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Licensed Unlicensed Requires Authentication Published by De Gruyter January 4, 2021

Ambient air pollution and multiple sclerosis: a systematic review

Mohammad Amin Farahmandfard, Ahmad Naghibzadeh-Tahami and Narges Khanjani

Abstract

Objectives

Some studies have shown that environmental risk factors, including air pollution, might be related to the incidence or recurrence of multiple sclerosis (MS). This systematic review was conducted to investigate the relation between air pollution and MS.

Methods

A systematic search was conducted in PubMed, Scopus, Science Direct, Embase, and Web of Science; until January 2020 with no restrictions. The search strategy was conducted with air pollution key words such as CO, PM2.5, PM10, SO2, and NO2, for exposure and the key word “Multiple sclerosis” as the outcome.

Results

Eventually, after applying the inclusion and exclusion criteria, 17 articles were included. The methodologies and outcomes reported were heterogeneous and different metrics had been used in the results; therefore conducting a meta-analysis was not possible. Eight studies had analyzed the relation between particulate matter (PM) and the prevalence or relapse of MS and had observed a significant relation. NO2 and NOx were associated with recurrence or prevalence of MS in three studies. But, in three cohort studies, no association was observed between air pollution and recurrence or occurrence of MS.

Conclusions

The results of this systematic review show that outdoor air pollution, especially PM and nitrogen oxides might be related to the prevalence or relapse of MS.


Corresponding author: Prof Narges Khanjani, Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, 76169-13555 Kerman, Iran; Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran; and Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran, Phone: 034 3132 5102, Fax: 034 3132 5102, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors have no conflicts of interest.

  4. Informed consent: Not applicable.

  5. Ethical approval: Not applicable.

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Received: 2020-06-23
Accepted: 2020-12-09
Published Online: 2021-01-04
Published in Print: 2021-12-20

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