{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:21:10Z","timestamp":1788402070897,"version":"build-2803163510"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"3-4","funder":[{"DOI":"10.13039\/100007217","name":"VA Health Services Research and Development Service","doi-asserted-by":"publisher","award":["DHI 09-237"],"award-info":[{"award-number":["DHI 09-237"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007217","name":"VA Health Services Research and Development Service","doi-asserted-by":"publisher","award":["RCS 17-297"],"award-info":[{"award-number":["RCS 17-297"]}],"id":[{"id":"10.13039\/100007217","id-type":"DOI","asserted-by":"publisher"}]},{"name":"VA Clinical Sciences Research and Development","award":["I01 CX001246"],"award-info":[{"award-number":["I01 CX001246"]}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Amyotrophic lateral sclerosis (ALS) is a recognized military service-connected condition. Prior prevalence studies of ALS among U.S. war Veterans were not able to address concerns related to neurodegenerative sequelae of traumatic brain injury (TBI) and disregarded risk heterogeneity from occupational categories within service branches.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We identified the prevalence of definite and possible ALS and cumulative incidence of definite ALS among Post-9\/11 U.S. Veterans deployed in support of Post-9\/11 conflicts (mean age 36.3) who received care in the Veterans Health Administration during fiscal years 2002\u20132015. Using a case-control study design, we also evaluated the association of TBI and major military occupation groups with ALS adjusting for demographics and comorbidities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The prevalence of ALS was 19.7 per 100,000 over 14 years. Both prevalence and cumulative incidence of definite ALS were significantly higher among Air Force personnel compared to other service branches and among tactical operation officers and health care workers compared to general and administrative officers. Neither TBI nor younger age (&amp;lt;45 years) was associated with ALS. Depression, cardiac disease, cerebrovascular disease, high blood pressure, and obstructive sleep apnea were clinical comorbidities significantly associated with ALS in this population of Veterans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study among a cohort of relatively young Veterans showed a high ALS prevalence, suggesting an early onset of ALS among deployed military service members. The higher prevalence among some military specific occupations highlights the need to determine which occupational exposures specific to these occupations (particularly, Air Force personnel, tactical operations officers, and health care workers) might be associated with early onset ALS.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usz350","type":"journal-article","created":{"date-parts":[[2019,10,23]],"date-time":"2019-10-23T11:59:15Z","timestamp":1571831955000},"page":"e501-e509","source":"Crossref","is-referenced-by-count":24,"title":["Amyotrophic Lateral Sclerosis Among Veterans Deployed in Support of Post-9\/11 U.S. Conflicts"],"prefix":"10.1093","volume":"185","author":[{"given":"Hari Krishna Raju","family":"Sagiraju","sequence":"first","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, 500 Foothill Drive Bldg. 182, Salt Lake City, UT 84148"},{"name":"Division of Epidemiology, University 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Porras","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston, School of Public Health in San Antonio, 7411 John Smith Dr #1100, San Antonio, TX 78229"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan E","family":"Amuan","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, 500 Foothill Drive Bldg. 182, Salt Lake City, UT 84148"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Jo V","family":"Pugh","sequence":"additional","affiliation":[{"name":"Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Health Care System, 500 Foothill Drive Bldg. 182, Salt Lake City, UT 84148"},{"name":"Division of Epidemiology, University of Utah, 383 Colorow Dr, Suite203, Salt Lake City, UT 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