Abstract

Abstract Summary

Overview

This systematic literature review aimed to evaluate occupational risk factors for amyotrophic lateral sclerosis (ALS) using high-quality epidemiological standards. The review adheres to the MOOSE and GRADE guidelines to maintain scientific integrity.

Methods

• Reviewed 79 original publications related to ALS and occupational exposures.
• Applied rigorous criteria to include 37 articles in the meta-analyses, excluding 42 due to methodological deficiencies.

Findings

The review highlights significant associations between ALS and several occupational factors:

• Heavy Physical Work: Weighted relative risk of 1.29 (95% CI: 0.97⁻1.72).
• Professional Sports: Particularly high risk with a relative risk of 3.98 (95% CI: 2.04⁻7.77).
• Metals Exposure: Relative risk of 1.45 (95% CI: 1.07⁻1.96).
• Chemicals: Relative risk of 1.19 (95% CI: 1.07⁻1.33), with emphasis on pesticides.
• Electromagnetic Fields and Electrical Work: Relative risk of 1.18 (95% CI: 1.07⁻1.31).
• Healthcare Work: Relative risk of 1.18 (95% CI: 1.05⁻1.34), particularly in nurses and physicians.

Conclusion

Consistent findings across well-conducted studies indicate a statistically significant elevation in ALS risk from multiple occupational exposures, including possibly to electromagnetic fields, supporting the need for ongoing research and preventive measures in occupational health.