Assessing Occupational Electric Shocks, Magnetic Fields and ALS

评估职业电击、磁场和 ALS

• 批准号: 8112962
• 负责人: Leeka Kheifets
• 金额: $ 19.49万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2013-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8112962
• 关键词: Assessing; Occupational; Electric; Shocks; Magnetic

DESCRIPTION (provided by applicant): Over the past 50 years, a demographic shift has occurred in the workforce. The Bureau of Labor Statistics (BLS) projects that the labor force participation rate of age 55 and older will continue to exhibit strong growth, reaching more than 42 percent in 2016 [1]. With a confluence of an aging workforce and unknown risk factors, a rise in age-related degenerative diseases will dramatically impact workforce productivity and the economy. As such, pursuing the etiology of costly neurodegenerative diseases like amyotrophic lateral sclerosis (ALS) is imperative for public health. A consistent association exists between "electric" occupations and ALS; however, it is unclear what aspect of the job might be responsible. Electric shocks and magnetic-field (EMF) exposures have been proposed as potential culprits. Compounding the problem is the current knowledge gaps about which specific occupations are experiencing electric shocks. The main aims of this proposal are to 1) identify workers exposed to electric shocks using multiple data sources and expert judgment and incorporate these data into an existing magnetic field job exposure matrix (JEM), 2) conduct a case-control study using the newly expanded JEM and U.S. mortality data, and 3) quantify potential sources of methodologic biases and identify the largest sources of uncertainty. In Specific Aim #1, we propose to develop a comprehensive, qualitative electric shocks and magnetic fields job exposure matrix (JEM) able to characterize many occupations at risk. We will achieve this aim by using numerous best available U.S. data sources on workplace electric shocks and expert judgment, quantifying uncertainty in the process. Our approach will result in a JEM and enhanced by expert judgments to be incorporated as priors into an occupational multiple-bias analysis. This JEM may be used in other studies with complete work histories. With new detailed information, we will pursue Specific Aim #2: to examine and disentangle the relationship between occupational MF, electric shocks and ALS. While previous studies have been published on occupational MF and ALS, this study will be novel in its attempt to simultaneously address electric shocks. Given its potential contribution to informing the EMF risk assessment, it is important to estimate uncertainties stemming from epidemiologic design and model assumptions. In Specific Aim #3, we propose to quantify biases from confounding, selection and exposure misclassification, so that proper inferences may be drawn from the case-control analysis of mortality data. Unlike traditional sensitivity analysis, we will employ multiple bias analysis which corrects for biases simultaneously. Integration of better exposure assessment methods and novel epidemiologic analyses will aid in framing the role occupational EMFs and electric shocks play in the etiology of ALS. PUBLIC HEALTH RELEVANCE: Despite its rarity, due to its severity amyotrophic lateral sclerosis has large societal impacts, both economic and social. Given that ALS mortality rates have steadily increased in recent years and the workforce is aging, it is vital to understand if and how implicated and modifiable workplace factors, such as magnetic fields and electric shocks, play a role in disease etiology to minimize work-related illnesses. A new job exposure matrix (JEM) and an innovative application of multiple bias analysis to JEM-based occupational studies will methodologically advance the field of occupational epidemiology.

描述（由申请人提供）：在过去的50年中，劳动力中发生了人口转变。劳工统计局（BLS）预测，劳动力参与55岁及以上的劳动力参与率将继续表现出强劲的增长，2016年将超过42％[1]。随着老龄化劳动力和未知风险因素的融合，与年龄相关的退化性疾病的增加将极大地影响劳动力生产率和经济。因此，追求肌萎缩性侧索硬化症（ALS）等昂贵的神经退行性疾病的病因对公共卫生至关重要。 “电动”职业与ALS之间存在一致的关联；但是，目前尚不清楚工作的哪个方面可能是负责任的。已经提出了电击和磁场（EMF）暴露作为潜在的罪魁祸首。问题更复杂的是当前有关哪些特定职业正在经历电击的知识差距。该提案的主要目的是对1）使用多个数据源和专家判断事件接触到电击的工人，并将这些数据纳入现有的磁场工作曝光矩阵（JEM），2），2）使用新扩展的JEM和美国死亡率数据进行案例对照研究，以及3）量化了方法的潜在偏见和不确定的方法。在特定的目标＃1中，我们建议开发全面的定性电击和磁场工作暴露矩阵（JEM），以表征许多处于危险中的职业。我们将通过使用许多最佳的美国数据源来实现这一目标，以实现工作场所电击和专家判断，从而量化此过程中的不确定性。我们的方法将导致JEM，并通过专家判断来增强，并将其纳入职业多偏置分析中。该JEM可以用于具有完整工作历史的其他研究中。有了新的详细信息，我们将追求特定的目标＃2：检查和解开职业MF，电击和ALS之间的关系。虽然先前的研究已经发表了职业MF和ALS，但该研究将是新颖的，试图同时解决电击。鉴于其在告知EMF风险评估方面的潜在贡献，重要的是要估算流行病学设计和模型假设引起的不确定性。在特定的目标＃3中，我们建议量化混淆，选择和暴露误差分类的偏见，以便可以根据死亡率数据的病例对照分析得出适当的推论。与传统的灵敏度分析不同，我们将采用多种偏见分析，同时纠正偏见。更好的接触评估方法和新型流行病学分析的整合将有助于构建ALS病因中职业EMF和电击的作用。 公共卫生相关性：尽管它罕见，但由于其严重性肌萎缩性横向硬化症具有巨大的社会影响，包括经济和社会。鉴于近年来ALS的死亡率稳步上升，劳动力正在老化，因此重要的是要了解以及磁场和电击等工作场所因素是否以及有影响力和可修改的工作场所因素，在疾病病因学中起作用，以最大程度地减少与工作相关的疾病。一个新的工作曝光矩阵（JEM）和对基于JEM的职业研究的多种偏见分析的创新应用将在方法论上促进职业流行病学领域。