TABLE 5.8 Amyotrophic Lateral Sclerosis (ALS)

Reference

Design

Population

Outcome

Results

Adjustment

Comments or Limitations

Horner et al. 2003

Retrospective cohort

All active, Gulf War-deployed military personnel (1990-1991), compared withnon-Gulf War-deployed veterans

ALS

All deployed forces, significant increased risk of ALS

RR = 1.92% 95% CL -1.29-2.84

Age-adjusted average, annual

10-year incidence; attributable risk

Case ascertainment method through screening of VA and DOD medical databases and benefit files (and TriCare) by ICD-9 code for ALSor riluzole use; toll-free telephone enrollment; Internetnotices; mass mailings to neurologists, VA centers, and veteran service organizations

Coffman et al. 2005

Capture-recapture reanalysis of Horner et al. cohort

See Horner et al. 2003

ALS

Found no under as certainment of ALS cases among deployed

Log-linear models; sample coverage; ecologic models

Possible slight undercounts not likely to substantively affect results

NOTE: DOD= Department of Defense; VA =Department of Veterans Affairs.



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