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<datestamp>2017-12-21</datestamp>
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<title lang=en>Small-area distribution of multiple sclerosis incidence in western France: in search of environmental triggers</title>
<creator>Hammas, Karima</creator>
<creator>Yaouanq, Jacqueline</creator>
<creator>Lannes, Morgane</creator>
<creator>Edan, Gilles</creator>
<creator>Viel, Jean-Francois</creator>
<contributor>CHU Pontchaillou [Rennes]</contributor>
<contributor>Institut de recherche, santé, environnement et travail [Rennes] (Irset) ; Université d'Angers (UA) - Université des Antilles et de la Guyane (UAG) - Université de Rennes 1 (UR1) - École des Hautes Études en Santé Publique [EHESP] (EHESP) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )</contributor>
<contributor>French Ministry of Health [PHRC API 09-41]</contributor>
<description>International audience</description>
<source>ISSN: 1476-072X</source>
<source>International Journal of Health Geographics</source>
<publisher>BioMed Central</publisher>
<identifier>hal-01616063</identifier>
<identifier>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01616063</identifier>
<source>https://hal-univ-rennes1.archives-ouvertes.fr/hal-01616063</source>
<source>International Journal of Health Geographics, BioMed Central, 2017, 16 (1), pp.35. 〈10.1186/s12942-017-0108-6〉</source>
<identifier>DOI : 10.1186/s12942-017-0108-6</identifier>
<relation>info:eu-repo/semantics/altIdentifier/doi/10.1186/s12942-017-0108-6</relation>
<identifier>PUBMED : 28934989</identifier>
<relation>info:eu-repo/semantics/altIdentifier/pmid/28934989</relation>
<language>en</language>
<subject lang=en>Environmental triggers</subject>
<subject lang=en>Multiple sclerosis</subject>
<subject lang=en>Small-area distribution</subject>
<subject lang=en>Spatial cluster</subject>
<subject>[SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health</subject>
<type>info:eu-repo/semantics/article</type>
<type>Journal articles</type>
<description lang=en>Background: Despite intensive research over several decades, the etiology of multiple sclerosis (MS) remains poorly understood, although environmental factors are supposedly implicated. Our goal was to identify spatial clusters of MS incident cases at the small-area level to provide clues to local environmental risk factors that might cause or trigger the disease. Methods: A population-based and multi-stage study was performed in the French Brittany region to accurately ascertain the clinical onset of disease during the 2000-2004 period. The municipality of residence at the time of clinical onset was geocoded. To test for the presence of MS incidence clusters and to identify their approximate locations, we used a spatial scan statistic. We adjusted for socioeconomic deprivation, known to be strongly associated with increased MS incident rates, and scanned simultaneously for areas with either high or low rates. Sensitivity analyses (focusing on relapsing-remitting forms and/or places of residence available within the year following clinical onset) were performed. Results: A total of 848 incident cases of MS were registered in Brittany, corresponding to a crude annual incidence rate of 5.8 per 100,000 inhabitants. The spatial scan statistic did not find a significant cluster of MS incidence in either the primary analysis (p value >= 0.56) or in the sensitivity analyses (p value >= 0.16). Conclusion: The findings of this study indicate that MS incidence is not markedly affected across space, suggesting that in the years preceding the first clinical expression of the disease, no environmental trigger is operative at the small-area population level in the French Brittany region.</description>
<date>2017</date>
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