Pesticide exposure assessed through agricultural crop proximity and risk of amyotrophic lateral sclerosis

Marco Vinceti, Tommaso Filippini, Federica Violi, Kenneth J. Rothman, Sofia Costanzini, Carlotta Malagoli, Lauren A. Wise, Anna Odone, Carlo Signorelli, Laura Iacuzio, Elisa Arcolin, Jessica Mandrioli, Nicola Fini, Francesco Patti, Salvatore Lo Fermo, Vladimiro Pietrini, Sergio Teggi, Grazia Ghermandi, Renato Scillieri, Caterina Ledda, Cristina Mauceri, Salvatore Sciacca, Maria Fiore, Margherita Ferrante

Epidemiologic studies have raised the possibility that some pesticide compounds induce the neurodegenerative disease amyotrophic lateral sclerosis (ALS), though the available evidence is not entirely consistent. We conducted a population-based case-control study in two Italian populations to assess the extent to which residence in the vicinity of agricultural crops associated with the application of neurotoxic pesticides is a risk factor for ALS, using crop acreage in proximity to the residence as an index of exposure. Based on 703 cases and 2737 controls, we computed an ALS odds ratio of 0.92 (95% confidence interval 0.78-1.09) for those in proximity to agricultural land. Results were not substantially different when using alternative exposure categories or when analyzing specific crop types, with the exception of a higher risk related to exposure to citrus orchards and olive groves in Southern Italy, though based on few exposed subjects (N = 89 and 8, respectively). There was little evidence of any dose-response relation between crop proximity and ALS risk, and using long-term residence instead of current residence did not substantially change our estimates. Though our index of exposure is indirect and subject to considerable misclassification, our results offer little support for the hypothesis that neurotoxic pesticide exposure increases ALS risk.