Occupational exposure to pesticides increases the risk of amyotrophyc lateral sclerosis: A systematic review and meta-analysis

Auteurs

• France Labrèche, Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST); Santé environnementale et santé au travail, École de santé publique (ESPUM), Université de Montréal; Centre de recherche en santé publique (CReSP), Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-MontréalFollow
• Pamela Prudhomme, Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST)Follow
• Maryse Gagnon, Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST)Follow
• Nicolas Dupré, Axe Neuroscience, Centre hospitalier universitaire (CHU) de Québec-Université Laval; Département de médecine, Faculté de Médecine, Université Laval
• Sabrina Gravel, Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST); Santé environnementale et santé au travail, École de santé publique (ESPUM), Université de MontréalFollow

ORCID

France Labrèche : 0000-0001-8722-0433

Pamela Prud'homme : 0009-0008-2633-1808

Sabrina Gravel : 0000-0003-2553-2700

Type de document

Études primaires

Année de publication

2026

Langue

Anglais

Titre de la revue

Occupational & Environmental Medicine

Première page

291

Dernière page

300

Résumé

Objective To systematically review the evidence on the association between occupational exposure to pesticides and the risk of amyotrophic lateral sclerosis (ALS).

Methods A systematic search, conducted in eight bibliographic databases for publications between 1990 and 2025, identified observational studies estimating the risk of ALS after occupational pesticide exposure. Study quality was assessed using the WHO Risk of Bias (RoB) assessment instrument for systematic reviews, with the ROBINS-E (RoB in non-randomised studies of exposure) tool domains of bias. Pooled risk estimates were produced using random-effects models with restricted maximum likelihood, heterogeneity was assessed with I² statistics, and meta-regressions and publication bias explored with funnel plots and Egger’s test.

Results Eight case-control studies (1734 cases) were retained for meta-analysis from 767 initially screened articles. ‘Ever’ occupational exposure to pesticides was associated with an increased risk of ALS (n=6 studies, pooled OR (pOR)=1.6; 95% CI 1.1, 2.2; I²=57%), for combined sexes. The risk for exposure to herbicides was slightly greater (pOR=1.7, I²=0.0%) than for exposure to insecticides or fungicides (pORs=1.6, I²=0.0%). Based on three studies, ever exposure to high levels of pesticides was associated with a higher risk (pOR=2.7; 95% CI=1.4, 5.0) than exposure to low levels (pOR=1.9; 95% CI=1.0, 3.7). Self-reported exposure assessment methods and older publication dates (< 2015) were statistically significant predictors of the effect size.

Conclusion Despite the small number of studies and some heterogeneity, our results add to the evidence suggesting that occupational exposure to pesticides may increase the risk of ALS.

Hyperlien

https://oem.bmj.com/content/83/5/291

Mots-clés

Pesticide, Sclérose latérale amyotrophique, Amyotrophic lateral sclerosis, Revue de la littérature, Literature review

Numéro de projet IRSST

2021-0005

Citation recommandée

Labrèche, F., Prud'homme, P., Gagnon, M., Dupré, N. et Gravel, S. (2026). Occupational exposure to pesticides increases the risk of amyotrophyc lateral sclerosis: A systematic review and meta-analysis. Occupational & Environmental Medicine, 83(5), 291-300. https://doi.org/10.1136/oemed-2025-110662