{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T19:50:52Z","timestamp":1767383452426,"version":"build-2065373602"},"reference-count":43,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T00:00:00Z","timestamp":1619222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["R01TS000288"],"award-info":[{"award-number":["R01TS000288"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001170","name":"Hitchcock Foundation","doi-asserted-by":"publisher","award":["NA"],"award-info":[{"award-number":["NA"]}],"id":[{"id":"10.13039\/100001170","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Most amyotrophic lateral sclerosis (ALS) cases are considered sporadic, without a known genetic basis, and lifestyle factors are suspected to play an etiologic role. We previously observed increased risk of ALS associated with high nail mercury levels as an exposure biomarker and thus hypothesized that mercury exposure via fish consumption patterns increases ALS risk. Lifestyle surveys were obtained from ALS patients (n = 165) and n = 330 age- and sex-matched controls without ALS enrolled in New Hampshire, Vermont, or Ohio, USA. We estimated their annual intake of mercury and omega-3 polyunsaturated fatty acid (PUFA) via self-reported seafood consumption habits, including species and frequency. In our multivariable model, family income showed a significant positive association with ALS risk (p = 0.0003, adjusted for age, sex, family history, education, and race). Neither the estimated annual mercury nor omega-3 PUFA intakes via seafood were associated with ALS risk. ALS incidence is associated with socioeconomic status; however, consistent with a prior international study, this relationship is not linked to mercury intake estimated via fish or seafood consumption patterns.<\/jats:p>","DOI":"10.3390\/ijerph18094528","type":"journal-article","created":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T21:49:20Z","timestamp":1619300960000},"page":"4528","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Amyotrophic Lateral Sclerosis Risk, Family Income, and Fish Consumption Estimates of Mercury and Omega-3 PUFAs in the United States"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6449-6944","authenticated-orcid":false,"given":"Hannah I.","family":"Hoffman","sequence":"first","affiliation":[{"name":"Department of Biological Sciences, Dartmouth College, Hanover, NH 03755, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1085-5040","authenticated-orcid":false,"given":"Walter G.","family":"Bradley","sequence":"additional","affiliation":[{"name":"Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celia Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, Dartmouth College, Hanover, NH 03755, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0737-6065","authenticated-orcid":false,"given":"Erik P.","family":"Pioro","sequence":"additional","affiliation":[{"name":"ALS and Neuromuscular Disease Center, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elijah W.","family":"Stommel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Geisel School of Medicine, Lebanon, NH 03756, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3731-5300","authenticated-orcid":false,"given":"Angeline S.","family":"Andrew","sequence":"additional","affiliation":[{"name":"Department of Neurology, Geisel School of Medicine, Lebanon, NH 03756, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Martin, S., Khaleifat, A.A., and Al-Chalabi, A. (2017). What causes amyotrophic lateral sclerosis?. F1000Research, 6.","DOI":"10.12688\/f1000research.10476.1"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1002\/mus.26055","article-title":"Toenail mercury Levels are associated with amyotrophic lateral sclerosis risk","volume":"58","author":"Andrew","year":"2018","journal-title":"Muscle Nerve"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1080\/21678421.2020.1753777","article-title":"Keratinous biomarker of mercury exposure associated with amyotrophic lateral sclerosis risk in a nationwide U.S. study","volume":"21","author":"Andrew","year":"2020","journal-title":"Amyotroph Lateral Scler Front. Degener"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1001\/jamaneurol.2014.1214","article-title":"Dietary omega-3 polyunsaturated fatty acid intake and risk for amyotrophic lateral sclerosis","volume":"71","author":"Fitzgerald","year":"2014","journal-title":"JAMA Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1111\/j.1095-8649.1973.tb04500.x","article-title":"Mercury concentrations in fish, plankton and water from three Western Atlantic estuaries","volume":"5","author":"Cocoros","year":"1973","journal-title":"J. Fish Biol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/0013-9351(80)90120-6","article-title":"Relation between trophic position and mercury accumulation among fishes from the Tongue River Reservoir, Montana","volume":"22","author":"Phillips","year":"1980","journal-title":"Environ. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1017\/S0025315415001356","article-title":"Mercury, selenium and fish oils in marine food webs and implications for human health","volume":"96","author":"Gribble","year":"2016","journal-title":"J. Mar. Biol. Assoc. UK"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s10393-008-0201-1","article-title":"Methylmercury in marine ecosystems: Spatial patterns and processes of production, bioaccumulation, and biomagnification","volume":"5","author":"Chen","year":"2008","journal-title":"Ecohealth"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1289\/ehp.5837","article-title":"Mercury levels in high-end consumers of fish","volume":"111","author":"Hightower","year":"2003","journal-title":"Environ. Health Perspect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1002\/mus.27085","article-title":"Risk factors for amyotrophic lateral sclerosis: A regional United States case-control study","volume":"63","author":"Andrew","year":"2021","journal-title":"Muscle Nerve"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1001\/archneurol.2012.254","article-title":"Awaji criteria for the diagnosis of amyotrophic lateral sclerosis:a systematic review","volume":"69","author":"Costa","year":"2012","journal-title":"Arch. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1093\/pan\/mpl013","article-title":"Matching as Nonparametric Preprocessing for Reducing Model Dependence in Parametric Causal Inference","volume":"15","author":"Ho","year":"2007","journal-title":"Political Anal."},{"key":"ref_13","unstructured":"(2020, April 25). Center for Food Safety and Applied Nutrition. Mercury Levels in Commercial Fish and Shellfish (1990\u20132012), Available online: https:\/\/www.fda.gov\/food\/foodborneillnesscontaminants\/metals\/ucm115644.htm."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1289\/ehp.1205122","article-title":"A quantitative synthesis of mercury in commercial seafood and implications for exposure in the United States","volume":"120","author":"Karimi","year":"2012","journal-title":"Environ. Health Perspect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1021\/ed500687b","article-title":"A Simplified Digestion Protocol for the Analysis of Hg in Fish by Cold Vapor Atomic Absorption Spectroscopy","volume":"92","author":"Kristian","year":"2015","journal-title":"J. Chem. Educ."},{"key":"ref_16","unstructured":"(2020, April 25). National Oceanic and Atmospheric Administration. Fisheries of the United States, 2017 Report, Available online: https:\/\/www.fisheries.noaa.gov\/resource\/document\/fisheries-united-states-2017-report."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"638","DOI":"10.3390\/ijerph10020638","article-title":"The Influence of Fish Length on Tissue Mercury Dynamics: Implications for Natural Resource Management and Human Health Risk","volume":"10","author":"Sackett","year":"2013","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_18","unstructured":"(2020, April 25). United States Environmental Protection Agency. FDA Fish Advice: Technical Information, Available online: https:\/\/www.epa.gov\/fish-tech\/epa-fda-fish-advice-technicalinformation."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/j.1541-4337.2011.00180.x","article-title":"The tale of sushi: History and regulations","volume":"11","author":"Feng","year":"2012","journal-title":"Compr. Rev. Food Sci. Food Saf."},{"key":"ref_20","unstructured":"(2020, April 25). National Service Center for Environmental Publications. The National Survey of Mercury Concentrations in Fish, Available online: https:\/\/nepis.epa.gov\/."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Office of the United States Trade Representative (2013). United States\u2013Measures concerning the importation, marketing and sale of tuna and tuna products. Am. Soc. Int. Law, 107, 192\u2013199.","DOI":"10.5305\/amerjintelaw.107.1.0192"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.chemosphere.2017.12.137","article-title":"Assessment of mercury content in Panga (Pangasius hypophthalmus)","volume":"196","author":"Rodriguez","year":"2018","journal-title":"Chemosphere"},{"key":"ref_23","first-page":"3","article-title":"Omega medicine","volume":"34","author":"Liebman","year":"2007","journal-title":"Nutr. Action"},{"key":"ref_24","unstructured":"(2020, April 25). United States Department of Agriculture. Full Report: Swai Fillet, Available online: https:\/\/ndb.nal.usda.gov\/."},{"key":"ref_25","unstructured":"Bellows, L., Clifford, J., Niebaum, K., and Bunning, M. (2020, April 25). Omega-3 Fatty Acids. Available online: https:\/\/extension.colostate.edu\/topic-areas\/nutrition-food-safety-health\/omega-3-fatty-acids-9-382\/."},{"key":"ref_26","unstructured":"(2020, April 25). Dieticians of Canada. Food Sources of Omega-3 Fats, Available online: https:\/\/www.dietitians.ca\/."},{"key":"ref_27","unstructured":"(2020, April 25). Harvard School of Public Health. Omega-3 Fatty Acids: An Essential Contribution, Available online: https:\/\/www.hsph.harvard.edu\/nutritionsource\/what-should-you-eat\/fats-and-cholesterol\/types-of-fat\/omega-3-fats\/."},{"key":"ref_28","unstructured":"(2020, April 25). 28. National Heart Foundation of Australia. Sources of Omega-3, Available online: https:\/\/www.heartfoundation.org.au\/."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1093\/biostatistics\/kxu058","article-title":"Bayesian kernel machine regression for estimating the health effects of multi-pollutant mixtures","volume":"16","author":"Bobb","year":"2015","journal-title":"Biostatistics"},{"key":"ref_30","first-page":"844","article-title":"Mercury in hair of patients with ALS","volume":"29","author":"Mano","year":"1989","journal-title":"Rinsho Shinkeigaku"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1289\/ehp.11674","article-title":"Adult women\u2019s blood mercury concentrations vary regionally in the United States: Association with patterns of fish consumption (NHANES 1999\u20132004)","volume":"117","author":"Mahaffey","year":"2009","journal-title":"Environ. Health Perspect."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Parkin Kullmann, J.A., and Pamphlett, R. (2018). A Comparison of Mercury Exposure from Seafood Consumption and Dental Amalgam Fillings in People with and without Amyotrophic Lateral Sclerosis (ALS): An International Online Case-Control Study. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15122874"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/1476-069X-13-80","article-title":"Particulate matter and risk of Parkinson disease in a large prospective study of women","volume":"13","author":"Palacios","year":"2014","journal-title":"Environ. Health"},{"key":"ref_34","unstructured":"USFDA (2021, April 04). Mercury Poisoning Linked to Skin Products. Available online: https:\/\/www.fda.gov\/consumers\/consumer-updates\/mercury-poisoning-linked-skin-products."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.tox.2013.06.002","article-title":"Intestinal transport of methylmercury and inorganic mercury in various models of Caco-2 and HT29-MTX cells","volume":"311","author":"Vazquez","year":"2013","journal-title":"Toxicology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s00128-018-2512-4","article-title":"Intestinal Methylation and Demethylation of Mercury","volume":"102","author":"Li","year":"2019","journal-title":"Bull. Environ. Contam. Toxicol."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Bowyer, R.C.E., Jackson, M.A., Le Roy, C.I., Ni Lochlainn, M., Spector, T.D., Dowd, J.B., and Steves, C.J. (2019). Socioeconomic Status and the Gut Microbiome: A TwinsUK Cohort Study. Microorganisms, 7.","DOI":"10.3390\/microorganisms7010017"},{"key":"ref_38","first-page":"e811","article-title":"Prediagnostic plasma polyunsaturated fatty acids and the risk of amyotrophic lateral sclerosis","volume":"94","author":"Bjornevik","year":"2020","journal-title":"Neurology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"184","DOI":"10.3945\/ajcn.2008.26987","article-title":"Omega-3 fatty acids and risk of dementia: The Canadian Study of Health and Aging","volume":"90","author":"Kroger","year":"2009","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1093\/aje\/kwv095","article-title":"Geographic Variation of Amyotrophic Lateral Sclerosis Incidence in New Jersey, 2009\u20132011","volume":"182","author":"Henry","year":"2015","journal-title":"Am. J. Epidemiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"718","DOI":"10.15585\/mmwr.mm6627a2","article-title":"Mortality from Amyotrophic Lateral Sclerosis and Parkinson\u2019s Disease Among Different Occupation Groups-United States, 1985\u20132011","volume":"66","author":"Beard","year":"2017","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_42","first-page":"12","article-title":"Environmental risk factors and amyotrophic lateral sclerosis (ALS): A case-control study of ALS in China","volume":"66","author":"Lian","year":"2019","journal-title":"J. Clin. Neurosci. Off. J. Neurosurg. Soc. Australas."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Bear, T.M., Malek, A.M., Foulds, A., Rager, J., Deperrior, S.E., Vena, J.E., Larson, T.C., Mehta, P., Horton, D.K., and Talbott, E.O. (2021). Recruitment of population-based controls for ALS cases from the National ALS Registry. Amyotroph. Lateral Scler. Front. Degener., 1\u20137.","DOI":"10.1080\/21678421.2021.1887262"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/9\/4528\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:52:20Z","timestamp":1760161940000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/9\/4528"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,24]]},"references-count":43,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["ijerph18094528"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18094528","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2021,4,24]]}}}