Risk of glioma and meningioma with exposure to lead determined by an expert and a job exposure matrix by ALAD G177C (rs1800435) genotype in the NCI Brain Tumour Study
| Overall | ALAD1 * | ALAD2 * | P† | |||||||
| Cases (%) | Controls (%) | OR (95% CI) | Cases (%) | Controls (%) | OR (95% CI) | Cases (%) | Controls (%) | OR (95% CI) | ||
| Glioma | ||||||||||
| Ever exposed to lead (expert) | ||||||||||
| No | 196 (55) | 288 (57) | 1.0 | 169 (56) | 236 (56) | 1.0 | 27 (50) | 52 (62) | 1.0 | 0.2 |
| Yes | 157 (44) | 216 (43) | 0.8 (0.5 to 1.1) | 130 (43) | 183 (44) | 0.7 (0.5 to 1.0) | 27 (50) | 33 (39) | 1.1 (0.5 to 2.3) | |
| Unknown | 2 (1) | 1 (<1) | – | 2 (1) | 1 (<1) | – | 0 (0) | 0 (0) | – | |
| Ever exposed to lead (JEM) | ||||||||||
| No | 253 (71) | 365 (72) | 1.0 | 214 (71) | 305 (73) | 1.0 | 39 (72) | 60 (71) | 1.0 | |
| Yes | 94 (26) | 136 (27) | 0.8 (0.6 to 1.1) | 80 (27) | 113 (27) | 0.9 (0.6 to 1.4) | 14 (26) | 23 (27) | 0.7 (0.3 to 1.6) | 0.8 |
| Unknown | 8 (2) | 4 (1) | – | 7 (2) | 2 (<1) | – | 1 (2) | 2 (2) | – | |
| Cumulative lead exposure (expert) | ||||||||||
| Unexposed | 196 (55) | 288 (57) | 1.0 | 169 (56) | 236 (56) | 1.0 | 27 (50) | 52 (61) | 1.0 | 0.8 |
| ≤80th percentile | 77 (22) | 110 (22) | 0.8 (0.5 to 1.1) | 64 (21) | 93 (22) | 0.7 (0.5 to 1.1) | 13 (24) | 17 (20) | 1.1 (0.4 to 2.6) | |
| >80th to 95th percentile | 48 (14) | 83 (16) | 0.6 (0.4 to 0.9) | 40 (13) | 70 (17) | 0.5 (0.3 to 0.9) | 8 (15) | 13 (15) | 0.7 (0.3 to 2.1) | |
| >95th percentile | 21 (6) | 21 (4) | 1.0 (0.5 to 2.0) | 17 (6) | 18 (4) | 0.9 (0.4 to 1.9) | 4 (7) | 3 (4) | 1.8 (0.3 to 8.9) | |
| Unknown | 13 (4) | 3 (1) | – | 11 (4) | 3 (1) | – | 2 (4) | 0 (0) | – | |
| p Trend‡ | 0.1 | 0.09 | 0.9 | |||||||
| Cumulative lead exposure (JEM) | ||||||||||
| Unexposed | 253 (71) | 365 (72) | 1.0 | 214 (71) | 305 (73) | 1.0 | 39 (72) | 60 (71) | 1.0 | 0.8 |
| ≤80th percentile | 15 (4) | 31 (6) | 0.6 (0.3 to 1.2) | 14 (5) | 28 (7) | 0.6 (0.3 to 1.2) | 1 (2) | 3 (4) | 0.4 (0.04 to 4.6) | |
| >80th to 95th percentile | 53 (15) | 78 (15) | 0.8 (0.5 to 1.2) | 45 (15) | 62 (15) | 0.9 (0.5 to 1.4) | 8 (15) | 16 (19) | 0.6 (0.2 to 1.7) | |
| >95th percentile | 22 (6) | 26 (5) | 0.9 (0.5 to 1.7) | 18 (6) | 22 (5) | 0.9 (0.4 to 1.7) | 4 (7) | 4 (5) | 1.1 (0.3 to 4.9) | |
| Unknown | 12 (3) | 5 (1) | – | 10 (3) | 3 (1) | – | 2 (4) | 2 (2) | – | |
| p Trend‡ | 0.4 | 0.4 | 0.6 | |||||||
| Meningioma | ||||||||||
| Ever exposed to lead (expert) | ||||||||||
| No | 108 (72) | 288 (57) | 1.0 | 86 (74) | 236 (56) | 1.0 | 22 (63) | 52 (61) | 1.0 | 0.09 |
| Yes | 42 (28) | 216 (43) | 0.9 (0.5 to 1.5) | 29 (25) | 183 (44) | 0.8 (0.4 to 1.3) | 13 (37) | 33 (39) | 1.8 (0.7 to 4.8) | |
| Unknown | 1 (<1) | 1 (<1) | – | 1 (1) | 1 (<1) | – | 0 (0) | 0 (0) | – | |
| Ever exposed to lead (JEM) | ||||||||||
| No | 123 (81) | 365 (72) | 1.0 | 95 (82) | 305 (73) | 1.0 | 28 (80) | 60 (71) | 1.0 | 0.9 |
| Yes | 26 (17) | 136 (27) | 0.9 (0.5 to 1.7) | 20 (17) | 113 (27) | 0.9 (0.5 to 1.7) | 6 (17) | 23 (27) | 1.0 (0.3 to 3.1) | |
| Unknown | 2 (1) | 4 (1) | – | 1 (1) | 2 (<1) | – | 1 (3) | 2 (2) | – | |
| Cumulative lead exposure (expert) | ||||||||||
| Unexposed | 108 (72) | 288 (57) | 1.0 | 86 (74) | 236 (56) | 1.0 | 22 (63) | 52 (62) | 1.0 | 0.04 |
| ≤80th percentile | 17 (11) | 110 (22) | 0.7 (0.4 to 1.3) | 15 (13) | 93 (22) | 0.7 (0.4 to 1.4) | 2 (6) | 17 (20) | 0.5 (0.09 to 2.5) | |
| >80th to 95th percentile | 15 (10) | 83 (16) | 1.0 (0.5 to 2.1) | 9 (8) | 70 (17) | 0.7 (0.3 to 1.8) | 6 (17) | 13 (15) | 2.4 (0.7 to 8.8) | |
| >95th percentile | 8 (5) | 21 (4) | 2.7 (1.0 to 7.8) | 3 (3) | 18 (4) | 1.2 (0.3 to 4.8) | 5 (14) | 3 (4) | 13.2 (2.4 to 72.9) | |
| Unknown | 3 (2) | 3 (<1) | – | 3 (3) | 3 (1) | – | 0 (0) | 0 (0) | – | |
| p Trend‡ | 0.4 | 0.6 | 0.007 | |||||||
| Cumulative lead exposure (JEM) | ||||||||||
| Unexposed | 123 (81) | 365 (72) | 1.0 | 95 (82) | 305 (73) | 1.0 | 28 (80) | 60 (71) | 1.0 | 0.9 |
| ≤80th percentile | 5 (3) | 31 (6) | 0.6 (0.2 to 1.8) | 4 (3) | 28 (7) | 0.6 (0.2 to 2.0) | 1 (3) | 3 (4) | 1.1 (0.09 to 12.5) | |
| >80th to 95th percentile | 16 (11) | 78 (15) | 1.1 (0.5 to 2.1) | 13 (11) | 62 (15) | 1.2 (0.6 to 2.5) | 3 (9) | 16 (19) | 0.7 (0.2 to 3.0) | |
| >95th percentile | 4 (3) | 26 (5) | 0.9 (0.3 to 2.8) | 3 (3) | 22 (5) | 0.8 (0.2 to 3.1) | 1 (3) | 4 (5) | 1.1 (0.1 to 12.0) | |
| Unknown | 3 (2) | 5 (1) | – | 1 (1) | 3 (1) | – | 2 (6) | 2 (2) | – | |
| p Trend‡ | 0.9 | 0.9 | 0.8 | |||||||
↵* ALAD1 homozygotes: n (%) controls=420 (83), n (%) glioma cases=301 (85), n (%) meningioma cases=116 (77); ALAD2 carriers: n (%) controls=85 (17), n (%) glioma cases=54 (15), n (%) meningioma cases=35 (23).
↵† p Value for effect modification of lead exposure by ALAD genotype.
↵‡ Test for trend excluded Unknown category.