Environmental research · 2026
Associations between pre-disease biomarkers of persistent organic pollutants and amyotrophic lateral sclerosis risk in four European cohorts.
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Davias Aline, Tang Ian W, Hansen Johnni, Knekt Paul, Rantakokko Panu, Weisskopf Marc G
Аннотация
OBJECTIVES: Previous retrospective studies suggested that occupational exposures to persistent organic pollutants (POPs) may be associated with amyotrophic lateral sclerosis (ALS), but prospective studies with biomarker exposure assessment are scarce. This study aimed to prospectively investigate the relationship between POP exposures and ALS risk in the Danish Diet, Cancer and Health study (EPIC) cohort and to conduct a meta-analysis including results from the prior study of 3 small prospective Finnish cohorts in addition to the Danish EPIC cohort.
METHODS: We identified 166 incident ALS cases between 1993 and 1997 using the Danish National Patient Register and randomly selected 334 controls by individual matching on birth-year and sex. Levels of 13 polychlorinated biphenyls, 9 organochlorine pesticides and 3 polybrominated diphenyl ethers were assessed from baseline plasma samples. We employed conditional logistic regression models using exposure quartiles, and generalized additive models (GAMs), adjusting for confounders. We conducted a meta-analysis combining 3 Finnish prospective cohorts with the Danish data using a random-effects model.
RESULTS: The Danish results suggested generally inverse trends between several POPs and the predicted ALS risk; especially for chlordane-related compounds (co-pollutant quartile model, p-value<0.01). GAMs supported these trends, although most were not statistically significant. However, hexachlorobenzene was positively associated with ALS risk in co-pollutant GAM (p-value = 0.02). Additionally, the GAMs suggested higher ALS odds at the highest levels of exposure of some POPs, but the data at these levels was sparse. Meta-analysis results were mostly consistent with the Danish findings.
CONCLUSION: Our study suggested elevated ALS risk among those exposed to hexachlorobenzene when adjusting for co-pollutants. Higher level of some POPs suggested a positive association with ALS occurrence, but the data was scarce at these levels.
METHODS: We identified 166 incident ALS cases between 1993 and 1997 using the Danish National Patient Register and randomly selected 334 controls by individual matching on birth-year and sex. Levels of 13 polychlorinated biphenyls, 9 organochlorine pesticides and 3 polybrominated diphenyl ethers were assessed from baseline plasma samples. We employed conditional logistic regression models using exposure quartiles, and generalized additive models (GAMs), adjusting for confounders. We conducted a meta-analysis combining 3 Finnish prospective cohorts with the Danish data using a random-effects model.
RESULTS: The Danish results suggested generally inverse trends between several POPs and the predicted ALS risk; especially for chlordane-related compounds (co-pollutant quartile model, p-value<0.01). GAMs supported these trends, although most were not statistically significant. However, hexachlorobenzene was positively associated with ALS risk in co-pollutant GAM (p-value = 0.02). Additionally, the GAMs suggested higher ALS odds at the highest levels of exposure of some POPs, but the data at these levels was sparse. Meta-analysis results were mostly consistent with the Danish findings.
CONCLUSION: Our study suggested elevated ALS risk among those exposed to hexachlorobenzene when adjusting for co-pollutants. Higher level of some POPs suggested a positive association with ALS occurrence, but the data was scarce at these levels.