L. Delabre

Matgene: A Program to Develop Job-Exposure Matrices in the General Population in France

OBJECTIVES Matgéné is a program to develop job-exposure matrices (JEMs) adapted to the general population in France for the period since 1950. The aim is to create retrospective exposure assessment tools for estimating the prevalence of occupational exposure to various agents that can then be correlated to health-related parameters. METHODS JEMs were drawn up by a team of six industrial hygienists who based their assessments on available occupational measurement, economic and statistical data, and several thousand job descriptions from epidemiological studies performed in France since 1984. Each JEM is specific to one agent, assessing exposure for a set of homogeneous combinations (occupation × activity × period) according to two occupational classifications (ISCO 1968 and PCS 1994) and one economic activities classification (NAF 2000). The cells of the JEM carry an estimate of the probability and level of exposure. Level is estimated by the duration and intensity of exposure-linked tasks or by description of the tasks when exposure measurement data are lacking for the agent in question. The JEMs were applied to a representative sample of the French population in 2007, and prevalence for each exposure was estimated in various population groups. All documents and data are available on a dedicated website. RESULTS By the end of 2010, 18 JEMs have been developed and eight are under development, concerning a variety of chemical agents: organic and mineral dust, mineral fibers, and solvents. By implementation in the French population, exposure prevalences were calculated at different dates and for complete careers, and attributable risk fractions were estimated for certain pathologies. Some of these results were validated by comparison with those of other programs. DISCUSSION Initial Matgéné JEMs results are in agreement with the French and international literature, thus validating the methodology. Exposure estimates precision, however, vary between agents and according to the amount of exposure measurement data available. These JEMs are important epidemiological tools, and improving their quality will require investment in occupational health data harvesting, especially in the case of low-level exposures.

Association of Parkinson's Disease and Its Subtypes with Agricultural Pesticide Exposures in Men: A Case-Control Study in France.

Background Pesticides have been associated with Parkinson’s disease (PD), but there are few data on important exposure characteristics such as dose–effect relations. It is unknown whether associations depend on clinical PD subtypes. Objectives We examined quantitative aspects of occupational pesticide exposure associated with PD and investigated whether associations were similar across PD subtypes. Methods As part of a French population-based case–control study including men enrolled in the health insurance plan for farmers and agricultural workers, cases with clinically confirmed PD were identified through antiparkinsonian drug claims. Two controls were matched to each case. Using a comprehensive occupational questionnaire, we computed indicators for different dimensions of exposure (duration, cumulative exposure, intensity). We used conditional logistic regression to compute odds ratios (ORs) and 95% confidence intervals (CIs) among exposed male farmers (133 cases, 298 controls). We examined the relation between pesticides and PD subtypes (tremor dominant/non-tremor dominant) using polytomous logistic regression. Results There appeared to be a stronger association with intensity than duration of pesticide exposure based on separate models, as well as a synergistic interaction between duration and intensity (p-interaction = 0.04). High-intensity exposure to insecticides was positively associated with PD among those with low-intensity exposure to fungicides and vice versa, suggesting independent effects. Pesticide exposure in farms that specialized in vineyards was associated with PD (OR = 2.56; 95% CI: 1.31, 4.98). The association with intensity of pesticide use was stronger, although not significantly (p-heterogeneity = 0.60), for tremor-dominant (p-trend < 0.01) than for non-tremor–dominant PD (p-trend = 0.24). Conclusions This study helps to better characterize different aspects of pesticide exposure associated with PD, and shows a significant association of pesticides with tremor-dominant PD in men, the most typical PD presentation. Citation Moisan F, Spinosi J, Delabre L, Gourlet V, Mazurie JL, Bénatru I, Goldberg M, Weisskopf MG, Imbernon E, Tzourio C, Elbaz A. 2015. Association of Parkinson’s disease and its subtypes with agricultural pesticide exposures in men: a case–control study in France. Environ Health Perspect 123:1123–1129; http://dx.doi.org/10.1289/ehp.1307970

The relation between type of farming and prevalence of Parkinson's disease among agricultural workers in five french districts†

Retrospective assessment of pesticide exposure is complex; however, patterns of pesticide use strongly depend on farming type, which is easier to assess than pesticide exposure. Our aim was to estimate Parkinsons disease (PD) prevalence in five French districts in 2007 among affiliates of Mutualité Sociale Agricole (MSA) and to investigate the relation between PD prevalence and farming type. We identified PD cases from administrative files as persons who used levodopa and/or benefited from free health care for PD. Densities of 16 farming types were defined at the canton of residence level (1988 French agricultural census). We used logistic regression to study the relation between PD prevalence and density of farming types and a semi‐Bayes approach to deal with correlated exposures. We identified 1,659 PD cases, yielding an age‐ and sex‐standardized PD prevalence of 3.01/1,000. Prevalence increased with age and was higher in men than women. We found a higher PD prevalence among affiliates living in cantons characterized by a higher density of farms specialized in fruits and permanent crops (multivariable semi‐Bayes model: OR4+5 vs 1+2+3 quintiles = 1.21, 95% CI = 1.08–1.36; test for trend, P = 0.035). In France, farms specialized in fruits and permanent crops rank first in terms of insecticide use per hectare. Our findings are consistent with studies reporting an association between PD and insecticide use and show that workers in farms specialized in fruits or permanent crops may be an occupational group at higher PD risk.

French registry of workers handling engineered nanomaterials as an instrument of integrated system for surveillance and research

Despite the lack of data on the human health potential risks related to the engineered nanomaterials (ENM) exposure, ENM handling spreads in industry. The French government officially charged the InVS to develop an epidemiological surveillance of workers occupationally exposed to ENM. An initial surveillance plan was proposed on the basis of literature review and discussions with national and international ENM and occupational safety and health (OSH) experts. In site investigations and technical visits were then carried out to build an adequate surveillance system and to assess its feasibility. The current plan consists of a multi-step methodology where exposure registry construction is paramount. Workers potentially exposed to carbon nanotubes (CNT) or nanometric titanium dioxide (TiO 2 ) will be identified using a 3-level approach: 1-identification and selection of companies concerned with ENM exposure (based on compulsory declaration and questionnaires), 2-in site exposure assessment and identification of the jobs/tasks with ENM exposure (based on job-expose matrix, further supplemented with measurements), and 3-identification of workers concerned. Data of interest will be collected by questionnaire. Companies and workers inclusion questionnaires are designed and currently under validation. This registration is at the moment planned for three years but could be extended and include other ENM. A prospective cohort study will be established from this registry, to pursue surveillance objectives and serve as an infrastructure for performing epidemiological and panel studies with specific research objectives.

0135 Prevalence of exposure to some occupational carcinogens in France: evolution between 1999 and 2007

Objectives To use job-exposure matrices (JEM), as a tool to describe trends of occupational exposure to carcinogenic chemicals present in the French workplace. Method MATGÉNÉ JEMs assess for each job and a given period in France, several exposure indices such as probability, intensity and frequency of exposure. Linking these matrices with job information data coming from French population allow to estimate the prevalence of workers exposed to several chemicals for a given year. To study the evolution of exposure to carcinogens, prevalence of exposure in France for the years 1999 and 2007 were estimated from the population census of 1999 and from a representative sample of the population in 2007. Results French available JEMs assess the exposure of workers since the 1950s for various occupational carcinogens: crystalline silica, benzene, trichlorethylene, perchlorethylene, leather dust, asbestos and refractory ceramic fibres (RCF). A significant decrease in the prevalence of exposure between 1999 and 2007 was observed among men for silica with 7.4% and 5.6% respectively, asbestos with 6.3% and 1.1% and RCF with 0.5% and 0.3%. For women, a significant decrease was also noticed for exposure to asbestos and leather dust. For solvents, the prevalence of exposure remained stable in both men and women. Conclusions The proportion of workers exposed to carcinogens, particularly to asbestos, has decreased in France since 1999. However a substantial number of workers are still exposed. As complete occupational histories are available in the 2007 population sample, the JEMs will also be used to estimate lifetime exposure prevalence and the associated disease burden.