Manual workers face twice the risk of developing ALS

ALS is a progressive neurological disease that attacks the nerves that interact with the muscles in the body. The disease usually leads to complete paralysis of the body, which results in patients being deprived of their ability to walk, speak, eat and breathe.

Researchers studied ALS patients and healthy elderly volunteers living in Malta who participated in an ongoing study aimed at identifying genetic and environmental risk factors. Malta is a small, sovereign country in the central Mediterranean, and is home to a geographically and culturally isolated population. Recently, it was found that ALS patients have a unique genetic makeup compared to their European counterparts.

In this study, based on demographic data collected over four years, researchers found that manual workers were twice as likely to develop ALS. In fact, nearly two-thirds of ALS patients report that a blue collar job is their main occupation during their entire career.

“We have known for a long time that Italian soccer players, NCAA players and military soldiers have an increased risk of ALS compared to the general population. The common denominator between these professions is constant or strenuous physical exertion.” Said study lead author Dr. Rubin. J. Kochi, PhD holder, Senior Lecturer at University of Malta Medical School and Principal Investigator at the Center for Molecular Medicine and Biobanking at the University of Malta, our study supports this idea.

Despite the fact that Malta had neither professional footballers nor elite military service, the study found that race-causing occupations including those in construction and carpentry were associated with a higher risk of ALS. Patients in these occupations were more likely to develop ALS, a form of the disease in which problems with speech or swallowing appear before muscle weakness in the extremities. Patients with bulbar amyotrophic lateral sclerosis perform worse than those who suffer from the appearance of limbs.

The establishment of the National ALS Registry and Biobank at the University of Malta in 2017, with the aim of identifying and tracking ALS patients and healthy volunteers, was central to this discovery. Currently, the research team is studying the interaction between genes and environmental exposures in the pathogenesis of ALS in patients.


The study’s co-authors are Maya Varugia Weismaire, Rebecca Borg, Dr Andrew Varugia Weismaire, Dr Karl Bonavia, and Professor Neville Vasalo of the University of Malta; Dr. Malcolm Vella of Mater De Hospital; Dr. Adrian Pace of Karen Getsch and Gozo Public Hospitals.

The study was funded by the University of Malta’s Research Excellence Fund, the Endeavor grant (partially funded by the European Social Fund), the Malta Council for Science and Technology Internationalization Partnership Award, the ALS Malta Foundation, and the University of Malta Research Fund (RIDT)).

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