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Type: Journal article
Title: Occupational exposure and risk of central nervous system demyelination
Author: Valery, P.
Lucas, R.
Williams, D.
Pender, M.
Chapman, C.
Coulthard, A.
Dear, K.
Dwyer, T.
Kilpatrick, T.
McMichael, A.
Van Der Mei, I.
Taylor, B.
Ponsonby, A.
Citation: American Journal of Epidemiology, 2013; 177(9):954-961
Publisher: Oxford University Press
Issue Date: 2013
ISSN: 0002-9262
Statement of
P.C. Valery, R.M. Lucas, D.B. Williams, M.P. Pender, C. Chapman, A. Coulthard, K. Dear, T. Dwyer, T.J. Kilpatrick, A.J. McMichael, I. van der Mei, B.V. Taylor, and A.-L. Ponsonby
Abstract: Inconsistent evidence exists regarding the association between work-related factors and risk of multiple sclerosis (MS). We examined the association between occupational exposures and risk of a first clinical diagnosis of central nervous system demyelination (FCD), which is strongly associated with progression to MS, in a matched case-control study of 276 FCD cases and 538 controls conducted in Australia (2003-2006). Using a personal residence and work calendar, information on occupational history and exposure to chemicals and animals was collected through face-to-face interviews. Few case-control differences were noted. Fewer cases had worked as professionals (≥6 years) than controls (adjusted odds ratio (AOR) = 0.60, 95% confidence interval (CI): 0.37, 0.96). After further adjustment for number of children, cases were more likely to have ever been exposed to livestock than controls (AOR = 1.54, 95% CI: 1.03, 2.29). Among women, there was an increase in FCD risk associated with 10 or more years of exposure to livestock (AOR = 2.78, 95% CI: 1.22, 6.33) or 6 or more years of farming (AOR = 2.00, 95% CI: 1.23, 3.25; also adjusted for number of children). Similar findings were not evident among men. Thus, farming and exposure to livestock may be important factors in the development of FCD among women, with this finding further revealed after the confounding effect of parity or number of children is considered.
Keywords: Confounding; multiple sclerosis; occupational exposure; risk factors
Rights: © The Author 2013. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail:
DOI: 10.1093/aje/kws361
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