Camille Carles

Pesticide use in agriculture and Parkinson’s disease in the AGRICAN cohort study

Background and AimnEpidemiological studies have reported an increased risk of Parkinsons disease (PD) in farmers exposed to pesticides, but no clear conclusion can be drawn on the type of pesticide and duration of use associated with an effect. In the French agricultural cohort AGRICAN, we assessed associations between PD and pesticide use according to the types of livestock and crops grown, including exposure to some active ingredients with duration of use.nnnMethodsnSelf-reported PD and history of lifetime exposure to 13 crops and 5 types of animals and pesticide use were collected at enrolment (2005-07) among 181 842 participants. Exposure to selected active ingredients and duration of use lifelong were assessed with the crop-exposure matrix PESTIMAT. Associations between pesticide use and PD were estimated by logistic regression according to crops and livestock, adjusted for sex, age, educational level, smoking status and alcohol consumption.nnnResultsnPD was reported by 1732 subjects (1.2%) at enrolment in the cohort. Pesticide use lifelong was associated with an increased risk of PD in all types of activities [odds ratio (OR)u2009=u20091.31 (cattle) to 1.79 (peas), Pu2009<u20090.05]. Rotenone, diquat, paraquat and several dithiocarbamates were associated with an increased risk of PD [ORu2009=u20091.31 (cuprobam) to 1.57 (rotenone)], especially in farmers with the longest exposure.nnnConclusionsnOur work suggests that the risk of PD is increased in farmers exposed to pesticides on several French crops and livestock, and supports additional evidence of an association of PD with dithiocarbamate fungicides, rotenone and the herbicides diquat and paraquat.

Descriptive epidemiology and risk factors of primary central nervous system tumors: Current knowledge.

Although comparisons are difficult due to differences in methodologies, the annual incidence rates of central nervous system (CNS) tumors range from 8.5 to 21.4/100,000 population according to cancer registries, with a predominance of neuroepithelial tumors in men and meningiomas in women. An increase in the incidence of CNS tumors has been observed during the past decades in several countries. It has been suggested that this trend could be due to aging of the population, and improvements in diagnostic imaging and healthcare access, but these factors do not explain differences in incidence by gender and histological subtypes. Several etiological hypotheses related to intrinsic (sociodemographic, anthropometric, hormonal, immunological, genetic) and exogenous (ionizing radiation, electromagnetic fields, diet, infections, pesticides, drugs) risk factors have led to analytical epidemiological studies to establish relationships with CNS tumors. The only established environmental risk factor for CNS tumors is ionizing radiation exposure. However, for other risk factors, studies have been inconsistent and inconclusive due to systematic differences in study design and difficulties in accurately measuring exposures. Thus, the etiology of CNS tumors is complex and may involve several genetic and/or environmental factors that may act differently according to histological subtype.

Allergic conditions and risk of glioma and meningioma in the CERENAT case-control study

Inverse association between allergic conditions and glioma risk has been consistently reported in epidemiological studies with little attention paid to potential environmental confounders; the association with meningioma risk is less consistent. We examined the association between allergy history and risk of glioma and meningioma in adults using data from the CERENAT (CEREbral tumors: a NATional study) multicenter case-control study carried out in 4 areas in France in 2004–2010. Participants’ histories of doctor-diagnosed allergic asthma, eczema, rhinitis/hay fever and other allergic conditions were collected at onset through a detailed questionnaire delivered in a face-to-face interview. Conditional logistic regression for matched sets was adjusted for participants’ educational level and mobile phone use. A total of 273 glioma cases, 218 meningioma cases and 982 matched controls selected from the local electoral rolls were analyzed. A significant inverse association was found between glioma and a history of any allergy (OR 0.52, 95% CI 0.36–0.75), with a dose–effect relationship with the number of allergic conditions reported (p-trendu2009=u20090.001) and a particularly strong association with hay fever/allergic rhinitis (OR 0.46, 95% CI 0.30–0.72). Interestingly, associations with glioma risk were more pronounced in women. For meningioma, no association was observed with overall or specific allergic conditions. Our findings confirmed the inverse association between allergic conditions and glioma risk but questioned the role of allergy in meningioma risk. Future research is needed to clarify the biological mechanism of overall allergy and allergic rhinitis on glioma and to confirm the different effect by gender.

Central nervous system tumors and agricultural exposures in the prospective cohort AGRICAN

Studies in farmers suggest a possible role of pesticides in the occurrence of Central Nervous System (CNS) tumors but scientific evidence is still insufficient. Using data from the French prospective agricultural cohort AGRICAN (Agriculture & Cancer), we investigated the associations between exposure of farmers and pesticide users to various kinds of crops and animal farming and the incidence of CNS tumors, overall and by subtypes. Over the 2005–2007, 181,842 participants completed the enrollment questionnaire that collected a complete job calendar with lifetime history of farming types. Associations were estimated using proportional hazards models with age as underlying timescale. During a 5.2 years average follow‐up, 273 incident cases of CNS tumors occurred, including 126 gliomas and 87 meningiomas. Analyses showed several increased risks of CNS tumors in farmers, especially in pesticide users (hazard ratiou2009=u20091.96; 95% confidence interval: 1.11–3.47). Associations varied with tumor subtypes and kinds of crop and animal farming. The main increases in risk were observed for meningiomas in pig farmers and in farmers growing sunflowers, beets and potatoes and for gliomas in farmers growing grasslands. In most cases, more pronounced risk excesses were observed among pesticide applicators. Even if we cannot completely rule out the contribution of other factors, pesticide exposures could be of primary concern to explain these findings.

1185 Maternal cumulative exposure to extremely low frequency electromagnetic fields and pregnancy outcomes in the elfe cohort

Objectives To study the relations between maternal cumulative exposure to extremely low frequency electromagnetic fields (ELF MF) and the risk of moderate prematurity and small for gestational age within the birth cohort Elfe. Methods The Elfe study included 18,329 infants born at 33 weeks of amenorrhea or more in France in 2011 and was designed to follow children until 20 years of age. Gestational age and anthropometric data at birth was collected in medical records and small for gestational age was defined according to a French customised growth standard. During interviews, mothers were asked to report their job status during pregnancy. If employed, their occupation was coded according to the ISCO-88 classification and the date on which they stopped their work was recorded. Cumulative exposure to ELF MF during pregnancy was assessed, for both mothers who worked and those who didn’t work during pregnancy, using a recently updated job-exposure matrix (JEM). Cumulative exposure was considered as a categorical variable (<17.5, 17.5–23.8, 23.8–36.2, 36.2–61.6 or ≥61.6 µT-days), as a binary variable (<44.1u2009and ≥44.1 µT-days) and as a continuous variable. Associations were analysed by logistic regression, adjusting for mother’s lifestyle factors, sociodemographic characteristics and some mother’s medical history during and before pregnancy. Analyses were restricted to single births and to complete values for the pregnancy outcomes (n=16,733). Results Cumulative exposure was obtained for 96.0% of the mothers. Among them, 37.5% were classified in the 23.8–36.2 µT-days category, but high exposures were rare: 1.3% in the ≥61.6 µT-days category and 5.5% in the ≥44.1 µT-days category. No significant association was observed between maternal cumulative exposure and moderate prematurity and small for gestational age. Conclusion This large population-based study does not suggest that maternal exposure to ELF MF during pregnancy is highly associated with risk of moderate prematurity or small for gestational age.

Maternal cumulative exposure to extremely low frequency electromagnetic fields and pregnancy outcomes in the Elfe cohort

OBJECTIVESnTo study the relations between maternal cumulative exposure to extremely low frequency electromagnetic fields (ELF EMF) and the risk of moderate prematurity and small for gestational age within the Elfe cohort.nnnMETHODSnThe Elfe study included 18,329 infants born at 33weeks of gestation or more in France in 2011 and was designed to follow the children until 20years of age. Gestational age and anthropometric data at birth were collected in medical records and small for gestational age was defined according to a French customized growth standard. During interviews, mothers were asked to report their job status during pregnancy. If employed, their occupation was coded according to the International Standard Classification of Occupations 1988 and the date on which they stopped their work was recorded. Cumulative exposure to ELF EMF during pregnancy was assessed, for both mothers who worked and those who did not during pregnancy, using a recently-updated job-exposure matrix (JEM). Cumulative exposure was considered as a categorical variable (<17.5, 17.5-23.8, 23.8-36.2, 36.2-61.6 or ≥61.6μT-days), a binary variable (<44.1 and ≥44.1μT-days) and a continuous variable. Associations were analyzed by logistic regression, adjusting for the mothers lifestyle factors, sociodemographic characteristics and some mothers medical history during and before pregnancy. Analyses were restricted to single births and to complete values for the pregnancy outcomes (n=16,733).nnnRESULTSnCumulative exposure was obtained for 96.0% of the mothers. Among them, 37.5% were classified in the 23.8-36.2μT-days category, but high exposures were rare: 1.3% in the ≥61.6μT-days category and 5.5% in the ≥44.1μT-days category. No significant association was observed between maternal cumulative exposure and moderate prematurity and small for gestational age in this exposure range.nnnCONCLUSIONnThis large population-based study does not suggest that maternal exposure to ELF EMF during pregnancy is highly associated with risks of moderate prematurity or small for gestational age.

1161 Central nervous system tumours and agricultural exposures in the prospective cohort agrican

Background Studies in farmers suggest a possible role of pesticides in the occurrence of Central Nervous System (CNS) tumours. However, scientific evidences are still insufficient because of methodological limits such as study designs, sample sizes or exposure assessments. We aimed to study the associations between occupational exposures to a range of farming activities and the incidence of primary CNS tumours, globally and by subtiles. Methods In the French prospective agricultural cohort AGRICAN, 181,842 participants completed the enrollment questionnaire over the period 2005–2011. Associations between exposures to 13 crops and 5 livestock and the risks of CNS tumours (identified through linkage to cancer registries) were estimated using Cox models with age as underlying timescale, adjusted on gender, professional status and educational level. Effects of specific tasks, duration and periods of exposure were also assessed. Results During a follow-up of 5.2 years in average, 273 incident cases of CNS tumours occurred, including 126 gliomas and 87 meningiomas. Analyses showed increased risks of CNS tumours that ranged from 10% to 85% with 11 of the 13 crops, significant in farmers growing peas and beets. Concerning gliomas, increases in risk were seen for all agricultural activities. A significant risk excess was observed in pesticide users (HR = 1.73; 95% CI: 1.05–2.84), especially in vine-growers performing treatments (HR = 1.86; 95% CI: 1.06–3.26). For meningiomas, significant positive associations were observed in sunflower growers, beet growers and hog raisers. A three-fold increased risk was seen in farmers using pesticides on potatoes (HR = 2.93; 95% CI: 1.15–7.47). Conclusion In the largest prospective agricultural cohort, we observed increased risks of CNS tumours among farmers. Even if we cannot completely rule out the contribution of other agricultural factors, pesticide exposures are our main hypothesis to explain these findings. Further analyses will explore the effects of some specific pesticides using the crop-exposure matrix PESTIMAT.