Amyotrophic Lateral Sclerosis and Air Pollutants in the Province of Ferrara, Northern Italy: An Ecological Study

Annibale Antonioni, Vittorio Govoni, Lisa Brancaleoni, Alessandro Donà, Enrico Granieri, Mauro Bergamini, Renato Gerdol and Maura Pugliatti ()
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Annibale Antonioni: Unit of Clinical Neurology, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
Vittorio Govoni: Unit of Clinical Neurology, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
Lisa Brancaleoni: Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
Alessandro Donà: Unit of Clinical Neurology, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
Enrico Granieri: Unit of Clinical Neurology, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy
Mauro Bergamini: Preventive Medicine and Risk Assessment, University of Ferrara, 44121 Ferrara, Italy
Renato Gerdol: Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
Maura Pugliatti: Unit of Clinical Neurology, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy

IJERPH, 2023, vol. 20, issue 8, 1-13

Abstract: The etiopathogenesis of amyotrophic lateral sclerosis (ALS) is still largely unknown, but likely depends on gene–environment interactions. Among the putative sources of environmental exposure are air pollutants and especially heavy metals. We aimed to investigate the relationship between ALS density and the concentration of air pollution heavy metals in Ferrara, northern Italy. An ecological study was designed to correlate the map of ALS distribution and that of air pollutants. All ALS cases diagnosed between 2000 and 2017 (Ferrara University Hospital administrative data) were plotted by residency in 100 sub-areas, and grouped in 4 sectors: urban, rural, northwestern and along the motorway. The concentrations of silver, aluminium, cadmium, chrome, copper, iron, manganese, lead, and selenium in moss and lichens were measured and monitored in 2006 and 2011. Based on 62 ALS patients, a strong and direct correlation of ALS density was observed only with copper concentrations in all sectors and in both sexes (Pearson coefficient ( ρ ) = 0.758; p = 0.000002). The correlation was higher in the urban sector ( ρ = 0.767; p = 0.000128), in women for the overall population ( ρ = 0.782, p = 0.000028) and in the urban ( ρ = 0.872, p = 0.000047) population, and for the older cohort of diagnosed patients (2000–2009) the assessment correlated with the first assessment of air pollutants in 2006 ( ρ = 0.724, p = 0.008). Our data is, in part, consistent with a hypothesis linking copper pollution to ALS.

Keywords: amyotrophic lateral sclerosis (ALS); pathophysiology; environmental factors; air pollutants; heavy metals; copper; neurodegeneration (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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