Manual labourers, especially construction workers and carpenters, are twice as likely to be diagnosed with ALS, according to University of Malta research.
Four years of analysing demographic data revealed that those engaged in heavy physical labour in Malta have an increased risk of developing amyotrophic lateral sclerosis (ALS).
“Close to two-thirds of ALS patients reported a blue-collar job as their main occupation during their entire career, which supports a link between a history of intense physical activity and this neurological condition,” senior lecturer Dr Ruben Cauchi told Times of Malta.
“However, while research abroad has shown increased risk among Italian football players, American National Football League players and military service people, in Malta the risk increases among craft and related trades workers, especially construction labourers.”
Moreover, those who undertake such sweat-inducing jobs are more prone to develop bulbar-onset ALS, a form of the disease in which speech or swallowing problems appear before muscle weakness in the limbs. Patients with bulbar-onset ALS fare worse than those with limb-onset.
ALS is a progressive neurological disease that destroys nerves that interact with the body’s muscles, and for which there is no cure. The disease typically leads to complete paralysis of the body, robbing patients of their ability to walk, speak, eat and breathe.
Local ALS patients have a unique genetic make-up
University of Malta researchers led by Cauchi, have been looking into the disease for more than a decade and recently found that treatment targeting the genes of patients with ALS may not be effective on Maltese people.
Local ALS patients have a unique genetic make-up, and it transpired that the most frequently mutated ALS genes around the globe were flawless in Maltese patients.
The discovery formed part of an ongoing study into genetic and environmental factors associated with ALS through data collected from Maltese ALS patients and ‘healthy’ elderly volunteers.
The data about participants’ occupation, lifestyle, environmental exposures and blood samples are ‘stored’ at a national ALS registry and biobank.
Maia Farrugia Wismayer, who is collecting and analysing the information noticed a trend of occupations that require strenuous physical exertion. There are two plausible hypotheses: when nerve cells use too much oxygen, highly reactive molecules are formed that do damage to the cell, while nerve cells could also die if they are over stimulated. Both could lead to ALS.
While the researchers cannot as yet provide any recommendations, they are hoping to be able to link such demographics with genetic traits and possibly alert ALS-prone people to avoid certain occupations.
“If we manage to map out the genetic background of people in Malta with ALS, in the future we would be able to warn them about strenuous jobs and hopefully prevent the onset of the disease,” Cauchi said.
The study will be published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration Journal, the official journal of the World Federation of Neurology Research Group on Motor Neuron Diseases.
The other study co-authors are Rebecca Borg, Dr Andrew Farrugia Wismayer, Dr Karl Bonavia and Prof. Neville Vassallo from the University of Malta; Dr Malcolm Vella from Mater Dei Hospital and Dr Adrian Pace from Karin Grech and Gozo general hospitals.
The study was funded by the University of Malta Research Excellence Fund, an Endeavour Scholarship, a Malta Council for Science & Technology Internationalisation Partnership Award, ALS Malta Foundation and the University of Malta’s Research Trust.
The research relies on volunteers, and anyone who would like to participate in the study – whether they are an ALS patient, or a person aged over 60 who does not have ALS can get in touch on mnd.research@um.edu.mt