Abstract
Some environmental factors are associated with an increased risk of multiple sclerosis (MS). Air pollution could be a main one. This study was conducted to investigate the association of particulate matter 2.5 (PM2.5) concentrations with MS prevalence in the province of Pavia, Italy. The overall MS prevalence in the province of Pavia is 169.4 per 100,000 inhabitants. Spatial ground-level PM2.5 gridded data were analysed, by municipality, for the period 2010–2016. Municipalities were grouped by tertiles according to PM2.5 concentration. Ecological regression and Bayesian statistics were used to analyse the association between PM2.5 concentrations, degree of urbanization, deprivation index and MS risk. MS risk was higher among persons living in areas with an average winter PM2.5 concentration above the European annual limit value (25 μg/m3). The Bayesian map revealed sizeable MS high-risk clusters. The study found a relationship between low MS risk and lower PM2.5 levels, strengthening the suggestion that air pollution may be one of the environmental risk factors for MS.
Highlights
IntroductionMultiple sclerosis (MS) is a complex disorder, likely arising from interactions between numerous genetic factors and several still incompletely clarified environmental factors (Thompson et al 2018)
Multiple sclerosis (MS) is a complex disorder, likely arising from interactions between numerous genetic factors and several still incompletely clarified environmental factors (Thompson et al 2018).These environmental factors include diet and vitamin D levels (Ascherio and Munger 2007), both of which have been widely studied
The proposed final full Bayesian hierarchical generalized mixed model (HGLMM) model related the observed count of MS cases for each area to spatially structured random effects and PM2.5 levels, degree of urbanization and deprivation index
Summary
Multiple sclerosis (MS) is a complex disorder, likely arising from interactions between numerous genetic factors and several still incompletely clarified environmental factors (Thompson et al 2018). These environmental factors include diet and vitamin D levels (Ascherio and Munger 2007), both of which have been widely studied. The existence of possible links between air pollution and the epidemiology of MS has been investigated in few studies It was found an association between PM10 levels and MS prevalence (Gregory et al 2008), as well as links with the occurrence of MS clinical relapses (Koski et al 2003; Roux et al 2017; Jeanjean et al 2018) and MRI ‘activity’ (Bergamaschi et al 2018)
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