二氯甲烷、甲苯、三氯乙烯、全氯乙烯和 1,1,1-三氯乙烷）的累积暴露量，并将其应用于丹麦养老基金的职业历史。性别分层条件逻辑回归分析显示，接触苯（aOR = 1.20；95% CI 1.02，1.41）和二氯甲烷（aOR = 1.23；95% CI 1.07，1.42）的男性，ALS 调整后的几率较高。我们使用加权分位数总和回归来探索暴露受试者的组合溶剂暴露和 ALS 风险，发现男性混合指数每增加 1 个单位，所有暴露滞后期的几率就会增加 26% 至 28%。在所有滞后期内，二氯甲烷的重量在混合物指数中占主导地位。我们的研究表明，接触多种溶剂的男性患 ALS 的风险会增加，其中影响最大的是二氯甲烷。这些发现强调了在考虑同时发生的暴露时需要利用混合物分析。