The Stacey Motor Neuron Disease Laboratory, Department of Pathology, The University of Sydney, Sydney, NSW, Australia.
Eur J Neurol. 2012 Oct;19(10):1343-8. doi: 10.1111/j.1468-1331.2012.03769.x. Epub 2012 May 29.
It remains unclear what role environmental toxins play in sporadic motor neuron disease (SMND) and its most common subtype, amyotrophic lateral sclerosis (SALS). Most previous studies of this issue have contained only small numbers of SMND cases. We sought to re-examine possible associations between toxins and SMND in a large Australian case-control study.
Questionnaire data were available from 787 patients with SMND (614 with SALS) and 778 non-related controls. Individuals were asked whether they had been exposed to metals or chemicals/solvents at work or to herbicides/pesticides. Chi-square tests with odds ratios and 95% confidence intervals were calculated for responses, and significance levels were corrected for multiple testing.
Men were more likely to acquire SALS if they worked with metals (OR = 1.95, 95% CI = 1.24-3.07) or chemicals/solvents (OR = 1.96, 95% CI = 1.46-2.61) or if they had been exposed to herbicides or pesticides (OR = 1.77, 95% CI = 1.30-2.39). Women who had worked with chemicals or solvents also appeared to be at increased risk of acquiring SALS (OR = 1.71, 95% CI = 1.22-2.40).
These results support previous reports that exposures to metals or chemicals are associated with SMND. A suggested protocol for future multinational studies of environmental toxins and SMND is presented.
环境毒素在散发性运动神经元病(SMND)及其最常见的亚型肌萎缩侧索硬化症(SALS)中的作用仍不清楚。大多数关于这个问题的先前研究都包含了少量的 SMND 病例。我们试图在一项大型澳大利亚病例对照研究中重新研究毒素与 SMND 之间可能存在的关联。
787 名 SMND 患者(614 名 SALS)和 778 名非相关对照的问卷调查数据可用。个体被问及他们是否在工作中接触过金属或化学物质/溶剂,或接触过除草剂/杀虫剂。对于回答,计算了卡方检验的比值比和 95%置信区间,并对多重检验进行了校正。
男性如果从事与金属(OR = 1.95,95% CI = 1.24-3.07)或化学物质/溶剂(OR = 1.96,95% CI = 1.46-2.61)相关的工作,或接触过除草剂或杀虫剂(OR = 1.77,95% CI = 1.30-2.39),则更有可能患上 SALS。从事化学物质或溶剂工作的女性似乎也有更高的风险患上 SALS(OR = 1.71,95% CI = 1.22-2.40)。
这些结果支持了先前的报告,即接触金属或化学物质与 SMND 有关。提出了未来环境毒素与 SMND 的跨国研究的建议方案。