Environmental risk factors for amyotrophic lateral sclerosis (ALS) in a military context

• ALS is a rare disease with an incidence worldwide of 2-3 persons per 100 000 inhabitants. However, an increase in incidence among military personell has been identified in several studies. Approximately 10% of the ALS cases are inherited (familiar ALS); the remaining cases might be due to a combination of genetic and environmental factors (sporadic ALS). The most likely hypothesis regarding the onset of ALS is accumulation of incorrectly folded proteins around neurons in the brain. Incorrect protein folding may be due to a mutation in the enzyme SOD1. Such mutations can be initiated if the cell is exposed to prolonged physiological or environmental stress, for example from prolonged extreme physical exercise. Epidemiologically substantiated risk factors for ALS include lead exposure, head trauma, extreme physical training, pesticide exposure and exposure to electromagnetic radiation. In addition, toxins from cyanobacteria has been discussed as a potential risk factor. Military personnel constitute a typical occupational group with low grade, sometimes long-lasting and parallel exposure to several of the relevant environmental riskfactors. For example, correlations between elevated levels of lead in the blood and increased risk of ALS among United States Veterans has been found, as well as a correlation with exposure to pesticides. In addition, correlation of ALS incidence with head trauma incidents have been suggested. The inflammation that might occur locally after repeated hard physical exertion and/or repeated mild trauma can lead to oxidative stress in the cell. It is known that oxidative stress may cause corrupted/incorrectly folded proteins. These correlations can be part of the explanation for the increased risk of ALS seen in groups exposed to hard physical exertion and/or repeated mild trauma, such as military personnel and athletes. This presentation constitutes a review of epidemiologic data from military environments and also present result from environmental sampling of soils in Timbuctoo.The conclusion that can be drawn from sampling the environment in Timbuctoo is that it is unlikely that the personnel who reside in and around camp Nobel are exposed to cyanobacteria and their toxins

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

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