title: An exploratory case-control study on spinal and bulbar forms of amyotrophic lateral sclerosis in the province of Rome.
abstract: Several environmental and life-style factors reported as possibly associated with ALS have been analysed in the present study, focusing on the two clinical onsets of ALS. A case-control study (77 cases and 185 controls) has been performed in the province of Rome in the period 2005-2006. Increased risks were observed in bulbar cases for former smokers (OR: 4.55, 90% CI 1.72-12.08) and more than 24 pack-years, compared with spinal cases for employment in the construction sector and professional exposure to building materials (OR: 5.27, 90% CI 1.15-24.12) and metals (OR: 2.94, 90% CI 1.20-7.21). Overall and bulbar cases showed an increased risk for consumption of cold cuts and a decreased risk for vegetables intake. Regarding head injuries, differences were observed if the last injury occurred in the age range of 30-40 years, among all (OR: 14.2, 90% CI 1.04-194.42) and bulbar (OR: 17.4, 90% CI 1.70-178.5) cases, and less than 30 years among spinal cases (OR: 7.13, 90% CI 1.34-37.94). Moreover, a risk for a time period of 11-30 years since the last head injury suffered was found in bulbar cases (OR: 3.51, 90% CI 1.03-11.95). Some of the hypothesized risk factors for ALS have been found positively associated in this study, with different patterns between bulbar and spinal ALS.
authors.affiliation: Epidemiology Unit, Department of Occupational Medicine, Italian National Institute for Occupational Safety and Prevention, Via Alessandria 220/E, Rome, Italy. alessandra.binazzi@ispesl.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Binazzi
authors.forename: Stefano
authors.initials: S
authors.lastname: Belli
authors.forename: Raffaella
authors.initials: R
authors.lastname: Uccelli
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Desiato
authors.forename: Irene Figà
authors.initials: IF
authors.lastname: Talamanca
authors.forename: Giovanni
authors.initials: G
authors.lastname: Antonini
authors.forename: Fabio M
authors.initials: FM
authors.lastname: Corsi
authors.forename: Ciriaco
authors.initials: C
authors.lastname: Scoppetta
authors.forename: Maurizio
authors.initials: M
authors.lastname: Inghilleri
authors.forename: Francesco E
authors.initials: FE
authors.lastname: Pontieri
authors.forename: Nicola
authors.initials: N
authors.lastname: Vanacore
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D016022:Case-Control Studies; D006259:Craniocerebral Trauma / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D012307:Risk Factors; D012384:Rome / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects; D055815:Young Adult