Giuseppe Stipa1, Antonio Ancidoni2, Monica Mazzola2, Emanuela Testai3, Enzo Funari3, Cristina Spera4, Cinzia Fanelli1, Alessia Mancini1, Nicola Vanacore2. 1. Clinical Neurophysiology Division, Neuroscience Department, S. Maria University Hospital, 05100 Terni, Italy. 2. National Center for Disease Prevention and Health Promotion, National Institute of Health (ISS), 34, 00162 Roma, Italy. 3. Department of Environment and Health, National Institute of Health (ISS), 299, 00161 Roma, Italy. 4. Neurology Division, Neuroscience Department, S. Maria University Hospital, 05100 Terni, Italy.
Abstract
BACKGROUND: The etiopathogenesis of amyotrophic lateral sclerosis (ALS) is still largely unknown. METHODS: We performed a case-control study (33 cases and 35 controls) in Umbria, Italy. We investigated associations between common lifestyle, clinical factors, as well as environmental exposures potentially implicated with ALS onset. Face-to-face interviews were carried out. All cases were recruited and diagnosed according to El Escorial criteria. Case-control comparisons were made for educational and residential status, occupational exposures, and clinical and lifestyle factors prior to cases' dates of diagnosis. RESULTS: Our results showed an increased risk of ALS for subjects chronically exposed to raw water use (odds ratio (OR) = 6.55, 95% confidence interval (CI): 2.24-19.12). Garden activities showed a tight association with ALS as well, very likely as a consequence of chronic raw water exposure. Indeed, we could exclude an impact for pesticides, as no significant differences were observed in pesticide exposure in the two groups interviewed. However, cases were more often exposed to fertilizers. After adjustment for age, sex, and heavy physical activities, exposure to raw water was still associated with increased ALS risk (OR = 4.74, 95% CI: 1.33-16.85). DISCUSSION: These findings suggest an association between ALS and exposure to raw water, which should be further investigated for the presence of chemicals interfering with nervous system functionality.
BACKGROUND: The etiopathogenesis of amyotrophic lateral sclerosis (ALS) is still largely unknown. METHODS: We performed a case-control study (33 cases and 35 controls) in Umbria, Italy. We investigated associations between common lifestyle, clinical factors, as well as environmental exposures potentially implicated with ALS onset. Face-to-face interviews were carried out. All cases were recruited and diagnosed according to El Escorial criteria. Case-control comparisons were made for educational and residential status, occupational exposures, and clinical and lifestyle factors prior to cases' dates of diagnosis. RESULTS: Our results showed an increased risk of ALS for subjects chronically exposed to raw water use (odds ratio (OR) = 6.55, 95% confidence interval (CI): 2.24-19.12). Garden activities showed a tight association with ALS as well, very likely as a consequence of chronic raw water exposure. Indeed, we could exclude an impact for pesticides, as no significant differences were observed in pesticide exposure in the two groups interviewed. However, cases were more often exposed to fertilizers. After adjustment for age, sex, and heavy physical activities, exposure to raw water was still associated with increased ALS risk (OR = 4.74, 95% CI: 1.33-16.85). DISCUSSION: These findings suggest an association between ALS and exposure to raw water, which should be further investigated for the presence of chemicals interfering with nervous system functionality.
Entities:
Keywords:
ALS; case-control study; environmental factors; raw water
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