Original Articles
8 April 2025
Vol. 37 No. 1 (2015)

[Amyotrophic lateral sclerosis and exposure to metals and other occupational/environmental risk agents: state of the art]

Sclerosi laterale amiotrofica ed esposizione a metalli ed altri agenti di rischio di natura occupazionale/ambientale: stato dell’arte

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In recent years, scientific literature has been giving more and more importance to the study of the occupational/environmental exposure to risk agents related to the onset of Amyotrophic Lateral Sclerosis (ALS), a neurodegenerative disease characterized by progressive muscular paralysis reflecting degeneration of motor neurons in the primary motor cortex. Aim of this work is to verify the state of art about the eventual role of occupationall environmental exposure to risk agents. Selected articles, on the basis of keywords, year of publication and topics, are related to occupational and environmental exposure to xenobiotics, and, in particular, to the exposure to heavy metals that could lead to neuronal damage mechanisms involved in ALS onset. The review shows that although the scientific production has increased the interest in the evaluation of extra-genetic causes of ALS onset, there are still few studies concerning the careful study of the work activities of the individual patient, and the inferences that can be drawn to date about the possible connection between occupational exposure to risk factors and the onset of ALS are still lacking.

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1) Brooks BR, Miller RG, Swash M, Munsat TL for the World Federation of Neurology Research Group on Motor Neuron Disease. El Escorial revisited: revised criteria for the diagnosis of amyotrophic lateral sclerosis. ALS and other motor neuron disease 2000; 1: 293-299. 2) Rabin BA, Griffin JW, Crain BJ, Scavina M, Chance PF, Cornblath DOI: https://doi.org/10.1080/146608200300079536
DR. Autosomal dominant juvenile amyotrophic lateral sclerosis. Brain 1999; 122: 1539-1550. DOI: https://doi.org/10.1093/brain/122.8.1539
3) Appel SH, Zhao W, Beers DR, Henkel JS. The microglial-motoneuron dialogue in ALS. Acta Myol 2011 Jun; 30(1): 4-8.
4) Rosen DR, Siddique T, Patterson D. et al. Mutations in Cu/Zn superoxide dismutase gene are associated with familial amyotrophic lateral sclerosis. Nature 1993; 362: 59-62. DOI: https://doi.org/10.1038/362059a0
5) Abrea 5, Cold ein ort hic ling al Front ural voise:
252(3): 321-331.
6) Altavista P, Belli S, Binazzi A, Comba P, Mastrantonio M, Uccelli R, Vanacore N. Increase in mortality for motor neuron disease in Italy, 1980-1999. Epidemiol Prev 2006; 30(2): 108-113.
7) Worms PM. The epidemiology of motor neuron diseases: a review of recent studies. J Neurol Sci 2001; 191(1-2): 3-9. DOI: https://doi.org/10.1016/S0022-510X(01)00630-X
8) Qureshi MM, Hayden D, Urbinelli L, Ferrante K, Newhall K, Myers D, Hilgenberg S, Smart R, Brown RH, Cudkowicz ME. Analysis of factors that modify susceptibility and rate of progression in amyotrophic lateral sclerosis (ALS). Amyotroph Lateral Scler 2006; 7: 173-182. DOI: https://doi.org/10.1080/14660820600640596
9) Sutedja NA, Veldink JH, Fischer K, Kromhout H, Heederik D, Huisman MH, Wokke JH, Van Den Berg LH. Exposure to chemicals and metals and risk of amyotrophic lateral sclerosis: a systematic review. Amyotroph Lateral Scler 2008; 8: 1-20. DOI: https://doi.org/10.1080/17482960802455416
10) Pedata P, Garzillo EM, Sannolo N. Ultrafine particles and effects on the body: review of the literature. G Ital Med Lav Ergon 2010 Jan-Mar; 32(1): 23-31.
11) Sannolo N, Lamberti M, Pedata P. Human health effects of ultrafine particles. G Ital Med Lav Ergon 2010 Oct-Dec; 32(4 Suppl): 348-51. 12) Das K, Nag C, Ghosh M. Familial, environmental and occupational risk factors in development of Amyotrophic Lateral Sclerosis. N Am J Med Sci 2012; 4(8).350-355. DOI: https://doi.org/10.4103/1947-2714.99517
13) Armon C, Kurland LT, Daube JR, O'Brien PC. Epidemiologic correlates of sporadic amyotrophic lateral sclerosis. Neurology 1991 Jul; 41(7): 1077-84. DOI: https://doi.org/10.1212/WNL.41.7.1077
14) Chió A, Meineri P, Tribolo A, Schiffer D. Risk factors in motor neuron disease: a case-control study. Neuroepidemiology 1991; 10(4): 174-84. 15) Fang F, Quinlan P, Ye W, Barber MK, Umbach DM, Sandler DP, Kamel F. Workplace exposures and the risk of amyotrophic lateral sclerosis. Environ Health Perspect 2009 Sep; 117(9): 1387-92. DOI: https://doi.org/10.1289/ehp.0900580
16) Sutedja NA, Veldink JH, Fischer K, Kromhout H, Wokke JH, Huisman MH, Heederik DJ, Van den Berg LH. Lifetime occupation, education, smoking, and risk of ALS. Neurology 2007 Oct 9; 69(15): 1508-14. DOI: https://doi.org/10.1212/01.wnl.0000277463.87361.8c
17) Weisskopf MG, McCullough ML, Morozova N, Calle EE, Thun MJ, Ascherio A. Prospective study of occupation and amyotrophic lateral sclerosis mortality. Am J Epidemiol 2005 Dec 15; 162(12): 1146-52. 18) McGuire V, Longstreth WT Jr, Nelson LM, Koepsell TD, Checkoway H, Morgan MS, van Belle G. Occupational exposures and amyotrophic lateral sclerosis. A population-based case-control study. Am J Epidemiol 1997 Jun 15; 145(12): 1076-88.
19) Strickland D, Smith SA, Dolliff G, Goldman L, Roelofs RI. Amyotrophic lateral sclerosis and occupational history. A pilot case-control study. Arch Neurol 1996 Aug; 53(8): 730-3. DOI: https://doi.org/10.1001/archneur.1996.00550080044011
20) Sutedja NA, Fischer K, Veldink JH, van der Heijden GJ, Kromhout H, Heederik D, Huisman MH, Wokke JJ, van den Berg LH. What we truly know about occupation as a risk factor for ALS: a critical and systematic review. Amyotroph Lateral Scler 2009 Oct-Dec; 10(5-6): 295-301. DOI: https://doi.org/10.3109/17482960802430799
21) Vinceti M, Bottecchi I, Fan A, Finkelstein Y, Mandrioli J. Are environmental exposures to selenium, heavy metals, and pesticides risk factors for amyotrophic lateral sclerosis? Rev Environ Health 2012; 27(1): 19-41. DOI: https://doi.org/10.1515/reveh-2012-0002
22) Pamphlett R. Exposure to environmental toxins and the risk of sporadic motor neuron disease: an expanded Australian case-control study. Eur J Neurol 2012 Oct; 19(10): 1343-8. DOI: https://doi.org/10.1111/j.1468-1331.2012.03769.x
23) Bettini M, Gargiulo-Monachelli GM, Rodríguez G, Rey RC, Peralta LM, Sica RE. Epidemiology of amyotrophic lateral sclerosis patients in a centre in Buenos Aires. Arq Neuropsiquiatr 2011 Dec; 69(6): 867-70. DOI: https://doi.org/10.1590/S0004-282X2011000700003
24) Gunnarsson LG, Lindberg G, Söderfeldt B, Axelson O. Amyotrophic lateral sclerosis in Sweden in relation to occupation. Acta Neurol Scand 1991 Jun; 83(6): 394-8. DOI: https://doi.org/10.1111/j.1600-0404.1991.tb03970.x
25) Bergomi M, Guidetti D, Vivoli R, Vinceti M. The occupational risk factors for amyotrophic lateral sclerosis in an Italian community. Ann Ig 1998 Jul-Aug; 10(4): 249-53.
26) Pinkerton LE, Hein MJ, Meyers A, Kamel F. Assessment of ALS mortality in a cohort of formaldehyde-exposed garment workers. Amyotroph Lateral Scler Frontotemporal Degener 2013 Sep; 14(5-6): 353-5. 27) Pamphlett R, Rikard-Bell A. Different occupations associated with amyotrophic lateral sclerosis: is diesel exhaust the link? PLos One 2013 Nov 11; 8(11): e80993. DOI: https://doi.org/10.3109/21678421.2013.778284
28) Furby A, Beauvais K, Kolev I, Rivain JG, Sébille V. Rural environment and risk factors of amyotrophic lateral sclerosis: a case-control 29) Hargreaves AJ. Neurodegenerations induced by organophosphorous compounds. Adv Exp Med Biol 2012; 724: 189-204. DOI: https://doi.org/10.1007/978-1-4614-0653-2_15
30) Govoni V, Granieri E, Fallica E, Casetta I. Amyotrophic lateral sclerosis, rural environment and agricultural work in the Local Health District of Ferrara, Italy, in the years 1964-1998. J Neurol 2005 Nov; 252(11): 1322-7. DOI: https://doi.org/10.1007/s00415-005-0859-z
31) Bonvicini F, Marcello N, Mandrioli J, Pietrini V, Vinceti M. Exposure to pesticides and risk of amyotrophic lateral sclerosis: a populationbased case-control study. Ann Ist Super Sanita 2010; 46(3): 284-7. 32) Freedman M. Amyotrophic lateral sclerosis and occupational exposure to 2,4-dichlorophenoxyacetic acid. Occup Environ Med 2001 Sep; 58(9): 609-10. DOI: https://doi.org/10.1136/oem.58.9.609a
33) Doi H, Kikuchi H, Murai H, Kawano Y, Shigeto H, Ohyagi Y, Kira J. Motor neuron disorder simulating ALS induced by chronic inhalation of pyrethroid insecticides. Neurology 2006 Nov 28; 67(10): 1894-5. 34) Kanavouras K, Tzatzarakis MN, Mastorodemos V, Plaitakis A, Tsatsakis AM. A case report of motor neuron disease in a patient showing significant level of DDTs, HCHs and organophosphate metabolites in hair as well as levels of hexane and toluene in blood. Toxicol Appl Pharmacol 2011 Nov 1; 256(3): 399-404. DOI: https://doi.org/10.1016/j.taap.2011.07.022
35) Malek AM, Barchowsky A, Bowser R, Heiman-Patterson T, Lacomis D, Rana S, Youk A, Stickler D, Lackland DT, Talbott EO. Environmental and Occupational Risk Factors for Amyotrophic Lateral Sclerosis: A Case-Control Study. Neurodegener Dis 2013 Nov 12 Epub ahead of print. DOI: https://doi.org/10.1159/000355344
36) Kamel F, Umbach DM, Bedlack RS, Richards M, Watson M, Alavanja MC, Blair A, Hoppin JA, Schmidt S, Sandler DP. Pesticide exposure and amyotrophic lateral sclerosis. Neurotoxicology 2012 Jun; 33(3): 457-62. DOI: https://doi.org/10.1016/j.neuro.2012.04.001
37) Malek AM, Barchowsky A, Bowser R, Youk A, Talbott EO. Pesticides exposure as a risk factor for amyotrophic lateral sclerosis: a metaanalysis of epidemiological studies. Environ Res 2012; 117: 112-119. 38) Pupillo E, Messina P, Logroscino G, Zoccolella S, Chiò A, Calvo A, Corbo M, Lunetta C, Micheli A, Millul A, Vitelli E, Beghi E; EURALS Consortium. Trauma and amyotrophic lateral sclerosis: a case-control study from a population-based registry. Eur J Neurol 2012; 19(12): 1509-1517. DOI: https://doi.org/10.1111/j.1468-1331.2012.03723.x
39) Vanacore N, Cocco P, Fadda D, Dosemeci M. Job strain, hypoxia and risk of amyotrophic lateral sclerosis: Results from a death certificate study. Amyotroph Lateral Scler 2010; 11(5): 430-434. DOI: https://doi.org/10.3109/17482961003605796
40) McGuire V, Longstreth WT Jr, Nelson LM, Koepsell TD, Checkoway H, Morgan MS, van Belle G. Occupational exposures and amyotrophic lateral sclerosis. A population-based case-control study. Am J Epidemiol 1997; 145(12): 1076-1088. DOI: https://doi.org/10.1093/oxfordjournals.aje.a009070
41) Johansen C. Exposure to electromagnetic fields and risk of central nervous system disease in utility workers. Epidemiology 2000, 11, 539-543. DOI: https://doi.org/10.1097/00001648-200009000-00009
42) Hakansson N, Gustavsson P, Johansen C, Floderus B. Neurodegenerative diseases in welders and other workers exposed to high levels of magnetic fields. Epidemiology 2003, 14, 420-426. DOI: https://doi.org/10.1097/01.EDE.0000078446.76859.c9
43) Savitz DA, Loomis DP, Tse CK. Electrical occupations and neurodegenerative disease: analysis of U.S. mortality data. Arch Environ Health 1998 Jan-Feb; 53(1): 71-4. DOI: https://doi.org/10.1080/00039899809605691
44) Ruder AM, Hein MJ, Hopf NB, Waters MA. Mortality among 24,865 workers exposed to polychlorinated biphenyls (PCBs) in three electrical capacitor manufacturing plants: a ten-year update. Int J Hyg Environ Health 2014 Mar; 217(2-3): 176-87. DOI: https://doi.org/10.1016/j.ijheh.2013.04.006
45) Johansen C, Olsen JH. Mortality from amyotrophic lateral sclerosis, other chronic disorders, and electric shocks among utility workers. Am J Epidemiol 1998 Aug 15; 148(4): 362-8. DOI: https://doi.org/10.1093/oxfordjournals.aje.a009654
46) Abhinav K, Al-Chalabi A, Hortobagyi T, Leigh PN. Electrical injury and amyotrophic lateral sclerosis: A systematic review of the literature. J Neurol Neurosurg Psychiatry 2007, 78, 450-453. DOI: https://doi.org/10.1136/jnnp.2006.104414
47) Barth SK, Kang HK, Bullman TA, Wallin MT. Neurological mortality among U.S. veterans of the Persian Gulf War: 13-year follow-up. Am J Ind Med 2009 Sep; 52(9): 663-70. DOI: https://doi.org/10.1002/ajim.20718
48) Ascherio A, Weisskopf MG, O'Reilly EJ, McCullough ML, Calle EE, Thun MJ. ALS and military service. Neurology 2005 Sep 27; 65(6): 972. DOI: https://doi.org/10.1212/WNL.65.6.972
49) Mundt DJ, Dell LD, Luippold RS, Sulsky SI, Skillings A, Gross R, Cox KL, Mundt KA. Cause-specific mortality among Kelly Air Force Base civilian employees, 1981-2001. J Occup Environ Med 2002 Nov; 44(11): 989-96. DOI: https://doi.org/10.1097/00043764-200211000-00003
50) Horner RD, Feussner JR, Kasarskis EJ. Prospective study of military service and mortality from ALS. Neurology 2005 Jul 12; 65(1): 180-1. 51) Chiò A, Benzi G, Dossena M, Mutani R, Mora G. Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players. Brain 2005 Mar; 128(Pt 3): 472-6. DOI: https://doi.org/10.1093/brain/awh373
52) Al-Chalabi A, Leigh PN. Trouble on the pitch: are professional football players at increased risk of developing amyotrophic lateral sclerosis? Brain 2005 Mar; 128(Pt 3): 451-3. DOI: https://doi.org/10.1093/brain/awh426
Neurology 2012 Nov 6; 79(19): 1970-4. DOI: https://doi.org/10.1212/WNL.0b013e31826daf50
54) Chiò A, Calvo A, Dossena M, Ghiglione P, Mutani R, Mora G. ALS in Italian professional soccer players: the risk is still present and could be soccer-specific. Amyotroph Lateral Scler 2009 Aug; 10(4): 205-9. 55) Vanacore N, Binazzi A, Bottazzi M, Belli S. Amyotrophic lateral sclerosis in an Italian professional soccer player. Parkinsonism Relat Disord 2006 Jun; 12(5): 327-9. DOI: https://doi.org/10.1080/17482960902721634
56) Belli S, Vanacore N. Proportionate mortality of Italian soccer players: is amyotrophic lateral sclerosis an occupational disease? Eur J Epidemiol 2005; 20(3): 237-42. DOI: https://doi.org/10.1007/s10654-004-6879-7
57) Pupillo E, Messina P, Giussani G, Logroscino G, Zoccolella S, Chiò A, Calvo A, Corbo M, Lunetta C, Marin B, Mitchell D, Hardiman O Rooney J, Stevic Z, Bandettini di Poggio M, Filosto M, Cotelli MS, Perini M, Riva N, Tremolizzo L, Vitelli E, Damiani D, Beghi E; and the EURALS Consortium. Physical activity and amyotrophic lateral sclerosis: A European population-based case-control study. Ann Neurol 2014 Apr 5. doi: 10.1002/ana.24150. Epub ahead of print. 58) Veldink JH, Kalmijn S, Groeneveld GJ, Titulaer MJ, Wokke JH, van den Berg LH. Physical activity and the association with sporadic ALS. Neurology 2005 Jan 25; 64(2): 241-5. DOI: https://doi.org/10.1002/ana.24150
59) Huisman MH, Seelen M, de Jong SW, Dorresteijn KR, van Doormaal PT, van der Kooi AJ, de Visser M, Schelhaas HJ, van den Berg LH, Veldink JH. Lifetime physical activity and the risk of amyotrophic lateral sclerosis. J Neurol Neurosurg Psychiatry 2013 Sep; 84(9): 976-81. 60) Davanipour Z, Sobel E, Vu H, Will AD. Electromagnetic field exposure and amyotrophic lateral sclerosis. Neuroepidemiology 1991; 10(5-6): 308. DOI: https://doi.org/10.1136/jnnp-2012-304724
61) Ahlbom IC, Cardis E, Green A, Linet M, Savitz D, Swerdlow A. Review of the epidemiologic literature on EMF and Health; ICNIRP (International Commission for Non-lonizing Radiation Protection) Standing Committee on Epidemiology. Environ Health Perspect 2001 Dec; 109 Suppl 6: 911-33. DOI: https://doi.org/10.1289/ehp.109-1240626
62) Li CY, Sung FC. Association between occupational exposure to power frequency electromagnetic fields andamyotrophic lateral sclerosis: a review. Am J Ind Med 2003 Feb; 43(2): 212-20. DOI: https://doi.org/10.1002/ajim.10148
63) Parlett LE, Bowman JD, van Wijngaarden E. Evaluation of occupational exposure to magnetic fields and motor neuron disease mortality in a population-based cohort. J Occup Environ Med 2011 Dec; 53(12): 1447-51. DOI: https://doi.org/10.1097/JOM.0b013e318237a1d0

How to Cite



[Amyotrophic lateral sclerosis and exposure to metals and other occupational/environmental risk agents: state of the art]: Sclerosi laterale amiotrofica ed esposizione a metalli ed altri agenti di rischio di natura occupazionale/ambientale: stato dell’arte. (2025). Giornale Italiano Di Medicina Del Lavoro Ed Ergonomia, 37(1), 8-19. https://doi.org/10.4081/gimle.673