283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort
Identifieur interne : 002E58 ( Main/Corpus ); précédent : 002E57; suivant : 002E59283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort
Auteurs : A. Huss ; Spoerri Egger ; Kromhout VermeulenSource :
- Occupational and Environmental Medicine [ 1351-0711 ] ; 2013-09.
Abstract
Background Previous studies have identified increased risks of amyotrophic lateral sclerosis (ALS) in electrical workers, but studies assessing risk in workers exposed to magnetic fields were ambiguous. Electric shocks have been hypothesised to be the relevant exposure, but potential risks from electric shocks have not been previously disentangled from those of magnetic fields. We aimed at analysing the association of ALS with both magnetic field exposure as well as risk of electric shocks at work. Methods We used the Swiss National Cohort study, which is based on census information from 1990 and 2000 linked with mortality records from 2000–2008. High or medium versus low exposure to magnetic fields and risk of electric shocks was assigned to occupations using two job exposure matrices. Data of 4.7 million persons were analysed using Cox proportional hazard models and adjusted for age, sex, educational level, civil status, nationality, language region, degree of urbanity of the municipality and an area-based proxy for socioeconomic position. Results During 2000–2008, 1313 persons with information on occupation died from ALS. Hazard ratios were around unity for persons exposed to magnetic fields or risk of electric shocks in either 1990 or 2000. In persons classified as medium or high exposed in both 1990 and 2000, a slight increase in mortality from ALS was observed for magnetic field exposures (HR 1.39, 95% CI 1.03–1.87), but less so for electric shocks (HR 1.20, 95%CI 0.88–1.65). When accounting for both exposures in the same model, magnetic fields had a similar HR (1.36, 95%CI 0.99–1.89) as before, but the HR for electric shocks was attenuated to 1.07 (95%CI 0.76–1.5). Conclusions We observed an association of long-term exposure to extremely low frequency magnetic fields and mortality from ALS, but not of risk of electric shocks and ALS.
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DOI: 10.1136/oemed-2013-101717.283
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort</title><author><name sortKey="Huss, A" sort="Huss, A" uniqKey="Huss A" first="A" last="Huss">A. Huss</name><affiliation><mods:affiliation>IRAS, Utrecht, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Egger, Spoerri" sort="Egger, Spoerri" uniqKey="Egger S" first="Spoerri" last="Egger">Spoerri Egger</name><affiliation><mods:affiliation>IRAS, Utrecht, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Vermeulen, Kromhout" sort="Vermeulen, Kromhout" uniqKey="Vermeulen K" first="Kromhout" last="Vermeulen">Kromhout Vermeulen</name><affiliation><mods:affiliation>IRAS, Utrecht, The Netherlands</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:5CF43E982C37F5B6221FFD256842A7D17A77780D</idno><date when="2013" year="2013">2013</date><idno type="doi">10.1136/oemed-2013-101717.283</idno><idno type="url">https://api.istex.fr/document/5CF43E982C37F5B6221FFD256842A7D17A77780D/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002E58</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort</title><author><name sortKey="Huss, A" sort="Huss, A" uniqKey="Huss A" first="A" last="Huss">A. Huss</name><affiliation><mods:affiliation>IRAS, Utrecht, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Egger, Spoerri" sort="Egger, Spoerri" uniqKey="Egger S" first="Spoerri" last="Egger">Spoerri Egger</name><affiliation><mods:affiliation>IRAS, Utrecht, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Vermeulen, Kromhout" sort="Vermeulen, Kromhout" uniqKey="Vermeulen K" first="Kromhout" last="Vermeulen">Kromhout Vermeulen</name><affiliation><mods:affiliation>IRAS, Utrecht, The Netherlands</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Occupational and Environmental Medicine</title><title level="j" type="abbrev">Occup Environ Med</title><idno type="ISSN">1351-0711</idno><idno type="eISSN">1470-7926</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2013-09">2013-09</date><biblScope unit="volume">70</biblScope><biblScope unit="issue">Suppl 1</biblScope><biblScope unit="page" from="A96">A96</biblScope></imprint><idno type="ISSN">1351-0711</idno></series><idno type="istex">5CF43E982C37F5B6221FFD256842A7D17A77780D</idno><idno type="DOI">10.1136/oemed-2013-101717.283</idno><idno type="href">oemed-70-A96-2.pdf</idno><idno type="ArticleID">oemed-2013-101717.283</idno><idno type="local">oemed;70/Suppl_1/A96-a</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1351-0711</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background Previous studies have identified increased risks of amyotrophic lateral sclerosis (ALS) in electrical workers, but studies assessing risk in workers exposed to magnetic fields were ambiguous. Electric shocks have been hypothesised to be the relevant exposure, but potential risks from electric shocks have not been previously disentangled from those of magnetic fields. We aimed at analysing the association of ALS with both magnetic field exposure as well as risk of electric shocks at work. Methods We used the Swiss National Cohort study, which is based on census information from 1990 and 2000 linked with mortality records from 2000–2008. High or medium versus low exposure to magnetic fields and risk of electric shocks was assigned to occupations using two job exposure matrices. Data of 4.7 million persons were analysed using Cox proportional hazard models and adjusted for age, sex, educational level, civil status, nationality, language region, degree of urbanity of the municipality and an area-based proxy for socioeconomic position. Results During 2000–2008, 1313 persons with information on occupation died from ALS. Hazard ratios were around unity for persons exposed to magnetic fields or risk of electric shocks in either 1990 or 2000. In persons classified as medium or high exposed in both 1990 and 2000, a slight increase in mortality from ALS was observed for magnetic field exposures (HR 1.39, 95% CI 1.03–1.87), but less so for electric shocks (HR 1.20, 95%CI 0.88–1.65). When accounting for both exposures in the same model, magnetic fields had a similar HR (1.36, 95%CI 0.99–1.89) as before, but the HR for electric shocks was attenuated to 1.07 (95%CI 0.76–1.5). Conclusions We observed an association of long-term exposure to extremely low frequency magnetic fields and mortality from ALS, but not of risk of electric shocks and ALS.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>A Huss</name><affiliations><json:string>IRAS, Utrecht, The Netherlands</json:string></affiliations></json:item><json:item><name>Spoerri Egger</name><affiliations><json:string>IRAS, Utrecht, The Netherlands</json:string></affiliations></json:item><json:item><name>Kromhout Vermeulen</name><affiliations><json:string>IRAS, Utrecht, The Netherlands</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Session: 11. Neurological outcomes</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Background Previous studies have identified increased risks of amyotrophic lateral sclerosis (ALS) in electrical workers, but studies assessing risk in workers exposed to magnetic fields were ambiguous. Electric shocks have been hypothesised to be the relevant exposure, but potential risks from electric shocks have not been previously disentangled from those of magnetic fields. We aimed at analysing the association of ALS with both magnetic field exposure as well as risk of electric shocks at work. Methods We used the Swiss National Cohort study, which is based on census information from 1990 and 2000 linked with mortality records from 2000–2008. High or medium versus low exposure to magnetic fields and risk of electric shocks was assigned to occupations using two job exposure matrices. Data of 4.7 million persons were analysed using Cox proportional hazard models and adjusted for age, sex, educational level, civil status, nationality, language region, degree of urbanity of the municipality and an area-based proxy for socioeconomic position. Results During 2000–2008, 1313 persons with information on occupation died from ALS. Hazard ratios were around unity for persons exposed to magnetic fields or risk of electric shocks in either 1990 or 2000. In persons classified as medium or high exposed in both 1990 and 2000, a slight increase in mortality from ALS was observed for magnetic field exposures (HR 1.39, 95% CI 1.03–1.87), but less so for electric shocks (HR 1.20, 95%CI 0.88–1.65). When accounting for both exposures in the same model, magnetic fields had a similar HR (1.36, 95%CI 0.99–1.89) as before, but the HR for electric shocks was attenuated to 1.07 (95%CI 0.76–1.5). Conclusions We observed an association of long-term exposure to extremely low frequency magnetic fields and mortality from ALS, but not of risk of electric shocks and ALS.</abstract><qualityIndicators><score>3.877</score><pdfVersion>1.3</pdfVersion><pdfPageSize>662.967 x 861.392 pts</pdfPageSize><refBibsNative>false</refBibsNative><keywordCount>1</keywordCount><abstractCharCount>1872</abstractCharCount><pdfWordCount>877</pdfWordCount><pdfCharCount>5786</pdfCharCount><pdfPageCount>1</pdfPageCount><abstractWordCount>292</abstractWordCount></qualityIndicators><title>283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort</title><genre><json:string>abstract</json:string></genre><host><volume>70</volume><pages><first>A96</first></pages><issn><json:string>1351-0711</json:string></issn><issue>Suppl 1</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1470-7926</json:string></eissn><title>Occupational and Environmental Medicine</title></host><publicationDate>2013</publicationDate><copyrightDate>2013</copyrightDate><doi><json:string>10.1136/oemed-2013-101717.283</json:string></doi><id>5CF43E982C37F5B6221FFD256842A7D17A77780D</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/5CF43E982C37F5B6221FFD256842A7D17A77780D/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/5CF43E982C37F5B6221FFD256842A7D17A77780D/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/5CF43E982C37F5B6221FFD256842A7D17A77780D/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort</title><respStmt xml:id="ISTEX-API" resp="Références bibliographiques récupérées via GROBID" name="ISTEX-API (INIST-CNRS)"></respStmt></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2013</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort</title><author><persName><forename type="first">A</forename><surname>Huss</surname></persName><affiliation>IRAS, Utrecht, The Netherlands</affiliation></author><author><persName><forename type="first">Spoerri</forename><surname>Egger</surname></persName><affiliation>IRAS, Utrecht, The Netherlands</affiliation></author><author><persName><forename type="first">Kromhout</forename><surname>Vermeulen</surname></persName><affiliation>IRAS, Utrecht, The Netherlands</affiliation></author></analytic><monogr><title level="j">Occupational and Environmental Medicine</title><title level="j" type="abbrev">Occup Environ Med</title><idno type="pISSN">1351-0711</idno><idno type="eISSN">1470-7926</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2013-09"></date><biblScope unit="volume">70</biblScope><biblScope unit="issue">Suppl 1</biblScope><biblScope unit="page" from="A96">A96</biblScope></imprint></monogr><idno type="istex">5CF43E982C37F5B6221FFD256842A7D17A77780D</idno><idno type="DOI">10.1136/oemed-2013-101717.283</idno><idno type="href">oemed-70-A96-2.pdf</idno><idno type="ArticleID">oemed-2013-101717.283</idno><idno type="local">oemed;70/Suppl_1/A96-a</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2013</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Background Previous studies have identified increased risks of amyotrophic lateral sclerosis (ALS) in electrical workers, but studies assessing risk in workers exposed to magnetic fields were ambiguous. Electric shocks have been hypothesised to be the relevant exposure, but potential risks from electric shocks have not been previously disentangled from those of magnetic fields. We aimed at analysing the association of ALS with both magnetic field exposure as well as risk of electric shocks at work. Methods We used the Swiss National Cohort study, which is based on census information from 1990 and 2000 linked with mortality records from 2000–2008. High or medium versus low exposure to magnetic fields and risk of electric shocks was assigned to occupations using two job exposure matrices. Data of 4.7 million persons were analysed using Cox proportional hazard models and adjusted for age, sex, educational level, civil status, nationality, language region, degree of urbanity of the municipality and an area-based proxy for socioeconomic position. Results During 2000–2008, 1313 persons with information on occupation died from ALS. Hazard ratios were around unity for persons exposed to magnetic fields or risk of electric shocks in either 1990 or 2000. In persons classified as medium or high exposed in both 1990 and 2000, a slight increase in mortality from ALS was observed for magnetic field exposures (HR 1.39, 95% CI 1.03–1.87), but less so for electric shocks (HR 1.20, 95%CI 0.88–1.65). When accounting for both exposures in the same model, magnetic fields had a similar HR (1.36, 95%CI 0.99–1.89) as before, but the HR for electric shocks was attenuated to 1.07 (95%CI 0.76–1.5). Conclusions We observed an association of long-term exposure to extremely low frequency magnetic fields and mortality from ALS, but not of risk of electric shocks and ALS.</p></abstract></profileDesc><revisionDesc><change when="2013-09">Published</change><change xml:id="refBibs-istex" who="#ISTEX-API" when="2016-3-14">References added</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/5CF43E982C37F5B6221FFD256842A7D17A77780D/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="abstract" xml:lang="EN"><front><journal-meta><journal-id journal-id-type="hwp">oemed</journal-id><journal-id journal-id-type="nlm-ta">Occup Environ Med</journal-id><journal-id journal-id-type="publisher-id">oemed</journal-id><journal-title>Occupational and Environmental Medicine</journal-title><abbrev-journal-title abbrev-type="publisher">Occup Environ Med</abbrev-journal-title><abbrev-journal-title>Occup Environ Med</abbrev-journal-title><issn pub-type="ppub">1351-0711</issn><issn pub-type="epub">1470-7926</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">oemed-2013-101717.283</article-id><article-id pub-id-type="doi">10.1136/oemed-2013-101717.283</article-id><article-id pub-id-type="other">oemed;70/Suppl_1/A96-a</article-id><article-id pub-id-type="other">oemed;oemed-2013-101717.283</article-id><article-id pub-id-type="other">A96.2</article-id><article-id pub-id-type="other">oemed-2013-101717.283</article-id><article-categories><subj-group subj-group-type="heading"><subject>Session: 11. Neurological outcomes</subject></subj-group></article-categories><title-group><article-title>283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Huss</surname><given-names>A</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Egger</surname><given-names>Spoerri</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Vermeulen</surname><given-names>Kromhout</given-names></name><xref ref-type="aff" rid="AF0001"></xref></contrib></contrib-group><aff id="AF0001">IRAS, Utrecht, The Netherlands</aff><pub-date pub-type="ppub"><month>09</month><year>2013</year></pub-date><volume>70</volume><volume-id pub-id-type="other">70</volume-id><volume-id pub-id-type="other">70</volume-id><issue>Suppl 1</issue><issue-id pub-id-type="other">oemed;70/Suppl_1</issue-id><issue-id pub-id-type="other" content-type="supplement">Suppl_1</issue-id><issue-id pub-id-type="other">70/Suppl_1</issue-id><issue-title>23rd Conference on Epidemiology in Occupational Health EPICOH 2013: Improving the Impact June 18–21, 2013, Utrecht, The Netherlands</issue-title><fpage seq="2">A96</fpage><permissions><copyright-statement>© 2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement><copyright-year>2013</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="oemed-70-A96-2.pdf"></self-uri><abstract><sec><title>Background</title><p>Previous studies have identified increased risks of amyotrophic lateral sclerosis (ALS) in electrical workers, but studies assessing risk in workers exposed to magnetic fields were ambiguous. Electric shocks have been hypothesised to be the relevant exposure, but potential risks from electric shocks have not been previously disentangled from those of magnetic fields. We aimed at analysing the association of ALS with both magnetic field exposure as well as risk of electric shocks at work.</p></sec><sec><title>Methods</title><p>We used the Swiss National Cohort study, which is based on census information from 1990 and 2000 linked with mortality records from 2000–2008. High or medium versus low exposure to magnetic fields and risk of electric shocks was assigned to occupations using two job exposure matrices. Data of 4.7 million persons were analysed using Cox proportional hazard models and adjusted for age, sex, educational level, civil status, nationality, language region, degree of urbanity of the municipality and an area-based proxy for socioeconomic position.</p></sec><sec><title>Results</title><p>During 2000–2008, 1313 persons with information on occupation died from ALS. Hazard ratios were around unity for persons exposed to magnetic fields or risk of electric shocks in either 1990 or 2000. In persons classified as medium or high exposed in both 1990 and 2000, a slight increase in mortality from ALS was observed for magnetic field exposures (HR 1.39, 95% CI 1.03–1.87), but less so for electric shocks (HR 1.20, 95%CI 0.88–1.65). When accounting for both exposures in the same model, magnetic fields had a similar HR (1.36, 95%CI 0.99–1.89) as before, but the HR for electric shocks was attenuated to 1.07 (95%CI 0.76–1.5).</p></sec><sec><title>Conclusions</title><p>We observed an association of long-term exposure to extremely low frequency magnetic fields and mortality from ALS, but not of risk of electric shocks and ALS.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>283 Occupational exposure to magnetic fields and electric shocks and risk of ALS - analysis of the Swiss National Cohort</title></titleInfo><name type="personal"><namePart type="given">A</namePart><namePart type="family">Huss</namePart><affiliation>IRAS, Utrecht, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Spoerri</namePart><namePart type="family">Egger</namePart><affiliation>IRAS, Utrecht, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kromhout</namePart><namePart type="family">Vermeulen</namePart><affiliation>IRAS, Utrecht, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="abstract" displayLabel="abstract"></genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2013-09</dateIssued><copyrightDate encoding="w3cdtf">2013</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Background Previous studies have identified increased risks of amyotrophic lateral sclerosis (ALS) in electrical workers, but studies assessing risk in workers exposed to magnetic fields were ambiguous. Electric shocks have been hypothesised to be the relevant exposure, but potential risks from electric shocks have not been previously disentangled from those of magnetic fields. We aimed at analysing the association of ALS with both magnetic field exposure as well as risk of electric shocks at work. Methods We used the Swiss National Cohort study, which is based on census information from 1990 and 2000 linked with mortality records from 2000–2008. High or medium versus low exposure to magnetic fields and risk of electric shocks was assigned to occupations using two job exposure matrices. Data of 4.7 million persons were analysed using Cox proportional hazard models and adjusted for age, sex, educational level, civil status, nationality, language region, degree of urbanity of the municipality and an area-based proxy for socioeconomic position. Results During 2000–2008, 1313 persons with information on occupation died from ALS. Hazard ratios were around unity for persons exposed to magnetic fields or risk of electric shocks in either 1990 or 2000. In persons classified as medium or high exposed in both 1990 and 2000, a slight increase in mortality from ALS was observed for magnetic field exposures (HR 1.39, 95% CI 1.03–1.87), but less so for electric shocks (HR 1.20, 95%CI 0.88–1.65). When accounting for both exposures in the same model, magnetic fields had a similar HR (1.36, 95%CI 0.99–1.89) as before, but the HR for electric shocks was attenuated to 1.07 (95%CI 0.76–1.5). Conclusions We observed an association of long-term exposure to extremely low frequency magnetic fields and mortality from ALS, but not of risk of electric shocks and ALS.</abstract><relatedItem type="host"><titleInfo><title>Occupational and Environmental Medicine</title></titleInfo><titleInfo type="abbreviated"><title>Occup Environ Med</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1351-0711</identifier><identifier type="eISSN">1470-7926</identifier><identifier type="PublisherID">oemed</identifier><identifier type="PublisherID-hwp">oemed</identifier><identifier type="PublisherID-nlm-ta">Occup Environ Med</identifier><part><date>2013</date><detail type="title"><title>23rd Conference on Epidemiology in Occupational Health EPICOH 2013: Improving the Impact June 18–21, 2013, Utrecht, The Netherlands</title></detail><detail type="volume"><caption>vol.</caption><number>70</number></detail><detail type="issue"><caption>no.</caption><number>Suppl 1</number></detail><extent unit="pages"><start>A96</start></extent></part></relatedItem><identifier type="istex">5CF43E982C37F5B6221FFD256842A7D17A77780D</identifier><identifier type="DOI">10.1136/oemed-2013-101717.283</identifier><identifier type="href">oemed-70-A96-2.pdf</identifier><identifier type="ArticleID">oemed-2013-101717.283</identifier><identifier type="local">oemed;70/Suppl_1/A96-a</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2013, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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