Risk of Amyotrophic Lateral Sclerosis and Exposure to Particulate Matter from Vehicular Traffic: A Case-Control Study

Tommaso Filippini, Jessica Mandrioli, Carlotta Malagoli, Sofia Costanzini, Andrea Cherubini, Giuseppe Maffeis and Marco Vinceti
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Tommaso Filippini: Department of Biomedical, Metabolic and Neural Sciences, CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, 41125 Modena, Italy
Jessica Mandrioli: Neurology Unit, Department of Neuroscience, S. Agostino Estense Hospital, Azienda Ospedaliero Universitaria di Modena, 41126 Modena, Italy
Carlotta Malagoli: Department of Biomedical, Metabolic and Neural Sciences, CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, 41125 Modena, Italy
Sofia Costanzini: DIEF Department of Engineering “Enzo Ferrari,” University of Modena and Reggio Emilia, 41125 Modena, Italy
Andrea Cherubini: TerrAria s.r.l., 20125 Milan, Italy
Giuseppe Maffeis: TerrAria s.r.l., 20125 Milan, Italy
Marco Vinceti: Department of Biomedical, Metabolic and Neural Sciences, CREAGEN Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, 41125 Modena, Italy

IJERPH, 2021, vol. 18, issue 3, 1-14

Abstract: (1) Background : Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with still unknown etiology. Some occupational and environmental risk factors have been suggested, including long-term air pollutant exposure. We carried out a pilot case-control study in order to evaluate ALS risk due to particulate matter with a diameter of ≤10 µm (PM 10 ) as a proxy of vehicular traffic exposure. (2) Methods : We recruited ALS patients and controls referred to the Modena Neurology ALS Care Center between 1994 and 2015. Using a geographical information system, we modeled PM 10 concentrations due to traffic emissions at the geocoded residence address at the date of case diagnosis. We computed the odds ratio (OR) and 95% confidence interval (CI) of ALS according to increasing PM 10 exposure, using an unconditional logistic regression model adjusted for age and sex. (3) Results : For the 132 study participants (52 cases and 80 controls), the average of annual median and maximum PM 10 concentrations were 5.2 and 38.6 µg/m 3 , respectively. Using fixed cutpoints at 5, 10, and 20 of the annual median PM 10 levels, and compared with exposure <5 µg/m 3 , we found no excess ALS risk at 5–10 µg/m 3 (OR 0.87, 95% CI 0.39–1.96), 10–20 µg/m 3 (0.94, 95% CI 0.24–3.70), and ≥20 µg/m 3 (0.87, 95% CI 0.05–15.01). Based on maximum PM 10 concentrations, we found a statistically unstable excess ALS risk for subjects exposed at 10–20 µg/m 3 (OR 4.27, 95% CI 0.69–26.51) compared with those exposed <10 µg/m 3 . However, risk decreased at 20–50 µg/m 3 (OR 1.49, 95% CI 0.39–5.75) and ≥50 µg/m 3 (1.16, 95% CI 0.28–4.82). ALS risk in increasing tertiles of exposure showed a similar null association, while comparison between the highest and the three lowest quartiles lumped together showed little evidence for an excess risk at PM 10 concentrations (OR 1.13, 95% CI 0.50–2.55). After restricting the analysis to subjects with stable residence, we found substantially similar results. (4) Conclusions : In this pilot study, we found limited evidence of an increased ALS risk due to long-term exposure at high PM 10 concentration, though the high statistical imprecision of the risk estimates, due to the small sample size, particularly in some exposure categories, limited our capacity to detect small increases in risk, and further larger studies are needed to assess this relation.

Keywords: amyotrophic lateral sclerosis; particulate matter; vehicular traffic; geographical information system; 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: 2021
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