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Updated: May 31, 2025
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Occupational histories in neuropathologically confirmed multiple system atrophy
William P Cheshire1, Philip W Tipton2, Shunsuke Koga3
1Division of Autonomic Neurology, Department of Neurology, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL, 32224, USA. cheshire@mayo.edu.
Purpose:
This study examined occupational histories in multiple system atrophy to identify environmental associations of potential relevance to disease causation.
Methods:
A total of 270 neuropathologically confirmed cases of multiple system atrophy obtained from the Mayo Clinic Brain Bank for neurodegenerative disorders in Jacksonville, Florida, were included in this case-control study. Demographic and disease information was collected from medical records. Information regarding occupational history was collected retrospectively from medical records and published obituaries. Proportions of employment by occupational sector were compared with US census data.
Results:
When comparing patients with US census data, significant differences were identified for education (15.2% versus 2.3%, P < 0.001), administration (14.8% versus 4.1%, P < 0.001), clerical (10.7% versus 5.5%, P = 0.001), petroleum industry (8.9% versus 5.6%, P = 0.024), metal industry (7.8% versus 3.0%, P < 0.001), electrical engineers and electricians (5.6% versus 0.4%, P < 0.001), civil or mechanical engineering (4.4% versus 0.2%, P < 0.001), real estate (4.4% versus 0.7%, P < 0.001), information technology (4.1% versus 1.8%, P = 0.011), woodworking (3.0% versus 0.03%, P < 0.001), writing or publishing (2.6% versus 0.3%, P < 0.001), law (2.2% versus 0.4%, P = 0.001), hairdressing (0.7% versus 0.1%, P = 0.03), and social work (0.7% versus 0.1%, P = 0.03).
Conclusions:
The listed occupational categories were significantly overrepresented in our series of patients with multiple system atrophy as compared with population data. We hypothesize that these occupational associations may signify environmental exposures, increasing the disease risk in genetically susceptible individuals. We cannot exclude a potential selection bias in patients willing to donate their brains to an academic center to contribute to scientific knowledge.
Insights
Certain occupations were overrepresented in multiple system atrophy (MSA) patients, suggesting potential environmental exposures linked to disease risk. Further research is needed to confirm these occupational associations with MSA causation.
Area of Science:
- Neuroscience
- Epidemiology
- Occupational Health
Background:
- Multiple system atrophy (MSA) is a rare, sporadic neurodegenerative disease with unknown etiology.
- Identifying environmental risk factors is crucial for understanding MSA pathogenesis and developing preventative strategies.
Purpose of the Study:
- To investigate occupational histories of individuals with MSA.
- To identify potential environmental exposures associated with MSA by comparing occupational data with US census data.
Main Methods:
- A case-control study included 270 neuropathologically confirmed MSA cases from the Mayo Clinic Brain Bank.
- Occupational histories were collected retrospectively from medical records and obituaries.
- Proportions of employment in various sectors were compared against US census data.
Main Results:
- Significant overrepresentation was found in education, administration, clerical roles, petroleum, metal industries, electrical engineering, civil/mechanical engineering, real estate, IT, woodworking, writing/publishing, law, hairdressing, and social work.
- These occupational categories showed higher prevalence in MSA patients compared to the general population.
Conclusions:
- Specific occupational categories are significantly overrepresented in MSA patients.
- These findings suggest potential environmental exposures linked to certain occupations may increase MSA risk in genetically susceptible individuals.
- Potential selection bias cannot be excluded.
