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

Tommaso Filippini, Marina Tesauro, Maria Fiore, Carlotta Malagoli, Michela Consonni, Federica Violi, Laura Iacuzio, Elisa Arcolin, Gea Oliveri Conti, Antonio Cristaldi, Pietro Zuccarello, Elisabetta Zucchi, Letizia Mazzini, Fabrizio Pisano, Ileana Gagliardi, Francesco Patti, Jessica Mandrioli, Margherita Ferrante and Marco Vinceti
Additional contact information
Tommaso Filippini: CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
Marina Tesauro: Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
Maria Fiore: Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy
Carlotta Malagoli: CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
Michela Consonni: Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
Federica Violi: CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
Laura Iacuzio: CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
Elisa Arcolin: CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
Gea Oliveri Conti: Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy
Antonio Cristaldi: Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy
Pietro Zuccarello: Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy
Elisabetta Zucchi: Neurology Unit, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
Letizia Mazzini: ALS Centre Department of Neurology, ‘Maggiore della Carità’ University Hospital, 28100 Novara, Italy
Fabrizio Pisano: Neurological Rehabilitation Division, Policlinico San Marco di Zingonia, 24046 Zingonia (BG), Italy
Ileana Gagliardi: ALS Centre Department of Neurology, ‘Maggiore della Carità’ University Hospital, 28100 Novara, Italy
Francesco Patti: Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy
Jessica Mandrioli: Neurology Unit, Department of Neuroscience, S. Agostino Estense Hospital, Azienda Ospedaliero Universitaria di Modena, 41126 Modena, Italy
Margherita Ferrante: Department of Medical, Surgical Sciences and Advanced Technologies “G. F. Ingrassia”, Catania University, 95123 Catania, Italy
Marco Vinceti: CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy

IJERPH, 2020, vol. 17, issue 8, 1-13

Abstract: 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.

Keywords: amyotrophic lateral sclerosis; occupational factors; environmental factors; case-control study (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (5)

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