Contributions
Abstract: EP1331
Type: ePoster
Abstract Category: Clinical aspects of MS - 5 Epidemiology
Background: The incidence and prevalence of Multiple Sclerosis have progressively and quite linearly increased in the Province of Padova, North-East Italy, over the last 5 decades. The cause(s) of this epidemiological trend are unknown. The role of environmental factors has to be considered.
Aims: To analyse the distribution of MS cases in the territory of Padua's Province and its association with residential locality types and local environmental features.
Methods: 1419 MS patients born and living in the province of Padua were included in the study. The following environmental parameters were considered: the residential locality type, the chemical composition of soil and the air quality (i.e., particulate matter < 2.5).
Based on the 2011 National Italian Territory classification, the province surface was classified in four different locality types: urban areas (789,233 inhabitants), isolated villages (50,570 inhabitants), productivity places (1,875 inhabitants) and countryside (79,683 inhabitants). Each patient's address was labelled according to such territorial classification. Furthermore, the urban domain of Padua was considered as an additional locality type.
Results: In the urban areas, MS prevalence was much higher (162/100,000) compared to isolated villages (109/100,000) or rural domains (98/100,000, p< 0.0001). Moreover, when the city of Padua was separately considered, the prevalence significantly increased to 195/100,000 (p< 0.00001). No association could be demonstrated with the content of selected metals (Cr, Co and Ni) in the soil. Three classes of air quality were used for grading the urban zones and their inhabitants (19.4-21.8, 21.8-23.0, 23.0-24.7 micrograms/cubic meter, annual average 1998-2015). Interestingly, the MS prevalence closely follows the three classes of air particulate (137, 165 and 193/ 100,000, respectively; p< 0.001).
Discussion: Our findings suggest that the prevalence of MS associates with the residential type locality. Moreover, in the urban areas (the most impacted by the disease) a further increment of the risk associates with air quality. These observation indicates that environmental factors play a major role in the increased MS prevalence in the Province of Padua, North-East Italy, that rose from 16/100,000 in the early '70ies to 182/100.000 in 2017.
Disclosure: Tateo Fabio and Grassivaro Francesca have nothing to disclose. Puthenparampil Marco received travel grant from Novartis, Sanofi-Genzyme, Biogen Idec, Almirall, Teva and Sanofi Aventis and honoraria from Almirall; he has been consultant for Genzyme Federle Lisa has received funding for travel from Novartis, Merck Serono, Biogen Idec, Sanofi-Genzyme, Bayer Schering Pharma, Almirall, Teva and honoraria from MerkSerono, Teva and Almirall. Miante Silvia received travel grant form Biogen Idec, Novartis, Sanofi Aventis and Teva Zito Antonio has nothing to disclose. Erica Stropparo has nothing to disclose. Cazzola Chiara has nothing to disclose. Toffanin Elisabetta has nothing to disclose. Ruggiero Susanna has nothing to disclose. Mario Ermani has nothing to disclose. Francesca Grassivaro has nothing to disclose. Davide Poggiali received travel grant from Biogen Idec, Novartis, Sanofi Aventis and Teva. Rinaldi Francesca serves as an advisory board member of Biogen-Idec and has received funding for travel and speaker honoraria from Merck Serono, Biogen Idec, Sanofi-Aventis, Teva and Bayer Schering Pharma. Perini Paola has received funding for travel and speaker honoraria from Merck Serono, Biogen Idec, Sanofi-Aventis, and Bayer Schering Pharma and has been consultant for Merck Serono, Biogen Idec and Teva; Gallo Paolo has been a consultant for Bayer Schering, Biogen Idec, Genzyme, Merck Serono and Novartis; has received funding for travel and speaker honoraria from Merck-Serono, Biogen Idec, Sanofi-Aventis, Novartis Pharma and Bayer-Schering Pharma, Teva; has received research support from Bayer, Biogen Idec/Elan, MerkSerono, Genzyme and Teva; and has received research grant from the University of Padova, Veneto Region of Italy, the Italian Association for Multiple Sclerosis, the Italian Ministry of Public Health.
Abstract: EP1331
Type: ePoster
Abstract Category: Clinical aspects of MS - 5 Epidemiology
Background: The incidence and prevalence of Multiple Sclerosis have progressively and quite linearly increased in the Province of Padova, North-East Italy, over the last 5 decades. The cause(s) of this epidemiological trend are unknown. The role of environmental factors has to be considered.
Aims: To analyse the distribution of MS cases in the territory of Padua's Province and its association with residential locality types and local environmental features.
Methods: 1419 MS patients born and living in the province of Padua were included in the study. The following environmental parameters were considered: the residential locality type, the chemical composition of soil and the air quality (i.e., particulate matter < 2.5).
Based on the 2011 National Italian Territory classification, the province surface was classified in four different locality types: urban areas (789,233 inhabitants), isolated villages (50,570 inhabitants), productivity places (1,875 inhabitants) and countryside (79,683 inhabitants). Each patient's address was labelled according to such territorial classification. Furthermore, the urban domain of Padua was considered as an additional locality type.
Results: In the urban areas, MS prevalence was much higher (162/100,000) compared to isolated villages (109/100,000) or rural domains (98/100,000, p< 0.0001). Moreover, when the city of Padua was separately considered, the prevalence significantly increased to 195/100,000 (p< 0.00001). No association could be demonstrated with the content of selected metals (Cr, Co and Ni) in the soil. Three classes of air quality were used for grading the urban zones and their inhabitants (19.4-21.8, 21.8-23.0, 23.0-24.7 micrograms/cubic meter, annual average 1998-2015). Interestingly, the MS prevalence closely follows the three classes of air particulate (137, 165 and 193/ 100,000, respectively; p< 0.001).
Discussion: Our findings suggest that the prevalence of MS associates with the residential type locality. Moreover, in the urban areas (the most impacted by the disease) a further increment of the risk associates with air quality. These observation indicates that environmental factors play a major role in the increased MS prevalence in the Province of Padua, North-East Italy, that rose from 16/100,000 in the early '70ies to 182/100.000 in 2017.
Disclosure: Tateo Fabio and Grassivaro Francesca have nothing to disclose. Puthenparampil Marco received travel grant from Novartis, Sanofi-Genzyme, Biogen Idec, Almirall, Teva and Sanofi Aventis and honoraria from Almirall; he has been consultant for Genzyme Federle Lisa has received funding for travel from Novartis, Merck Serono, Biogen Idec, Sanofi-Genzyme, Bayer Schering Pharma, Almirall, Teva and honoraria from MerkSerono, Teva and Almirall. Miante Silvia received travel grant form Biogen Idec, Novartis, Sanofi Aventis and Teva Zito Antonio has nothing to disclose. Erica Stropparo has nothing to disclose. Cazzola Chiara has nothing to disclose. Toffanin Elisabetta has nothing to disclose. Ruggiero Susanna has nothing to disclose. Mario Ermani has nothing to disclose. Francesca Grassivaro has nothing to disclose. Davide Poggiali received travel grant from Biogen Idec, Novartis, Sanofi Aventis and Teva. Rinaldi Francesca serves as an advisory board member of Biogen-Idec and has received funding for travel and speaker honoraria from Merck Serono, Biogen Idec, Sanofi-Aventis, Teva and Bayer Schering Pharma. Perini Paola has received funding for travel and speaker honoraria from Merck Serono, Biogen Idec, Sanofi-Aventis, and Bayer Schering Pharma and has been consultant for Merck Serono, Biogen Idec and Teva; Gallo Paolo has been a consultant for Bayer Schering, Biogen Idec, Genzyme, Merck Serono and Novartis; has received funding for travel and speaker honoraria from Merck-Serono, Biogen Idec, Sanofi-Aventis, Novartis Pharma and Bayer-Schering Pharma, Teva; has received research support from Bayer, Biogen Idec/Elan, MerkSerono, Genzyme and Teva; and has received research grant from the University of Padova, Veneto Region of Italy, the Italian Association for Multiple Sclerosis, the Italian Ministry of Public Health.