Oddone Enrico, Scaburri Alessandra, Modonesi Carlo, Montomoli Cristina, Bergamaschi Roberto, Crosignani Paolo, Imbriani Marcello
G Ital Med Lav Ergon. 2013 Jul-Sep;35(3):133-7.
The aim of the study is to explore possible relationships between occupational exposures and Multiple Sclerosis (MS), whose etiology is not well defined yet. To date, only few literature data are available on this subject.
We carried out a case-control study, where cases were MS patients included in the MS Register of the Province of Pavia, Northern Italy, and controls, 1:4 matched by sex and age (5 years classes), were randomly selected from the National Health Service population files. The occupational histories were obtained from Italian Institute for Social Security (INPS) archives by automatic linkage using Italian Occupational Cancer Monitoring (OCCAM) method that estimates the risk of specific occupational cancers, by geographic area and industrial sector. OR adjusted for sex and age and corresponding 90% confidence intervals were used to estimate the association between exposure and disease.
We included in the study 227 MS patients (130 (57.3%) female, 97 (42.7%) male) and 907 controls (514 (56.7%) female, 393 (43.3%) male). Our results suggest an increased risk for men in mechanical manufacturing industry (OR 1.71, 90% CI 1.03-2.85) and agriculture (OR 2.47, 90% CI 1.03-5.91). Women show an increased risk in mechanical manufacturing industry (OR 2.05, 90% CI 1.22-3.45), agriculture (OR 2.57, 90% CI 1.09-6.09) and leather/shoe industry (OR 2.34, 90% CI 1.06-5.20).
Our preliminary findings indicate that solvent exposures could be related to the risk of MS, as both shoe/leather workers and mechanical manufacturing industry workers are exposed to organic solvents. Interestingly, a major risk of MS was also found among workers engaged in agriculture, suggesting a role of pesticides, whose neurotoxic effect is well known.
本研究旨在探讨职业暴露与多发性硬化症(MS)之间可能存在的关系,MS的病因尚未明确。迄今为止,关于该主题的文献资料很少。
我们开展了一项病例对照研究,病例为意大利北部帕维亚省MS登记册中的MS患者,对照则通过性别和年龄(5岁分组)按1:4匹配,从国家卫生服务人群档案中随机选取。职业史通过意大利职业癌症监测(OCCAM)方法从意大利社会保障局(INPS)档案中自动关联获取,该方法按地理区域和工业部门估计特定职业癌症的风险。经性别和年龄调整的比值比(OR)及相应的90%置信区间用于估计暴露与疾病之间的关联。
我们的研究纳入了227例MS患者(女性130例(57.3%),男性97例(42.7%))和907例对照(女性514例(56.7%),男性393例(43.3%))。我们的结果表明,机械制造业(OR 1.71,90% CI 1.03 - 2.85)和农业(OR 2.47,90% CI 1.03 - 5.91)中的男性患病风险增加。女性在机械制造业(OR 2.05,90% CI 1.22 - 3.45)、农业(OR 2.57) ,90% CI 1.09 - 6.09)和皮革/制鞋业(OR 2.34,90% CI 1.06 - 5.20)中患病风险增加。
我们的初步研究结果表明,溶剂暴露可能与MS风险有关,因为制鞋/皮革工人和机械制造业工人都接触有机溶剂。有趣的是,从事农业的工人中也发现MS风险较高,这表明农药可能起了作用,其神经毒性作用是众所周知的。