Incidence of amyotrophic lateral sclerosis in the province of Novara, Italy, and possible role of environmental pollution

Abstract

Overall, our study did not confirm previous findings of an excess ALS incidence in an area characterised by severe environmental heavy metal pollution, and it suggests the need to interpret with caution clusters identified through mortality data.

Spatial Assessment of the Association between Long-Term Exposure to Environmental Factors and the Occurrence of Amyotrophic Lateral Sclerosis in Catalonia, Spain: A Population-Based Nested Case-Control Study

“…However, only in some of them have environmental factors been suggested as a possible explanation for their occurrence [14, 48, 76-82]. This is particularly notable for exposure to metals [48, 77, 80, 81] and to agricultural chemicals [78-81], although exposure to industrial toxins [77] and to paper paste and water treatment plants [82] also appears.…”

“…Similarly, Uccelli et al [81] identified 16 clusters with significant high relative risk of ALS mortality (12 of them included in a single municipality) in all Italian municipalities in the period 1980–2001 and suggest, in addition to genetics, that agricultural chemicals and lead could be involved. However, very recently, Tesauro et al [14], investigated an ALS cluster reported in the Briga area (in the province of Novara, northern Italy), known for its high level of heavy metal contamination, which has had a serious impact on soil, surface water and groundwater, but they could not confirm an excess of ALS incidence.…”

“…However, it would seem that the sample we used was, in fact, quite representative. First, we estimated a prevalence of ALS at 5.09 per 100,000 inhabitants, (i.e., within the range indicated in the literature [5–5.4] [9, 14]), and a crude incidence at 1.12 per 100,000 person/years (95% CI 0.85–1.48), an interval containing the incidence estimated by Pradas et al [12], for Catalonia (1.4 per 100,000 inhabitants). Second, the male/female ratio in the incidence in our sample was only slightly less than that reported in the literature [15, 10, 12] (1.25 vs. 1.3–1.5 ­respectively).…”

“…However, for the same period in Japan, the ALS incidence was estimated equal to 2.2 per 100,000 persons/years [13]. The prevalence of ALS has been estimated to be between 5 [14] and 5.4 per 100,000 inhabitants [9]. Geographic variability also occurs.…”

Psychological Intervention in Amyotrophic Lateral Sclerosis: Suggestions for Clinical Practice

“…Subsequently, spreading paralysis of the voluntary muscles often develops, and eventually it can also reach respiratory muscles [1]. It is now well recognized complex topics and especially with expert participants as in that case [9].…”