New research led by Macquarie University indicates that Australians residing in regional areas experience higher rates of motor neurone disease (MND) mortality compared to those in major cities. The study suggests a potential link between increased agricultural activity and exposure to pesticides in these regions and the elevated incidence of the neurodegenerative condition.
Nationwide, MND mortalities have tripled over the past four decades, prompting calls for a national registry and further investigation into environmental factors.
Increased MND Rates in Regional Australia
A study by Macquarie University has found that Australians in regional communities exhibit a higher incidence of motor neurone disease, a condition that currently claims approximately 800 Australian lives annually. The research, which analyzed MND-related deaths between 2019 and 2023, reported that the risk of developing MND is up to 40% higher in certain parts of the country.
Specifically, Tasmania recorded 1.4 times, and South Australia 1.2 times, the number of MND deaths compared to New South Wales. Overall, MND mortalities across Australia have tripled since the 1980s, increasing from 238 in 1986 to 781 in 2023. Approximately 1 in 200 Australians die from MND annually.
Professor Dominic Rowe, a senior author of the study and a neurology professor at Macquarie Medical School, suggested that this correlation may be due to the co-location of population and intensive agriculture in areas such as South Australia's viticulture regions and Tasmania's orchard industry.
Potential Environmental Factors
While the study did not definitively identify the reasons for higher MND susceptibility in regional communities, it proposed several potential factors, including increased levels of agricultural activity. International research has previously linked farm work and exposure to pesticides with an elevated risk of developing MND.
Professor Rowe highlighted the significant use of insecticides in Australian agriculture.
"Insecticides are chemicals that are designed to kill motor neurons."
He added that since the 1980s, "millions of kilograms of chemicals" have been released across Australian agricultural areas without what he described as adequate oversight or understanding of their toxicity. Professor Rowe suggested that cumulative exposure, rather than a single toxic exposure, could be contributing to the higher incidence of MND in regional areas.
Patient Experiences and Diagnosis Challenges
Simon Downes, 68, was diagnosed with MND in 2024 after more than three decades of dairy farming in New South Wales' Hunter Valley. Mr. Downes, who experiences limited mobility in his right arm and is no longer able to work, acknowledged the severe impact MND has on patients and their families, though he refrained from speculating on the cause of his condition.
Kelli Skipper, diagnosed with progressive bulbar palsy, a form of MND, described difficulties in obtaining a diagnosis in regional Australia. Her diagnosis followed 18 months of tests, many requiring travel over three hours to Hobart.
Ms. Skipper reported financial strain due to being unable to work and the inability to access assistance without a formal diagnosis. She cited paying for multiple specialists out-of-pocket and incurring costs for medical procedures like MRIs and X-rays, often requiring overnight stays due to limited local access to specialists and long booking times. Since her diagnosis, Ms. Skipper has accessed treatment closer to home and receives financial assistance via the National Disability Insurance Scheme.
Understanding MND and Calls for Action
According to MND Australia, motor neurone disease is a term encompassing diseases that affect motor neurones, which control basic bodily movements. The organization states that MND is currently incurable, with the cause of most cases unknown. Treatment typically focuses on improving quality of life and extending life expectancy.
Authors of the study advocate for the creation of a compulsory national MND registry. Such a registry would allow researchers to track patterns and better investigate potential risk factors related to geography and environmental factors. Professor Rowe additionally advocates for MND to be designated a notifiable disease, which would legally require cases to be reported to public health authorities.
"Identifying the causes of MND to develop mechanistic therapies, which are crucial for slowing or stopping the universally fatal disease, is of utmost importance."
Ms. Skipper also expressed a desire for increased research into MND causes, with the hope that the disease could one day be curable and preventable. Additionally, she called for financial support to be made available to individuals awaiting an official MND diagnosis.