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Multiple sclerosis
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=== Other === [[Tobacco smoking|Smoking]] may be an independent risk factor for MS.<ref name="pmid17492755" /> [[Stress (biological)|Stress]] may also be a risk factor, although the evidence to support this is weak.<ref name="pmid15556803" /> Environmental risk factor reviews have correlated lower sun exposure with higher MS rates though the effect does not completely align with earth's [[solar irradiance]] [[latitude]] gradient. Regional perturbations exist indicating involvement of additional, more influential localized MS risk factors.<ref name="FPH-2023">{{cite journal |last1=Vitturi |first1=Bruno Kusznir |last2=Montecucco |first2=Alfredo |last3=Rahmani |first3=Alborz |last4=Dini |first4=Guglielmo |last5=Durando |first5=Paolo |title=Occupational risk factors for multiple sclerosis: a systematic review with meta-analysis |journal=Frontiers in Public Health |date=November 15, 2023 |volume=11 |issue=2023 |page=Introduction, Results |doi=10.3389/fpubh.2023.1285103 |doi-access=free|pmid=38054069 |pmc=10694508 }}</ref> See also: [[Multiple sclerosis#Geography]]. A 2023 meta-analysis screened data from 4,183,166 individuals identifying environmental and occupational risks associated with MS development. High environmental risks were found from oil well fumes, pesticides and [[Extremely low frequency|low-frequency magnetic fields]], e.g., [[electric power transmission]] towers and passageways. Cleaning agents, solvents and animal contact did not appear to elevate MS risks.<ref name="FPH-2023" /> The highest occupational risks were observed for hairdressers, having a 8.25-fold increased risk versus the general population (GP) ([[Odds ratio|OR]]β=β8.25, 95% [[Confidence interval|CI]] 1.02β66.52); offshore workers with a 3.56-fold risk (ORβ=β3.56, 95% CI 2.74β4.61); and agricultural workers with a 1.44-fold risk, (ORβ=β1.44, 95% CI 1.13β1.83).<ref name="FPH-2023" /> Occupational risks for MS development, relative to GP, were not observed for shoe and leather workers, construction and tradesmen, healthcare aides, chemical industry workers, food industry staff, cleaning company technicians or military servicepersons.<ref name="FPH-2023" /> [[vaccine|Vaccinations]] were studied as causal factors; most studies, though, show no association.<ref name="pmid15556803" /><ref>{{cite journal | vauthors = Stowe J, Andrews N, Miller E | title = Do Vaccines Trigger Neurological Diseases? Epidemiological Evaluation of Vaccination and Neurological Diseases Using Examples of Multiple Sclerosis, Guillain-BarrΓ© Syndrome and Narcolepsy | journal = CNS Drugs | volume = 34 | issue = 1 | pages = 1β8 | date = January 2020 | pmid = 31576507 | pmc = 7224038 | doi = 10.1007/s40263-019-00670-y }}</ref> Several other possible risk factors, such as [[Diet (nutrition)|diet]] and [[hormone]] intake, have been evaluated, but evidence on their relation with the disease is "sparse and unpersuasive".<ref name="pmid17492755" /> [[Gout]] occurs less than would be expected and lower levels of [[uric acid]] have been found in people with MS. This has led to the theory that uric acid is protective, although its exact importance remains unknown.<ref name="pmid18219824">{{cite book | vauthors = Spitsin S, Koprowski H | chapter = Role of Uric Acid in Multiple Sclerosis | veditors = Rodriguez M | title = Advances in multiple Sclerosis and Experimental Demyelinating Diseases | series = Current Topics in Microbiology and Immunology | volume = 318 | pages = 325β342 | year = 2008 | pmid = 18219824 | doi = 10.1007/978-3-540-73677-6_13 | isbn = 978-3-540-73676-9 }}</ref> Obesity during adolescence and young adulthood is a risk factor for MS.<ref name="Nourbakhsh2019RisksPathogenesis">{{cite journal | vauthors = Nourbakhsh B, Mowry EM | title = Multiple Sclerosis Risk Factors and Pathogenesis | journal = Continuum | volume = 25 | issue = 3 | pages = 596β610 | date = June 2019 | pmid = 31162307 | doi = 10.1212/CON.0000000000000725 | s2cid = 174806511 }}</ref>
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