Occupation and amyotrophic lateral sclerosis risk: a case-control study in the isolated island population of Malta

Objective: Amyotrophic lateral sclerosis (ALS) is a mostly sporadic neurodegenerative disease. The role of environmental factors has been extensively investigated but associations remain controversial. Considering that substantial proportion adult life spent at work, identifying occupations and work-related exposures considered an effective way to detect increase ALS risk. This process may be further facilitated in population isolates due genetic homogeneity. Our study occupational potentially associated with risk the isolated island Malta, using case-control design. Methods: Patients randomly identified matched controls (1:1) were recruited throughout four-year window, from 2017 through 2020. Data on educational level, residence, main occupation, smoking, alcohol history collected. Results: We found compared (44.4%), higher percentage (73.7%) patients reported blue-collar job as their occupation (OR 2.04, 95% CI 1.2–3.72; p = 0.0072). Through regression analysis, craft related trades such carpentry construction (ISCO-08 major group 7), positively ALS, this category more prone develop bulbar-onset (p 0.0297). Overall, significantly exposure strenuous physical activity 2.35, 1.53–3.59; 0.0002). Conclusion: findings suggest manual workers particularly those working industries have increased risk, possibly intense or sustained activity.