Multiple Sclerosis in Galion, Ohio: Prevalence and Results of a Case-Control Study

Abstract

An investigation of the occurence of multiple sclerosis (MS) was undertaken in the City of Galion, Ohio, USA, because of a report of an increased number of cases. As of June 1,1987, there were 18 living cases of MS in Galion and Polk Township, for a prevalence rate of 112 cases per 100,000 population. The expected rate is approximately 65–170 cases per 100,000. In a case-control study, residents of Galion or Polk Township who had MS were compared to residents who did not have MS. The controls were matched to the cases on age and sex and had lived in Galion for at least as long as their matched case. The cases and controls did not differ in the distribution of their present or past Galion addresses, occupational histories or workplace exposures. Cases were more likely to have graduated from high school and college than controls. Cases were more likely than controls to report a history of allergies, to recall two or more relatives who had neurologic diseases that began before their first MS symptoms, to report owning a cat that died of unexplained causes and to recall having received oral polio vaccine. Cases and controls had similar levels of antibodies to measles, chickenpox, cytomegalovirus and the human T-cell lymphotrophic virus I.

A Systematic Review of Several Potential Non-Genetic Risk Factors for Multiple Sclerosis

“…In examining the epidemiologic data on sex hormones and MS, we focused on 4 hormonal risk factors: (1) age at menarche: we found 5 case-control studies, 4 of which we graded as 'c' [36,[70][71][72] and 1 of which we graded as 'b/c' [73]; (2) pregnancy: we found 3 case-control studies of which 1 was graded as 'b' [44] and 2 as 'c' [70,74]; (3) parity: we found 3 cohort studies, 2 of which we graded as 'b' [75,76] and the other as 'b/c' [77]. Two case-control studies were also identified, both of which we graded as 'c' [36,70], and (4) oral contraceptives: we found 3 cohort studies, 2 of which we graded as 'b' [75,76] and the other as 'b/c' [77].…”

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

“…Second, relevant exposures of interest are unmeasured, particularly historical exposures that are needed to help determine the latency of disease. Cluster investigations of MS in the USA have typically been conducted in areas where there is local concern regarding exposure from a hazardous waste site [7][8][9]. Unfortunately, past exposure information at the individual or pertinent geographic area level is generally not available so studies rely on self-reported exposure information.…”

“…Third, the small number of cases in such (clusters) often limits the ability to differentiate between an excess of etiologic interest and a chance occurrence. MS cluster investigations have been conducted with less than 10 individuals [23,24] although most have less than 40 individuals [7][8][9].…”

“…Many believe the occurrence of the disease is directly linked to exposure to chemical agents from the hazardous waste site [8][9][10]. The Agency for Toxic Substances and Disease Registry (ATSDR), a US federal public health agency, and collaborators at local and state health agencies, work to prevent exposure and adverse health effects associated with exposure to hazardous substances from waste sites, unplanned releases and other sources of pollution present in the environment.…”

Health hazard evaluation report: HETA-99-0250-2815, University of Kentucky, College of Pharmacy, Lexington, Kentucky.

“…9 A case-control study by Hopkins et al investigated complete occupational histories, but there was little correlation between MS and "exposure to various chemicals, radiation, or potentially toxic gases". 10 In a prospective cohort study consisting of 124,766 "solvent-exposed" Danish men and 87,501 "solvent-unexposed" Danish men, both groups were followed over a period of 20 years. After 20 years of follow-up, the number of MS cases among men presumed to be exposed to organic solvents was similar to the number of cases expected on the basis of the rates in all Danish men.…”