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Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival.

Publication ,  Journal Article
Beard, JD; Engel, LS; Richardson, DB; Gammon, MD; Baird, C; Umbach, DM; Allen, KD; Stanwyck, CL; Keller, J; Sandler, DP; Schmidt, S; Kamel, F
Published in: PLoS One
2017

BACKGROUND: Military veterans may have higher rates of amyotrophic lateral sclerosis (ALS) mortality than non-veterans. Few studies, with sparse exposure information and mixed results, have studied relationships between military-related factors and ALS survival. We evaluated associations between military-related factors and ALS survival among U.S. military veteran cases. METHODS: We followed 616 medical record-confirmed cases from enrollment (2005-2010) in the Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis study until death or July 25, 2013, whichever came first. We ascertained vital status information from several sources within the Department of Veterans Affairs. We obtained information regarding military service, deployments, and 39 related exposures via standardized telephone interviews. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals. We adjusted for potential confounding and missing covariate data biases via inverse probability weights. We also used inverse probability weights to adjust for potential selection bias among a case group that included a disproportionate number of long-term survivors at enrollment. RESULTS: We observed 446 deaths during 24,267 person-months of follow-up (median follow-up: 28 months). Survival was shorter for cases who served before 1950, were deployed to World War II, or mixed and applied burning agents, with HRs between 1.58 and 2.57. Longer survival was associated with exposure to: paint, solvents, or petrochemical substances; local food not provided by the Armed Forces; or burning agents or Agent Orange in the field with HRs between 0.56 and 0.73. CONCLUSIONS: Although most military-related factors were not associated with survival, associations we observed with shorter survival are potentially important because of the large number of military veterans.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2017

Volume

12

Issue

10

Start / End Page

e0185751

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Survivors
  • Proportional Hazards Models
  • Polychlorinated Dibenzodioxins
  • Military Personnel
  • Middle Aged
  • Medical Records
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Beard, J. D., Engel, L. S., Richardson, D. B., Gammon, M. D., Baird, C., Umbach, D. M., … Kamel, F. (2017). Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival. PLoS One, 12(10), e0185751. https://doi.org/10.1371/journal.pone.0185751
Beard, John D., Lawrence S. Engel, David B. Richardson, Marilie D. Gammon, Coleen Baird, David M. Umbach, Kelli D. Allen, et al. “Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival.PLoS One 12, no. 10 (2017): e0185751. https://doi.org/10.1371/journal.pone.0185751.
Beard JD, Engel LS, Richardson DB, Gammon MD, Baird C, Umbach DM, et al. Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival. PLoS One. 2017;12(10):e0185751.
Beard, John D., et al. “Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival.PLoS One, vol. 12, no. 10, 2017, p. e0185751. Pubmed, doi:10.1371/journal.pone.0185751.
Beard JD, Engel LS, Richardson DB, Gammon MD, Baird C, Umbach DM, Allen KD, Stanwyck CL, Keller J, Sandler DP, Schmidt S, Kamel F. Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival. PLoS One. 2017;12(10):e0185751.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2017

Volume

12

Issue

10

Start / End Page

e0185751

Location

United States

Related Subject Headings

  • Veterans
  • United States
  • Survivors
  • Proportional Hazards Models
  • Polychlorinated Dibenzodioxins
  • Military Personnel
  • Middle Aged
  • Medical Records
  • Male
  • Humans