Environmental and Occupational Risk Factors of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study

Objectives: Amyotrophic lateral sclerosis (ALS) is a progressive and fatal neurodegenerative disease with still unknown etiology. We aimed at investigating the association between environmental and occupational factors with ALS risk. Methods: We performed a population-based case-control study in four Italian provinces (Catania, Modena, Novara, and Reggio Emilia) by administration of tailored questionnaires to ALS cases (n = 95) and randomly selected population referents (n = 135). We estimated ALS risk by calculating the odds ratio (OR) with its 95% confidence interval (CI) using an unconditional logistic regression model. Results: We found a positive association with disease risk for history of occupation in the agricultural sector (OR = 2.09, 95% CI 0.79–7.54), especially for longer than 10 years (OR = 2.72, 95% 1.02–7.20). Overall occupational exposure to solvents also suggested a positive association, especially for thinners (OR = 2.27, 95% CI 1.14–4.54) and paint removers (OR = 2.01, 95% CI 0.90–4.48). Both occupational and environmental exposure to electromagnetic fields show a slightly increased risk with OR = 1.69 (95% CI 0.70–4.09) and 2.41 (95% CI 1.13–5.12), respectively. Occupational but not environmental exposure to pesticides (OR = 1.22, 95% CI 0.63–2.37), particularly fungicides, and exposure to metals (OR = 4.20, 95% CI 1.88–9.38), particularly lead, mercury, and selenium, showed an imprecise but positive association. Finally, there was an indication of increased risk for living in proximity to water bodies. Conclusions: Despite the caution that needs to be used due to some study limitations, such as the low number of exposed subjects and the possibility of recall bias, these results suggest the potential role of some environmental and occupational factors in ALS etiology.

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Environmental Exposure to Trace Elements and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case–Control Study

Environmental Research ◽

10.1006/enrs.2002.4361 ◽

2002 ◽

Vol 89 (2) ◽

pp. 116-123 ◽

Cited By ~ 68

Author(s):

Margherita Bergomi ◽

Marco Vinceti ◽

Grazia Nacci ◽

Vladimiro Pietrini ◽

Peter Brätter ◽

...

Keyword(s):

Amyotrophic Lateral Sclerosis ◽

Trace Elements ◽

Environmental Exposure ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Control Study ◽

Lateral Sclerosis

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Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17030857 ◽

2020 ◽

Vol 17 (3) ◽

pp. 857 ◽

Cited By ~ 5

Author(s):

Tommaso Filippini ◽

Maria Fiore ◽

Marina Tesauro ◽

Carlotta Malagoli ◽

Michela Consonni ◽

...

Keyword(s):

Amyotrophic Lateral Sclerosis ◽

Case Control Study ◽

Southern Italy ◽

Population Based ◽

Case Control ◽

Lifestyle Factors ◽

Inverse Association ◽

Increased Risk ◽

Control Study ◽

Lateral Sclerosis

Background: Amyotrophic lateral sclerosis (ALS) is a progressive, fatal neurodegenerative disease of the motor neurons. The etiology of ALS remains largely unknown, particularly with reference to the potential environmental determinants. Methods: We performed a population-based case-control study in four provinces from both Northern and Southern Italy in order to assess non-genetic ALS risk factors by collecting through tailored questionnaires information about clinical and lifestyle factors. We estimated ALS risk by calculating odds ratio (OR) with its 95% confidence interval (CI) using unconditional logistic regression models adjusted for sex, age and educational attainment. Results: We recruited 230 participants (95 cases and 135 controls). We found a possible positive association of ALS risk with trauma, particularly head trauma (OR = 2.61, 95% CI 1.19–5.72), electric shock (OR = 2.09, 95% CI 0.62–7.06), and some sports, although at a competitive level only. In addition, our results suggest an increased risk for subjects reporting use of private wells for drinking water (OR = 1.38, 95% CI 0.73–2.27) and for use of herbicides during gardening (OR = 1.95, 95% CI 0.88–2.27). Conversely, there was a suggestion of an inverse association with overall fish consumption (OR = 0.27, 95% CI 0.12–0.60), but with no dose-response relation. Consumption of some dietary supplements, namely those containing amino acids and, in the Southern Italy population, vitamins and minerals such as selenium, seemed associated with a statistically imprecise increased risk. Conclusions: Our results suggest a potential etiologic role a number of clinical and lifestyle factors with ALS risk. However, caution is needed due to some study limitations. These include the small sample size and the low number of exposed subjects, which affect statistical precision of risk estimates, the potential for exposure misclassification, and the uncertainties about mechanisms underpinning the possible association between these factors and disease risk.

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Association between alcohol exposure and the risk of amyotrophic lateral sclerosis in the Euro-MOTOR study

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-318559 ◽

2018 ◽

Vol 90 (1) ◽

pp. 11-19 ◽

Cited By ~ 6

Author(s):

Fabrizio D'Ovidio ◽

James P K Rooney ◽

Anne E Visser ◽

Umberto Manera ◽

Ettore Beghi ◽

...

Keyword(s):

Amyotrophic Lateral Sclerosis ◽

Alcohol Consumption ◽

Red Wine ◽

Case Control Study ◽

Population Based ◽

Case Control ◽

Increased Risk ◽

Control Study ◽

Lateral Sclerosis

ObjectivesSeveral studies focused on the association between alcohol consumption and amyotrophic lateral sclerosis (ALS), although with inconsistent findings. Antioxidants may play a role since lyophilised red wine was found to prolong SOD1 mice lifespan. The aim of this international population-based case–control study performed in Ireland, The Netherlands and Italy was to assess the role of alcohol, and red wine in particular, in developing ALS.MethodsEuro-MOTOR is a case–control study where patients with incident ALS and controls matched for gender, age and area of residency were recruited in a population-based design. Logistic regression models adjusted for sex, age, cohort, education, leisure time physical activity, smoking, heart problems, hypertension, stroke, cholesterol and diabetes were performed.Results1557 patients with ALS and 2922 controls were enrolled in the study. Exposure to alcohol drinking was not significantly associated with ALS risk. A stratified analysis of exposure to alcohol by cohort revealed significant ORs in The Netherlands and in Apulia, with opposite directions (respectively 0.68 and 2.38). With regard to red wine consumption, only in Apulia the double-fold increased risk (OR 2.53) remained significant. A decreased risk was found for current alcohol drinkers (OR 0.83), while a significantly increased risk was detected among former drinkers (OR 1.63). Analysis of cumulative exposure to alcohol revealed no significant associations with ALS risk.ConclusionWith few exceptions, no significant association was found between alcohol consumption and ALS. The study of the association between alcohol and ALS requires a thorough exploration, especially considering the role of different type of alcoholic beverages.

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