TABLE 7.12 Alzheimer’s Disease and Solvent Exposure

Reference, Country

Cases

Controls

Exposure Determination

Exposure

Adjusted OR (95% CI)

Comments

Kukull et al., 1995

193 cases of probable or definite (if deceased) AD from Group Health Cooperative AD registry;

243 controls randomly sampled from same Group Health Cooperative;

frequency-matched on age, sex

Interview with proxy about all jobs over 1 year since age 16 years;

Both sexes: ever (vs never) occupationally exposed to any solvent class

2.3 (1.1–4.7)

Adjusted for age, sex, child proxy, greater than high-school education

US

Considered exposure to five specific classes of solvents (aromatic hydrocarbons, chlorinated solvents, ketones, fuels, alcohol);

Men only: exposure to any solvent class

6.0 (2.1–17.3)

Authors comment that underreporting by controls may have accounted for higher association in men;

Required proxy for interview

Women only: exposure to any solvent class

0.7 (0.2–2.1)

15–20 years elapsed between last exposure and onset of AD

Also asked about “probable” solvent exposure based on job descriptions of occupations (printing, asphalt-related, oils, glues, rubber production);

Reference year was 1 year before onset of first symptom

Graves et al., 1998

89 cases of probable AD from Group Health Cooperative AD registry;

subset of Kukull et al. (1995)

89 controls randomly sampled from same Group Health Cooperative;

frequency-matched on age, sex;

Interview with spouse proxy about all jobs over 1 year since age 16 years;

Ever (vs never) occupationally exposed to any solvent class:

1.77 (0.8–3.9)

Participation by only 89 of 130 eligible cases and 89 of 166 eligible controls;

US

Industrial hygienist blind to case-control status rated each job for exposure to solvents; five classes of solvents (aromatic hydrocarbons, chlorinated solvents, ketones, fuels, alcohol);

Duration exposure:

Dose-response findings divergent

1–17 years

1.10 (0.43–2.82)

18 or more years

2.62 (1.07–7.43)

Required spouse informant for interview

Spouses both interviewed

p-trend=0.03

Age at half cumulative exposure:

1.20 (0.48–3.00)

1–33 years

2.67 (1.03–6.94)

Rreference year was 1 year before onset of first symptom

34 or more years

p-trend>0.05

 

Low intensity×duration

1.57 (0.62–3.96)

High intensity×duration

2.00 (0.79–5.10)

Low intensity

2.46 (0.92–6.57)

Moderate-high intensity

1.37 (0.60–3.36)



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