87 results on '"Bénédicte, Clin"'
Search Results
2. Rôle des services de santé au travail dans le repérage et l’accompagnement des personnes concernées par des symptômes persistants suite à la Covid-19. Recommandations de la Société française de médecine du travail (SFMT)
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Audrey Petit, Corinne Letheux, Bénédicte Clin, Jean-Claude Pairon, Jean-François Gehanno, Isabelle Thaon, Catherine Verdun-Esquer, Jean-Dominique Dewitte, Yves Roquelaure, María González, Yolande Esquirol, Alexis Descatha, Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Université Paris 13 (UP13)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Universitaire d'Angers (CHU Angers), and PRES Université Nantes Angers Le Mans (UNAM)
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business.industry ,[INFO.INFO-IR]Computer Science [cs]/Information Retrieval [cs.IR] ,Public Health, Environmental and Occupational Health ,Medicine ,business ,Article ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience
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- 2021
3. Impact of adjuvant trastuzumab treatment on fatigue, emotional status and quality of personal and work life of patients with localised breast cancer: results of the 'HER-ception' study
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Gwenn Le Gall, Sabine Noal, Natacha Heutte, Bénédicte Clarisse, Alexandra Leconte, François Cherifi, Corinne Delcambre, Florence Joly, and Bénédicte Clin
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Oncology ,Chemotherapy, Adjuvant ,Quality of Life ,Humans ,Female ,Breast Neoplasms ,Prospective Studies ,Trastuzumab ,Fatigue - Abstract
The aim of this study was to analyse the impact of adjuvant trastuzumab on fatigue, emotional status, and quality of personal and work life of patients treated for localised breast cancer.In a prospective setting, we recruited age-matched localised breast cancer patients, treated by adjuvant chemotherapy with (group 1) or without IV trastuzumab (group 2), between September 2011 and May 2014. Patients completed questionnaires on quality of life (FACT-G, FACT-B), fatigue (FACIT-F, ICQ), anxiety-depression (HADS), and work life (dedicated self-questionnaire) at inclusion then at 3, 6, 9, and 15 months.We included 35 patients in each group. No significant difference was found between the two groups concerning return to work, fatigue, and quality of life scores at each phase of the study. In total, 39 patients (72.2%) reported having returned to work at T15, with no significant difference between the two groups (p = 0.53). Significantly higher scores for'helplessness' outcomes were observed in group 1, 9, and 15 months (6.138 and 5.731; p = 0.047 and 0.048, respectively). Patients in group 1 reported higher score of anxiety-depression than group 2 at 3 months (p = 0.027) then no significant difference was observed at the other times of the study.Trastuzumab does not appear to affect fatigue and return to work in patients with localised breast cancer. The emotional well-being could be affected in patients treated by trastuzumab, with a more pronounced 'helplessness' feeling which could be more related to the additional follow-up imposed by the prescription of trastuzumab.
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- 2022
4. Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects
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Sébastien Gendarme, Jean-Claude Pairon, Pascal Andujar, François Laurent, Patrick Brochard, Fleur Delva, Bénédicte Clin, Antoine Gislard, Christophe Paris, Isabelle Thaon, Helene Goussault, Florence Canoui-Poitrine, Christos Chouaïd, Centre Hospitalier Intercommunal de Créteil (CHIC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique (CEpiA), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Université de Caen Normandie (UNICAEN), Normandie Université (NU), Aliments Bioprocédés Toxicologie Environnements (ABTE), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), CHU Rouen, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), and Tapia, Claudia
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Cancer Research ,screening ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,lung neoplasms ,asbestos ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,JEL: I - Health, Education, and Welfare/I.I1 - Health/I.I1.I18 - Government Policy • Regulation • Public Health ,Oncology ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,occupational diseases ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,cost-effectiveness ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,[SHS.ECO] Humanities and Social Sciences/Economics and Finance - Abstract
Background: The National Lung Screening Trial (NLST) and NELSON study opened the debate on the relevance of lung cancer (LC) screening in subjects exposed to occupational respiratory carcinogens. This analysis reported the incremental cost-effectiveness ratios (ICER) of an organized LC screening program for an asbestos-exposed population. Methods: Using Markov modelization, individuals with asbestos exposure were either monitored without intervention or annual low-dose thoracic computed-tomography (LDTCT) scan LC screening. LC incidence came from a prospective observational cohort of subjects with occupational asbestos exposure. The intervention parameters were those of the NLST study. Utilities and LC-management costs came from published reports. A sensitivity analysis evaluated different screening strategies. Results: The respective quality-adjusted life year (QALY) gain, supplementary costs and ICER [95% confidence interval] were: 0.040 [0.010–0.065] QALY, 6900 [3700–11,800] € and 170,000 [75,000–645,000] €/QALY for all asbestos-exposed subjects; and 0.144 [0.071–0.216] QALY, 13,000 [5700–26,800] € and 90,000 [35,000–276,000] €/QALY for smokers with high exposure. When screening was based on biennial LDTCT scans, the ICER was 45,000 [95% CI: 15,000–116,000] €/QALY. Conclusions: Compared to the usual ICER thresholds, biennial LDTCT scan LC screening for smokers with high occupational exposure to asbestos is acceptable and preferable to annual scans.
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- 2022
5. A Multicenter Study to Assess a Systematic Screening of Occupational Exposures in Lung Cancer Patients
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Olivia Pérol, Nadège Lepage, Hugo Noelle, Pierre Lebailly, Benoit de Labrusse, Bénédicte Clin, Mathilde Boulanger, Delphine Praud, Françoise Fournié, Géraud Galvaing, Frédéric Dutheil, Brigitte Le Meur, Daniel Serin, Eric Dansin, Catherine Nisse, Barbara Charbotel, Beatrice Fervers, Centre Léon Bérard [Lyon], Unité Ad Hoc INSERM 000008 'Radiations : Défense, Santé, Environnement' [Lyon] (Inserm U1296), Centre Léon Bérard [Lyon]-Université Lumière - Lyon 2 (UL2)-Service de Santé des Armées-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Lille, Impact de l'environnement chimique sur la santé humaine - ULR 4483 (IMPECS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Institut Sainte Catherine [Avignon], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), CHU Clermont-Ferrand, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR_T9405), Université de Lyon-Université de Lyon-Université Gustave Eiffel, and Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS)
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[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,LUNG CANCER ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,SYSTEMATIC SCREENING ,COMPENSATION ,RESPIRATION ,occupational exposures ,lung cancer ,systematic screening ,compensation ,VISCERES ,EXPOSITION AU RISQUE ,ENQUETE ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,OCCUPATIONAL EXPOSURES ,TUMEUR - Abstract
Occupational lung cancer cases remain largely under-reported and under-compensated worldwide. In order to improve the detection and compensation of work-related lung cancers, we implemented a systematic screening of occupational exposures, combining a validated self-administered questionnaire to assess occupational exposures and a specialized occupational cancer consultation. After a pilot study, the present prospective, open-label, scale-up study aimed to assess this systematic screening of occupational exposures in lung cancer patients in five sites in France by associating university hospitals with cancer centers. Patients with lung cancer were sent a self-administered questionnaire to collect their job history and potential exposure to lung carcinogens. The questionnaire was assessed by a physician to determine if a specialized occupational cancer consultation was required. During the consultation, a physician assessed if the lung cancer was occupation-related and, if it was, delivered a medical certificate to claim for compensation. Patients were offered help from a social worker for the administrative procedure. Over 15 months, 1251 patients received the questionnaire and 462 returned it (37%). Among them, 176 patients (38.1%) were convened to the occupational cancer consultation and 150 patients attended the consultation. An exposure to occupational lung carcinogen was identified in 133 patients and a claim for compensation was judged possible for 90 patients. A medical certificate was delivered to 88 patients and 38 patients received compensation. Our national study demonstrated that a systematic screening of occupational exposures is feasible and will bring a significant contribution to improve the detection of occupational exposures in lung cancer patients.
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- 2023
6. Deep Learning for the Automatic Quantification of Pleural Plaques in Asbestos-Exposed Subjects
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Ilyes Benlala, Baudouin Denis De Senneville, Gael Dournes, Morgane Menant, Celine Gramond, Isabelle Thaon, Bénédicte Clin, Patrick Brochard, Antoine Gislard, Pascal Andujar, Soizick Chammings, Justine Gallet, Aude Lacourt, Fleur Delva, Christophe Paris, Gilbert Ferretti, Jean-Claude Pairon, François Laurent, CHU Bordeaux [Bordeaux], Institut de Mathématiques de Bordeaux (IMB), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS), Modélisation Mathématique pour l'Oncologie (MONC), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Institut Bergonié [Bordeaux], UNICANCER-UNICANCER-Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHRU de Nancy, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU de Bordeaux Pellegrin [Bordeaux], UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Intercommunal de Créteil (CHIC), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), This research was funded by French National Health Insurance (Occupational Risk Prevention Department), French Ministry of Labour and Social Relations, French Agency for Food, Environmental and Occupational Health and Safety (ANSES grant 07-CRD-51, EST 2006/1/43, EST 2009/68)., Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Normandie Université (NU), Université de Bordeaux (UB), Aliments Bioprocédés Toxicologie Environnements (ABTE), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), CHU Rouen, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Universitaire [Grenoble] (CHU), Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail, Ministère du Travail, de l’Emploi, de la Formation Professionnelle et du Dialogue Social, and Admin, Oskar
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artificial intelligence ,pleural plaques ,asbestos exposure ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Asbestos ,Deep Learning ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Artificial Intelligence ,Occupational Exposure ,Medicine ,Humans ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,[SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing ,Retrospective Studies - Abstract
International audience; OBJECTIVE: This study aimed to develop and validate an automated artificial intelligence (AI)-driven quantification of pleural plaques in a population of retired workers previously occupationally exposed to asbestos. METHODS: CT scans of former workers previously occupationally exposed to asbestos who participated in the multicenter APEXS (Asbestos PostExposure Survey) study were collected retrospectively between 2010 and 2017 during the second and the third rounds of the survey. A hundred and forty-one participants with pleural plaques identified by expert radiologists at the 2nd and the 3rd CT screenings were included. Maximum Intensity Projection (MIP) with 5 mm thickness was used to reduce the number of CT slices for manual delineation. A Deep Learning AI algorithm using 2D-convolutional neural networks was trained with 8280 images from 138 CT scans of 69 participants for the semantic labeling of Pleural Plaques (PP). In all, 2160 CT images from 36 CT scans of 18 participants were used for AI testing versus ground-truth labels (GT). The clinical validity of the method was evaluated longitudinally in 54 participants with pleural plaques. RESULTS: The concordance correlation coefficient (CCC) between AI-driven and GT was almost perfect (>0.98) for the volume extent of both PP and calcified PP. The 2D pixel similarity overlap of AI versus GT was good (DICE = 0.63) for PP, whether they were calcified or not, and very good (DICE = 0.82) for calcified PP. A longitudinal comparison of the volumetric extent of PP showed a significant increase in PP volumes (p < 0.001) between the 2nd and the 3rd CT screenings with an average delay of 5 years. CONCLUSIONS: AI allows a fully automated volumetric quantification of pleural plaques showing volumetric progression of PP over a five-year period. The reproducible PP volume evaluation may enable further investigations for the comprehension of the unclear relationships between pleural plaques and both respiratory function and occurrence of thoracic malignancy.
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- 2022
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7. Kidney cancer and occupational agricultural exposures in the AGRIculture and CANcer (AGRICAN) cohort
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Carine Nassar, Mathilde Boulanger, Séverine Tual, Pierre Lebailly, Isabelle Baldi, Agrican Group, and Bénédicte Clin
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Chemical Health and Safety ,Public Health, Environmental and Occupational Health ,Public aspects of medicine ,RA1-1270 ,Safety, Risk, Reliability and Quality ,Safety Research - Published
- 2022
8. Pleural plaques and risk of lung cancer in workers formerly occupationally exposed to asbestos: extension of follow-up
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Justine Gallet, François Laurent, Christophe Paris, Bénédicte Clin, Antoine Gislard, Isabelle Thaon, Soizick Chammings, Celine Gramond, Guy Ogier, Gilbert Ferretti, Pascal Andujar, Patrick Brochard, Fleur Delva, Jean-Claude Pairon, Aude Lacourt, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Rouen, Normandie Université (NU), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Lorraine (UL), CHI Créteil, Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), Caisse primaire d'assurance maladie (CPAM), Centre Hospitalier Universitaire [Grenoble] (CHU), Université Grenoble Alpes (UGA), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), French Ministry of Labour and Social Relations, French National Health Insurance (Occupational Risk Prevention Department), French Agency for Food, Environmental and Occupational Health Safety [07-CRD-51, EST 2006/1/43, EST 2009/68], Jonchère, Laurent, Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
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[SDV] Life Sciences [q-bio] ,CT scan ,screening ,[SDV]Life Sciences [q-bio] ,occupational health ,Public Health, Environmental and Occupational Health ,Lung cancer ,asbestos ,pleural plaques ,respiratory system - Abstract
BackgroundOccupational asbestos exposure is associated with pleural plaques (PP), a benign disease often seen as a marker of past exposure to asbestos and lung cancer. The association between these two diseases has not been formally proved, the aim of this study was to evaluate this association in the asbestos-related disease cohort (ARDCO) cohort.MethodsARDCO is a French multicentric cohort including workers formerly occupationally exposed to asbestos from 2003 to 2005. CT scan was performed to diagnose PP with double reading and lung cancer (incidence and mortality) was followed through health insurance data and death certificates. Cox models were used to estimate the association between PP and lung cancer adjusting for occupational asbestos exposure (represented by cumulative exposure index, time since first exposure and time since last exposure) and smoking status.ResultsA total of 176 cases (of 5050 subjects) and 88 deaths (of 4938 subjects) of lung cancer were recorded. Smoking status was identified as an effect modifier. Lung cancer incidence and mortality were significantly associated with PP only in non-smokers, respectively, HR=3.13 (95% CI 1.04 to 9.35) and HR=16.83 (95% CI 1.87 to 151.24) after adjustment for age, occupational asbestos exposure and smoking status.ConclusionsARDCO study was the first to study this association considering equal asbestos exposure, and more specifically, our study is the first to test smoking as an effect modifier, so comparison with scientific literature is difficult. Our results seem to consolidate the hypothesis that PP may be an independent risk factor for lung cancer but they must be interpreted with caution.
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- 2022
9. Head and neck cancer and asbestos exposure
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Bénédicte Clin, Celine Gramond, Isabelle Thaon, Patrick Brochard, Fleur Delva, Soizick Chammings, Antoine Gislard, François Laurent, Christophe Paris, Aude Lacourt, Jean-Claude Pairon, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Intercommunal de Créteil (CHIC), CHU Rouen, Normandie Université (NU), Université de Bordeaux (UB), CHU Pontchaillou [Rennes], Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail, and Admin, Oskar
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Male ,[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health ,Lung Neoplasms ,Public Health, Environmental and Occupational Health ,Asbestos ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Pleural Diseases ,Otorhinolaryngologic Diseases ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Head and Neck Neoplasms ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Occupational Exposure ,Humans ,[SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Laryngeal Neoplasms ,Occupational Health ,Follow-Up Studies ,Cancer - Abstract
ObjectivesThe aim of this study was to analyse, within a French cohort of workers previously occupationally exposed to asbestos, incidence and mortality from various sites of head and neck cancers (larynx excluded) and to examine the potential link of these cancers with pleural plaques.MethodsA 10-year follow-up study was conducted in the 13 481 male subjects included in the cohort between October 2003 and December 2005. Asbestos exposure was assessed by industrial hygienist analysis of a standardised questionnaire. The final cumulative exposure index (CEI; in equivalent fibres.years/mL) for each subject was calculated as the sum of each employment period’s four-level CEI. The number of head and neck cancers recorded by the National Health Insurance fund was collected in order to conduct an incidence study. Complementary analysis was restricted to men who had performed at least one chest CT scan (N=4804). A mortality study was also conducted. We used a Cox model with age as the time axis variable adjusted for smoking, time since first exposure, CEI of exposure to asbestos and pleural plaques on CT scans.ResultsWe reported a significant dose–response relationship between CEI of exposure to asbestos and head and neck cancers after exclusion of laryngeal cancers, in the mortality study (HR 1.03, 95% CI (1.01 to 1.06) for an increase of 10 f.years/mL) and a close to significant dose–response relationship in the incidence study (HR 1.02, 95% CI (1.00 to 1.04) for an increase of 10 f.years/mL). No statistically significant association between pleural plaques and head and neck cancer incidence was observed.ConclusionsThis large-scale study suggests a relationship between asbestos exposure and head and neck cancers, after exclusion of laryngeal cancers, regardless of whether associated pleural plaques were present.
- Published
- 2022
10. Agricultural exposure and risk of soft tissue sarcomas and gastrointestinal stromal sarcoma in the AGRIculture and CANcer (AGRICAN) cohort
- Author
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Marine, Renier, Amandine, Busson, Mathilde, Boulanger, Clément, Piel, Romain, Pons, Séverine, Tual, Brice, Amadéo, Matthieu, Meryet-Figuiere, Elisabeth, Marcotullio, Bénédicte, Clin, Isabelle, Baldi, and Pierre, Lebailly
- Subjects
Cancer Research ,Farmers ,Oncology ,Gastrointestinal Stromal Tumors ,Occupational Exposure ,Animals ,Humans ,Agriculture ,Cattle ,Sarcoma ,Prospective Studies ,Pesticides - Abstract
Sarcomas are a heterogeneous group of tumors whose incidence is nearly 5 per 100 000 inhabitants in Europe. Their causes are poorly understood, although occupational exposures (especially farming and pesticides) are suspected. The AGRICAN cohort is a prospective study of 181 842 individuals enrolled in 2005 to 2007 who completed an enrolment questionnaire with data on lifelong agricultural exposure. Associations between agricultural exposure and sarcoma overall, gastrointestinal stromal tumors (GIST) and myomatous and fibrous sarcoma together, were analyzed with a Cox model. Until 2015, 188 incident cases of sarcoma were identified. Increased risks were observed (a) among cattle farmers working10 years (HR
- Published
- 2021
11. O-19 Colorectal cancer among farmers in the AGRICAN cohort study
- Author
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Isabelle Baldi, Pierre Lebailly, Madar Talibov, Stéphanie Perrier, Matthieu Meryet-Figuière, Bénédicte Clin, Fabrice Morlais, Mathilde Boulanger, Séverine Tual, and Véronique Bouvier
- Subjects
Oncology ,medicine.medical_specialty ,business.industry ,Colorectal cancer ,Internal medicine ,Medicine ,business ,medicine.disease ,Cohort study - Published
- 2021
12. Reliability of baseline self-reported information in the AGRICAN cohort
- Author
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Séverine Tual, Clémentine Lemarchand, Johanna Giovannini, Mathilde Boulanger, Matthieu Meryet-Figuiere, Madar Talibov, Bénédicte Clin, Rémy Morello, Isabelle Baldi, and Pierre Lebailly
- Subjects
Cancer Research ,Chemical Health and Safety ,Public Health, Environmental and Occupational Health ,Reproducibility of Results ,Oncology ,Occupational Exposure ,Surveys and Questionnaires ,Humans ,Female ,Self Report ,Public aspects of medicine ,RA1-1270 ,Pesticides ,Safety, Risk, Reliability and Quality ,Safety Research - Abstract
An important challenge in epidemiology is to ensure the reliability of collected data. Very few studies have been conducted in farming populations. We assessed the reliability of self-reported data on lifestyle, reproductive history, health and agricultural activities and tasks from the AGRICAN cohort.Our analysis focused on 739 individuals from the 181,842 cohort members who completed the questionnaire twice between 2005 and 2007 with a median time interval of 452 days. Consistency in the responses to questionnaire items (lifestyle, health and agricultural activities including pesticide treatments) was assessed by the percentage of exact agreement (PA), Cohen's Kappa value (K) and the intraclass correlation coefficient (ICC).Agreement was substantial to almost perfect for education, smoking, reproductive history and most health indicators (K/ICC 0.61). Agreement was moderate for alcohol consumption and fair for diet. Agreement was substantial for animal and crop farming activities and tasks such as pesticide use on crops and protective equipment use (PA 81-99%, K/ICC 0.61-0.96). Most tasks showed moderate to substantial agreement, except a few with low agreement. Substantial to perfect agreement was observed for the duration of tasks, based on exact years of beginning and ending.Farmers' answers appeared reliable for most occupational data, including data used to assess individual exposure to specific pesticides, and for most potential confounders.
- Published
- 2021
13. Analysis of Medico-Social Factors for Job Retention Among Patients Presenting With Haematological Malignancy (Adamentine): Results of a ‘Pilot Study’
- Author
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Bénédicte CLIN, Natacha Heutte, Mathilde Boulanger, Xavier Troussard, Edouard Cornet, Ghandi Laurent Damaj, Véronique Bouvier, Anne-Valérie Guizard, Guy Launoy, and Idlir Licaj
- Abstract
Objective The aim of this study was to describe return to work determinants in patients with haematological malignancy. Results This medico-social pilot study included patients with haematological malignancy in the département of Calvados, aged 18 to 55 years, diagnosed between 1st January and 31st December 2010 and alive at 1st January 2015. Patients were identified via consultation of the Lower Normandy haematological malignancy Registry. They completed a specially developed self-questionnaire, in addition to validated questionnaires for anxiety-depression, quality of life and fatigue. Of the patients contacted, 50% accepted to participate. The mean age at diagnosis was 49.8 years, and the majority of patients (79.2%) was professionally active at the time of diagnosis. Only 64.9% of subjects had stopped work due to illness. The psychological impact (demonstrated anxiety) was significantly greater in men (p = 0.01). The majority of subjects returned to work after treatment (80.7%) and among them, the mean duration of absence from work was 16.1 months. Only 52.6% of subjects had informed their occupational physician and 56.7% had benefited from a pre-return visit.
- Published
- 2020
14. Analysis of medico-social factors for return to work among patients presenting with haematological malignancy (adamantine): Results of a 'pilot study'
- Author
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Idlir Licaj, Bénédicte Clin, Edouard Cornet, Guy Launoy, Anne-Valérie Guizard, Mathilde Boulanger, Natacha Heutte, Véronique Bouvier, Ghandi Laurent Damaj, and Xavier Troussard
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Return to work ,lcsh:Medicine ,Pilot Projects ,Anxiety ,General Biochemistry, Genetics and Molecular Biology ,Occupational safety and health ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Social Factors ,lcsh:Science (General) ,Occupational reintegration ,lcsh:QH301-705.5 ,Fatigue ,Cancer ,Response rate (survey) ,Occupational health ,VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801 ,Depression ,business.industry ,lcsh:R ,Haematological malignancy ,General Medicine ,Middle Aged ,Research Note ,lcsh:Biology (General) ,Hematologic Neoplasms ,030220 oncology & carcinogenesis ,Quality of Life ,Female ,medicine.symptom ,VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801 ,business ,Social inequalities ,lcsh:Q1-390 - Abstract
Objective The aim of this study was to describe return to work determinants in patients with haematological malignancy.Results This medico-social pilot study included patients with haematological malignancy in the département of Calvados, aged 18 to 55 years, diagnosed between 1st January and 31st December 2010 and alive at 1st January 2015. Patients were identified via consultation of the Lower Normandy haematological malignancy Registry. They completed a specially developed self-questionnaire, in addition to validated questionnaires for anxiety-depression, quality of life and fatigue. Of the patients contacted, 50% accepted to participate. The mean age at diagnosis was 49.8 years, and the majority of patients (79.2%) was professionally active at the time of diagnosis. Only 64.9% of subjects had stopped work due to illness. The psychological impact (demonstrated anxiety) was significantly greater in men (p=0.01). The majority of subjects returned to work after treatment (80.7%) and among them, the mean duration of absence from work was 16.1 months. Only 52.6% of subjects had informed their occupational physician and 56.7% had benefited from a pre-return visit.The satisfactory response rate obtained is promising for the extension of the present project as a prospective multicentric study.
- Published
- 2020
15. Interstitial Lung Abnormalities Detected by CT in Asbestos-Exposed Subjects Are More Likely Associated to Age
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Aude Lacourt, Bénédicte Clin, Gilbert Ferretti, A. Gislard, Pascal Andujar, Ilyes Benlala, Gaël Dournes, François Laurent, Fleur Delva, Céline Gramond, Jean-Claude Pairon, Isabelle Thaon, Christophe Paris, Patrick Brochard, Justine Gallet, Soizick Chamming's, CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Aliments Bioprocédés Toxicologie Environnements (ABTE), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Rouen, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Henri Mondor, Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), French National Health Insurance (Occupational Risk Prevention Department), French Ministry of Labour and Social Relations, French Agency for Food, Environmental and Occupational Health and Safety (ANSES) [07-CRD-51, EST 2006/1/43, EST 2009/68], Chard-Hutchinson, Xavier, CHU Henri Mondor [Créteil], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
- Subjects
[SDV.MHEP.AHA] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,medicine.medical_specialty ,asbestosis ,Asbestosis ,Population ,Cumulative Exposure ,medicine.disease_cause ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Article ,Asbestos ,Pulmonary function testing ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,[SDV.MHEP.AHA]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO] ,[SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health ,Medicine ,030212 general & internal medicine ,education ,[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health ,education.field_of_study ,Lung ,business.industry ,General Medicine ,respiratory system ,medicine.disease ,asbestos-exposition ,3. Good health ,medicine.anatomical_structure ,030228 respiratory system ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,Cohort ,HRCT ,[SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,Population study ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business - Abstract
Objective: the aim of this study was to evaluate the association between interstitial lung abnormalities, asbestos exposure and age in a population of retired workers previously occupationally exposed to asbestos. Methods: previously occupationally exposed former workers to asbestos eligible for a survey conducted between 2003 and 2005 in four regions of France, underwent chest CT examinations and pulmonary function testing. Industrial hygienists evaluated asbestos exposure and calculated for each subject a cumulative exposure index (CEI) to asbestos. Smoking status information was also collected in this second round of screening. Expert radiologists performed blinded independent double reading of chest CT-scans and classified interstitial lung abnormalities into: no abnormality, minor interstitial findings, interstitial findings inconsistent with UIP, possible or definite UIP. In addition, emphysema was assessed visually (none, minor: emphysema <, 25%, moderate: between 25 and 50% and severe: >, 50% of the lung). Logistic regression models adjusted for age and smoking were used to assess the relationship between interstitial lung abnormalities and occupational asbestos exposure. Results: the study population consisted of 2157 male subjects. Interstitial lung abnormalities were present in 365 (16.7%) and emphysema in 444 (20.4%). Significant positive association was found between definite or possible UIP pattern and age (OR adjusted =1.08 (95% CI: 1.02–1.13)). No association was found between interstitial abnormalities and CEI or the level of asbestos exposure. Conclusion: presence of interstitial abnormalities at HRCT was associated to aging but not to cumulative exposure index in this cohort of former workers previously occupationally exposed to asbestos.
- Published
- 2021
16. Prevalence of occupational exposure to asbestos and crystalline silica according to phenotypes of lung cancer from the CaProMat study: A case-only study
- Author
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Isabelle Stücker, Jack Siemiatycki, Christophe Paris, Pascale Salameh, Jean Claude Pairon, Fleur Delva, Antoine Gislard, Vincent Bonneterre, Bénédicte Clin, Mohamad El Zoghbi, Patrick Brochard, Aude Lacourt, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Lebanese University [Beirut] (LU), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Centre de consultations de pathologies professionnelles [CHRU Nancy] (CCPP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHI Créteil, Service de santé au travail et pathologie professionnelle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Aliments Bioprocédés Toxicologie Environnements (ABTE), Université de Caen Normandie (UNICAEN), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), Environnement et Prédiction de la Santé des Populations (TIMC-IMAG-EPSP), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Cancers et Populations : Facteurs de Risque, Depistage, Pratiques Diagnostiques et Therapeutiques, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Lung Neoplasms ,Histological types ,[SDV]Life Sciences [q-bio] ,Age at diagnosis ,medicine.disease_cause ,Asbestos ,03 medical and health sciences ,0302 clinical medicine ,Occupational Exposure ,Prevalence ,medicine ,Humans ,Lung cancer ,Histological type ,business.industry ,Smoking ,Significant difference ,Quebec ,Public Health, Environmental and Occupational Health ,Middle Aged ,respiratory system ,Silicon Dioxide ,medicine.disease ,030210 environmental & occupational health ,Crystalline silica ,3. Good health ,Occupational Diseases ,Phenotype ,[SDV.TOX]Life Sciences [q-bio]/Toxicology ,030220 oncology & carcinogenesis ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,France ,sense organs ,Occupational exposure ,business - Abstract
International audience; BackgroundThe objective of the study was to compare the prevalence of occupational exposure to asbestos and crystalline silica according to histological types of lung cancer and age at diagnosis.MethodsCaProMat study is a pooled case‐only study conducted between 1996 and 2011. The current study consisted of 6521 lung cancer cases. Occupational exposure to asbestos and crystalline silica was assessed by two Job‐Exposure Matrices. A weighted prevalence of exposure was derived and compared according to histological types and age at diagnosis.ResultsThere was no difference of weighted prevalence of exposure to asbestos and crystalline silica according to histological types of lung cancer. There was a statistically significant difference of weighted prevalence of exposure to asbestos and crystalline silica according to age at diagnosis.ConclusionsDue to the limited clinical importance of the difference, neither the histological type, nor the age at diagnosis can be used as an indicator for the occupational exposure to asbestos or crystalline silica.
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- 2017
17. Phenotypes of lung cancer and statistical interactions between tobacco smoking and occupational exposure to asbestos and crystalline silica from a large case-only study: The CaProMat study
- Author
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Aude Lacourt, Antoine Gislard, Jack Siemiatycki, Bénédicte Clin, Isabelle Stücker, Vincent Bonneterre, Mohamad El Zoghbi, Patrick Brochard, Pascale Salameh, Fleur Delva, Christophe Paris, Jean Claude Pairon, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Lebanese University [Beirut] (LU), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Centre de consultations de pathologies professionnelles [CHRU Nancy] (CCPP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, CHI Créteil, Service de santé au travail et pathologie professionnelle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Aliments Bioprocédés Toxicologie Environnements (ABTE), Université de Caen Normandie (UNICAEN), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), Environnement et Prédiction de la Santé des Populations (TIMC-IMAG-EPSP), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Cancers et préventions, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), and Normandie Université (NU)-Normandie Université (NU)
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Oncology ,Canada ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Interaction ,[SDV]Life Sciences [q-bio] ,Age at diagnosis ,medicine.disease_cause ,Logistic regression ,Asbestos ,Toxicology ,03 medical and health sciences ,0302 clinical medicine ,Occupational Exposure ,Internal medicine ,Odds Ratio ,medicine ,Humans ,Basal cell ,Tumor location ,Lung cancer ,Aged ,Retrospective Studies ,Occupational exposures ,business.industry ,Histological type ,Middle Aged ,Silicon Dioxide ,medicine.disease ,030210 environmental & occupational health ,Tobacco smoking ,Crystalline silica ,3. Good health ,Occupational Diseases ,Phenotype ,Population Surveillance ,[SDV.TOX]Life Sciences [q-bio]/Toxicology ,030220 oncology & carcinogenesis ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Occupational exposure ,business - Abstract
Objectives The aim of this study was to assess the effect modification of the association between tobacco smoking and phenotypes of lung cancer (histological type, tumor location, and age at diagnosis) by occupational exposure to asbestos or to crystalline silica. Materials and methods The CaProMat study is a pooled case-only study including 7256 male lung cancer cases recruited between 1996 and 2011 in France and Canada. Two job-exposure matrices (JEMs) were used to assess occupational exposure to asbestos and crystalline silica. Statistical interactions between tobacco smoking and occupational exposure to asbestos or crystalline silica were assessed using unconditional logistic regression models for histological type and tumor location and linear regression models for age at diagnosis. Results Tobacco smoking was associated with squamous cell carcinoma and small cell carcinomas as well as an earlier age at diagnosis. Additional exposure to either asbestos or crystalline silica did not modify the effect of tobacco smoking for either histological type or age at diagnosis. Neither tobacco smoking nor occupational exposure to asbestos or crystalline silica influenced tumor location. Conclusions Tobacco smoking was the main factor related to histological type and age at diagnosis. Those associations were not modified by occupational exposure to asbestos or crystalline silica.
- Published
- 2017
18. Differential Diagnosis of Epithelioid Malignant Mesothelioma With Lung and Breast Pleural Metastasis: A Systematic Review Compared With a Standardized Panel of Antibodies-A New Proposal That May Influence Pathologic Practice
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Nicolas Girard, Bénédicte Clin, Allen R. Gibbs, Louise M. Burke, Pierre Lebailly, Nolwenn Le Stang, Françoise Galateau-Sallé, Gaetane Blaizot, and Euracan networks
- Subjects
0301 basic medicine ,Male ,Mesothelioma ,Pathology ,medicine.medical_specialty ,Lung Neoplasms ,Pleural Neoplasms ,Breast Neoplasms ,Adenocarcinoma ,Sensitivity and Specificity ,Antibodies ,Pathology and Forensic Medicine ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Pleural metastasis ,medicine ,Biomarkers, Tumor ,Humans ,Lung ,biology ,Pleural mesothelioma ,business.industry ,Mesothelioma, Malignant ,General Medicine ,medicine.disease ,Rare cancer ,Immunohistochemistry ,Medical Laboratory Technology ,030104 developmental biology ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,biology.protein ,Female ,Differential diagnosis ,Antibody ,business - Abstract
Context.—Pleural mesothelioma is a rare cancer with an often-challenging diagnosis because of its potential to be a great mimicker of many other tumors. Among them, primary lung and breast cancers are the 2 main causes of pleural metastasis. The development and application of targeted therapeutic agents have made it even more important to achieve an accurate diagnosis. In this setting, international guidelines have recommended the use of 2 positive and 2 negative immunohistochemical biomarkers.Objectives.—To define the most highly specific and sensitive minimum set of antibodies for routine practice to use for the separation of epithelioid malignant mesothelioma from lung and breast metastasis and to determine the most relevant expression cutoff.Design.—To provide information at different levels of expression of 16 mesothelial and epithelial biomarkers, we performed a systematic review of articles published between 1979 and 2017, and we compared those data to results from the Mesothelioma Telepathology Network (MESOPATH) of the standardized panel used in routine practice database since 1998.Results.—Our results indicate that the following panel of markers—calretinin (poly)/thyroid transcription factor 1 (TTF-1; clone 8G7G3/1) and calretinin (poly)/estrogen receptor-α (ER-α; clone EP1)—should be recommended; ultimately, based on the MESOPATH database, we highlight their relevance which are the most sensitive and specific panel useful to the differential diagnosis at 10% cutoff.Conclusions.—Highlighted by their relevance in the large cohort reported, we recommend 2 useful panels to the differential diagnosis at 10% cutoff.
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- 2019
19. Incidence and survival of peritoneal malignant mesothelioma between 1989 and 2015: A population-based study
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Françoise Galateau-Sallé, Olivier Glehen, N. Le Stang, Bénédicte Clin, Véronique Bouvier, Laurent Villeneuve, Registre Multicentrique à Vocation Nationale des Mésothéliomes Pleuraux (MESONAT), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), FRANCIM, Réseau des registres français du cancer, Registre des cancers digestifs du Calvados [CHU Caen], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Réseau national des tumeurs rares du péritoine (RENAPE), Hospices Civils de Lyon (HCL), Centre Léon Bérard [Lyon], Service de Santé au Travail et Pathologie Professionnellel [CHU Caen], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), 'Santé Publique France' and 'Institut National du Cancer'., and CCSD, Accord Elsevier
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Male ,Mesothelioma ,Cancer Research ,Lung Neoplasms ,Time Factors ,Survival ,Epidemiology ,0302 clinical medicine ,Medicine ,Malignant peritoneal mesothelioma ,Registries ,030212 general & internal medicine ,Peritoneal Neoplasms ,Aged, 80 and over ,education.field_of_study ,Incidence (epidemiology) ,Incidence ,Time trends ,Middle Aged ,Prognosis ,3. Good health ,Oncology ,Research Design ,030220 oncology & carcinogenesis ,Peritoneal mesothelioma ,symbols ,Female ,Adult ,medicine.medical_specialty ,Population ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,History, 21st Century ,Young Adult ,03 medical and health sciences ,symbols.namesake ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Internal medicine ,Humans ,Poisson regression ,education ,Aged ,business.industry ,Proportional hazards model ,Mesothelioma, Malignant ,Cancer ,medicine.disease ,Peritoneal Malignant Mesothelioma ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business - Abstract
Background Peritoneal malignant mesothelioma is a rare disease for which few population-based studies are available. The aim of this study was to describe the evolution of the incidence and survival of peritoneal malignant mesothelioma in France between 1989 and 2015, using data derived from the French network of cancer registries. Methods Age world-standardized incidence rates and overall survival were calculated using data from 16 French cancer registries. Log-linear Poisson regression analysis was used to estimate the average annual percentage change in incidence rates. Overall survival was performed using age-adjusted Cox proportional hazards model. Results In French men, the incidence has increased quietly over the reporting period from 0.07 to 0.10 with a maximum of 0.16 per 100,000 persons-years in 2001–2003. For women, the increase in incidence has been lower than for men over the period 1989–2015, ranging from 0.04 to 0.11. A better prognosis was associated with a diagnosis made after 2000 (HR = 1.76; p = 0.013), the epithelioid histological type (p = 0.003), and the fact of being a woman, which has a 5-year risk of death half that of men (HR = 0.55; p = 0.001), regardless of age, diagnosis period or histology. Conclusion Our results are similar to those currently available for other countries. In France, peritoneal mesothelioma remains a rare and fatal cancer with a small increase in the incidence rate since 1989 and a median survival of 1 year; it seemed to develop equally in women and men over this period of time.
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- 2019
20. LUCSO-1-French pilot study of LUng Cancer Screening with low-dose computed tomography in a smokers population exposed to Occupational lung carcinogens: study protocol
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O. Bylicki, Jacques Margery, Jean-François Gehanno, Christos Chouaid, Patrick Brochard, Jean-Dominique Dewitte, Fleur Delva, Jean-Claude Pairon, Bénédicte Clin, Simone Mathoulin-Pélissier, Véronique Le Denmat, Milia Belacel, Christophe Paris, Catherine Verdun-Esquer, François Laurent, Aude Lacourt, Service de Médecine du travail et Pathologies professionnelles [Bordeaux], CHU Bordeaux [Bordeaux], Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Rennes], Centre Hospitalier Intercommunal de Créteil (CHIC), Hôpital d'instruction des Armées Percy, Service de Santé des Armées, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de santé au travail et pathologie professionnelle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Université Paris 13 (UP13)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut Bergonié [Bordeaux], UNICANCER, Service de Pneumologie et de Pathologie Professionnelle [CHI Créteil], CHI Créteil, IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), and Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
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Male ,mass screening ,medicine.medical_specialty ,Lung Neoplasms ,Population ,X-ray computed ,Pilot Projects ,Radiation Dosage ,Risk Assessment ,Occupational safety and health ,03 medical and health sciences ,tomography scanners ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Protocol ,Medicine ,Humans ,030212 general & internal medicine ,Lung cancer ,education ,Mass screening ,Carcinogen ,Early Detection of Cancer ,Aged ,Occupational and Environmental Medicine ,education.field_of_study ,Lung ,Smokers ,business.industry ,tomography scanners, X-ray computed ,Cancer ,General Medicine ,occupational exposure ,Middle Aged ,medicine.disease ,3. Good health ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Carcinogens ,Female ,France ,business ,Tomography, X-Ray Computed ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Lung cancer screening - Abstract
IntroductionGuidelines concerning the follow-up of subjects occupationally exposed to lung carcinogens, published in France in 2015, recommended the setting up of a trial of low-dose chest CT lung cancer screening in subjects at high risk of lung cancer.ObjectiveTo evaluate the organisation of low-dose chest CT lung cancer screening in subjects occupationally exposed to lung carcinogens and at high risk of lung cancer.Methods and analysisThis trial will be conducted in eight French departments by six specialised reference centres (SRCs) in occupational health. In view of the exploratory nature of this trial, it is proposed to test initially the feasibility and acceptability over the first 2 years in only two SRCs then in four other SRCs to evaluate the organisation. The target population is current or former smokers with more than 30 pack-years (who have quit smoking for less than 15 years), currently or previously exposed to International Agency for Research on Cancer group 1 lung carcinogens, and between the ages of 55 and 74 years. The trial will be conducted in the following steps: (1) identification of subjects by a screening invitation letter; (2) evaluation of occupational exposure to lung carcinogens; (3) evaluation of the lung cancer risk level and verification of eligibility; (4) screening procedure: annual chest CT scans performed by specialised centres and (5) follow-up of CT scan abnormalities.Ethics and disseminationThis protocol study has been approved by the French Committee for the Protection of Persons. The results from this study will be submitted to peer-reviewed journals and reported at suitable national and international meetings.Trial registration numberNCT03562052; Pre-results.
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- 2019
21. 3-Dimensional Quantification of Composite Pleural Plaque Volume in Patients Exposed to Asbestos Using High-resolution Computed Tomography: A Validation Study
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Jean-Claude Pairon, Ilyes Benlala, Bénédicte Clin, François Laurent, Christophe Paris, Gaël Dournes, Antoine Gislard, Fabien Baldacci, Aude Lacourt, Adrian Dubois, Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université Bordeaux Segalen - Bordeaux 2, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pontchaillou [Rennes], CHU Rouen, Normandie Université (NU), Aliments Bioprocédés Toxicologie Environnements (ABTE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Service de santé au travail et pathologie professionnelle [Rouen], Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Biomécanique cellulaire et respiratoire (BCR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Bordelais de Recherche en Informatique (LaBRI), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS)-École Nationale Supérieure d'Électronique, Informatique et Radiocommunications de Bordeaux (ENSEIRB), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Bordeaux (UB)-École Nationale Supérieure d'Électronique, Informatique et Radiocommunications de Bordeaux (ENSEIRB)-Centre National de la Recherche Scientifique (CNRS)
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Pulmonary and Respiratory Medicine ,Male ,Validation study ,High-resolution computed tomography ,[SDV]Life Sciences [q-bio] ,Pleural plaque ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Asbestos ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Imaging, Three-Dimensional ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Mesothelioma ,Lung cancer ,ComputingMilieux_MISCELLANEOUS ,Aged ,Retrospective Studies ,Reproducibility ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,respiratory system ,Pleural Diseases ,medicine.disease ,Plaque, Atherosclerotic ,respiratory tract diseases ,3. Good health ,[SDV.TOX]Life Sciences [q-bio]/Toxicology ,Female ,Tomography ,Chest imaging ,Nuclear medicine ,business ,Tomography, X-Ray Computed - Abstract
As pleural plaque has been reported as a risk factor in the occurrence of lung cancer and mesothelioma, a reproducible and precise method of measurement of pleural plaque volume (PPV) is needed to further describe these relationships. The aim of the study was to assess the reproducibility of a 3-dimensional computed tomography (3D-CT) volumetric analysis of PPV in patients with occupational exposure to asbestos.A total of 28 patients were retrospectively randomly selected from the multicenter APEXS (Asbestos Post Exposure Survey) study, which was held between 2003 and 2005. All patients underwent a 3D-CT scan. Two readers specialized in chest radiology completed the 3D semiautomated quantification of lung volume using dedicated software. They also had to categorize the visual extent of pleural plaque in terms of thickness and circumference. Reproducibility of the continuous PPV variable was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis. Reproducibility of categorical variables was assessed using the κ test.Intraobserver reproducibility of PPV was almost perfect (ICC=0.98 [95% interval: 0.97-0.99]), and interobserver reproducibility was very good (ICC=0.93 [0.88-0.97]). At Bland-Altman analysis, the mean differences were 0.1 (limit of agreement: -11.0 to 11.2) and 3.7 cc (-17.8 to 25.2), respectively. Visual analysis of both plaque in terms of thickness and circumference were fair to moderate, with κ values ranging from 0.30 to 0.60.3D semiautomatic quantification of PPV is feasible and reproducible using CT in patients with occupational exposure to asbestos. PPV measurement may be useful to correlate with other asbestos-related disease outcomes and prognosis.
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- 2018
22. Évaluation médico-économique d’un programme de dépistage des cancers broncho-pulmonaires chez des sujets exposés à l’amiante
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Helene Goussault, François Laurent, Christos Chouaid, Bénédicte Clin, Aude Lacourt, S. Gendarme, Pascal Andujar, C. Paris, A. Gislard, Jean-Claude Pairon, Céline Gramond, Patrick Brochard, and S. Chamming's
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Pulmonary and Respiratory Medicine ,03 medical and health sciences ,0302 clinical medicine ,030212 general & internal medicine ,030204 cardiovascular system & hematology - Abstract
Introduction Les Resultats de l’etude NLST aux Etats-Unis et de l’etude NELSON en Europe ont ouvert le debat sur l’opportunite d’un depistage du cancer broncho-pulmonaire (CBP) chez des patients exposes a des carcinogenes respiratoires [1] , [2] . L’objectif de cette analyse est d’evaluer l’impact medico-economique, en France, de la mise en place d’un programme de depistage du CBP dans une cohorte de sujets exposes a l’amiante. Methodes L’analyse est basee sur une modelisation MCMC (Monte Carlo Markok Chain) permettant d’etablir le rapport cout utilite de la mise en place d’un depistage annuel du CBP par tomodensitometrie thoracique chez des sujets fumeurs et exposes fortement a l’amiante. Les donnees utilisees dans la modelisation sont l’incidence de CBP dans la cohorte francaise ARDCO (cohorte multiregionale de sujets exposes a l’amiante avec suivi longitudinal depuis 2002), et leurs consommations de soins, les parametres d’intervention sont issus de l’etude NLST. Les donnees d’utilites et de couts de prise en charge des CBP diagnostiques sont issues de la litterature. Une analyse de sensibilite a permis d’evaluer differentes strategies de depistage selon l’intervalle entre les scanners et la population cible. Resultats La mise en place d’un depistage annuel par TDM thoracique chez les sujets fumeurs et exposes fortement a l’amiante permet un gain de QALY de 0.041 par personne [IC 95 % 0.028–0.052] pour un cout de 6208 € par personne [IC 95 % 4536€–7904€], soit un ratio cout-utilite differentiel de 93 020 €/QALY [IC 95 % 51 898€–170 492€]. Lorsque le depistage repose sur un scanner tous les 2 ans, le rapport cout-utilite est plus favorable: 40 938 €/QALY [IC 95 % 22 440€–65 364€]. Conclusion Au regard des seuils habituels pour une intervention de sante, un depistage du CBP par TDM thoracique tous les 2 ans est acceptable et preferable a un depistage annuel dans cette population.
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- 2021
23. Prostate cancer risk among French farmers in the AGRICAN cohort
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Clémentine Lemarchand, Michel Velten, Pierre Lebailly, Mathilde Boulanger, Anne-Valérie Guizard, Emma Rigaud, Isabelle Baldi, Bénédicte Clin, Stéphanie Perrier, Séverine Tual, and Noémie Levêque-Morlais
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Male ,farming ,Cohort Studies ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,Risk Factors ,Prostate ,Occupational Exposure ,Environmental health ,medicine ,cohort study ,Animals ,Humans ,cancer ,Prospective Studies ,030212 general & internal medicine ,Pesticides ,Prospective cohort study ,farmer ,pesticide ,Aged ,agriculture ,Farmers ,prostate ,agrican ,business.industry ,Proportional hazards model ,Hazard ratio ,Public Health, Environmental and Occupational Health ,Prostatic Neoplasms ,Cancer ,cohort ,Middle Aged ,french farmer ,medicine.disease ,prostate cancer ,030210 environmental & occupational health ,Agricultural Workers' Diseases ,medicine.anatomical_structure ,exposure ,Cohort ,Public aspects of medicine ,RA1-1270 ,Agrochemicals ,business ,france ,Cohort study - Abstract
Objectives Prostate cancer is one of the most frequent cancers among men worldwide. Its etiology is largely unknown, but an increased risk has been repeatedly observed among farmers. Our aim was to identify occupational risk factors for prostate cancer among farmers in the prospective cohort study AGRICAN. Methods Data on lifetime agricultural exposures (type of crops, livestock and tasks including pesticide use, re-entry and harvesting) were collected from the enrolment questionnaire. During the period from enrolment (2005–2007) to 31 December 2009, 1672 incident prostate cancers were identified. Hazard ratios (HR) were estimated using Cox regression analysis. Results We found an increased risk for cattle breeders using insecticides [HR 1.20, 95% confidence interval (95% CI) 1.01–1.42] with a significant dose–response relationship with number of cattle treated (P for trend 0.01). A dose–response relationship was also observed with the number of hogs (P for trend 0.06). We found an excess of prostate cancer risk among people involved in grassland activities, mainly in haymaking (HR 1.18, 95% CI 1.02–1.36). Pesticide use and harvesting among fruit growers were associated with an elevated prostate cancer risk, with a two-fold increased risk for the largest area. For potato and tobacco producers, an elevated prostate cancer risk was observed for almost all tasks, suggesting a link with pesticide exposure since all of them potentially involved pesticide exposure. Conclusions Our analysis suggests that the risk of prostate cancer is increased in several farming activities (cattle and hog breeding, grassland and fruit-growing) and for some tasks including pesticide use.
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- 2016
24. Repérage des expositions professionnelles au cours des hémopathies lymphoïdes : programme Rhelypro
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Catherine Nisse, Milia Belacel, Isabelle Leclerc, Corinne Haioun, Isabelle Baldi, Gérard Lasfargues, Claire Chauvet, Fabrice Herin, Juliette Bloch, Jean-Claude Pairon, Christos Chouaid, Murielle Gain, Mireille Matrat, Elise Sergent, Robert Garnier, Natalie Vongmany, Catherine Verdun-Esquer, Pascal Andujar, Léna Tison, and Bénédicte Clin-Godard
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Public Health, Environmental and Occupational Health - Abstract
Introduction Les lymphomes non hodgkiniens (LNH), les myelomes multiples (MM) et les leucemies lymphoides chroniques (LLC), hemopathies malignes derivees de la lignee lymphoide, sont des maladies frequentes et dont l’incidence est en augmentation. Ces affections sont possiblement en rapport avec une exposition environnementale et/ou professionnelle, avec de nombreux agents etiologiques suspectes. Le programme Rhelypro, soutenu par l’Anses, a pour but le reperage des expositions professionnelles aux cancerogenes consideres comme certains ou probables apres analyse des donnees de la litterature chez tous les patients ayant un diagnostic incident de LNH, MM, LLC, a partir d’un questionnaire specifique mis en place pour ce programme. Methode Il s’agit d’une etude multicentrique incluant 7 centres de consultation de pathologies professionnelles de Creteil, Paris - F.-Widal, Bordeaux, Caen, Lille, Toulouse, de juillet 2017 a avril 2019. Tous les cas incidents de LNH, MM et LLC, ont beneficie d’un questionnaire de reperage elabore collectivement par les equipes de pathologies professionnelles impliquees, et permettant de lister les principales situations d’exposition aux agents cancerogenes probables ou certains du Centre international de recherche sur le cancer (CIRC) pour lesquels un exces de LNH, MM ou LLC a ete rapporte. Un questionnaire professionnel classique etait ensuite utilise, suivie d’une expertise en pathologie professionnelle. L’acceptabilite du questionnaire par les patients, le nombre de sujets faisant l’objet d’une proposition de declaration de maladie professionnelle et l’identification du type de secteurs d’activites et de postes de travail concernes pour chaque nuisance ont ete evalues. Resultats La population d’etude est constituee de 205 patients avec un âge moyen de 60 ans. Les 3 nuisances les plus souvent retenues sont les solvants organiques (hors trichloroethylene, benzene et dichloromethane), le benzene et les pesticides. Des expositions professionnelles ont ete retenues pour 21 % des sujets d’apres l’expertise finale et ont conduit a proposer une demande de reconnaissance de maladie professionnelle. La sensibilite du questionnaire de reperage etait de 92 % et sa specificite de 83 % par rapport au questionnaire de pathologie professionnelle suivi d’expertise. Conclusion Le questionnaire de reperage propose parait avoir des performances (sensibilite, specificite) satisfaisantes, incitant a l’utiliser dans les services d’hematologie en routine pour les cas incidents de LNH. En cas de reponse positive, une expertise complementaire peut etre proposee en pathologie professionnelle dans le cadre du Reseau national de vigilance et de prevention des pathologies professionnelles.
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- 2020
25. Expositions agricoles et risque de sarcomes au sein de la cohorte AGRIculture et CANcer (AGRICAN)
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Mathilde Boulanger, Bénédicte Clin, Marine Renier, Camille Pouchieu, Pierre Lebailly, B. Amadéo, Isabelle Baldi, Romain Pons, Amandine Busson, Séverine Tual, Elisabeth Marcotullio, and Clément Piel
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Public Health, Environmental and Occupational Health - Abstract
Introduction Les sarcomes sont un groupe de tumeurs tres heterogene et complexe, leur taux d’incidence en Europe est d’environ 5 pour 100 000 habitants et leur etiologie est encore inconnue et peu etudiee. Quelques facteurs de risques professionnels sont suspectes de jouer un role dans leur developpement, en particulier les pesticides. Notre objectif est d’etudier les associations entre activites et tâches professionnelles agricoles et la survenue de sarcomes. Materiel et methodes Nos analyses s’appuient sur les donnees de la cohorte prospective AGRICAN. Entre 2005 et 2007, 181 842 individus ont ete inclus, et ont rempli un questionnaire d’inclusion retracant leur histoire professionnelle et leurs expositions agricoles. Entre l’inclusion et 2013 nous avons identifie 156 cas de sarcomes incidents, dont 33 cas de GIST (tumeurs stromales gastro-intestinales) et 38 cas de myosarcomes ou fibrosarcomes. Les associations ont ete etudiees grâce a un modele de Cox avec l’âge comme echelle de temps. Resultats Plus de la moitie de notre population d’etude etait composee d’hommes (55,87 %). L’âge median a l’inclusion etait de 67 ans. Les analyses ont montre plusieurs augmentations de risque pour le sarcome. Pour les personnes faisant de l’elevage bovin pendant moins de dix ans (HR = 2,43 [1,25–4,75]), et en particulier ceux avec plus de 50 bovins (HR = 3,85 [1,40–10,61]). Mais egalement des elevations de risque non significatives, pour les eleveurs de plus de 45 volailles (HR = 1,70 [0,91–3,15]) et pour ceux utilisant des insecticides sur les volailles (HR = 1,54 [0,85–2,80]). Pour les cultures, une augmentation de risque a ete trouvee pour la culture legumiere en plein champ (HR = 1,62 [1,01–2,60]) et la culture sous serres (HR = 2,23 [1,22–4,07]). Pour les analyses par sous type, aucune association n’a pu etre mise en evidence avec les GIST. Neanmoins, malgre des effectifs faibles, des associations positives ont ete trouvees entre les myosarcomes et fibrosarcomes et certaines activites, telle que la culture legumiere en plein champ (HR = 8,75 [1,95–39,3]). Conclusions Diverses associations ont ete mises en evidence entre certains elevages (bovins, volaille) et cultures (culture legumiere, culture sous serres) et la survenue de sarcomes. Mais egalement pour les sous-types histologiques des myosarcomes et fibrosarcomes (culture legumiere), malgre de tres faibles effectifs. Enfin, notre etude apporte de nouvelles connaissances sur l’exposition professionnelle agricole et le risque de sarcome dans un contexte tres peu documente dans la litterature.
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- 2020
26. Lung cancer risk and occupational exposures in crop farming: results from the AGRIculture and CANcer (AGRICAN) cohort
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Isabelle Baldi, Mathilde Boulanger, Anne-Valérie Guizard, Pierre Lebailly, Séverine Tual, Patricia Delafosse, Clémentine Lemarchand, Camille Pouchieu, Romain Pons, Bénédicte Clin, Clément Piel, Elisabeth Marcotullio, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Registre des cancers de l’Isère [CHU de Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU)-Université Grenoble Alpes (UGA), Caisse Centrale de la Mutualité Sociale Agricole (CCMSA), Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Service de Santé au Travail et Pathologie Professionnellel [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Normandie Université (NU), The authors would like to thank the Ligue Contre le Cancer (Nationale and Comités du Calvados, de l’Orne, de la Manche, du Maine et Loire et de Paris), the Mutualité Sociale Agricole (caisse centrale et caisses des Alpes du Nord, de l’Alsace, de Bourgogne, des Côtes Normandes, de Franche Comté, de Gironde, de Loire-Atlantique Vendée, de Midi Pyrénées Nord, de la Picardie), the Fondation de France (Mr Edouard Serres), the Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail (within the call for projects 2005, 2006 and 2010 of the programme ’Environnement Santé Travail’ of ANSES, with funding from l’ONEMA in support of the Ecophyto 2018 plan), the Institut National du Cancer, the Association pour la Recherche sur le Cancer (grant number ARC 02-010), the Institut National de Médecine Agricole, the Conseil Régional de Basse Normandie and the François Baclesse Comprehensive Cancer Centre, which funded this work., Bodescot, Myriam, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), and Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)
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Adult ,Male ,Lung Neoplasms ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,Adenocarcinoma ,Lower risk ,lung ,03 medical and health sciences ,0302 clinical medicine ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Risk Factors ,Occupational Exposure ,medicine ,Animals ,Humans ,030212 general & internal medicine ,Prospective Studies ,Lung cancer ,Aged ,Proportional Hazards Models ,Vehicle Emissions ,agriculture ,2. Zero hunger ,Lung ,business.industry ,Proportional hazards model ,Public Health, Environmental and Occupational Health ,Cancer ,food and beverages ,pesticides ,Middle Aged ,medicine.disease ,crops ,030210 environmental & occupational health ,Small Cell Lung Carcinoma ,Agricultural Workers' Diseases ,[SDV.TOX] Life Sciences [q-bio]/Toxicology ,medicine.anatomical_structure ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.TOX]Life Sciences [q-bio]/Toxicology ,Cohort ,Livestock ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,France ,business ,neoplasm ,Demography - Abstract
ObjectivesFarmers are considered at lower risk of lung cancer. However, specific tasks can expose them to hazardous air contaminants such as pesticides, diesel exhaust and mineral dust. This study aimed to assess the associations between various crops and related tasks and the risk of lung cancer, overall and by histological subtypes.MethodsAGRIculture and CANcer is a prospective French cohort of individuals affiliated to the agricultural health insurance scheme. Incident lung cancers (n=897) were identified by cancer registries from enrolment (2005–2007) to 2013. Data on crop and livestock exposure during lifetime were obtained from the enrolment questionnaire. We used a Cox model with attained age as timescale, adjusted for gender, smoking history and exposure to cattle and horses. Effects of duration and surface were assessed and analyses stratified on gender and smoking status were performed.ResultsWinegrowers were at higher risk of adenocarcinoma (HR=1.27 (95% CI 0.94 to 1.72)). We also found an association between pea growing and small cell lung cancer: significant effect of duration (ptrend=0.04) and the suggestion of a surface–effect relationship (ptrend=0.06); increased risk (HR=2.38 (95% CI 1.07 to 5.28)) for pesticide users; and significant effect of duration (ptrend=0.01) for harvesters. The risk of squamous cell carcinoma was increased for sunflower growing (HR=1.59 (95% CI 0.97 to 2.62), fruit-tree pruning (HR=1.44 (95% CI 0.92 to 2.27)) and pesticide use on beets (HR=1.47 (95% CI 0.92 to 2.34)). Corn and/or wheat/barley growers were at lower risk of lung cancer.ConclusionsOur results suggest associations between lung cancer and several crop-related tasks, even if we cannot rule out some chance findings due to multiple comparisons.
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- 2018
27. Liens entre cancer de l’œsophage et exposition professionnelle à l’amiante : étude au sein de la cohorte ARDCo
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Soizick Chamming's, Patrick Brochard, Isabelle Thaon, Mathilde Boulanger, Aude Lacourt, Jean-Claude Pairon, Bénédicte Clin, Amandine Luc, Christophe Paris, Guy Ogier, Antoine Gislard, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Centre de consultations de pathologies professionnelles [CHRU Nancy] (CCPP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), and Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF)
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030506 rehabilitation ,03 medical and health sciences ,0302 clinical medicine ,Public Health, Environmental and Occupational Health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,0305 other medical science ,030210 environmental & occupational health ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,ComputingMilieux_MISCELLANEOUS ,3. Good health - Abstract
Contexte L’association eventuelle entre l’exposition professionnelle a l’amiante et le cancer de l’œsophage demeure actuellement controversee, comme en temoigne l’evaluation du Centre international de recherche sur le cancer (CIRC) realisee en 2012. La question du lien eventuel entre ce cancer et l’exposition a l’amiante est cependant tres importante, tant en matiere de surveillance medicale des sujets exposes, qu’en matiere de reparation medico-legale des patients presentant ce type de pathologie. Objectif L’objectif de notre etude est d’analyser l’incidence et la mortalite par cancer de l’œsophage dans une cohorte de sujets ayant ete exposes professionnellement a l’amiante (cohorte ARDCo : « Asbestos-Related Diseases Cohort »). Methode Un suivi sur 10 ans de 14 515 hommes inclus dans le programme ARDCo entre octobre 2003 et decembre 2005 a ete realise. L’exposition a l’amiante a ete analysee par des hygienistes industriels a partir des donnees issues d’un questionnaire standardise adresse aux sujets eligibles. Les variables utilisees pour caracteriser cette exposition a l’amiante ont associe : la duree d’exposition a l’amiante, un indice d’exposition cumulee a l’amiante (IEC) et la latence (delai entre le debut de l’exposition et l’apparition des premiers symptomes de la maladie). Une analyse statistique des associations entre les variables d’exposition a l’amiante et, d’une part, l’incidence du cancer de l’œsophage et, d’autre part, la mortalite par cancer de l’œsophage, a ete realisee a l’aide d’un modele de Cox, avec ajustement sur le statut tabagique, la latence et l’IEC (exprime en Ln (IEC + 1)). Resultats Nous avons mis en evidence une relation dose-effet significative entre l’IEC a l’amiante et le cancer de l’œsophage, a la fois en incidence et en mortalite. Conclusion Cette vaste etude est en faveur d’une relation entre l’exposition a l’amiante et le cancer de l’œsophage.
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- 2018
28. Cancer naso-sinusien et expositions professionnelles : données du Réseau national de vigilance et de prévention des pathologies professionnelles (RNV3P) 2001–2016
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Nathalie Nourry, Serge Brunel, Vincent Bonneterre, Bénédicte Clin, Catherine Nisse, Juliette Bloch, Quentin Durand-Moreau, Fabrice Herin, Christophe Paris, Murielle Gain, Natalie Vongmany, Lynda Bensefa-Colas, Lynda Larabi, Isabelle Baldi, Isabelle Vanrullen, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de consultations de pathologies professionnelles [CHU Toulouse], CHU Toulouse [Toulouse], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU-Hôpitaux de Rouen, CCPPE, Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Environnement et Prédiction de la Santé des Populations (TIMC-IMAG-EPSP), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Morvan - CHRU de Brest (CHU - BREST ), Service de Pneumologie et Pathologie Professionnelle, CHI Créteil-Faculté de Médecine, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and Les Hôpitaux Universitaires de Strasbourg (HUS)
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030506 rehabilitation ,03 medical and health sciences ,0302 clinical medicine ,[SDV]Life Sciences [q-bio] ,Public Health, Environmental and Occupational Health ,RNV3P ,Cancer naso-sinusien ,0305 other medical science ,030210 environmental & occupational health ,Facteurs professionnels ,ComputingMilieux_MISCELLANEOUS ,3. Good health - Abstract
Introduction L’exposition a l’amiante est largement decrite comme facteur de risque du cancer du larynx dans la litterature et classe par le CIRC comme cancerogene de groupe 1 depuis 2009. Toutefois, il n’existe en France aucun tableau de reconnaissance de maladie professionnelle pour cette pathologie dans le regime general ou agricole. D’autres facteurs de risque professionnels sont suspectes (brouillards d’acide fort inorganiques, hydrocarbures aromatiques polycycliques). L’action 12.4 du plan cancer 2014–2019 vise l’amelioration des connaissances en cancerologie professionnelle et ceci en exploitant notamment les donnees du reseau national de vigilance et de prevention des pathologies professionnelles (rnv3p) dans ce domaine. L’objectif de cette etude est une description des situations professionnelles a risque de cancer de larynx recenses dans le rnv3p de 2001 a 2016. Methodes Une extraction des cas de cancer du larynx (Codes CIM-10 C32 et D02.0) entre 2001 et 2016 dans la base du rnv3p a ete realisee. Les parametres etudies sont les donnees demographiques, les expositions professionnelles, le poste de travail, le secteur d’activite. Nous avons conserve pour notre etude les cas de cancer du larynx dont l’exposition est consideree par le medecin expert comme en lien direct avec la pathologie, c’est-a-dire avec une imputabilite moyenne (directe mais non essentielle) ou forte (directe et essentielle). Une analyse des commentaires saisis pour chacun des dossiers a ete realisee. Resultats Entre 2011 et 2016, 244 de probleme de sante (PST) de cancers du larynx ont ete enregistres dans la base du rnv3p. Parmi eux, 147 ont ete conclus comme d’origine professionnelle dont 87 juges par le medecin expert avec une imputabilite moyenne ou forte. Cette population est exclusivement masculine, avec un âge median de 59 ans. Sur 97 expositions professionnelles retrouvees parmi ces 87 dossiers, 78 concernent l’amiante. Les secteurs d’activite les plus representes correspondent a ceux des travaux de construction specialises (14 dossiers) et de la metallurgie (7 dossiers). Pour 60 cas sur les 87 etudies, une declaration de maladie professionnelle a ete conseillee au patient. Discussion L’exposition a l’amiante est la situation professionnelle a risque la plus decrite dans les cas de cancer du larynx recenses au sein de la base de 2001 a 2016. Cela apporte un element supplementaire quant a l’implication de l’amiante dans la cancerogenicite pour le larynx. Une reflexion sur la mise en place d’un nouveau tableau de maladie professionnelle paraitrait legitime de ce point de vue.
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- 2018
29. Étude de faisabilité d’un dépistage organisé du cancer bronchopulmonaire chez des sujets exposés professionnellement à des agents cancérogènes pulmonaires — « LUCSO »
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Jean-Claude Pairon, Christos Chouaid, Jean-François Gehanno, Patrick Brochard, Catherine Verdun-Esquer, Jean-Dominique Dewitte, Christophe Paris, Fleur Delva, Milia Belacel-Ouari, François Laurent, Véronique Le Denmat, Jacques Margery, Olivier Bylicki, Simone Mathoulin-Pélissier, Aude Lacourt, Bénédicte Clin, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), and Université Paris 13 (UP13)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
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0301 basic medicine ,Pulmonary and Respiratory Medicine ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,030220 oncology & carcinogenesis ,[INFO.INFO-IR]Computer Science [cs]/Information Retrieval [cs.IR] ,Public Health, Environmental and Occupational Health ,ComputingMilieux_MISCELLANEOUS ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Contexte En 2015, des recommandations labellisees par la Haute Autorite de sante et l’institut national du cancer preconisaient la mise en place d’une experimentation sur le depistage du cancer bronchopulmonaire (CBP) chez les sujets exposes professionnellement a des agents cancerogenes pulmonaires par scanner thoracique. Objectif principal Evaluer la faisabilite d’un depistage du CBP chez des sujets exposes ou ayant ete expose professionnellement a des agents cancerogenes pulmonaires par scanner thoracique basse dose sans injection de produit de contraste. Methodes Seront inclus dans cette etudes des sujets a haut risque de CBP tel que defini dans la recommandation : sujets fumeurs âges de 55 a 74 ans, exposes ou ayant ete exposes a des cancerogenes pulmonaires certains selon le centre international de recherche sur le cancer (CIRC). L’etude se deroulera dans six centres specialises de reference (CSR). Compte tenu de la complexite du dispositif, il est propose dans un premier temps de tester la faisabilite et l’acceptabilite du dispositif de maniere sequentielle, les deux premieres annees (24 mois) sur deux CSR « Phase 1 : 2018–2020 ». Il est prevu d’etendre aux autres CSR apres deux ans « Phase 2 : 2020–2026 ». L’experimentation s’effectuera en plusieurs etapes : – reperage des sujets exposes ou ayant ete exposes professionnellement a des agents cancerogenes sur le poumon ; – evaluation des expositions professionnelles aux cancerogenes pulmonaires ; – evaluation du niveau de risque de CBP et verification de l’eligibilite ; – mise en œuvre du depistage, la realisation des scanners thoraciques sera effectuee par des centres specialises en imagerie thoracique ; – suivi pneumo-oncologique en cas de mise en evidence d’anomalies suspectes de CBP. Le critere d’evaluation principal est pour la phase 1 (2018–2020) : le taux de participation qui sera mesure par la proportion de sujets realisant le scanner thoracique basse dose parmi les sujets repondants eligibles et pour la phase 2 (2020–2026) : l’evaluation de l’impact du depistage du CBP mesure par des indicateurs de qualite des examens et des indicateurs de suivi. Retombees attendues Cette etude de faisabilite doit permettre d’apporter des elements essentiels avant d’envisager une generalisation au niveau national notamment en termes d’acceptabilite et de realisation pratique dans des centres specialises. Cette thematique correspond a une attente sociale forte (le champ des risques professionnels et des affections susceptibles d’en decouler).
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- 2018
30. 1354 Measuring airborne exposure of french farmers during work related to livestock and to harvesting of various crops: the airexpa project
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Mathilde Boulanger, Isabelle Baldi, Romain Pons, Séverine Tual, Yannick Lecluse, Pierre Lebailly, Valérie Bouchart, and Bénédicte Clin
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2. Zero hunger ,Airborne exposure ,Diesel exhaust ,business.industry ,food and beverages ,Contamination ,Pesticide ,Work related ,Toxicology ,chemistry.chemical_compound ,chemistry ,13. Climate action ,Agriculture ,Environmental science ,Livestock ,business ,Mycotoxin - Abstract
Introduction Beyond pesticide exposure, farmers are likely to be exposed to several air pollutants. Some of them are of particular interest, either because of their known carcinogenic properties, for lung cancer (total dust, Diesel exhaust, crystalline silica,) or other cancer sites (mycotoxins) or because of a supposed protective effect on lung cancer risk (endotoxins). However, except for endotoxins, very few studies, assessed farmers’ exposure levels by individual samplings. Our study aims at describing the levels, and assessing the determinants, of agricultural exposure to these air pollutants. Methods We assessed French farmers’ individual exposure to several air contaminants: (1) inhalable endotoxins and mycotoxins during various tasks in several breedings (cattle, horse) and 3 crops (grassland, wheat/barley, peas); (2) respirable crystalline silica during harvesting of these 3 crops; (3) respirable elementary carbon during the use of Dieselized farm equipment. Inhalable dusts, up to 20 µ, were assessed in real time. Sampling was performed during the whole activity, and endotoxin exposure was also assessed for each task separately. Field monitors followed the farmers and collected detailed information on the activity. Results The field study is on-going, we already observed around 40 individual measurements in 20 different farms. The protocol was judged acceptable by the participants. Sampling duration ranges from 80 to 240 min, depending on the type of activity. First results from real-time dust measurements suggest a higher exposure during stables cleaning and mulching (mean concentration of inhalable dusts: 0.545 mg/m3). A total of several hundreds of measurements is expected in various types of farms and working conditions (number of animals, cultivated area, type of equipment). Discussion We hope our study will improve the assessment of occupational health hazards in agriculture, and thus primary prevention, by quantifying the levels of individual exposure to several air pollutants.
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- 2018
31. Sclérodermie systémique et expositions professionnelles : à propos d’un cas chez un foreur-artificier
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Mathilde Boulanger, Marc Letourneux, Bénédicte Clin, Marie-France Marquignon, and B. Bienvenu
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Gastroenterology ,Internal Medicine - Abstract
Resume Introduction Le syndrome d’Erasmus se definit comme l’association d’une sclerodermie systemique et d’une exposition a la silice. Observation Nous en rapportons un cas chez un foreur-artificier en carrieres de roches massives, expose a la silice et aux derives nitres contenus dans les explosifs. Conclusion La physiopathologie et les etiologies de la sclerodermie systemique sont encore imparfaitement connues mais il s’avere que le monoxyde d’azote, libere notamment lors de la metabolisation des derives nitres, est aussi implique dans la genese de la maladie : il semble donc licite de s’interroger sur les consequences d’une co-exposition au monoxyde d’azote non maitrisee et non quantifiee sur l’etat vasculaire, deja degrade par la sclerodermie. Plus largement, notre observation souligne l’importance d’un recueil soigneux et exhaustif des expositions professionnelles pour les patients atteints de sclerodermie systemique.
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- 2015
32. 0441 Exposure to dinitroanilines and risk of lung cancer (lc) by subtypes: results from the agrican cohort
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Pierre Lebailly, Mathilde Boulanger, Isabelle Baldi, Séverine Tual, Clémentine Lemarchand, and Bénédicte Clin
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education.field_of_study ,Benfluralin ,business.industry ,Population ,Dinitroaniline ,Trifluralin ,Oryzalin ,medicine.disease ,Biotechnology ,chemistry.chemical_compound ,Pendimethalin ,chemistry ,Environmental health ,Cohort ,medicine ,Lung cancer ,business ,education - Abstract
Introduction 2,6-Dinitroanilines included 15 herbicides, some of which are still used on a wide range of crops worldwide and in France, especially pendimethalin which was given special attention by the IARC. The aim of our analyses was to estimate the associations between LC and exposure to pendimethalin, benfluralin, butralin, ethalfluralin, nitralin, oryzalin, trifluralin -all once or still authorised in France-, in the French AGRIculture and CANcer (AGRICAN) cohort. Methods More than 1 80 000 people affiliated for at least 3 years to the agricultural health insurance scheme were enrolled between 2005 and 2007. A total of 563 incident LC were identified from enrollment to 2011. Data on crop exposure during lifetime (13 crops, specific tasks including pesticide use) were collected. The evaluation of potential exposure to each dinitroaniline relied on a specific crop-exposure matrix, PESTIMAT. Analyses were adjusted on smoking history, involvement in cattle and horse breeding, peas growing, exposure to farming activities during childhood. Results In the population, 16 533 people (11.2% of the cohort) were potentially exposed to one or more dinitroanillines. Pendimethalin and trifluralin were the most frequently used, but not associated to any increased risk of LC, nor was exposure to dinitroanillines in general. We observed an increased risk of adenocarcinoma for oryzalin exposure (HR=2.93[1.13–7.59], n=5 exposed cases), but with no linear effect with duration. Conclusion We did not found any increased risk of LC among pendimethalin users. Our results suggest a possible association of lung adenocarcinoma with oryzalin, currently authorised in France, especially on the vineyard.
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- 2017
33. Occupational Asbestos Exposure and Incidence of Colon and Rectal Cancers in French Men: The Asbestos-Related Diseases Cohort (ARDCo-Nut)
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Christophe Paris, Pilar Galan, Fabrice Herin, Pascal Wild, Patrick Brochard, Serge Hercberg, Gaëlle Coureau, Aude Lacourt, Soizick Chamming's, Jean-Claude Pairon, Isabelle Thaon, Bénédicte Clin, Pascal Andujar, Amandine Luc, Antoine Gislard, Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Cancers et préventions, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Service de Santé au Travail et Pathologie Professionnellel [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), Service de santé au travail et pathologie professionnelle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Aliments Bioprocédés Toxicologie Environnements (ABTE), Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Paris 13 (UP13)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Direction Scientifique (DS), Institut national de recherche et de sécurité (Vandoeuvre lès Nancy) (INRS ( Vandoeuvre lès Nancy)), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies Professionnelles et Environnementales, Université Fédérale Toulouse Midi-Pyrénées-Centre hospitalier universitaire de Toulouse - CHU Toulouse, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique et d'épidémiologie clinique 7 (CIC-EC7), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut Bergonié - CRLCC Bordeaux-Institut National de la Santé et de la Recherche Médicale (INSERM)-Cancéropôle du Grand Sud-Ouest, Registre Général des Cancers de la Gironde, Université Bordeaux Segalen - Bordeaux 2-Institut Bergonié - CRLCC Bordeaux-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED), Service de Médecine du Travail et de Pathologies Professionnelles, CHU Bordeaux [Bordeaux]-Hôpital Pellegrin, Institut Interuniversitaire de Médecine du Travail de Paris Ile de France (IIMTPIF), CHI Créteil-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Epidémiologie et anlyses en santé publique: risques, maladies chroniques et handicaps, Université Paul Sabatier - Toulouse 3 (UPS) - Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Toulouse - Centre hospitalier universitaire de Toulouse - CHU Toulouse, Normandie Université (NU) - Normandie Université (NU) - Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Santé au Travail et Pathologie Professionnelle, CHU Caen, Université de Bordeaux (UB) - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Université de Bordeaux (UB) - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier de Nancy (CHU Nancy), Université Bordeaux Segalen - Bordeaux 2 - CHU Bordeaux [Bordeaux] - Institut Bergonié - CRLCC Bordeaux - Institut National de la Santé et de la Recherche Médicale (INSERM) - Cancéropôle du Grand Sud-Ouest, Université Bordeaux Segalen - Bordeaux 2 - Institut Bergonié - CRLCC Bordeaux - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED), CHU Bordeaux [Bordeaux] - Hôpital Pellegrin, CHI Créteil - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de médecin du travail et de pathologie professionnelle du CHU de Rouen, CHU de Rouen, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), Institut National de la Recherche Agronomique (INRA) - Université Paris Diderot - Paris 7 (UPD7) - Université Paris Descartes - Paris 5 (UPD5) - Université Paris 13 - Institut National de la Santé et de la Recherche Médicale (INSERM) - Institut National de la Recherche Agronomique (INRA) - Université Paris Diderot - Paris 7 (UPD7) - Université Paris Descartes - Paris 5 (UPD5) - Université Paris 13 - Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA) - Université Paris Diderot - Paris 7 (UPD7) - Université Paris Descartes - Paris 5 (UPD5) - Université Paris 13 - Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12) - Institut National de la Santé et de la Recherche Médicale (INSERM) - IFR10
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Oncology ,Adult ,Male ,medicine.medical_specialty ,Pathology ,Colorectal cancer ,Health, Toxicology and Mutagenesis ,Air Pollutants, Occupational ,medicine.disease_cause ,Asbestos ,03 medical and health sciences ,0302 clinical medicine ,Air pollutants ,Internal medicine ,Occupational Exposure ,medicine ,[SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health ,Humans ,030212 general & internal medicine ,ComputingMilieux_MISCELLANEOUS ,Asbestos-related diseases ,[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health ,business.industry ,Rectal Neoplasms ,Incidence (epidemiology) ,Incidence ,Research ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,3. Good health ,Occupational Diseases ,030220 oncology & carcinogenesis ,[SDV.TOX]Life Sciences [q-bio]/Toxicology ,Cohort ,Colonic Neoplasms ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,France ,business - Abstract
Background: The relationships between asbestos exposure and colorectal cancer remain controversial. Objectives: We examined the association between asbestos exposure and colorectal cancer incidence. Methods: Volunteer retired workers previously exposed to asbestos were invited to participate in the French ARDCo screening program between 2003 and 2005. Additional data on risk factors for colorectal cancer were collected from the ARDCo-Nut subsample of 3,769 participants in 2011. Cases of colon and rectal cancer were ascertained each year through 2014 based on eligibility for free medical care following a cancer diagnosis. Survival regression based on the Cox model was used to estimate the relative risk of colon and rectal cancer separately, in relation to the time since first exposure (TSFE) and cumulative exposure index (CEI) to asbestos, and with adjustment for smoking in the overall cohort and for smoking, and certain risk factors for these cancers in the ARDCo-Nut subsample. Results: Mean follow-up was 10.2 years among 14,515 men, including 181 colon cancer and 62 rectal cancer cases (41 and 17, respectively, in the ARDCo-Nut subsample). In the overall cohort, after adjusting for smoking, colon cancer was significantly associated with cumulative exposure (HR = 1.14; 95% CI: 1.04, 1.26 for a 1-unit increase in ln-CEI) and ≥ 20–40 years since first exposure (HR = 4.67; 95% CI: 1.92, 11.46 vs. 0–20 years TSFE), and inversely associated with 60 years TSFE (HR = 0.26; 95% CI: 0.10, 0.70). Although rectal cancer was also associated with TSFE 20–40 years (HR = 4.57; 95% CI: 1.14, 18.27), it was not associated with ln-CEI, but these findings must be interpreted cautiously due to the small number of cases. Conclusions: Our findings provide support for an association between occupational exposure to asbestos and colon cancer incidence in men. Citation: Paris C, Thaon I, Hérin F, Clin B, Lacourt A, Luc A, Coureau G, Brochard P, Chamming’s S, Gislard A, Galan P, Hercberg S, Wild P, Pairon JC, Andujar P. 2017. Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the Asbestos-Related Diseases Cohort (ARDCo-Nut). Environ Health Perspect 125:409–415; http://dx.doi.org/10.1289/EHP153
- Published
- 2017
34. Cancer of the esophagus and asbestos exposure
- Author
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Mathilde Boulanger, Christophe Paris, Guy Ogier, Bénédicte Clin, Jean-Claude Pairon, Amandine Luc, Isabelle Thaon, Soizick Chamming's, Patrick Brochard, Antoine Gislard, Aude Lacourt, Bodescot, Myriam, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Santé au Travail et Pathologie Professionnellel [CHU Caen], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), Service de santé au travail et pathologie professionnelle [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Aliments Bioprocédés Toxicologie Environnements (ABTE), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de santé au travail et pathologie professionnelle [Rouen], Agence Régionale de la Santé (ARS), Centre Hospitalier Intercommunal de Créteil (CHIC), Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, This work was supported by the French National Health Insurance (Occupational Risk Prevention Department), the French Ministry of Labor and Social Relations, the French Agency for Food, Environmental, and Occupational Health & Safety (ANSES grant 07-CRD-51 and EST 2006/1/43 and EST 2009/68)., CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, and Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
- Subjects
Male ,medicine.medical_specialty ,Esophageal Neoplasms ,Cumulative Exposure ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,medicine.disease_cause ,Asbestos ,03 medical and health sciences ,0302 clinical medicine ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Internal medicine ,Humans ,Medicine ,cancer ,030212 general & internal medicine ,Aged ,esophagus ,business.industry ,Proportional hazards model ,Incidence (epidemiology) ,Hazard ratio ,Public Health, Environmental and Occupational Health ,Cancer ,occupational exposure ,Middle Aged ,medicine.disease ,asbestos ,mortality ,Confidence interval ,3. Good health ,Occupational Diseases ,[SDV.TOX] Life Sciences [q-bio]/Toxicology ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,030220 oncology & carcinogenesis ,[SDV.TOX]Life Sciences [q-bio]/Toxicology ,Cohort ,Carcinogens ,incidence ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,France ,business ,Follow-Up Studies - Abstract
International audience; BACKGROUND:Our study aimed at analyzing incidence and mortality from esophageal cancer within a cohort of workers with previous occupational asbestos exposure (ARDCo Program).METHODS:A 10-year follow-up study was conducted in the 14 515 male subjects included in this program between October 2003 and December 2005. Follow-up began when exposure stopped. Asbestos exposure was analyzed by industrial hygienists using data from a standardized questionnaire. The Cox model was used, with age as the time axis variable adjusted for smoking, time since first exposure (TSFE) and cumulative exposure index (CEI) of exposure to asbestos.RESULTS:We reported a significant dose-response relationship between CEI of exposure to asbestos and esophageal cancer, in both incidence (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.00-1.58), and mortality (HR 1.40, [95%CI 1.12-1.75]).CONCLUSIONS:This large-scale study suggests the existence of a relationship between asbestos exposure and cancer of the esophagus.
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- 2017
35. Inter-reader agreement in HRCT detection of pleural plaques and asbestosis in participants with previous occupational exposure to asbestos
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Gilbert Ferretti, Yasmina Badachi, Antoine Gislard, Marc Letourneux, Adrien Jankowski, Catherine Beigelman, Jean-Claude Pairon, Valérie Latrabe, François Laurent, Patrick Brochard, Michel Montaudon, Jacques Ameille, Evelyne Schorle, Bénédicte Clin, Amandine Luc, and Christophe Paris
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medicine.medical_specialty ,Cross-sectional study ,Health Personnel ,Asbestosis ,medicine.disease_cause ,Asbestos ,Informed consent ,Occupational Exposure ,medicine ,Humans ,Diagnostic Errors ,Asbestos-related diseases ,Aged ,business.industry ,Public Health, Environmental and Occupational Health ,Ethics committee ,Middle Aged ,Pleural Diseases ,medicine.disease ,Fibrosis ,Surgery ,Cross-Sectional Studies ,Cohort ,Pleura ,Occupational exposure ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
Objectives To investigate inter-reader agreement for the detection of pleural and parenchymal abnormalities using CT in a large cross-sectional study comprising information on individual cumulative exposure to asbestos. Methods The project was approved by the hospital ethics committee, and all patients received information on the study and gave their written informed consent. In 5511 CT scans performed in a cohort of retired workers previously exposed to asbestos and volunteering to participate in a multiregional survey programme (Asbestos Related Diseases Cohort, ARDCO), double randomised standardised readings, triple in case of disagreement, were performed by seven trained expert radiologists specialised in thoracic imaging and blind to the initial interpretation. Inter-reader agreement was evaluated by calculating the κ-weighted coefficient between pairs of expert readers and results of routine practice and final diagnosis after expert reading. Results κ-Weighted coefficients between trained experts ranged from 0.28 to 0.52 (fair to good), 0.59 to 0.86 (good to excellent) and 0.11 to 0.66 (poor to good) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. κ-Weighted coefficients between results of routine practice and final diagnosis after expert reading were 0.13 (poor), 0.53 (moderate) and 0.11 (poor) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. Conclusions Interpretation of benign asbestos-related thoracic abnormalities requires standardisation of the reading and trained readers, particularly for participants asking for compensation, and with a view to the longitudinal survey of asbestos-exposed workers.
- Published
- 2014
36. Exposition professionnelle aux champs électromagnétiques et dérèglement d’une valve de dérivation ventriculo-péritonéale : à propos d’un cas
- Author
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Marc Letourneux, E. Leluan, Marie-France Marquignon, Mathilde Boulanger, and Bénédicte Clin
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Physics ,Public Health, Environmental and Occupational Health - Published
- 2014
37. The AGRIculture and CANcer (AGRICAN) cohort study: enrollment and causes of death for the 2005–2009 period
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Pierre Lebailly, Isabelle Baldi, Séverine Tual, Bénédicte Clin, Noémie Levêque-Morlais, and Annie Adjemian
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Adult ,Male ,Population ,Cohort Studies ,Age Distribution ,Breast cancer ,Cause of Death ,Neoplasms ,Surveys and Questionnaires ,Humans ,Medicine ,Prospective Studies ,Sex Distribution ,education ,Prospective cohort study ,Aged ,Cause of death ,Aged, 80 and over ,education.field_of_study ,business.industry ,Public Health, Environmental and Occupational Health ,Middle Aged ,medicine.disease ,Agricultural Workers' Diseases ,Cancer registry ,Standardized mortality ratio ,Cohort ,Female ,France ,business ,Cohort study ,Demography - Abstract
To elaborate and describe a large prospective agricultural cohort including males and females in France with various agricultural activities and to study causes of death. To date, few large prospective cohorts have been conducted among agricultural population. AGRIculture and CANcer cohort is a large prospective cohort of subjects in agriculture studying cancer among active and retired males and females, farm owners and workers, living in eleven areas of France with a population-based cancer registry. Enrollment was conducted from 2005 to 2007 with a postal questionnaire. In January 2008, 180,060 individuals (54 % males, 54 % farm owners, 50 % retired) were enrolled. Mortality was studied until December 2009 (605,956 person-years with standardized mortality ratio (SMR) by comparison with the general population of the areas. Over this period, 11,450 deaths 6,741 in men and 4,709 in women were observed, including 3,405 cancer-related deaths. SMRs were significantly reduced for global mortality (SMR = 0.68, 95 % CI 0.67–0.70 in males and SMR = 0.71, 95 % CI 0.69–0.73 in females) and for death by cancer (SMR = 0.67, 95 % CI 0.65, 0.70 in males and SMR = 0.76, 95 % C: 0.71, 0.80 in females). These results were mainly explained by less frequent smoking-related causes of death (lung cancer, cardiovascular diseases). Nonsignificant excesses of death were observed only for rheumatoid arthritis and arthrosis, suicides (in females), death for event of undetermined intent (in males) and breast cancer in male agricultural workers. These first results are the first ones obtained in France based on a large prospective agricultural cohort showing that farmers would be in healthier condition than the general population.
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- 2014
38. Agricultural exposures and chronic bronchitis: findings from the AGRICAN (AGRIculture and CANcer) cohort
- Author
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Bénédicte Clin, Noémie Levêque-Morlais, Pierre Lebailly, Séverine Tual, Isabelle Baldi, and Chantal Raherison
- Subjects
Adult ,Crops, Agricultural ,Male ,Chronic bronchitis ,Epidemiology ,Air Pollutants, Occupational ,Logistic regression ,Young Adult ,Risk Factors ,Neoplasms ,Occupational Exposure ,Surveys and Questionnaires ,Environmental health ,Confidence Intervals ,Odds Ratio ,Animals ,Humans ,Medicine ,Prospective Studies ,Pesticides ,Risk factor ,Aged ,Aged, 80 and over ,business.industry ,Agriculture ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Agricultural Workers' Diseases ,Bronchitis, Chronic ,Logistic Models ,Cohort ,Bronchitis ,Cattle ,Female ,business - Abstract
Purpose Livestock farming has been recognized as a risk factor for chronic bronchitis (CB). The role of crop farming, however, has been less studied. We sought to assess the role of a large range of farming activities on the risk of CB in the French agricultural cohort AGRICAN (AGRIculture and CANcer). Methods Data on respiratory health and farming activities were collected by questionnaire from 2005 to 2007. Associations between farming activities and self-reported doctor's diagnosis of CB were estimated by a logistic regression adjusted for confounders. Results CB was reported by 1207 farmers (8.4%). Two farming activities were associated with CB: cattle raising (odds ratio [OR] 1.24, 95% confidence interval 1.03–1.48), and potato production (OR 1.33, 95% confidence interval 1.13–1.57). Associations were more pronounced in small-scale cattle raising and in large-scale potato production, in particular among the longest exposed workers (≥20 years). Pesticide poisoning and exposure to pesticides in potato farmers were significantly associated with CB risk (OR 1.64 and OR 1.63, respectively). Conclusions This analysis suggests that other agricultural settings not previously reported, such as potato production, may be a risk factor for CB. The nature and circumstances of exposure to hazardous agents need to be further explored.
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- 2013
39. Pleural Plaques and the Risk of Pleural Mesothelioma
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Bénédicte Clin, Pascal Andujar, Amandine Luc, Soizick Chamming's, Marc Letourneux, Mickael Rinaldo, Jacques Ameille, Gilbert Ferretti, Françoise Galateau-Sallé, Antoine Gislard, Jean-Claude Pairon, Evelyne Schorle, Christophe Paris, Patrick Brochard, and François Laurent
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Adult ,Male ,Mesothelioma ,Cancer Research ,medicine.medical_specialty ,Pleural Neoplasms ,medicine.disease_cause ,Asbestos ,Pleural disease ,Occupational Exposure ,Odds Ratio ,medicine ,Humans ,Risk factor ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,Proportional hazards model ,business.industry ,Incidence ,Respiratory disease ,Hazard ratio ,Odds ratio ,Middle Aged ,respiratory system ,medicine.disease ,respiratory tract diseases ,Oncology ,Pleura ,France ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
Background The association between pleural plaques and pleural mesothelioma remains controversial. The present study was designed to examine the association between pleural plaques on computed tomography (CT) scan and the risk of pleural mesothelioma in a follow-up study of asbestos-exposed workers. Methods Retired or unemployed workers previously occupationally exposed to asbestos were invited to participate in a screening program for asbestos-related diseases, including CT scan, organized between October 2003 and December 2005 in four regions in France. Randomized, independent, double reading of CT scans by a panel of seven chest radiologists focused on benign asbestos-related abnormalities. A 7-year follow-up study was conducted in the 5287 male subjects for whom chest CT scan was available. Annual determination of the number of subjects eligible for free medical care because of pleural mesothelioma was carried out. Diagnosis certification was obtained from the French mesothelioma panel of pathologists. Survival regression based on the Cox model was used to estimate the risk of pleural mesothelioma associated with pleural plaques, with age as the main time variable and time-varying exposure variables, namely duration of exposure, time since first exposure, and cumulative exposure index to asbestos. All statistical tests were two-sided. Results A total of 17 incident cases of pleural mesothelioma were diagnosed. A statistically significant association was observed between mesothelioma and pleural plaques (unadjusted hazard ratio (HR) = 8.9, 95% confidence interval [CI] = 3.0 to 26.5; adjusted HR = 6.8, 95% CI = 2.2 to 21.4 after adjustment for time since first exposure and cumulative exposure index to asbestos). Conclusion The presence of pleural plaques may be an independent risk factor for pleural mesothelioma.
- Published
- 2013
40. Déclaration et reconnaissance en maladie professionnelle après dépistage tomodensitométrique de maladies pleuropulmonaires bénignes dans le programme multirégional de surveillance postprofessionnelle de personnes exposées à l’amiante
- Author
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A. Gislard, Christophe Paris, Patrick Brochard, F. Conso, François Laurent, J. Ameille, M Letourneux, Jean-Claude Pairon, Bénédicte Clin, E. Schorlé, and Amandine Luc
- Subjects
medicine.medical_specialty ,Pediatrics ,Benign disease ,Epidemiology ,business.industry ,Public Health, Environmental and Occupational Health ,Occupational disease ,medicine.disease ,medicine.disease_cause ,Asbestos ,Surgery ,Screening programme ,National health insurance ,medicine ,business - Abstract
Background Underreporting of occupational diseases related to asbestos exposure remains a matter of concern in France. The aim of this study was to evaluate the number of claims for compensation for asbestos-related non-malignant pulmonary or pleural occupational disease in subjects having undergone a chest CT-scan in a multiregional screening programme. Methods Among the 5444 voluntary retired asbestos-exposed subjects recruited in four regions between 2003 and 2005 who had undergone a chest CT-scan, the number of claims for compensation for an asbestos-related pulmonary or pleural benign disease was analysed in 2006 and 2010. Results Following CT-scan screening, 17.2% of participants were acknowledged as presenting with an asbestos-related non-malignant occupational disease, essentially pleural plaques, by the French National Health Insurance fund. Underreporting decreased as duration of follow-up after CT-scan increased. Nevertheless, 4 years after CT-scan, underreporting was still as high as 36% for subjects identified as presenting with pleural plaques. Mean duration between the date of CT-scan and the date of recognition as occupational disease was 7.4 months, shorter in cases where screening was coordinated by specialized centres. Conclusion A plan of action for an easier claiming process for compensation of asbestos-related diseases is desired. This could probably be obtained through improved sensitization of physicians engaged in the follow-up of asbestos-exposed subjects, and by standardization of the interpretation and reporting of asbestos-related abnormalities observed on chest CT-scans.
- Published
- 2013
41. O14-4 Breast cancer risk among postmenopausal women in the agriculture & cancer cohort
- Author
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Anne-Valérie Guizard, Séverine Tual, Clémentine Lemarchand, Stéphanie Perrier, Noémie Levêque-Morlais, Pierre Lebailly, Mathilde Boulanger, Isabelle Baldi, Bénédicte Clin, Michel Velten, and Elisabeth Marcotullio
- Subjects
Gynecology ,021110 strategic, defence & security studies ,medicine.medical_specialty ,Proportional hazards model ,business.industry ,Hazard ratio ,Lobular carcinoma ,0211 other engineering and technologies ,Cancer ,02 engineering and technology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Risk factors for breast cancer ,Agriculture ,030220 oncology & carcinogenesis ,Cohort ,medicine ,business ,Demography - Abstract
Introduction Even though some risk factors for breast cancer are well-established (reproductive history or lifestyle), they explain no more than 50% of cases. Occupational exposures, including farming, have been seldom studied and were based on small-scale studies. Our aim was to assess the association between farming activities and breast cancer in the AGRICAN cohort. Methods AGRICAN consisted of 181,842 participants affiliated to the French agricultural health insurance. Data on lifetime agricultural exposures (18 farming activities, up to 5 tasks) and living in a farm during first year of life were collected from the enrollment questionnaire (2005–2007). Hazard ratios were estimated using Cox regression analysis with age as time scale. Results From enrolment to 2011, 743 incident breast cancers were identified among 55,558 postmenopausal women (555 ductal and 99 lobular carcinoma) through linkage with cancer registries. We found an overall lower breast cancer risk among farmers (HR 0.81, 95% CI: 0.65–1.01) and cattle breeders, with a linear inverse relationship with duration (≥40 years HR 0.71, 95% CI: 0.52–0.95; p-trend Conclusion This work provides new results on associations between farming activities and breast cancer among postmenopausal women. It also emphasises the need to consider pesticide exposures during other tasks than application.
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- 2016
42. P054 Lower lung cancer risks among farmers raising cattle and horses in the agrican cohort
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Isabelle Baldi, A.V. Guizard, Mathilde Boulanger, Bénédicte Clin, Pierre Lebailly, Jean-Charles Dalphin, Bernard Rachet, Michel Velten, Séverine Tual, Clémentine Lemarchand, and Elisabeth Marcotullio
- Subjects
medicine.medical_specialty ,Veterinary medicine ,business.industry ,Proportional hazards model ,Cancer ,medicine.disease ,Milking ,Environmental health ,Epidemiology ,Cohort ,medicine ,Adenocarcinoma ,Pig farming ,business ,Lung cancer - Abstract
Background Epidemiological studies have repeatedly found lower risks of lung cancer in farmers. Besides a lower prevalence of tobacco-smoking, exposure to endotoxins, which is highly present in animal farming, has been offered as an explanation. However, its role remains controversial. Little is known about the agricultural activities concerned. In the AGRICAN cohort, we assessed the relationship between animal farming and lung cancer by investigating the type of animals, tasks, timing of exposure and taking smoking history into account. Methods The AGRICAN cohort consisted of 170,834 participants affiliated to the French agricultural health insurance scheme. Linkage with cancer registries identified 487 incident lung cancers from enrolment (2005–2007) to 2011. The enrolment questionnaire provided detailed information on lifelong farming, including tasks performed with cattle, horses, pigs, poultry, sheep and/or goats with years of beginning and end, and exposure to a farm during the first year of life. Associations between lung cancer and exposure to animals were analysed using a Cox model with adjustment for smoking, using age as time scale. Results Risk in lung cancer (especially adenocarcinoma) was inversely associated with duration of occupational exposure to cattle (≥40 years: HR = 0.60, [95% CI=0.41–0.89], p–trend = 0.04) and horse (≥20 years: 0.64 [0.35–1.17], p–trend = 0.08), but not with poultry or pig farming. Lower lung cancer risk remained associated with long–term exposure to cattle, even 25 years after cessation of exposure. More pronounced decreased risks were observed among individuals who had cared for animals, undertaken milking and who had been exposed to cattle in infancy. Interpretation Our study provides strong evidence of an inverse association between cattle and horse farming, and lung cancer. Further research is warranted to identify the etiologic protective agents and biological mechanisms involved.
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- 2016
43. O32-1 Digestive cancers and occupational asbestos exposure: significant associations in a french cohort of asbestos plant workers
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Marie-France Marquignon, Guy Launoy, Bénédicte Clin, Mathilde Boulanger, Fabrice Morlais, Lydia Guittet, Christophe Paris, Claude Raffaelli, Françoise Galateau-Sallé, and Véronique Bouvier
- Subjects
education.field_of_study ,medicine.medical_specialty ,Pathology ,business.industry ,Job-exposure matrix ,Population ,Cumulative Exposure ,Cancer ,Retrospective cohort study ,medicine.disease_cause ,medicine.disease ,Asbestos ,Internal medicine ,Cohort ,medicine ,Peritoneal mesothelioma ,business ,education - Abstract
Introduction Certain digestive cancers, especially colorectal cancer, may be related to asbestos exposure. The aim of our study was to estimate the incidence of digestive cancers within a cohort of asbestos plant workers. Methods Our study was based on a retrospective cohort of 2,024 male and female workers occupationally exposed to asbestos, in the Calvados departement (France). Data on the cases of digestive cancers were collected thanks to the Calvados’ digestive cancer registry. For each localization, the observed number of cancers was calculated from 1st January 1978 to 31st December 2009 and compared with the expected number among the local general population, using Standardised Incidence Ratios (SIR). Asbestos exposure was assessed for each subject, using the company’s specific job exposure matrix, and according to three indicators: duration of exposure, Cumulative Exposure Index (CEI), mean atmospheric level. Results One hundred and nineteen cases of digestive cancers were observed, for an expected number of 77 (SIR = 1.54 [1.28; 1.85]). A significant excess of risk was observed for peritoneal mesothelioma, especially in women (SIR = 43.0 [13.9; 100]). Significantly elevated SIR were also observed among men for: all digestive cancers, even when excluding peritoneal mesothelioma (SIR = 1.50 [1.23; 1.82]); esophageal cancer in general (SIR = 1.67 [1.08; 2.47]) and among those with CEI above 80 fibres/ml.years (SIR = 1.90 [1.16; 2.94]); liver cancer (SIR = 1.85 [1.09; 2.92]). Concerning colorectal cancer, a significant excess of risk was observed for men with exposure duration above 25 years (SIR = 1.75 [1.05; 2.73]). Conclusions Our results are in favour of a link between long-duration asbestos exposure and colorectal cancer in men, which is consistent with most of the literature. They also suggest a relationship between asbestos exposure and cancer of the oesophagus in men. Finally, there might be an association with small intestine and liver cancers in men.
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- 2016
44. P038 Cancer incidence in the agrican cohort study (2005–2011)
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Clémentine Lemarchand, Séverine Tual, Noémie Levêque-Morlais, Stéphanie Perrier, Aurélien Belot, Michel Velten, Anne-Valérie Guizard, Elisabeth Marcotullio, Alain Monnereau, Bénédicte Clin, Isabelle Baldi, and Pierre Lebailly
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- 2016
45. Co-exposure between asbestos and inorganic particles and risk of lung cancer in the ARDCO study
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Christos Chouaid, Bénédicte Clin-Godard, Fançois Laurent, Amandine Luc, Jean-Claude Pairon, Patrick Brochard, Antoine Gislard, Aude Lacourt, Christophe Paris, and Soizick Chamming's
- Subjects
business.industry ,Incidence (epidemiology) ,Physiology ,medicine.disease ,medicine.disease_cause ,Asbestos ,Cohort ,medicine ,Occupational exposure ,Co exposure ,Lung cancer ,business ,Inorganic particles ,Asbestos-related diseases - Abstract
For lung cancer, there is evidence of a joint effect between smoking and asbestos. However, little is known about a possible joint effect between asbestos and other inorganic particles. The objective was to study the association between lung cancer and occupational asbestos exposure in the abscence or presence of additional exposure to inorganic particles. A 12-year follow-up study was conducted to analyse lung cancer incidence in a cohort of 13,814 retired workers previously exposed to asbestos and volunteering to participate in a multiregional survey program (Asbestos Related Diseases Cohort, ARDCO) from October 2003 and December 2005. From complete work histories, occupational exposure to asbestos, mineral wools, refractory ceramic fibers, crystalline silica and cement dust were assessed by job-exposure matrices. Association between lung cancer and occupational asbestos exposure was estimated by Cox model, adjusted for smoking, in the presence or absence of additional exposure to inorganic particles. At the end of follow-up (April 2015), 364 incident lung cancer cases were diagnosed. The association between lung cancer and asbestos exposure was statistically significant (HR=2.3 [95% CI=1.0-5.4]), but it seemed increased in the presence of additional exposure to mineral wools (HR=3.1 [95% CI=1.4-7.2]). However, at equal asbestos exposure level, the association was no longer different in the presence of additional exposure to mineral wools. Other inorganic particles did not modify the association between asbestos and lung cancer. Mineral wools may modify the association between lung cancer and asbestos. However, subjects exposed to both factors seemed also to be more exposed to asbestos.
- Published
- 2016
46. O41-2 Lung cancer, including histological subtypes, and agricultural crop-related exposures: results of the agriculture and cancer cohort
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Isabelle Baldi, Anne-Valérie Guizard, Mathilde Boulanger, Séverine Tual, Elisabeth Marcotullio, Clémentine Lemarchand, Michel Velten, Pierre Lebailly, and Bénédicte Clin
- Subjects
business.industry ,Proportional hazards model ,food and beverages ,Cancer ,medicine.disease ,Crop ,Agriculture ,Environmental health ,Cohort ,Health insurance ,Medicine ,Prospective cohort study ,business ,Lung cancer - Abstract
Introduction Epidemiologic studies have found lower risks of lung cancer (LC), partly due to a lower prevalence of smoking, and with increasing evidence of potential protection in some animal farmers. However, farmers are also exposed to some hazardous air contaminants (pesticides, diesel exhaust, mineral dust). In the prospective cohort AGRICAN, we assessed associations between several crop-related activities and tasks and LC risk, including adenocarcinomas (ADC), squamous cell carcinomas (SqCC) and small cell carcinomas (SmCC). Methods AGRICAN includes French individuals affiliated to the agricultural health insurance scheme. Incident LC were identified by linkage with cancer registries from enrolment (2005–2007) to 2011. Data on crop exposure during lifetime (13 crops and from 2 to 5 specific tasks) were obtained from the enrolment questionnaire. Analyses were performed using a Cox model, with attained age as time scale, adjusted for gender, smoking history and exposure to potential protective activities – cattle and horses. Results Among the 148,046 subjects, 487 incident LC were identified. Higher risks were observed in pea growers, especially in those who harvested, (harvesting: HR = 1.43[0.99–2.06], with a significant relationship with duration of exposure (p-trend for duration = 0.06)), for all subtypes except ADC. Increased risks were also observed among (i) farmers growing vegetables (HR = 1.26[0.93–1.72]), (ii) vine-growers (ADC: HR = 1.37[0.97–1.93]), especially in those performing re-entry tasks (ADC: HR 1.40 [0.96–2.04]) and harvesting (ADC: HR = 1.37[0.95–1.95]); (iii) pesticide users on beets (SqCC: HR = 1.88[1.13–3.11]) and (iv) farmers who treated rape seeds (SqCC: HR = 2.55[1.17–5.53]). No significant relationship was observed with duration for any of these activities and tasks. Conclusions We found positive associations between LC risk and several crop-related tasks including pesticide exposure (application in fields or on seeds, re-entry tasks) or not like peas harvesting.
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- 2016
47. O22-6 Occupational exposure to organochlorine insecticides and prostate cancer risk in agrican
- Author
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Clémentine Lemarchand, Michel Velten, Perrier Stéphanie, Anne-Valérie Guizard, Pierre Lebailly, Noémie Levêque-Morlais, Isabelle Baldi, Elisabeth Marcotullio, Bénédicte Clin, Séverine Tual, Camille Carles, and Mathilde Boulanger
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business.industry ,Proportional hazards model ,Cancer ,Chlordane ,Pesticide ,medicine.disease ,Toxicology ,chemistry.chemical_compound ,Dieldrin ,Prostate cancer ,chemistry ,Environmental health ,Cohort ,medicine ,Aldrin ,business - Abstract
Introduction Farming and pesticide use have been repeatedly and consistently associated with prostate cancer risk but analysis on the role of specific active ingredients remain scarce and results inconclusive. We assessed associations between occupational exposure to specific organochlorines and prostate cancer in the agricultural cohort AGRICAN. Methods The AGRICAN cohort consisted of 181,842 participants, affiliated for at least 3 years to the French agricultural health insurance. Data on pesticide use on 6 crops, including years of beginning and ending, were collected from the enrolment questionnaire. Exposure to organochlorine insecticides and duration of exposure between 1950 and 2010 was assessed with the help of a crop-exposure matrix (PESTIMAT). Associations with prostate cancer were estimated using a Cox regression analysis with attained age as time scale. Results From enrolment (2005–2007) to 2009, 1 672 incident prostate cancer cases among 98,974 male participants were identified through linkage with cancer registries. A nearly significant increase in prostate cancer risk was observed when considering organochlorines as a group (HR 1.15, 95% CI: 0.99–1.32; 463 cases) with no linear relationship with duration of exposure. A significant association was observed for eight individual organochlorine pesticides (out of 18) and a significant relationship with duration of exposure was observed for 6 of them (aldrin, chlordane, dieldrin, DDD, toxaphene and HCH). When adjusting for exposure to the 5 other organochlorines, a greater prostate cancer risk remained among men with the highest duration of exposure to HCH and DDD. Conclusions Our study provides new results concerning the association between pesticide exposure and prostate cancer, especially for two organochlorines: DDD (a DDT metabolite) and HCH (a mix of isomers including γ-HCH also called lindane).
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- 2016
48. Breast cancer risk among postmenopausal women in the AGRIculture & CANcer cohort
- Author
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Michel Velten, Anne-Valérie Guizard, Stéphanie Perrier, Séverine Tual, Mathilde Boulanger, Pierre Lebailly, Elisabeth Marcotullio, Clémentine Lemarchand, Isabelle Baldi, Noémie Levêque-Morlais, and Bénédicte Clin
- Subjects
medicine.medical_specialty ,Postmenopausal women ,business.industry ,Obstetrics ,Cancer ,medicine.disease ,Breast cancer ,Risk factors for breast cancer ,Cohort ,General Earth and Planetary Sciences ,Reproductive history ,Medicine ,business ,General Environmental Science - Abstract
Introduction: Even though some risk factors for breast cancer are well-established (reproductive history or lifestyle), they explain no more than 50% of cases. Occupational exposures, including far...
- Published
- 2016
49. Occupational exposure to organochlorine insecticides and prostate cancer risk in AGRICAN
- Author
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Noémie Levêque-Morlais, Mathilde Boulanger, Michel Velten, Stéphanie Perrier, Anne-Valérie Guizard, Pierre Lebailly, Bénédicte Clin, Clémentine Lemarchand, Isabelle Baldi, Elisabeth Marcotullio, and Séverine Tual
- Subjects
Prostate cancer risk ,Pesticide use ,business.industry ,Environmental health ,General Earth and Planetary Sciences ,Medicine ,Occupational exposure ,business ,General Environmental Science - Abstract
Introduction: Farming and pesticide use have been repeatedly and consistently associated with prostate cancer risk but analysis on the role of specific active ingredients remain scarce and results ...
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- 2016
50. Programme multirégional de suivi post-professionnel après exposition à l’amiante : plaques pleurales et risque de cancers respiratoires
- Author
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Jacques Ameille, Pascal Andujar, Céline Gramond, Soizick Chamming's, Amandine Luc, Christos Chouaid, Aude Lacourt, François Laurent, Julien Baron, Christophe Paris, Patrick Brochard, Isabelle Thaon, Bénédicte Clin, Gilbert Ferretti, Françoise Galateau-Sallé, Antoine Gislard, Jean-Claude Pairon, Pascal Wild, Institut Santé-Travail Paris-Est [Créteil], Université Paris-Est Créteil, Faculté de Médecine [Créteil] (UPEC-Médecine), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Centre de consultations de pathologies professionnelles [CHRU Nancy] (CCPP), and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
- Subjects
03 medical and health sciences ,0302 clinical medicine ,Public Health, Environmental and Occupational Health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,030212 general & internal medicine ,030210 environmental & occupational health ,[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract ,ComputingMilieux_MISCELLANEOUS ,3. Good health - Abstract
Contexte Dans les suites de la conference de consensus de 1999 sur le suivi medical des personnes ayant ete exposees a l’amiante, un programme experimental multiregional a ete mis en place, avec constitution de la cohorte asbestos-related diseases cohort (ARDCO). Objectif Ce travail etudie l’association entre plaques pleurales identifiees sur examen tomodensitometrique (TDM) du thorax et risque de mesotheliome ou de deces par cancer du poumon. Methodes Entre 2003 et 2005, des sujets retraites, anterieurement exposes a l’amiante et relevant du RGSS ont ete invites a participer a un programme de depistage dans les regions Aquitaine, Haute et Basse Normandie et Rhone-Alpes. Un index d’exposition cumule (IEC) a l’amiante a ete calcule pour chaque individu a partir d’un questionnaire professionnel standardise. Les examens TDM thoraciques ont ete relus par des experts radiologues, afin de determiner notamment l’existence d’anomalies pleurales liees a l’amiante (donnees disponibles chez plus de 5000 sujets). Les cas de mesotheliome incidents ont ete reperes a partir des demandes de prise en charge en ALD ou en maladie professionnelle (MP) aupres de la Securite sociale, avec sollicitation du College des anatomopathologistes specialises (MESOPATH) pour confirmer le diagnostic. Pour l’etude des CBP, une etude de mortalite a ete realisee avec obtention des causes de deces jusqu’au 31-12-2010 aupres du service CepiDc de l’Inserm. L’analyse statistique s’appuie sur une analyse de survie basee sur un modele de Cox, l’âge etant la variable principale. Resultats Chez les hommes, l’etude d’incidence (donnees ALD-MP) a retrouve une association significative entre la presence de plaques pleurales sur le TDM et le risque de developper un mesotheliome (hazard ratio [HR] ajuste sur l’IEC a l’amiante et la latence : 6,8 [IC 95 % : 2,2–21,4] pour les plaques pleurales typiques). L’etude de mortalite a identifie une association significative entre plaques pleurales et mortalite par cancer du poumon (HR ajuste sur le tabac et l’IEC a l’amiante : 2,41 [IC 95 % : 1,21–4,85]). Conclusion La presence de plaques pleurales apparait etre un facteur de risque independant pour la survenue du mesotheliome pleural et pour le risque de deces par cancer du poumon chez des sujets ayant ete exposes a l’amiante.
- Published
- 2016
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