Functional Motoneurona Unit (UFMNA), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain.
Neuroepidemiology. 2018;51(1-2):33-49. doi: 10.1159/000489664. Epub 2018 May 31.
It is believed that an interaction between genetic and non-genetic factors may be involved in the development of amyotrophic lateral sclerosis (ALS). With the exception of exposure to agricultural chemicals like pesticides, evidence of an association between environmental risk factors and ALS is inconsistent. Our objective here was to investigate the association between long-term exposure to environmental factors and the occurrence of ALS in Catalonia, Spain, and to provide evidence that spatial clusters of ALS related to these environmental factors exist.
We carried out a nested case-control study constructed from a retrospective population-based cohort, covering the entire region. Environmental variables were the explanatory variables of interest. We controlled for both observed and unobserved confounders.
We have found some spatial clusters of ALS. The results from the multivariate model suggest that these clusters could be related to some of the environmental variables, in particular agricultural chemicals. In addition, in high-risk clusters, besides corresponding to agricultural areas, key road infrastructures with a high density of traffic are also located.
Our results indicate that some environmental factors, in particular those associated with exposure to pesticides and air pollutants as a result of urban traffic, could be associated with the occurrence of ALS.
据信，遗传和非遗传因素的相互作用可能与肌萎缩侧索硬化症（ALS）的发展有关。除了接触农药等农业化学品外，环境风险因素与 ALS 之间的关联证据并不一致。我们的目的是调查环境因素与西班牙加泰罗尼亚地区 ALS 发生之间的关联，并提供与这些环境因素相关的 ALS 空间聚集存在的证据。
我们进行了一项嵌套病例对照研究，该研究基于回顾性的基于人群的队列，涵盖了整个地区。环境变量是我们感兴趣的解释变量。我们控制了观察到的和未观察到的混杂因素。
我们发现了一些 ALS 的空间聚集。多变量模型的结果表明，这些聚集可能与某些环境变量有关，特别是农业化学品。此外，在高风险聚集区，除了农业区外，还分布着交通流量大的主要道路基础设施。
我们的结果表明，一些环境因素，特别是与接触农药和城市交通造成的空气污染物有关的因素，可能与 ALS 的发生有关。
