title: The Evaluation of Multiple Sclerosis Dispersal in Iran and Its Association with Urbanization, Life Style and Industry.
abstract: BACKGROUND
  Multiple Sclerosis (MS) is an autoimmune disease with unknown factor. The prevalence and incidence rate of this disease had an upward trend in many regions in the world such as Middle east and consequently in Iran over the recent years. As the risk factors of this increased trend and high-prevalence is unknown in Iran, the current study has been designed to evaluate the correlation between MS dispersal with urbanization, life style and industry, as an ecological research.
  
  
  METHODS
  This retrospective study was designed as an ecological approach in 2011. Data were collected from three databases by high precision (CI95%) from national registry plans. The subjects of study were provinces of Iran (n=31). The linear regression was used to perform statistical analyses.
  
  
  RESULTS
  The obtained results indicated an ascendant trend of MS during the recent years, as the incidence of this disease reached from 26.24/100000 (CI95%) people in 2006 to 44.53/100000 (CI95%) in 2011. There is a direct correlation (P<0.05) between the percentage of urbanization and the percentage of male smokers with the prevalence of MS in provinces.
  
  
  CONCLUSIONS
  The role of smoking was more highlighted in this study as a probable factor in increasing risk and causing MS disease. Urbanization could be introduced as an augmentative factor, but this is a combination of several complex factors that this effect must be appraised with smaller scale in other researches.
authors.affiliation: Social Determinants of Health (SDH) Research Center and Dept. of Environmental Health, School of Health, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Rouhullah
authors.initials: R
authors.lastname: Dehghani
authors.affiliation: Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran ; Dept. of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Yunesian
authors.affiliation: MS Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Sahraian
authors.affiliation: Dept. of Epidemiology, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Dept. of Biostatistics and Epidemiology, School of Health, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Gilasi
authors.affiliation: Dept. of Environmental Health, School of Health, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Vahid
authors.initials: V
authors.lastname: Kazemi Moghaddam
keywords: Ecological study; Industry; Life style; Multiple sclerosis; Urbanization