Fischer H, Kheifets L, Huss A, Peters T.L., Vermeulen R, Ye W, Fang F, Wiebert P, Vergara X.P., Feychting M

Transcription

1 Supplementry mteril: A Nested Cse-Control Study of Occuptionl Exposure to Electric Shocks nd Mgnetic Fields nd Amyotrophic Lterl Sclerosis in Sweden from 1991 to 2010 Fischer H, Kheifets L, Huss A, Peters T.L., Vermeulen R, Ye W, Fng F, Wiebert P, Vergr X.P., Feychting M Content etble 1A. Complete Description of mgnetic field nd electric shock JEMs etble 2A: Sensitivity Anlyses with Secondry JEMs etble 3A: Sensitivity Anlysis with Secondry JEMS for Individuls Less thn 65 Yers of Age etble 4A: Sensitivity Anlysis with Secondry JEMS for individuls greter thn or equl to 65 yers of ge etble 5A: Tble 5: Exposure distributions Primry nd Secondry JEMs etble 6A: Sensitivity nlysis with primry JEMs excluding welders for full dtset nd ge subgroups etble 7A: Exposure Combintions for 1980 nd 1990 etble 8A: Cumultive Exposure for Primry JEMs

2 etble 1A: Complete Description of mgnetic field nd electric shock JEMs Cutpoint JEM Selection Electric Shocks Europen Ctegorized into low, ES,b medium, nd high risk 3-digit bsed on the 75 th, nd 90 th ISCO88 percentiles US ES 4-digit ISCO88 Mgnetic Fields Mod. INTEROCC MF,b 4-digit ISCO88 Swedish MF 3-digit Swedish codes Mod. Bowmn MF 4-digit ISCO88 Ctegorized into low, medium, nd high risk bsed on the 75 th, nd 90 th percentiles Bsed on distributionl cut points t 0.15μT nd 0.30μT Bsed on distributionl cut points t 0.15μT nd 0.30μT, sensitivity nlyses for cutpoints (<0.11, , , nd >0.3μT) Bsed on distributionl cut points of exposure intensity t 0.15μT nd 0.30μT, re-evluted by industril hygienists ccording to probbility of exposure. MF=mgnetic fields, ES=electric shocks b Primry JEM Exposure Mesure Accident counts over workers per occuption. Proportion of workers exposed to electric shocks by occuption. Geometric men of full-shift timeweighted-verge of the mgnetic flux density in micro-tesl Geometric men of full-shift timeweighted-verge of the mgnetic flux density in micro-tesl Geometric men of full-shift timeweighted-verge of the mgnetic flux density in micro-tesl Dt Source Bsed on ccident rtes were pooled cross countries with rndom effects model (Huss et l, 2013). Exposures were derived from expert judgment using combintion of US dt on electrocution nd electric injuries nd expert occuptionl knowledge. (Vergr et l, 2014). Extension of the INTEROCC JEM (INTEROCC 2014) updted with occuptionl mesurements from 1000 Person Study (Brcken 2008). Combined two JEMs utilizing Swedish exposure dt developed by Floderus for men nd Forssén for women (Floderus et l, 1996; Forssén et l, 2004) Continuous JEM published by Joe Bowmn (Bowmn et l, 2007) 2

3 etble 2A. Sensitivity Anlyses with Secondry JEMs Undjusted for other exposure Adjusted for other exposure OR 95% CI OR 95% CI Primry ES JEM with Swedish MF JEM MF Med Exposure 0.99 ( ) 0.98 ( ) MF High Exposure 1.01 ( ) 1.00 ( ) ES Med Exposure 1.03 ( ) 1.04 ( ) ES High Exposure 1.01 ( ) 1.01 ( ) Primry ES JEM with Modified Bowmn MF JEM MF Med Exposure 0.95 ( ) 0.94 ( ) MF High Exposure 0.99 ( ) 0.97 ( ) ES Med Exposure 1.03 ( ) 1.05 ( ) ES High Exposure 1.01 ( ) 1.03 ( ) US ES JEM with Primry MF JEM MF Med Exposure 1.01 ( ) 1.01 ( ) MF High Exposure 0.93 ( ) 0.93 ( ) ES Med Exposure 1.01 ( ) 1.01 ( ) ES High Exposure 0.98 ( ) 0.98 ( ) 3

4 etble 3A: Sensitivity Anlysis with Secondry JEMS for Individuls Less thn 65 Yers of Age Undjusted for other exposure Adjusted for other exposure OR 95% CI OR 95% CI Primry ES JEM with Swedish MF JEM MF Med Exposure 0.87 ( ) 0.84 ( ) MF High Exposure 0.99 ( ) 0.93 ( ) ES Med Exposure 1.18 ( ) 1.26 ( ) ES High Exposure 1.20 ( ) 1.22 ( ) Primry ES JEM with Modified Bowmn MF JEM MF Med Exposure 0.95 ( ) 0.91 ( ) MF High Exposure 1.10 ( ) 1.00 ( ) ES Med Exposure 1.18 ( ) 1.20 ( ) ES High Exposure 1.20 ( ) 1.23 ( ) US ES JEM with Primry MF JEM MF Med Exposure 1.01 ( ) 0.99 ( ) MF High Exposure 1.06 ( ) 1.03 ( ) ES Med Exposure 1.19 ( ) 1.18 ( ) ES High Exposure 1.12 ( ) 1.12 ( ) 4

5 etble 4A: Sensitivity Anlysis with Secondry JEMS for individuls greter thn or equl to 65 yers of ge Undjusted for other exposure Adjusted for other exposure OR 95% CI OR 95% CI Primry ES JEM with Swedish MF JEM MF Med Exposure 1.06 ( ) 1.08 ( ) MF High Exposure 1.02 ( ) 1.05 ( ) ES Low Exposure 1 reference 1.00 reference ES Med Exposure 0.96 ( ) 0.94 ( ) ES High Exposure 0.92 ( ) 0.91 ( ) Primry ES JEM with Modified Bowmn MF JEM MF Med Exposure 0.95 ( ) 0.96 ( ) MF High Exposure 0.93 ( ) 0.96 ( ) ES Med Exposure 0.96 ( ) 0.98 ( ) ES High Exposure 0.92 ( ) 0.93 ( ) US ES JEM with Primry MF JEM MF Med Exposure 1.01 ( ) 1.03 ( ) MF High Exposure 0.87 ( ) 0.88 ( ) ES Med Exposure 0.93 ( ) 0.93 ( ) ES High Exposure 0.91 ( ) 0.91 ( ) 5

6 etble 5A: Exposure distributions Primry nd Secondry JEMs Cses (N=4,709) Controls (N=23,335) Primry Europen Electric Shocks JEM Primry JEM: High Med Low High Med Low Mod. Interocc MF High 4.7% 1.9% 4.0% High 4.9% 2.2% 4.5% JEM Med 10.0% 14.1% 17.1% Med 10.0% 13.8% 16.5% Low 4.4% 3.6% 40.3% Low 4.5% 3.4% 40.2% High Med Low High Med Low Secondry JEM 1: High 6.9% 3.0% 5.6% High 6.8% 2.9% 5.6% Swedish MF JEM Med 9.1% 13.9% 27.1% Med 9.3% 14.1% 27.0% Low 3.5% 2.9% 28.1% Low 3.7% 2.5% 28.0% High Med Low High Med Low Secondry JEM 2: High 2.5% 1.3% 0.4% High 2.4% 1.4% 0.4% Mod. Bowmn MF Med 11.2% 13.1% 20.6% Med 11.5% 12.9% 21.7% JEM Low 5.4% 5.3% 40.3% Low 5.5% 5.1% 39.0% Secondry US Electric Shocks JEM High Med Low High Med Low Primry JEM: High 2.7% 3.9% 4.1% High 2.8% 3.9% 4.8% Mod. Interocc MF Med 9.1% 9.6% 22.5% Med 9.0% 9.6% 21.7% JEM Low 1.1% 8.1% 39.1% Low 1.4% 8.2% 38.5% 6

7 etble 6A. Sensitivity nlysis with primry JEMs excluding welders for full dtset nd ge subgroups Undjusted for other exposure Adjusted for other exposure OR 95% CI OR 95% CI Full Dtset MF Med Exposure 1.01 ( ) 1.01 ( ) MF High Exposure 0.90 ( ) 0.90 ( ) ES Low Exposure 1.00 reference 1 reference ES Med Exposure 1.03 ( ) 1.03 ( ) ES High Exposure 1.00 ( ) 1.01 ( ) Less thn 65 yers MF Med Exposure 1.01 ( ) 0.96 ( ) MF High Exposure 1.00 ( ) 0.95 ( ) ES Low Exposure 1.00 reference 1 reference ES Med Exposure 1.17 ( ) 1.19 ( ) ES High Exposure 1.17 ( ) 1.19 ( ) Greter thn or equl to 65 yers MF Med Exposure 1.02 ( ) 1.04 ( ) MF High Exposure 0.86 ( ) 0.88 ( ) ES Low Exposure 1.00 reference 1 reference ES Med Exposure 0.97 ( ) 0.95 ( ) ES High Exposure 0.93 ( ) 0.92 ( ) 7

8 etble 7A: Exposure Combintions for 1980 nd 1990 ES-JEM MF-JEM OR 95% CI OR 95% CI Full Dtset Not Exposed 80 not exposed Reference 1.00 reference Exposed 80 not exposed ( ) 1.03 ( ) Not exposed 80 exposed ( ) 1.06 ( ) Exposed 80 exposed ( ) 1.00 ( ) Less thn 65 yers Not Exposed 80 not exposed Reference 1.00 reference Exposed 80 not exposed ( ) 1.03 ( ) Not exposed 80 exposed ( ) 1.10 ( ) Exposed 80 exposed ( ) 0.95 ( ) Greter thn or Equl to 65 Yers Not Exposed 80 not exposed Reference 1.00 reference Exposed 80 not exposed ( ) 1.04 ( ) Not exposed 80 exposed ( ) 1.01 ( ) Exposed 80 exposed ( ) 1.04 ( ) 8

9 etble 8A: Cumultive Exposure for Primry JEMs Undjusted for other exposure Adjusted for other exposure OR 95% CI OR 95% CI Full Dtset MF Low Exposure 1.00 Reference 1.00 reference MF Med Exposure 0.94 ( ) 0.93 ( ) MF High Exposure 0.98 ( ) 0.97 ( ) ES Low Exposure 1.00 Reference 1.00 reference ES Med Exposure 1.02 ( ) 1.04 ( ) ES High Exposure 1.05 ( ) 1.06 ( ) Less thn 65 yers MF Low Exposure 1.00 Reference 1.00 reference MF Med Exposure 1.06 ( ) 1.00 ( ) MF High Exposure 0.86 ( ) 0.83 ( ) ES Low Exposure 1.00 Reference 1.00 reference ES Med Exposure 1.12 ( ) 1.13 ( ) ES High Exposure 1.28 ( ) 1.29 ( ) Greter thn or equl to 65 yers MF Low Exposure 1.00 Reference 1.00 reference MF Med Exposure 0.90 ( ) 0.91 ( ) MF High Exposure 1.02 ( ) 1.03 ( ) ES Low Exposure 1.00 Reference 1.00 reference ES Med Exposure 0.98 ( ) 1.00 ( ) ES High Exposure 0.93 ( ) 0.94 ( ) 9