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Association of the global distribution of multiple sclerosis with ultraviolet radiation and air pollution: an ecological study based on GBD data

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Abstract

Given the growing global trend of multiple sclerosis (MS), this study was designed to evaluate environmental determinates of the worldwide distribution of MS in the presence of socioeconomic and geographic indices. MS data was obtained from the Institute for Health Metrics and Evaluation website. The air pollution parameters, including particles with aerodynamic diameter less than 2.5 μm (PM2.5), tropospheric ozone, and solid fuel use, were acquired from global burden of disease resources and the World Health Organization. Ultraviolet index (UVI) values were obtained from the Tropospheric Emission Monitoring Internet Service website. Correlation and linear regression analyses were used to investigate the relationship between air pollution and environmental parameters with MS variables. The average prevalence and incidence rates in countries with high UVI were 5.17 and 0.25 per 100,000, respectively, and in countries with low UVI were 101.37 and 0.78, respectively. The results showed negative associations between prevalence, incidence and mortality of MS with ozone concentrations (β = − 1.04, − 0.04, and − 0.01 respectively; P < 0.01). Also, the fully adjusted model showed significant negative correlation of UVI with the MS variables in the presence of other variables (P < 0.01). Our findings demonstrated that UVI had the strongest significant inverse association with MS distribution. Consequently, vitamin D intake may be a major contributor to MS development. However, this study showed a slight influence of air pollution on the prevalence of MS in the presence of other parameters. Given the inconsistent results of previous studies, further studies may be required.

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Data availability

All data generated or analyzed during this study are included in this published article [and its supplementary information file].

Abbreviations

CNS:

central nervous system

DALY:

disability-adjusted life year

GBD:

Global Burden of Disease

HDI:

Human Development Index

MS:

multiple sclerosis

SDI:

socio-demographic index

PM:

particle matter

UVI:

ultraviolet index

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Acknowledgments

The authors would like to thank Torbat Heydariyeh University of Medical Sciences for their financial support for performing this research and Dr. Maryam Foroghi for her comments.

Funding

This work was supported by the Torbat Heydariyeh University of Medical Sciences [grant numbers: A-10-1311-13].

Author information

Author notes

  1. Vahid Kazemi Moghadam, Aisha S. Dickerson and Fateme Shahedi contributed equally to this work.

Authors and Affiliations

  1. Department of Environmental Health Engineering, Neyshabur University of Medical Sciences, Neyshabur, Iran

    Vahid Kazemi Moghadam

  2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Aisha S. Dickerson

  3. Department of Radiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

    Fateme Shahedi

  4. Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

    Fateme Shahedi & Mohammad Sarmadi

  5. Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

    Edris Bazrafshan & Mohammad Sarmadi

  6. Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

    Edris Bazrafshan, Seyedeh Nahid Seyedhasani & Mohammad Sarmadi

  7. Department of Health Information Technology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran

    Seyedeh Nahid Seyedhasani

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  1. Vahid Kazemi Moghadam
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Contributions

Vahid Kazemi Moghadam: conceptualization, methodology, data curation, formal analysis, writing—original draft preparation, writing—review and editing. Aisha S. Dickerson: methodology, data curation, formal analysis, writing—original draft, writing—review and editing. Fateme Shahedi: conceptualization, data curation, writing—original draft preparation. Edris bazrafshan: conceptualization, data curation, writing—review and editing. Seyedeh Nahid Seyedhasani: methodology, data curation, writing—review and editing. Mohammad Sarmadi: conceptualization, methodology, data curation, formal analysis, writing—original draft preparation, writing—review and editing, supervision, funding acquisition. All authors read and approved the manuscript.

Corresponding author

Correspondence to Mohammad Sarmadi.

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Competing interests

The authors declare that they have no competing interests.

Ethical approval

The study was approved by the Ethics Committee of Torbat Heydariyeh University of Medical Sciences (Ethical code: IR.THUMS.REC.1397.027).

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Responsible Editor: Lotfi Aleya

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Kazemi Moghadam, V., Dickerson, A.S., Shahedi, F. et al. Association of the global distribution of multiple sclerosis with ultraviolet radiation and air pollution: an ecological study based on GBD data. Environ Sci Pollut Res 28, 17802–17811 (2021). https://doi.org/10.1007/s11356-020-11761-5

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  • DOI: https://doi.org/10.1007/s11356-020-11761-5

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