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Occupational causes of amyotrophic lateral sclerosis: where to from here?
  1. Neil Pearce1,2,
  2. Hans Kromhout3
  1. 1Centre for Global NCDs, London School of Hygiene and Tropical Medicine, London, UK
  2. 2Centre for Public Health Research, Massey University Wellington Campus, Wellington, New Zealand
  3. 3Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
  1. Correspondence to Professor Neil Pearce, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; neil.pearce{at}

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In a previous editorial in this journal1 we have argued that there are likely to be important occupational causes of neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS) (also commonly known as motor neuron disease) which have not yet been discovered or established.

However, for most neurodegenerative diseases, including ALS, the epidemiology has not been ‘done’, and there have been relatively few high-quality studies, in contrast to the situation with other non-communicable diseases (NCDs) such as cancer and respiratory disease.

Nevertheless, a number of occupational exposures are suspected of contributing to the risk of ALS,2 including agricultural chemicals, metals, welding fume, electric shocks and extremely low-frequency electromagnetic fields (ELF-EMFs)3 and organic solvents (eg, formaldehyde), although the evidence to date is inconsistent. Recently, a cluster of motor neurone disease (MND) cases has been linked to exposure to the fumigant methyl bromide.4 Other putative risk factors include military service,5 rural or urban residence, and a history of head injury including sporting injuries.6 ,7

The paper by Peters …

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  • Contributors NP wrote the first draft of the commentary; HK revised it.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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