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

Author

Listed:
  • 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
    Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, 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
    Department of Public Health, Local Health Unit, 41121 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
    Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA)

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.

Suggested Citation

  • Tommaso Filippini & Marina Tesauro & Maria Fiore & Carlotta Malagoli & Michela Consonni & Federica Violi & Laura Iacuzio & Elisa Arcolin & Gea Oliveri Conti & Antonio Cristaldi & Pietro Zuccarello & E, 2020. "Environmental and Occupational Risk Factors of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study," IJERPH, MDPI, vol. 17(8), pages 1-13, April.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:8:p:2882-:d:348787
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    References listed on IDEAS

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    1. Tommaso Filippini & Maria Fiore & Marina Tesauro & Carlotta Malagoli & Michela Consonni & Federica Violi & Elisa Arcolin & Laura Iacuzio & Gea Oliveri Conti & Antonio Cristaldi & Pietro Zuccarello & E, 2020. "Clinical and Lifestyle Factors and Risk of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study," IJERPH, MDPI, vol. 17(3), pages 1-17, January.
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    Citations

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    Cited by:

    1. Riccardo Mazzoli & Annalisa Chiari & Marco Vitolo & Caterina Garuti & Giorgia Adani & Giulia Vinceti & Giovanna Zamboni & Manuela Tondelli & Chiara Galli & Manuela Costa & Simone Salemme & Giuseppe Bo, 2024. "Atrial Fibrillation and Other Cardiovascular Factors and the Risk of Dementia: An Italian Case–Control Study," IJERPH, MDPI, vol. 21(6), pages 1-12, May.
    2. Aisha S. Dickerson, 2020. "Comment on: Filippini, T.; Tesauro, M.; Fiore, M.; Malagoli, C.; Consonni, M.; Violi, F.; Iacuzio, L.; Arcolin, E.; Oliveri Conti, G.; Cristaldi, A.; Zuccarello, P.; Zucchi, E.; Mazzini, L.; Pisano, F," IJERPH, MDPI, vol. 17(18), pages 1-2, September.
    3. Tommaso Filippini & Marina Tesauro & Maria Fiore & Carlotta Malagoli & Michela Consonni & Federica Violi & Laura Iacuzio & Elisa Arcolin & Gea Oliveri Conti & Antonio Cristaldi & Pietro Zuccarello & E, 2020. "Reply to Comment on “Environmental and Occupational Risk Factors of Amyotrophic Lateral Sclerosis: A Population-Based Case-Control Study”," IJERPH, MDPI, vol. 17(18), pages 1-3, September.
    4. Giorgia Adani & Tommaso Filippini & Caterina Garuti & Marcella Malavolti & Giulia Vinceti & Giovanna Zamboni & Manuela Tondelli & Chiara Galli & Manuela Costa & Marco Vinceti & Annalisa Chiari, 2020. "Environmental Risk Factors for Early-Onset Alzheimer’s Dementia and Frontotemporal Dementia: A Case-Control Study in Northern Italy," IJERPH, MDPI, vol. 17(21), pages 1-18, October.
    5. Tommaso Filippini & Jessica Mandrioli & Carlotta Malagoli & Sofia Costanzini & Andrea Cherubini & Giuseppe Maffeis & Marco Vinceti, 2021. "Risk of Amyotrophic Lateral Sclerosis and Exposure to Particulate Matter from Vehicular Traffic: A Case-Control Study," IJERPH, MDPI, vol. 18(3), pages 1-14, January.

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