Abstract
We studied 60 patients with multiple system atrophy and autonomic failure and 60 control subjects matched for age, sex and race. Their psychosocial history, pedigree and occupation were obtained by personal interview. An inventory of autonomic and neurologic symptoms was obtained from 148 first-degree relatives of the patients and 80 controls by a self-administered questionnaire. Patients with multiple system atrophy had significantly more potential exposures to metal dusts and fumes, plastic monomers and additives, organic solvents, and pesticides than the control population. The potential exposures were determined in most subjects by their reported usual occupation. Clinical symptoms of multiple system atrophy were reported by a significantly larger group of patients' relatives than controls. These findings are possibly consistent with the hypothesis that multiple system atrophy develops as a result of a genetically determined selective vulnerability in the nervous system. Specific neuronal systems may become targets for environmental insults or toxins, and the disease state may occur when ageing neuronal systems can no longer sustain functional capacity. This preliminary study supports the need to further explore possible environmental, occupational, and familial contributions to the aetiology of multiple system atrophy.
References
Bannister R, Oppenheimer DR. Degenerative diseases of the nervous system associated with autonomic failure.Brain 1972;95: 457–74.
Robbins JH, Moshell AN, Scarpinats RG, Polinsky RJ, Nee LE, Tarone RE. Hypersensitivity to ionizing radiation in sporadic primary neuronal degenerations.Clin Res 1981;29: 669.
Nee LE, Brown RT, Polinsky RJ. HLA in autonomic failure.Arch Neurol 1989;46: 758–9.
Polinsky RJ. Multiple system atrophy: clinical aspects, pathophysiology and treatment. In: Jankovic J, ed.Neurologic Clinics, Vol 2. Philadelphia: Saunders. 1984: 487–98.
Lewis P. Familial orthostatic hypotension.Brain 1964;47: 719–28.
Sittig M.Handbook of Toxic and Hazardous Chemicals and Carcinogens. 2nd ed. Park Ridge. NJ, USA: Noyes Publications. 1985.
Spencer PS, Schaumburg HH. Organic solvent neurotoxicity.Scand J Work Environ Health 1985;1 (Suppl): 53–60.
Krigman MR, Bouldin TW, Mushak P. Metal toxicity in the nervous system.Monogr Pathol 1985;26: 58–100.
Ferraz HB, Bertolucci PHF, Pereira JS, Lima JGC, Andrade LAF. Chronic exposure to the fungicide maneb may produce symptoms and signs of CNS manganese intoxication.Neurology 1988;38: 550–3.
Albers JW, Kallenback LR, Fine LI, Langoff GD, Wolfe RA, Domofrio PD, Alessi AG, Stolp-Smith KA, Bromberg MB and the Mercury Worker Study Group. Neurological abnormalities associated with remote occupational elemental mercury exposure.Ann Neurol 1988;24: 651–9.
Araki S, Murata K, Aono H. Central and peripheral nervous system dysfunction in workers exposed to lead, zinc and copper.Int Arch Occup Environ Health 1987;59: 177–87.
Seppäläinen AM. Variability in response of the nervous system (central, peripheral) to workplace chemicals.Int Arch Occup Environ Health 1988 (Suppl): 84–90.
Wiklund K, Dich J, Holm L-E, Eklund G. Risk of tumors of the nervous system among mercury and other seed disinfectant applications in Swedish agriculture.Acta Oncol 1988;6: 865.
Sahenk Z. Toxic neuropathies.Semin Neurol 1987;7: 9–17.
Hayes RB, Raatgever JW, De Bruyn A, Gerin M. Cancer of the nasal cavity and paranasal sinuses, and formaldehyde exposure.Int J Cancer 1986;37: 487–92.
Byar DP. Identification of prognostic factors. In: Buyse ME, Staquet MJ, Sylvester RJ, eds.Cancer Clinical Trials: Methods and Practice. Oxford: Oxford University Press, 1984: 423–43.
Bonney GE. Regressive logistic models for familial disease and other binary traits.Biometrics 1986;42: 611–26.
Schlesselman JJ.Case-Control Studies: Design, Conduct, Analysis. New York: Oxford Press, 1982.
Breslow NE, Day NE.Statistical Methods in Cancer Research, Vol. 1. The Analysis of Case-Control Studies. IARC Scientific Publication No. 32. Lyon: IARC, 1980.
Brody H, Vijayashankar N. Anatomical changes in the neuron system. In: Finch CE, Hayflick L, eds.Handbook of the biology of Aging New York: Van Nostrand Reinhold. 1977: 241–61.
Robison SH, Bradley WG. DNA damage and chronic neuronal degenerations.J Neurol Sci 1984;64: 11–20.
Bradley WG, Tanden R, Robison SH. Clinical subtypes, DNA repair efficiency, and therapeutic trials in the postpolio syndromes.Birth Defects 1987;23: 343–60.
Rosenberg RN.Neurogenetics: Principles and Practice. New York: Raven Press, 1986: 119–24.
Siddique T, McKinney R, Hung WY, Bartlett RJ, Bruns G, Mohandas TK, Ropers H-H, Wilfert C and Roses AD. The poliovirus sensitivity (PVS) gene on chromosome 19q12→q13.2.Genomics 1988;3: 156–60.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Nee, L.E., Gomez, M.R., Dambrosia, J. et al. Environmental— occupational risk factors and familial associations in multiple system atrophy: A preliminary investigation. Clinical Autonomic Research 1, 9–13 (1991). https://doi.org/10.1007/BF01826052
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01826052