Challenges in Addressing Community Concerns Regarding Clusters of Multiple Sclerosis and Potential Environmental Exposures

Abstract

Citizens living around hazardous waste sites in the USA have expressed concern to public health officials at the local, state and federal level about a perceived high prevalence of multiple sclerosis (MS) in their communities. Many believe the occurrence of the disease is directly linked to exposure to chemical agents from the nearby hazardous waste site. Although the public’s concern regarding these clusters should be addressed, epidemiologists have long known that evaluating perceived clusters is rarely fruitful for identifying an etiologic agent. In order to adequately address concerns regarding clusters of MS, as well as examining the role of environmental exposures and genetic susceptibility in the causal mechanism of disease, several activities need to be conducted including characterizing the occurrence of disease, developing a standardized case definition and establishing partnerships to develop innovative research techniques. Only with collaboration across disciplines and lessons learned from past research will we be able to effectively guide research efforts directed at determining the etiology of this disease.

Multiple Sclerosis disease distribution and potential impact of environmental air pollutants in Georgia

“…They also theorized common infections occurring during the cold season, such as sinusitis, may play a role in these seasonal fluctuations of MS. (Ogawa et al 2004) In another study, Edwards et al (1998) (Ingalls 1986) (Landrigan et al 1975). In addition to this, Williamson and Henry (2004) acknowledged there has been community concern over the possible role of toxins from hazardous waste sites in new cases of MS.…”

Pathogenic Role of Environmental Toxins in Immune-Mediated Liver Diseases

“…In urban environments, these sites may abut residential areas. Increasingly, sophisticated statistical programs are being used to identify significant geographic clusters (areas of unusually high prevalence of affected individuals) of patients and to determine if these clusters non-randomly associate with the locations of known toxic sites (Buffler et al, 1985;Dayal et al, 1995;Williamson and Henry, 2004;Albert et al, 2005). The geographic area included in these analyses can vary considerably, and statistically significant clusters of a very small number of individuals can be identified.…”

Case-Finding for MS Prevalence Studies in Small Communities Requires a Community-Based Approach

“…Williamson and Henry [13] emphasized the need for new approaches to MS epidemiological cluster studies. Traditionally, MS cluster studies have compared the number of MS cases in a community to an expected level based on published articles of MS prevalence which vary widely by region and methodology.…”