Amyotrophic Lateral Sclerosis and Occupational Exposures: A Systematic Literature Review and Meta-Analyses

Area of Science:

• Epidemiology
• Occupational Health
• Neurology

Background:

• Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease.
• Identifying occupational risk factors for ALS is crucial for prevention strategies.
• Previous studies on occupational risks for ALS have varied in quality.

Purpose of the Study:

• To systematically review and meta-analyze occupational risk factors for ALS using studies of good scientific epidemiological standards.
• To identify specific work-related exposures associated with an increased risk of developing ALS.

Main Methods:

• A systematic literature review was conducted to identify original publications on work and ALS.
• Studies were assessed for quality using MOOSE and GRADE guidelines.
• Thirty-seven methodologically sound articles were included in the meta-analyses.

Main Results:

• Statistically significant elevated risks for ALS were found for heavy physical work (RR 1.29), professional sports (RR 3.98), metals (RR 1.45), chemicals (RR 1.19), electromagnetic fields/electricity (RR 1.18), and healthcare work (RR 1.18).
• Specific exposures like pesticides and lead showed increased risk.
• Results were robust and not explained by publication bias.

Conclusions:

• High-quality epidemiological evidence indicates that certain occupational exposures are linked to an increased risk of ALS.
• Key risk factors include excessive physical work, exposure to chemicals (pesticides), metals (lead), electromagnetic fields, and healthcare professions.
• These findings emphasize the importance of occupational safety measures in mitigating ALS risk.