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Occupational Exposures and Neurodegenerative Diseases: A Systematic Literature Review and Meta-Analyses
Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine.ORCID iD: 0000-0002-4192-8273
Örebro University, Örebro University School of Business. Department of Statistics, Örebro University, Örebro, Sweden; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
2019 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 3, article id 337Article, review/survey (Refereed) Published
Abstract [en]

Objectives: To carry out an integrated and stratified meta-analysis on occupational exposure to electromagnetic fields (EMFs), metals and pesticides and its effects on amyotrophic lateral sclerosis (ALS) and Parkinson's and Alzheimer's disease, and investigate the possibility of publication bias.

Methods: In the current study, we updated our recently published meta-analyses on occupational exposures in relation to ALS, Alzheimer's and Parkinson's disease. Based on 66 original publications of good scientific epidemiological standard, according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines, we analysed subgroups by carrying out stratified meta-analyses on publication year, statistical precision of the relative risk (RR) estimates, inspection of the funnel plots and test of bias.

Results: Based on 19 studies the weighted RR for occupational exposure to EMFs was 1.26 (95% confidence interval (CI) 1.07-1.50) for ALS, 1.33 (95% CI 1.07-1.64) for Alzheimer's disease and 1.02 (95% CI 0.83-1.26) for Parkinson's disease. Thirty-one studies concerned occupational exposure to pesticides and the weighted RR was 1.35 (95% CI 1.02-1.79) for ALS, 1.50 (95% CI 0.98-2.29) for Alzheimer's disease and 1.66 (95% CI 1.42-1.94) for Parkinson's disease. Finally, 14 studies concerned occupational exposure to metals and only exposure to lead (five studies) involved an elevated risk for ALS or Parkinson's disease and the weighted RR was 1.57 (95% CI 1.11-2.20). The weighted RR for all the non-lead exposures was 0.97 (95% CI 0.88-1.06).

Conclusions: Exposure to pesticides increased the risk of getting the mentioned neurodegenerative diseases by at least 50%. Exposure to lead was only studied for ALS and Parkinson's disease and involved 50% increased risk. Occupational exposure to EMFs seemed to involve some 10% increase in risk for ALS and Alzheimer's disease only.

Place, publisher, year, edition, pages
MDPI , 2019. Vol. 16, no 3, article id 337
Keywords [en]
epidemiology, metals, pesticides, electromagnetic fields, ALS, Parkinson's disease, Alzheimer's disease
National Category
Environmental Sciences Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:oru:diva-73127DOI: 10.3390/ijerph16030337ISI: 000459113600043PubMedID: 30691095Scopus ID: 2-s2.0-85060621765OAI: oai:DiVA.org:oru-73127DiVA, id: diva2:1296178
Available from: 2019-03-14 Created: 2019-03-14 Last updated: 2019-03-14Bibliographically approved

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Gunnarsson, Lars-GunnarBodin, Lennart

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