Male Veterans At
Higher Risk For Lou Gehrig's Disease
ALS Found At All
Time Periods Of Service
New evidence suggests that all men who serve in the military
are at an increased risk of developing Lou Gehrig's disease,
according to a presentation at the American Academy of
Neurology annual meeting.
The higher odds of getting the disease, also known as
amyotrophic lateral sclerosis (ALS), did not appear to be
associated with a particular branch of the military or particular
time period. Previous research found a similar risk for Gulf War
veterans.
"In looking for some agent, we should perhaps not be focusing
on the Gulf War but looking for those that are common across eras
and military experiences," says study author Dr. Marc Weisskopf, a
research associate at the Harvard School of Public Health. "What
exactly those are is tough."
ALS Symptoms Stand Out
ALS is a progressive, fatal neurodegenerative disease that
attacks nerve cells in the brain and the spinal cord.
ALS affects as many as 20,000 US adults, with about 5,000 new
cases each year, according to the National Institutes of
Health (NIH).
At the onset of ALS, the symptoms may be so slight that they
are frequently overlooked. The initial symptoms of ALS can be
quite varied in different people.
The rate at which ALS progresses can be quite variable from one
person to another. Survival time with ALS ranges from three to 10
years or more.
In a small number of people, ALS is known to halt its
progression, although there is no scientific understanding as to
how and why this happens. Symptoms can begin in the muscles of
speech, swallowing, or in the hands, arms, legs, or feet.
Not all people with ALS experience the same symptoms or the
same sequences or patterns of progression. But, progressive muscle
weakness and paralysis are universally experienced.
Muscle weakness is a hallmark initial sign in ALS, occurring in
approximately 60 percent of patients.
Early symptoms vary with each individual, but usually include
tripping, dropping things, abnormal fatigue of the arms and/or
legs, slurred speech, muscle cramps and twitches, and/or
uncontrollable periods of laughing or crying.
The hands and feet may be affected first, causing difficulty in
lifting, walking, or using the hands for the activities of daily
living such as dressing, washing, and buttoning clothes.
As the weakening and paralysis continue to spread to the
muscles of the trunk of the body, the disease eventually affects
speech, swallowing, chewing, and breathing. When the breathing
muscles become affected, ultimately, the patient will need
permanent ventilatory support in order to survive.
Military Connection Reaches All
Branches
The new study appears to be the first to detect a wider
association between military service and ALS, and seems to make it
less likely that a military connection with the disease is an
anomaly.
"Our study has its own limitations, but certainly the mounting
evidence would suggest that this is not a fluke," Dr. Weisskopf
adds.
"Any clue as to some environmental trigger in this disease is a
helpful thing," says Dr. Stephen Scelsa, director of the
neuromuscular division and the ALS Center at Beth Israel Medical
Center in New York City. Yet, he says, the full significance of
the finding is not yet clear.
Two recent studies had indicated an increased risk of ALS among
Gulf War veterans.
Dr. Weisskopf wanted to see if that risk extended to more
people. Between 1989 and 1998, he followed 268,258 men who had
served in the military and 126,414 who had not. During this time,
274 men died of ALS.
All of the participants were part of the American Cancer
Society's Cancer Prevention Study II, begun in 1982. Dates of
entering military service ranged from 1906 to 1982.
Overall, men who had served in the military had a lower death
rate, yet they were 60 percent more likely to develop ALS than men
who had not served in the military. The increased risk was similar
in the Army, National Guard, Navy, and Air Force.
There is no clear answer as to why this might be the case.
People have variously postulated that risk might be elevated due
to heavy metal exposure (particularly lead), extreme physical
exertion, and electrical work (including shocks), Dr. Weisskopf
said.
"This hasn't been shown with rigorous scientific data, but this
disease does occur in people who are athletic, like Lou Gehrig,"
Dr. Scelsa added. "There may be people in the military who do a
lot of physical work and strain, and that may predispose them to
the disease, but I think the answer is just not in."
Always consult your physician for more information.
