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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 &lt, 25%, moderate: between 25 and 50% and severe: &gt, 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.

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.

International audience; Objectives: Nanoscale particles (1-100 nm) can be of natural origin, and either intentionally or unintentionally produced by human activities. Toxicological data have suggested a possible carcinogenic effect of such particles. The aim of this study was to estimate the association between occupational exposure to nanoscale particles and risk of lung cancer, pleural mesothelioma and brain tumors in adults.Methods: Three French population-based case-control studies were analyzed: 1) the ICARE study including 2,029 lung cancer cases and 2,591 controls; 2) the PNSM study including 371 pleural mesothelioma cases and 730 controls and 3) the CERENAT study including 257 brain tumor cases and 511 controls. Occupational exposure to unintentionally emitted nanoscale particles (UNPs) was retrospectively assessed by a job exposure matrix providing a probability and a frequency of exposure.Results: In adjusted analyses among men, significant associations between occupational exposure to UNPs and lung cancer (OR=1.51; 95% CI: 1.22-1.86 and brain tumors (OR=1.69; 95% CI: 1.17-2.44) were observed. No increased OR was observed for pleural mesothelioma (OR=0.78; 95% CI: 0.46-1.33).Conclusion: This is the first study showing positive associations between occupational exposure to UNPs and increased risk of lung cancer and brain tumors. These preliminary results should encourage further epidemiological research.

Objectifs Mis en place en 1998, le Programme national de surveillance du mesotheliome pleural fonctionne depuis vingt ans. Il permet de dresser un bilan de l’evolution de la situation epidemiologique des mesotheliomes pleuraux entre 1998 et 2017, en France, en termes d’incidence, de survie, d’expositions des patients atteints et de leur reconnaissance medico-sociale. Methodes Dans les 21 departements couverts par le programme, une procedure standardisee de recueil actif et de confirmations diagnostiques anatomopathologique et clinique des tumeurs primitives de la plevre est mise en œuvre. Les expositions vie entiere a l’amiante et aux autres facteurs etudies, professionnelles et extra-professionnelles, sont recueillies par questionnaire aupres de chaque cas. Les recours des cas de mesotheliome aux dispositifs d’indemnisation (maladie professionnelle et Fonds d’indemnisation des victimes de l’amiante-Fiva) sont recueillis et analyses. Resultats Sur la periode 1998-2016, on observe une augmentation du nombre de cas annuel estime, passant de 800 a1100 cas avec une augmentation de la proportion de femmes de 20 a 25 %. Chez les hommes, les expositions professionnelles sont encore largement predominantes et restent stables depuis 1998 (environ 90 %), avec toutefois un deplacement de la problematique des metiers d’utilisation et de transformation de l’amiante vers les metiers d’intervention sur des materiaux contenant de l’amiante tel que le secteur du BTP. Chez les femmes, la part des expositions professionnelles a l’amiante reste faible (environ 40 %), mais 35 % des femmes ont ete exposees en dehors du travail (via le fait de resider avec des proches exposes professionnellement, le bricolage ou expos domestiques). Pour 25 % des femmes, on ne retrouve aucune de ces expositions. Le recours aux dispositifs d’indemnisation est encore insuffisant, avec 27 % des cas affilies au regime general de securite sociale (RGSS) ne faisant aucune demarche et 53 % des cas hors RGSS n’ayant pas recours au Fiva. Perspectives La mise en œuvre du dispositif national de surveillance des mesotheliomes (DNSM) integrant le PNSM et la declaration obligatoire (DO) permettra de moderniser et optimiser la surveillance de tous les mesotheliomes (plevre et autres localisations) sur le territoire national, de l’adapter aux nouveaux enjeux (dont les expositions environnementales), d’optimiser le dispositif national d’enquetes d’expositions et de renforcer l’articulation avec les travaux de recherche, tel que l’estimation de la proximite des lieux de vie des sujets a des sources naturelles ou industrielles potentiellement exposantes.

The aim of this study was to investigate the hypothesis of an increased risk of pleural mesothelioma due to co-exposure to asbestos and refractory ceramic fibres (RCF) compared to asbestos exposure alone. Males were selected from a French case-control study conducted in 1987-1993 and from the French National Mesothelioma Surveillance Program in 1998-2006. Two population controls were frequency matched to each case by year of birth. Complete job histories were collected and occupational asbestos and RCF exposures were assessed using job exposure matrices. The dose-response relationships for asbestos exposure were estimated from an unconditional logistic regression model in subjects exposed to asbestos only (group 1) and subjects exposed to both asbestos and RCF (group 2). A total of 988 cases and 1125 controls ever-exposed to asbestos were included. A dose-response relationship was observed in both groups but it was stronger in group 2. In comparison with subjects exposed at the minimum value of the cumulative index of exposure, the odds ratio was 2.6 (95% CI 1.9-3.4) for subjects exposed to 75 fibres · mL(-1) · year(-1) in group 1 increasing to 12.4 (95% CI 4.6-33.7) in group 2. Our results suggest that the pleural carcinogenic effect of occupational asbestos exposure may be modified by additional exposure to RCF.

Methods: A total of 1,199 male cases and 2,379 control subjects were included in a French pooled case-control study. Complete job histories were collected, and occupational exposure to asbestos, mineral wool (MW), and silica were assessed by three French job exposure matrices.Unconditional logisticregressionmodelsadjustedfor age, birth date, and occupational asbestos exposure were used to estimate odds ratios (OR) and 95% confidence intervals (CIs). Measurements and Main Results: A significant association between mesothelioma and MW exposure was observed after adjustment for occupational asbestos exposure. OR for subjects exposed to less than 0.01 fibers$ml 21 $yr 21 was 1.6 (95% CI, 1.2–2.1) and increased to 2.5 (95% CI, 1.8–3.4) for subjects exposed to more than 0.32 fibers$ml 21 $yr 21 . All ORs for silica exposure were around the null. CoexposuretoeitherasbestosandMWorasbestosandsilicaseemed toincreasethe risk ofpleuralmesothelioma. ORswere 17.6 (95%CI, 11.8–26.2) and 9.8 (95% CI, 4.2–23.2) for subjects exposed to both asbestos and MW and for subjects exposed to both asbestos and silica, respectively, compared with 4.3 (95% CI, 1.9–9.8) for occupational asbestos exposure alone. Conclusions: Our results are in favor of an increased risk of pleural mesothelioma for subjects exposed to both asbestos and MW or asbestos and silica.

Aims Unintentional nanoscale particles (UNP) are generated from usual work processes and thus exist since a long time and are more prevalent than the manufactured nanoscale particles. The objective of this study was to develop a job-exposure matrix, a useful tool to estimate prevalence of occupational exposure to UNP for epidemiologic studies. . Methods Work-processes generating UNP and their associated chemical families have been identified through an extensive literature review and the knowledge of an expert’s panel in various domain such as industrial hygiene, toxicology, atmospheric physics and chemistry, epidemiology… These processes were associated to occupations extracted from the ISCO classification edition 1968. A probability and a frequency were assessed for each specific combination “occupation × work-process”. When an occupation was related to several work-processes, the final exposure assessment consisted in the highest probability of exposure and a weighted-frequency of exposure combining assessments from each related work-process. Exposure assessment for some specific occupations could differ according to industries and historical periods. Due to the few available measurement data, intensity could not be assessed at that time. Results Over 50 work-processes generating UNP have been identified and were related with seven UNP chemical families: metal, mineral, carbon, wood, polymer, polycyclic aromatic hydrocarbon (PAH) and other organic. A little less than 50% occupational ISCO codes were unexposed, and 9%, 13% and 31% were possibly, probably and certainly exposed, respectively. Most of occupations were exposed to carbonaceous, PAHs UNP and then to metallic and mineral UNP. Conclusions These results suggest that occupational exposure to UNP might be important at the workplace and might concern a wide variety of workers. In order to assess intensity of exposure, we are currently organising measurement campaigns in French and Canadian workplaces (ExproPNano program).

Introduction Nanoscale particles (1-100 nm) may be naturally occurring; intentionally-produced for commercial purposes or unintentionally-produced by manufacturing processes or human activities. Toxicological data have suggested a possible carcinogenic effect of nanoscale particles and have shown that they have the ability to translocate into different organs including the brain. While epidemiological data on nanoscale particles are very scarce to date, there is some suggestion of their potential role in cancer (e.g. diesel exhaust emissions classified as carcinogenic for humans by IARC). The objective of this study was to estimate the association between occupational exposure to nanoscale particles and risk of brain tumour in adults. Methods The CERENAT study is a multicenter case-control study carried out in four districts of France between 2004 and 2006. From detailed occupational histories, occupational exposure to unintentionally-produced nanoscale particles was retrospectively assessed by the MatPUF job exposure matrix providing a probability and frequency of exposure for each combination occupation × industry according to international and national classifications. Conditional logistic regression was used to estimate ORs and 95% CIs. Results Overall, 596 brain tumour cases and 1192 matched controls were included in this study. Among men, a significant association between occupational exposure to nanoscale particles and brain tumour was observed (OR = 1.5; 95% CI: 1.1–2.2). This increased OR was essentially observed in the highest exposure categories (OR = 1.6; 95% CI: 1.1–2.4 for a total duration of exposure over 30 years) as well as for carbonaceous (OR = 1.5; 95% CI: 1.1–2.3) and HAP nanoscale particles (OR = 1.6; 95% CI: 1.1–2.4). Conclusion Even if these preliminary results should be confirmed by other analyses including the intensity of exposure (on-going work in a further version of the job-exposure matrix), these results should encourage further epidemiological research on nanoscale particles.

Introduction Parmi les particules nanometriques (diametre nominal inferieur a 100 nm), on distingue les particules manufacturees, generees a des fins commerciales, de celles non intentionnellement emises, d’origine naturelle ou produites lors d’emissions secondaires de procedes technologiques courants (moteurs thermiques…). Les donnees toxicologiques ont montre une relation probable entre particules nanometriques et cancer [1] . De meme, les donnees epidemiologiques ont permis de classer les particules diesel et celles de la pollution atmospherique (fraction elevee en nombre de particules nanometrique), comme cancerogenes certains pour l’homme [2] , [3] . Enfin, la capacite des particules nanometriques a traverser les differentes barrieres biologiques et notamment la barriere hemato-encephalique conduit a s’interroger sur un possible role dans la survenue de tumeurs du systeme nerveux central. L’objectif de notre etude etait d’analyser l’association entre exposition professionnelle aux particules nanometriques non intentionnellement generees et survenue de cancer (poumon, mesotheliome pleural et tumeurs du systeme nerveux central). Methode Les donnees de trois etudes cas–temoins francaises (ICARE, PNSM et CERENAT) ont ete analysees. A partir de l’histoire professionnelle complete des sujets, l’exposition professionnelle aux particules nanometriques a ete evaluee par une matrice emplois–exposition (MatPUF) permettant d’attribuer a chaque emploi une probabilite et une frequence d’exposition [4] . Pour chaque sujet, la duree totale d’exposition (en annee) a ete calculee. Les rapports de cotes et intervalles de confiance a 95 % ont ete estimes par regressions logistiques ajustes sur les principaux facteurs de risque des cancers etudies. Resultats Des associations significatives entre particules nanometriques et cancer du poumon d’une part (RC = 1,3 ; IC 95 % = 1,0–1,7) et tumeurs du systeme nerveux central d’autre part ont ete observees (RC = 1,7 ; IC 95 % = 1,1–2,4) chez les hommes. La prise en compte de la duree n’a pas permis de montrer de relation dose-effet. Par ailleurs, aucun lien n’a ete mis en evidence avec le mesotheliome pleural (RC = 0,9 ; IC 95 % = 0,5–1,4). Conclusion Ces premiers resultats incitent a renforcer la connaissance sur les expositions (notamment par des mesures de differents postes de travail, et differentes tâches) et a developper des etudes epidemiologiques integrant des parametres d’exposition plus precis, comme l’intensite dans la matrice MatPUF.

Asbestos is the primary cause of pleural mesothelioma (PM). The objective of this study was to elucidate the importance of different temporal patterns of occupational asbestos exposure on the risk of PM using case–control data in male subjects. Cases were selected from a French case–control study conducted in 1987–1993 and the French National Mesothelioma Surveillance Program in 1998–2006. Population controls were frequency matched to cases by year of birth. Occupational asbestos exposure was evaluated with a job–exposure matrix. The dose–response relationships were estimated using restricted cubic spline functions in logistic regression models. A total of 2,466 ever-asbestos-exposed males (1,041 cases and 1,425 controls) were used. After adjustment for intensity and total duration of occupational asbestos exposure, the risk of PM was lower for subjects first exposed after the age of 20 yrs and continued to increase until 30 yrs after cessation of exposure. The effect of total duration of exposure decreased when age at first exposure and time since last exposure increased. These results, based on a large population-based case–control study, underline the need to take into account the temporal pattern of exposure on risk assessment.

Background Occupational exposure to asbestos, widely used in various industries for decades, is the most important risk factor for pleural mesothelioma. We report here the ranking of occupations and industries in France at high risk for this cancer among men and women. Methods A population-based case–control study, conducted from 1998 to 2002, included 462 cases (80.3% men) and 897 controls. Data were collected in face-to-face interviews with a standardized questionnaire. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each occupation and industry; subjects never employed in each category were the reference. Results For men, risks were high for several occupations and industries. Besides the expected high risks for non-metallic mineral product makers and manufacturing asbestos products, occupations such as plumbers (OR ¼ 5.57, 95% CI: 2.90–10.69), sheet-metal workers, welders, metal molders, coremakers, and cabinetmakers were also at high risk. Elevated risks were found in the industries of shipbuilding (OR ¼ 9.13, 95% CI: 5.20– 16.06) and construction, but also in the manufacturing of metal products, chemicals, and railroad and aircraft equipment. The results for women showed increased but not significant risks in several occupational activities. Conclusions This report provides new insight into the epidemiology of mesothelioma, confirming risks for occupational activities reported earlier and pointing out risks in activities never previously reported. It offers guidance to authorities for the compensation of asbestos victims and for prevention in at-risk activities still involving asbestoscontaining products. Am. J. Ind. Med. 53:1207–1219, 2010. 2010 Wiley-Liss, Inc.

Contexte Des etudes ont montre une association significative entre l’exposition aux particules microniques et les issues defavorables de grossesse. Les particules nanometriques (PN) sont incluses dans cette fraction, en dominent la concentration en nombre et ont une reactivite biologique plus grande. Pourtant peu d’etudes se sont interessees a leurs effets specifiques sur la sante, particulierement sur les issues de grossesse. Objectif De decrire les expositions professionnelles aux particules nanometriques non intentionnelles (PNNI) au cours de la grossesse a partir des donnees de la cohorte ELFE. Methode Les analyses sont issues des donnees de la cohorte Elfe qui a ete lancee en 2011 et a inclus 18 275 meres et leurs enfants nes a 33 semaines d’amenorrhee ou plus. Les donnees sur les caracteristiques sociodemographiques, les habitudes de vie, les emplois occupes par les meres durant leur grossesse et les donnees de sante ont ete collectees au moyen d’un questionnaire standardise et du dossier medical a la naissance. Les meres qui n’ont pas travaille pendant leur grossesse ont ete exclues des analyses. L’exposition professionnelle aux PNNI de la mere au cours de la grossesse a ete caracterisee a partir d’une matrice emplois-exposition, par la frequence et la probabilite d’exposition. Les meres ayant occupe un emploi associe a une probabilite d’exposition superieure a 50 %, etaient definis comme exposees. Resultats L’echantillon d’etude porte sur 11 224 couples meres-enfants. Parmi les meres 5,1 % etaient exposees professionnellement aux PNNI pendant la grossesse. Au total, 45 emplois sur 168 etaient exposants. Parmi ces emplois, les plus frequemment occupes sont : cuisiniers (n = 111), voyageurs de commerce, representants et placiers (n = 110), agents commerciaux techniciens (n = 40), conducteurs des vehicules automobiles (n = 39), proprietaires gerants d’hotels et restaurants (n = 31). Parmi les 45 emplois, certains avaient une probabilite d’exposition de plus de 90 % : joailliers et orfevres (n = 3), exploitants agricoles specialises (n = 26), toliers-chaudronniers (n = 2), ingenieurs metallurgistes (n = 1), ouvriers pepinieristes et jardiniers (n = 11). Dans une analyse de regression multivariee, l’exposition professionnelle maternelle aux PNNI etait significativement associee au petit poids de naissance pour l’âge gestationnel (RCa = 1,63, IC a 95 % : [1,22 ; 2,18]). Conclusion L’exposition aux PNNI en milieu professionnel est non negligeable. Il est important a ce jour d’approfondir la recherche sur ce sujet et de prendre de mesures de precaution car le fœtus en developpement serait vulnerable aux effets toxiques des PNNI.

Contexte et objectifs Le mesotheliome pleural malin est un cancer rare dont le lien avec l’amiante est bien connu et l’origine professionnelle de la maladie le plus souvent evoquee. Le travail presente ici etudie les facteurs associes a la prise en charge medico-sociale des mesotheliomes pleuraux inclus dans le Programme national de surveillance du mesotheliome (PNSM) qui couvre actuellement 21 departements en France. Methodes Les declarations en maladie professionnelle (DMP) pour la periode 1999–2014 et le recours au Fonds d’indemnisation des victimes de l’amiante (FIVA) pour les annees 2005–2014, ont ete analyses chez les sujets dont le diagnostic de mesotheliome a ete confirme par le college des anatomopathologistes specialistes du mesotheliome (groupe Mesopath). Les tests du Chi 2 , ou le test exact de Fisher ainsi qu’un modele de regression logistique non conditionnelle ont ete utilises pour tester l’association avec differentes variables : sexe, âge au diagnostic, categorie socio-professionnelle, situation familiale, probabilite d’exposition professionnelle a l’amiante, regime de protection sociale, departement de residence. Resultats Parmi les 2839 sujets etudies entre 1999 et 2014 et qui relevent du Regime general de la Securite sociale (RGSS), 60 % ont effectue une DMP. Les facteurs associes a la DMP chez les hommes etaient l’âge, la categorie socio-professionnelle, la situation familiale et la probabilite d’exposition professionnelle a l’amiante. Chez les femmes, seule la probabilite d’exposition professionnelle a l’amiante etait associee a la DMP. Chez les hommes comme chez les femmes, la proportion de DMP variait selon les departements. Parmi les 2746 sujets identifies entre 2005 et 2014, 55 % avaient adresse une demande au FIVA. Cette proportion significativement plus importante chez les sujets relevant du RGSS que pour ceux relevant d’autres regimes de protection sociale, variait selon les departements. La demande aupres du FIVA etait associee a l’âge, a la situation familiale, et a l’exposition professionnelle a l’amiante. Au total, sur les 2193 sujets relevant du RGSS sur la meme periode (2005–2014), seulement 45 % avaient conjointement effectue une DMP et adresse une demande au FIVA. Il est a noter que 27 % n’avaient effectue aucune demarche. Conclusion Ces resultats confirment l’importance de renforcer l’information des acteurs medicaux prenant en charge ce type de patients, afin de les sensibiliser aux enjeux medico-sociaux lies au mesotheliome pleural.

Objectives To estimate the proportion of pleural mesothelioma cases that can be attributed to asbestos exposure in France including non-occupational exposure. Methods A population-based case-control study including 437 incident cases and 874 controls was conducted from 1998 to 2002. Occupational and non-occupational asbestos exposure was assessed retrospectively by two expert hygienists. ORs of pleural mesothelioma for asbestos-exposed subjects compared to non-exposed subjects, and population-attributable risk (ARp) of asbestos exposure were estimated using a conditional logistic regression. Results A clear dose-response relationship was observed between occupational asbestos exposure and pleural mesothelioma (OR=4.0 (99% CI 1.9 to 8.3) for men exposed at less than 0.1 f/mL-year vs 67.0 (99% CI 25.6 to 175.1) for men exposed at more than 10 f/mL-year). The occupational asbestos ARp was 83.1% (99% CI 74.5% to 91.7%) for men and 41.7% (99% CI 25.3% to 58.0%) for women. A higher risk of pleural mesothelioma was observed in subjects non-occupationally exposed to asbestos compared to those never exposed. The non-occupational asbestos ARp for these subjects was 20.0% (99% CI −33.5% to 73.5%) in men and 38.7% (99% CI 8.4% to 69.0%) in women. When considering all kinds of asbestos exposure, ARp was 87.3% (99% CI 78.9% to 95.7%) for men and 64.8% (99% CI 45.4% to 84.3%) for women. Conclusions Our study suggests that the overall ARp in women is largely driven by non-occupational asbestos exposure arguing for the strong impact of such exposure in pleural mesothelioma occurrence. Considering the difficulty in assessing domestic or environmental asbestos exposure, this could explain the observed difference in ARp between men and women.

Background More than 80% of mesothelioma cases in men are attributable to occupational asbestos exposure compared to only 40% in women. The objective of the study was to characterize a series of female pleural mesotheliomas according to known and suspected risk factors. Methods From the exhaustive recording of 318 female mesothelioma cases in the French National Mesothelioma Surveillance Program between 1998 and 2009, multiple correspondence analysis and hybrid clustering were performed to characterize these cases according to expert assessed occupational and non-occupational exposure to asbestos and man-made vitreous fibers, X-ray exposure, and history of cancer and non-malignant respiratory diseases. Results Four clusters were identified: (1) occupational exposure to asbestos and man-made vitreous fibers (7.9% of subjects); (2) radiation exposure during radiotherapy (12.9%); (3) increased asbestos exposure (19.8%); and (4) “non-exposure” characteristics (59.4%). Conclusion These results will allow hypotheses to be generated about associations between mesothelioma and non-occupational asbestos exposure, X-ray exposure and history of respiratory disease. Am. J. Ind. Med. 56:1307–1316, 2013. © 2013 Wiley Periodicals, Inc.

Introduction Les particules nanometriques sont couramment definies comme ayant un diametre nominal inferieur a 100 nm. Il est possible de distinguer les particules manufacturees, generees a des fins commerciales, de celles non intentionnellement emises et qui peuvent etre d’origine naturelle (erosion des sols…), ou anthropique lors des emissions secondaires de procedes technologiques courants tels que les moteurs thermiques. Les donnees toxicologiques ont montre une relation probable entre particules nanometriques et cancer. De meme, les donnees epidemiologiques ont permis de classer les particules diesel et les particules de la pollution atmospherique comme cancerogenes certains pour l’homme (independamment de leur taille). Enfin, la capacite des particules nanometriques a traverser les differentes barrieres biologiques et notamment, la barriere hemato-encephalique a fait emerger l’hypothese d’un possible lien avec la survenue de tumeurs du systeme nerveux central. L’objectif de ces analyses est d’etudier l’association entre l’exposition professionnelle aux particules nanometriques non-intentionnellement generees au travers de differents procedes de travail et la survenue de tumeurs du systeme nerveux central. Methode Les donnees de l’etude cas-temoins CERENAT incluant 596 cas de tumeurs du systeme nerveux central et 1192 temoins, entre 2004 et 2006, dans 4 departements francais, ont ete analysees. A partir de l’histoire professionnelle complete des sujets, l’exposition professionnelle aux particules nanometriques a ete evaluee par le biais d’une matrice emplois-exposition. Pour chaque sujet, la duree totale d’exposition ainsi qu’un score d’exposition ont ete calcules. Les rapports de cotes et intervalles de confiance a 95 % ont ete estimes par une regression logistique conditionnelle. Resultats Une association significative entre exposition professionnelle aux particules nanometriques et tumeurs du systeme nerveux central a ete observee chez les hommes (RC = 1,5 ; IC 95 % = 1,1–2,2). Cet exces de risque semble etre plus particulierement lie a de fortes expositions (RC = 1,9 ; IC 95 % = 1,2–2,8 pour des durees totales d’exposition superieures a 30 ans) ainsi qu’aux particules carbonees (RC = 1,5 ; IC 95 % = 1,1–2,3) et HAP (RC = 1,6 ; IC 95 % = 1,1–2,4). Conclusion Meme si ces premieres analyses doivent etre confirmees, notamment en prenant en compte l’intensite des expositions (en cours de determination dans une nouvelle version de la matrice), ces resultats incitent au developpement de recherches epidemiologiques sur ces nuisances ainsi qu’a une reflexion sur les expositions et sur les mesures de prevention en milieu de travail.

Background The aim of this study was to determine the rates of compensation awarded to patients presenting with pleural mesothelioma and factors linked to such compensation in France. Methods The study population consisted of 2,407 patients presenting with pleural mesothelioma, recorded by the National Mesothelioma Surveillance Programme between January 1, 1999 and December 31, 2009. Analysis of claims for recognition as “occupational disease” (OD) and claims for compensation by the Compensation Fund for Asbestos Victims (FIVA) were analyzed. Results Approximately 30% of subjects presenting with pleural mesothelioma, affiliated to the General National Health Insurance fund, neither sought recognition as an OD nor claimed for FIVA compensation. Gender, age at diagnosis, type of health insurance, and socio-professional category influence the likelihood of patients presenting with mesothelioma seeking compensation for this disease. Conclusions Results show an under-compensation of pleural mesothelioma as OD and by the FIVA in France. Am. J. Ind. Med. 56:146–154, 2013. © 2011 Wiley Periodicals, Inc.