8287737 Occupational exposure to pesticides increases the risk of amyotrophic lateral sclerosis: a meta-analysis
Bibliographic record
Abstract
Objective To assess the strength of evidence on the association between occupational exposure to pesticides and the risk of amyotrophic lateral sclerosis (ALS). Material and Methods A systematic literature search was conducted in nine bibliographic databases for articles published between January 1980 and August 2023. Eligible articles reported on observational studies that presented specific risk estimates for ALS in relation to occupational exposure to pesticides. Evaluation of the quality of studies was carried out using the WHO Risk of bias (RoB) assessment instrument for systematic reviews with the ROBINS-E domains of bias. Adjusted risk estimates were pooled with random-effect models, heterogeneity was assessed using the I² statistic, and publication bias, using funnel plots and Egger’s test. Results One cohort and eight case-control studies, published between 1997 and 2022 representing a total of 2600 ALS cases, were retained as relevant for meta-analysis, out of 140 initially identified articles. Ever occupational exposure to pesticides was associated with an increased risk of ALS (n=7 studies, odds ratio [OR]=1.5, 95% confidence interval [CI] 1.1-2.1; I²=60%), for all sex combined. With estimates stratified by type of pesticides, the overall OR was 1.3 (n=6, 95%CI 1.0-1.7; I²=13%), with herbicides and insecticides being associated with higher risks (both ORs=1.4) than fungicides (OR=1.2). The exclusion of the cohort study only marginally increased these risk estimates. Ever exposure to high levels of pesticides was associated with a larger risk than exposure to low levels (n=3, OR=2.7, 1.4-5.0 vs. OR=1.9, 1.0-3.7, I2=0%). There was no obvious funnel plot asymmetry and the heterogeneity between studies appeared to be due to differences in study population and the variety of exposure assessment methods. Conclusion Despite inconsistencies between certain results, and remaining problems with the quality of exposure assessment, the available evidence suggests that occupational exposure to pesticides may increase the risk of SLA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.022 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.016 | 0.057 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".