Smoking and risk for amyotrophic lateral sclerosis: analysis of the EPIC cohort.

TitleSmoking and risk for amyotrophic lateral sclerosis: analysis of the EPIC cohort.
Publication TypeJournal Article
Year of Publication2009
AuthorsGallo, V, H Bueno-de-Mesquita, B, Vermeulen, R, Andersen, PM, Kyrozis, A, Linseisen, J, Kaaks, R, Allen, NE, Roddam, AW, Boshuizen, HC, Peeters, PH, Palli, D, Mattiello, A, Sieri, S, Tumino, R, Jiménez-Martín, J-M, Díaz, MJosé Torm, Suárez, LRodríguez, Trichopoulou, A, Agudo, A, Arriola, L, Barricante-Gurrea, A, Bingham, S, Khaw, K-T, Manjer, J, Lindkvist, B, Overvad, K, Bach, FW, Tjønneland, A, Olsen, A, Bergmann, MM, Boeing, H, Clavel-Chapelon, F, Lund, iv, E, Hallmans, G, Middleton, L, Vineis, P, Riboli, E
JournalAnn Neurol
Volume65
Issue4
Pagination378-85
Date Published2009 Apr
ISSN1531-8249
KeywordsAdult, Age Factors, Aged, Amyotrophic Lateral Sclerosis, Cohort Studies, Europe, Female, Humans, International Cooperation, Male, Middle Aged, Proportional Hazards Models, Risk, Sex Factors, Smoking, Surveys and Questionnaires
Abstract

OBJECTIVE: Cigarette smoking has been reported as "probable" risk factor for Amyotrophic Lateral Sclerosis (ALS), a poorly understood disease in terms of aetiology. The extensive longitudinal data of the European Prospective Investigation into Cancer and Nutrition (EPIC) were used to evaluate age-specific mortality rates from ALS and the role of cigarette smoking on the risk of dying from ALS.METHODS: A total of 517,890 healthy subjects were included, resulting in 4,591,325 person-years. ALS cases were ascertained through death certificates. Cox hazard models were built to investigate the role of smoking on the risk of ALS, using packs/years and smoking duration to study dose-response.RESULTS: A total of 118 subjects died from ALS, resulting in a crude mortality rate of 2.69 per 100,000/year. Current smokers at recruitment had an almost two-fold increased risk of dying from ALS compared to never smokers (HR = 1.89, 95% C.I. 1.14-3.14), while former smokers at the time of enrollment had a 50% increased risk (HR = 1.48, 95% C.I. 0.94-2.32). The number of years spent smoking increased the risk of ALS (p for trend = 0.002). Those who smoked more than 33 years had more than a two-fold increased risk of ALS compared with never smokers (HR = 2.16, 95% C.I. 1.33-3.53). Conversely, the number of years since quitting smoking was associated with a decreased risk of ALS compared with continuing smoking.INTERPRETATION: These results strongly support the hypothesis of a role of cigarette smoking in aetiology of ALS. We hypothesize that this could occur through lipid peroxidation via formaldehyde exposure.

DOI10.1002/ana.21653
Alternate JournalAnn. Neurol.
Citation Key10.1002/ana.21653
PubMed ID19399866
Grant List / / British Heart Foundation / United Kingdom
/ / Department of Health / United Kingdom
/ / Cancer Research UK / United Kingdom
G0401527 / / Medical Research Council / United Kingdom
/ / Wellcome Trust / United Kingdom