J Clin Neurol.  2018 Apr;14(2):234-241. 10.3988/jcn.2018.14.2.234.

Prevalence of Multiple Sclerosis in a Turkish City Bordering an Iron and Steel Factory

• Börü UT
• Bilgiç AB
• KöseoÄŸlu Toksoy C
• Yılmaz AY
• Tasdemir M
• Sensöz NP
• Öztop Çakmak O
• Duman A
• Bölük C

• KMID: 2407952
• DOI: http://doi.org/10.3988/jcn.2018.14.2.234

Abstract

BACKGROUND AND PURPOSE
Multiple sclerosis (MS) is an autoimmune disease characterized by inflammatory demyelination. Recent studies have shown that long-term exposure to air pollutants (including PM10 particulates) is potentially an environmental risk factor for MS. We aimed to determine the prevalence rates of MS in two cities with different levels of air pollution.
METHODS
This door-to-door population-based study was conducted between April 2014 and June 2015. Two cities were screened for the prevalence rates of MS: 1) Karabük, which borders an iron-and-steel factory, and 2) Akçakoca, which is a coastal city located in the same region. A validated survey form was used for screening MS. The 2010 McDonald Criteria were used for diagnosing MS. The patients were examined twice, first by a neurology assistant in the field and then by a senior neurologist in public health centers in the cities.
RESULTS
The prevalence of MS was 95.9/100,000 in Karabük and 46.1/100,000 in Akçakoca. In total, 33 patients were diagnosed with clinically definite MS. The female/male ratio was 1.5, and 21 patients were diagnosed with relapsing-remitting MS, 9 with secondary progressive MS, and 3 with primary progressive MS.
CONCLUSIONS
We found that the prevalence of MS was more than two fold higher in Karabük than in Akçakoca, which supports a link between air pollution and the pathogenesis of MS. However, larger etiological and epidemiological studies are needed to confirm this hypothesis.

Keyword

multiple sclerosis; prevalence; air pollution; Turkey

MeSH Terms

Air Pollutants
Air Pollution
Autoimmune Diseases
Demyelinating Diseases
Epidemiologic Studies
Humans
Iron*
Mass Screening
Multiple Sclerosis*
Neurology
Prevalence*
Public Health
Risk Factors
Steel*
Turkey
Air Pollutants
Iron
Steel

Figure

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  Fig. 1 Population pyramid for Karabük.

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  Fig. 2 Population pyramid for Akçakoca.

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  Fig. 3 Geographical locations of Karabük and Akçakoca.

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