Epidemiological investigations into multiple sclerosis in southern Hesse. II. The distribution of cases in relation to exogenous features.

In order to discover possible exogenous variables associated with a higher multiple sclerosis risk, the distribution of cases with definite and probable multiple sclerosis ascertained in the course of a micro-epidemiologic study in Southern Hesse was evaluated and compared with some environmental factors. The prevalence in 1980, the prevalence of cases with disease-onset within the region according to locality of onset and the rate of native Southern Hesse patients according to childhood residence all showed a similar geographical distribution, with the highest values in the south-eastern, mountainous part of the region. This district has a lower annual mean temperature, more annual snow-days and a higher annual precipitation compared to the remaining area. A statistical comparison revealed no association with industrial or agricultural activities, with a particular type of land use, with cattle, pig- or horse-breeding, or with sanitary or housing standards. On the other hand, a slight association with the soil type could be demonstrated, with higher rates on loam and clay subsoils when compared to predominantly sandy regions. Whether this finding has any significance or not remains to be clarified.