Occupational and domestic exposure associations with cerebral small vessel disease and vascular dementia: A systematic review and meta‐analysis

Abstract

AbstractINTRODUCTIONThe prevalence of cerebral smallvessel disease (SVD) and vascular dementia according to workplace or domestic exposure to hazardous substances is unclear.METHODSWe included studies assessing occupational and domestic hazards/at‐risk occupations and SVD features. We pooled prevalence estimates using random‐effects models where possible, or presented a narrative synthesis.RESULTSWe included 85 studies (n = 47,743, mean age = 44·5 years). 52/85 reported poolable estimates. SVD prevalence in populations exposed to carbon monoxide was 81%(95% CI = 60‐93%; n = 1373; results unchanged in meta‐regression), carbon disulfide73% (95% CI = 54‐87%; n = 131), 1,2‐dichloroethane 88% (95% CI = 4‐100%, n = 40), toluene 82% (95% CI = 3‐100%, n = 64), high altitude 49% (95% CI = 38‐60%; n = 164),and diving 24% (95% CI = 5‐67%, n = 172). We narratively reviewed vascular dementia studies and contact sport, lead, military, pesticide, and solvent exposures as estimates were too few/varied to pool.DISCUSSIONSVD and vascular dementia may be associated with occupational/domestic exposure to hazardous substances. CRD42021297800.