ALS Risk Factors: An Evidence-Based Self-Assessment Tool

This tool presents a compilation of potential risk and protective factors associated with ALS as identified in published scientific literature. This self-assessment tool is designed to help individuals explore their potential exposures to these factors. Users can review various environmental factors, daily items, and activities potentially associated with ALS risk. Each factor is linked to relevant peer-reviewed research papers, providing the scientific basis for its inclusion. It's important to note that the presence of these factors does not necessarily indicate causation or guarantee the development of ALS. This tool aims to provide evidence-based information to support patient awareness and facilitate discussions with healthcare providers. Users should interpret the results in consultation with medical professionals, as the complex interplay of genetic and environmental factors in ALS development remains an active area of research.

Risk Factor Pesticides
References
Evidence Level: ★★★
Agricultural work Home gardening with pesticide use Proximity to pesticide-treated areas

Melanie Engstrom Newell et al. Systematic and state-of the science review of the role of environmental factors in Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig's Disease. The Science of the total environment, 2022

Stephen A Goutman et al. The amyotrophic lateral sclerosis exposome: recent advances and future directions. Nature reviews. Neurology, 2023

Stephen A Goutman et al. Residential exposure associations with ALS risk, survival, and phenotype: a Michigan-based case-control study. Amyotrophic lateral sclerosis & frontotemporal degeneration, 2024

Diane B Re et al. A perspective on persistent toxicants in veterans and amyotrophic lateral sclerosis: identifying exposures determining higher ALS risk. Journal of neurology, 2022

Feng-Chiao Su et al. Association of Environmental Toxins With Amyotrophic Lateral Sclerosis. JAMA neurology, 2016

Stephen A Goutman et al. Associations of self-reported occupational exposures and settings to ALS: a case-control study. International archives of occupational and environmental health, 2022

Francesca Trojsi et al. Exposure to environmental toxicants and pathogenesis of amyotrophic lateral sclerosis: state of the art and research perspectives. International journal of molecular sciences, 2013

Qing-Qing Duan et al. Risk factors of amyotrophic lateral sclerosis: a global meta-summary. Frontiers in neuroscience, 2023

Ming-Dong Wang et al. Identification of risk factors associated with onset and progression of amyotrophic lateral sclerosis using systematic review and meta-analysis. Neurotoxicology, 2017

Nadia A Sutedja et al. Exposure to chemicals and metals and risk of amyotrophic lateral sclerosis: a systematic review. Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases, 2009

Angela M Malek et al. Exposure to hazardous air pollutants and the risk of amyotrophic lateral sclerosis. Environmental pollution (Barking, Essex : 1987), 2015

Tom Koeman et al. Occupational exposure and amyotrophic lateral sclerosis in a prospective cohort. Occupational and environmental medicine, 2017

V McGuire et al. Occupational exposures and amyotrophic lateral sclerosis. A population-based case-control study. American journal of epidemiology, 1997

R Pamphlett et al. Exposure to environmental toxins and the risk of sporadic motor neuron disease: an expanded Australian case-control study. European journal of neurology, 2012

Julia M Morahan et al. Amyotrophic lateral sclerosis and exposure to environmental toxins: an Australian case-control study. Neuroepidemiology, 2006

Risk Factor Oxychlordane
References
Evidence Level: ★☆☆
Contaminated soil or food near agricultural areas Exposure through pesticide residues
Risk Factor Heptachlor
References
Evidence Level: ★☆☆
Exposure to termite control chemicals in older homes Eating contaminated food (e.g., fish)
Risk Factor Gasoline and/or Kerosene
References
Evidence Level: ★☆☆
Inhalation during refueling Exposure in poorly ventilated areas with fuel use
Protective Polyunsaturated Fatty Acids Consumption
References
Evidence Level: ★☆☆
Consumption of certain oils like sunflower or corn oil
Risk Factor Cyanide
References
Evidence Level: ★☆☆
Inhalation from smoke during house fires Occupational exposure in metal processing Accidental ingestion of certain pesticides
Risk Factor 2,4-Dinitrotoluene
References
Evidence Level: ★☆☆
Exposure in explosives manufacturing Handling or proximity to certain dyes Working in ammunition plants
Risk Factor Vinyl Chloride
References
Evidence Level: ★☆☆
PVC manufacturing Plastics production Inhalation of vapors from products or industries using vinyl chloride
Risk Factor Carbon Disulfide
References
Evidence Level: ★☆☆
Rubber manufacturing Viscose rayon production Solvent exposure in industrial settings
Risk Factor Hexachlorobenzene
References
Evidence Level: ★☆☆
Occupational exposure in chemical plants Eating contaminated foods like fish or meat
Risk Factor Stroke
References
Evidence Level: ★☆☆
Sedentary lifestyle Uncontrolled high blood pressure Smoking
Risk Factor Lead
References
Evidence Level: ★☆☆
Exposure from lead-based paint in older homes Drinking water from lead pipes
Risk Factor Elemental Carbon
References
Evidence Level: ★☆☆
Exposure to industrial soot or emissions Urban air pollution
Risk Factor Volatile Organic Compounds
References
Evidence Level: ★☆☆
Inhalation of fumes from paints, cleaners, or fuels Living in newly constructed homes with off-gassing materials
Risk Factor Iron
References
Evidence Level: ★☆☆
Occupational exposure in foundries or mining Overconsumption through supplements
Risk Factor Selenium
References
Evidence Level: ★☆☆
Occupational exposure in electronics or glass manufacturing Overconsumption through supplements
Risk Factor Mercury
References
Evidence Level: ★☆☆
Consumption of fish with high mercury levels Handling broken thermometers or fluorescent bulbs
Risk Factor Copper
References
Evidence Level: ★☆☆
Exposure from copper pipes in plumbing Occupational exposure in copper mining or processing
Risk Factor Manganese
References
Evidence Level: ★☆☆
Inhalation in welding or metalwork Excessive dietary intake from contaminated water or supplements
Risk Factor Arsenic
References
Evidence Level: ★☆☆
Contaminated groundwater Ingesting contaminated food (e.g., rice) or drinking water
Risk Factor Dioxins
References
Evidence Level: ★☆☆
Incineration of waste materials Consumption of animal products like fish and meat
Risk Factor Jet Exhaust
References
Evidence Level: ★☆☆
Exposure near airports or military bases Inhalation in areas with high jet traffic
Risk Factor Burn Pits
References
Evidence Level: ★☆☆
Proximity to military burn pits Occupational exposure in waste burning
Risk Factor Dichloromethane
References
Evidence Level: ★☆☆
Paint stripping Use of industrial solvents or degreasers
Risk Factor Nickel
References
Evidence Level: ★☆☆
Nickel alloy manufacturing Prolonged contact with nickel-containing jewelry or coins
Risk Factor Nitric Acid
References
Evidence Level: ★☆☆
Industrial cleaning operations Laboratory work with chemicals
Risk Factor Styrene
References
Evidence Level: ★☆☆
Plastic manufacturing Occupational exposure in boat-building or fiberglass industries
Risk Factor Carbaryl
References
Evidence Level: ★☆☆
Use of household insecticides Agricultural pesticide exposure
Risk Factor Terbacil
References
Evidence Level: ★☆☆
Use in agricultural weed control Exposure through contaminated crops or water
Risk Factor Chlorpyrifos
References
Evidence Level: ★☆☆
Home pest control Agricultural use
Risk Factor Permethrin
References
Evidence Level: ★☆☆
Insect repellents Use of lice treatment products
Risk Factor Hymexazol
References
Evidence Level: ★☆☆
Agricultural fungicide exposure Working in fields treated with fungicides
Risk Factor Mancozeb
References
Evidence Level: ★☆☆
Use in agricultural settings Exposure through residues on food
Risk Factor Chlorothalonil
References
Evidence Level: ★☆☆
Agricultural fungicide use Exposure from treated plants or crops
Risk Factor Captan
References
Evidence Level: ★☆☆
Fungicide use in gardening Inhalation during agricultural application
Risk Factor Paraquat
References
Evidence Level: ★☆☆
Agricultural herbicide use Handling or accidental ingestion of herbicides
Risk Factor 2,4-Dichlorophenoxyacetic Acid (2,4-D)
References
Evidence Level: ★☆☆
Agricultural weed control Exposure through treated lawns or gardens
Risk Factor Glyphosate
References
Evidence Level: ★☆☆
Use in home gardening or farming Consumption of residues in treated crops
Risk Factor 4-(2-Methyl-4-Chlorophenoxy) Butyric Acid (MCPB)
References
Evidence Level: ★☆☆
Agricultural herbicide application Exposure through drift or contaminated water
Risk Factor Perchloroethylene
References
Evidence Level: ★☆☆
Dry cleaning work Inhalation of vapors in dry-cleaned clothes or in certain industrial settings
Risk Factor Benzene
References
Evidence Level: ★☆☆
Inhalation from gasoline fumes Occupational exposure in chemical industries
Protective Polybrominated Diphenyl Ether 66 (PBDE 66)
References
Evidence Level: ★☆☆
Exposure through older electronics or furniture Household dust in homes with flame-retardant materials
Risk Factor cis-Chlordane
References
Evidence Level: ★☆☆
Exposure to contaminated soil or food Use of banned insecticides
Risk Factor Aromatic Solvents
References
Evidence Level: ★☆☆
Use of paint thinners Industrial solvent exposure
Risk Factor Cyanobacteria
References
Evidence Level: ★☆☆
Swimming in contaminated water Drinking contaminated water from algal blooms
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