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Living near waterbodies as a proxy of cyanobacteria exposure and risk of amyotrophic lateral sclerosis: a population based case-control study

By Maria Fiore, Roberto Parisio, Tommaso Filippini, Valerio Mantione, Armando Platania, Anna Odone, Carlo Signorelli, Vladimiro Pietrini, Jessica Mandrioli, Sergio Teggi, Sofia Costanzini, Antonio Cristaldi, Pietro Zuccarello, Gea Oliveri Conti, Alessandra Nicoletti, Mario Zappia, Marco Vinceti and Margherita Ferrante


Background: Epidemiological studies highlighted the possibility that exposure to cyanotoxins leads to the development of the neurodegenerative disease amyotrophic lateral sclerosis (ALS). Methods: We devised a population-based case-control study in two Italian populations. We used residential proximity of the residence to water bodies as a measure of possible exposure to cyanotoxins. Results: Based on 703 newly-diagnosed ALS cases and 2737 controls, we calculated an ALS odds ratio (OR) of 1.41 (95% CI: 0.72\u20132.74) for current residence in the vicinity of water bodies, and a slightly lower estimate for historical residence (OR: 1.31; 95% CI: 0.57\u20132.99). Subjects <65 years and people living in the Northern Italy province of Modena had higher ORs, especially when historical residence was considered. Conclusions: Overall, despite some risk of bias due to exposure misclassification and unmeasured confounding, our results appear to support the hypothesis that cyanotoxin exposure may increase ALS risk

Topics: Amyotrophic lateral sclerosis, Case-control study, Cyanotoxins, Epidemiology, Risk
Publisher: 'Elsevier BV'
Year: 2020
DOI identifier: 10.1016/j.envres.2020.109530
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