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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.

Knowledge of pesticide exposure levels in farmers is necessary for epidemiological studies and regulatory purposes. In the European pesticide registration process, operators’ exposure is predicted using the Agricultural Operator Exposure Model (AOEM), created in 2014 by the European Food Safety Authority based on studies conducted by the pesticide industry. We compared operators’ exposures during treatment days in the apple-growing industry under non-controlled working conditions and AOEM-predicted values. The dermal exposure of thirty French apple-growers from the CANEPA study when applying two fungicides was measured using body patches and cotton gloves. For each observation, the corresponding exposure was calculated by means of the AOEM, using data recorded about the operator, spraying equipment and personal protective equipment (PPE) used. A significant linear correlation was observed between calculated and measured daily exposures. The model overestimated the daily exposure approximately 4-fold and the exposure during application 10-fold. However, exposure was underestimated during mixing/loading for 70% of the observations when the operator wore PPE. The AOEM did not overestimate exposures in all circumstances, especially during mixing/loading, when operators handle concentrated products. The protection provided by PPE appeared to be overestimated. This could be due to the optimal working conditions under which the “industrial” studies are conducted, which may not be representative of real working conditions of operators in fruit-growing.

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

Introduction Agricultural work can expose workers to potentially hazardous agents including known and suspected carcinogens. Objectives We aimed to evaluate the cancer incidence in agricultural cohorts in an international consortium, AGRICOH, relative to the respective general populations. Methods For 24 cancer sites/types and all cancers combined, we estimated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) in eight cohorts that were linked to respective cancer registries: France (AGRICAN: n=128,101), the United States (AHS: n=51,165, MESA: n=2,177), Norway (CNAP: n=43,834), Australia (2 cohorts combined, Australian Pesticide Exposed Workers and Victorian Grain Farmers: n=13,134), Republic of Korea (KMCC: n=8,432), and Denmark (SUS: n=1,899). We then combined the SIR estimates across cohorts by random-effects meta-analysis. Results During nearly 2,800,000 person-years, 23,188 cancers were diagnosed. We observed an elevated risk for melanoma of the skin (number of cohorts included=3, meta-SIR=1.18, 95% CI: 1.01–1.38) and multiple myeloma in women (n=4, meta-SIR=1.27, 95% CI: 1.04–1.54) and prostate cancer (n=6, meta-SIR=1.06, 95% CI: 1.01–1.12) compared to the general population. For several cancer sites, including bladder, breast (female), colorectum, esophagus, larynx, lung, and pancreas and all cancers combined, the risk was lower in the agricultural cohorts than in the general population (n=7, sex-adjusted meta-SIR for all cancers combined=0.83, 95% CI: 0.77–0.90). The direction of risk was mostly consistent across cohorts while for some cancer sites, such as liver and lung in men and women, and stomach, colorectum, and skin in men, the SIR varied greatly across cohorts. Conclusion Our findings suggest that agricultural workers have a lower risk of various cancers and an elevated risk for prostate cancer, multiple myeloma (female), and melanoma of skin (female) compared to the general population. The observed excesses and deficits of cancer incidence in agricultural workers may be largely due to underlying differences in risk factors and warrant further investigation of specific agricultural exposures.

Introduction Many studies have shown a link between exposure to pesticides and a higher level of DNA damage. However, longitudinal studies are rare and little is known about long term DNA damage and cancer risk in exposed subjects. Objectives i) Quantify DNA damage for the women included in a French agricultural cohort at two time points, ii) study the relationship between DNA damage and agricultural tasks, and iii) between DNA damage and cancer incidence. Methods 320 female agricultural workers were enrolled from 1997 to 2000 and completed a face-to-face questionnaire. 245 gave a blood sample at enrolment (T0). Ten years later, 104 donated another sample (T10). Using the comet assay with an internal historical negative control, we quantified DNA damage in PBMC on 200 nuclei using a 4-category visual scoring system. Results At enrolment, there were no differences in DNA damage for farm owners/co-owners (n=135, 55%, p=0.84), or participants in livestock tasks within our study population (n=159, 65%, p=0.23). Pesticide exposure through application of anti-parasites to livestock (n=138, 56%, p=0.25) and disinfection of milking equipment (n=117, 48%, p=0.78) did not influence DNA damage. However, damage tended to be higher for those implicated in milking (n=109, 44%, p=0.18). Women who carried out administrative (n=180, 73%) and domestic tasks (n=213, 87%) tended to have lower damage scores (p=0.08 and p=0.07, respectively), as well as women who undertook other tasks had significantly lower damage (p=0.04) than those not involved. From enrolment to end of 2017, 37 incident cancer cases were diagnosed, of which 21 were breast cancer cases. No association was found between DNA damage and cancer incidence (p=0.45). Conclusion Occupational exposure in the agricultural field could be evaluated using the comet assay. Women’s involvement to tasks not related to farm upkeep show a lower level of DNA damage than those not undertaking these tasks.

Introduction Pesticide exposures increase the risk of chronic diseases in farmers. Knowledge of exposure levels are needed for epidemiological studies and for regulation. In pesticide registration process, operator’s exposure is predicted by the AOEM, set up in 2014 by the European Food Safety Authority, based on thirty studies conducted by the pesticide industry. To date, we are not aware of any field study comparing predicted data with those measured under real working conditions. Objective We aimed to compare operators’ exposures during treatment days in apple-growing under non-controlled conditions of work and values predicted by AOEM. Methods Thirty apple growers from the French CANEPA study, were observed applying two fungicides (captan/dithianon) in 2016–2017. Dermal exposure was measured by body patches and cotton gloves. Detailed parameters about the farm, operator, application day, spraying equipment and personal protective equipment (PPE) used were recorded. For each observation, the corresponding exposure was calculated by the AOEM, using these parameters. The relationship between measured and calculated exposures was studied by linear regression. Results Significant linear correlation was observed between calculated and measured daily exposures. Overall, the model overestimated daily exposure and exposure during application. However exposure was underestimated at mixing/loading in many observations, especially when the operator wore long working clothes or gloves. Conclusion The AOEM model did not appear conservative in the sense that it did not overestimate exposures in all circumstances. More specifically: 1) the overestimation at spraying appeared a consequence of the overestimation of daily treated area, 2) the protection provided by PPE appeared overestimated, 3) mixing/loading exposure, a phase in which operators are exposed to concentrated products, appeared underestimated. These discrepancies could be due to optimal working conditions (larger farms, newer equipment) under which industries’ studies are conducted that are not representative of operators’ actual working conditions in fruit growing.

Introduction Data on pesticide exposure during occupational knapsack spraying is scarce. Objective This field study assessed its levels and determinants. Methods Private landscapers/gardeners and municipal workers in the Normandy region, France, were enrolled between March and May 2011. They were equipped with cotton undergarments and gloves to assess actual dermal exposure to glyphosate, and with cotton coveralls separately for each phase to assess the contribution of mixing/loading and spraying and the distribution on 11 body areas. A field monitor observed the whole workshift and filled in a standardized observation grid. Respiratory samplings were also systematically performed, and additional surface wipes obtained from various equipment. Results Twenty-four workers were included, all men, with a median age of 40 years old, and a median experience in pesticide use of 14.5 years. The total work time varied between 110 and 360 min (median 210), and the number of mixing/loading-spraying cycles ranged from 1 to 8 (median 2). Spraying was more exposing than mixing/loading for all body parts except hands. Hands contributed to nearly 90% of body exposure during mixing/loading, and 30% during spraying, followed by back for spraying (14%). The median actual body contamination was 5,256 µg, with a median of 4,620 µg for hands. Dermal PPE use was associated with a decreased actual dermal exposure (estimate -0.81, p=0.001), and the number of mixing/spraying cycles with an increased exposure (more or less than 2 cycles: estimate 0.85, p=0.0006). Conclusion Given their large contribution to overall dermal exposure, caution should be paid to handwashing and common hygiene rules during knapsack spraying. To our knowledge, our study is the first to report a high contamination of the back during spraying.

International audience; Objective Although apple trees are heavily sprayed, few studies have assessed the pesticide exposure of operators and workers in apple orchards. However, these data are crucial for assessing the health impact of such exposures. The aim of this study was to measure pesticide exposure in apple growing according to tasks and body parts. Methods A non-controlled field study was conducted in apple orchards in 4 regions of France during the 2016 and 2017 treatment seasons. Workers’ external contamination and their determinants were assessed over 156 working days corresponding to 30 treatment days, 68 re-entry days and 58 harvesting days. We measured pesticide dermal contamination during each task and made detailed observations of work characteristics throughout the day. Captan and dithianon were used as markers of exposure. Results The median dermal contamination per day was 5.50 mg of captan and 3.33 mg of dithianon for operators, 24.39 mg of captan and 1.84 mg of dithianon for re-entry workers, and 5.82 mg of captan and 0.74 mg of dithianon for harvesters. Thus, workers performing re-entry tasks, especially thinning and anti-hail net opening, presented higher contamination, either equal to or higher than in operators. For these last ones, mixing/loading and equipment cleaning were the most contaminating tasks. Most of the contamination was observed on workers’ hands in all tasks, except for net-opening in which their heads accounted for the most daily contamination. Conclusions This study highlights the importance of taking indirect exposures into account during re-entry work in apple growing.

Correction to: Scientific Reports https://doi.org/10.1038/s41598-021-95976-7, published online 18 August 2021

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.

Objectives In few retrospective studies, prolonged time-to-pregnancy (TTP) was observed for women exposed to pesticides especially in flower production. The present study investigated time-to-pregnancy in the AGRICAN cohort. Methods Analyses were performed on 616 women reporting a pregnancy (2005 to 2017), and data on agricultural activities performed before the last pregnancy was retrospectively collected. Fecundability odds ratios (fOR) were estimated using a discrete time analogue of Cox proportional hazard model adjusted on maternal and paternal age, body mass index (BMI), and alcohol consumption. Results A decrease in fecundability was non-significantly associated with farm work (adjusted fOR = 0.86; 95% confidence interval [CI]: 0.71 to 1.05). Decreases were also observed for nightwork (afOR = 0.75; 95% CI: 0.49 to 1.15) and exposure to vibrations (afOR = 0.68; 95% CI: 0.43 to 1.09). Conclusion Women working on a farm before conception appeared to experience a longer TTP. Negative associations were suggested for some agricultural activities and working conditions.

Background: The etiology of the central nervous system (CNS) tumors remains largely unknown. The role of pesticide exposure has been suggested by several epidemiological studies, but with no definitive conclusion. Objective: To analyze associations between occupational pesticide exposure and primary CNS tumors in adults in the CERENAT study. Methods: CERENAT is a multicenter case-control study conducted in France in 2004-2006. Data about occupational pesticide uses - in and outside agriculture - were collected during detailed face-to-face interviews and reviewed by experts for consistency and exposure assignment. Odds ratios (ORs) and 95% confidence intervals (95%CI) were estimated with conditional logistic regression. Results: A total of 596 cases (273 gliomas, 218 meningiomas, 105 others) and 1 192 age- and sex-matched controls selected in the general population were analyzed. Direct and indirect exposures to pesticides in agriculture were respectively assigned to 125 (7.0%) and 629 (35.2%) individuals and exposure outside agriculture to 146 (8.2%) individuals. For overall agricultural exposure, we observed no increase in risk for all brain tumors (OR=1.04, 0.69-1.57) and a slight increase for gliomas (OR=1.37, 0.79-2.39). Risks for gliomas were higher when considering agricultural exposure for more than 10 years (OR=2.22, 0.94-2.24) and significantly trebled in open field agriculture (OR=3.58, 1.20-0.70). Increases in risk were also observed in non-agricultural exposures, especially in green space workers who were directly exposed (OR=1.89, 0.82-4.39), and these were statistically significant for those exposed for over 10 years (OR=2.84, 1.15-6.99). Discussion: These data support some previous findings regarding the potential role of occupational exposures to pesticides in CNS tumors, both inside and outside agriculture.

[Abstract] The alkaline comet assay, or single cell gel electrophoresis, is one of the most popular methods for assessing DNA damage in human population. One of the open issues concerning this assay is the identification of those factors that can explain the large inter-individual and inter-laboratory variation. International collaborative initiatives such as the hCOMET project - a COST Action launched in 2016 - represent a valuable tool to meet this challenge. The aims of hCOMET were to establish reference values for the level of DNA damage in humans, to investigate the effect of host factors, lifestyle and exposure to genotoxic agents, and to compare different sources of assay variability. A database of 19,320 subjects was generated, pooling data from 105 studies run by 44 laboratories in 26 countries between 1999 and 2019. A mixed random effect log-linear model, in parallel with a classic meta-analysis, was applied to take into account the extensive heterogeneity of data, due to descriptor, specimen and protocol variability. As a result of this analysis interquartile intervals of DNA strand breaks (which includes alkali-labile sites) were reported for tail intensity, tail length, and tail moment (comet assay descriptors). A small variation by age was reported in some datasets, suggesting higher DNA damage in oldest age-classes, while no effect could be shown for sex or smoking habit, although the lack of data on heavy smokers has still to be considered. Finally, highly significant differences in DNA damage were found for most exposures investigated in specific studies. In conclusion, these data, which confirm that DNA damage measured by the comet assay is an excellent biomarker of exposure in several conditions, may contribute to improving the quality of study design and to the standardization of results of the comet assay in human populations. This article is based upon work from COST Action hCOMET CA15132, supported by COST (European Cooperation in Science and Technology www.cost.eu) - STSM fellowships for Mirta Milić (IMROH, EU 19); IMROH, Zagreb, Croatia, Institute for Medical Research and Occupational Health (IMROH), Zagreb, Croatia, and the Ministry of Science, Education and Sports of the Republic of Croatia (Grant No. 022-0222148-2125) (EU4); Cancer Plan for PestiBG; Grant number: no ENV201401(EU 8, EU9); Italian Ministry of Education, University and Research PRIN 2005, prot. 2005058197 and Cariplo Foundation (Milan, Italy), Rif. Pratica 2007-5810 and Rif. Pratica 2010.2303 (EU 18); Associazione Italiana per la Ricerca sul Cancro (AIRC) (IG 2015/17564). (EU19); European Union Integrated Projects New Generis, 6th Framework Programme, Priority 5: Food Quality and Safety; Newborns and Genotoxic Exposure Risks, FOOD-CT-2005-016320 (EU22); ACT project No. 036APy/09 and No. 005DBB/12 (EU 24); FCT-SFRH/BPD/96196/2013, SFRH/BPD/100948/2014, Portugal (EU 26); MZ 2012/8-UKBA-8; VEGA 1/0703/13, APVV 15-0063 (EU30); Xunta de Galicia (XUGA 10605B98; INCITE08PXIB106155PR; ED481B2016/190-0; Grants ED431B2019/02), Spain (EU 32); Grant 01 173034, Ministry of Education, Science and Technological Development of the Republic of Serbia (EU 42); The Centre for Industrial and Technological Development within National Strategic Consortia for Techical Research (Industrial Research diets and food with specific characteristics for elderly, SENIFOOD); University of Navarra LE/97; Physiopathology of Obesity and Nutrition (CIBER Obn); Carlos III Health Research Institute (CB12/03/30002); Ministerio de Economia y Compatitividad (‘Ramón y Cajal’ Programme, RYC-2013-14370) of the Spanish Government for personal support (EU 45); the Ministry of Education, Youth and Sports of the Czech Republic project Healthy Aging in Industrial Environment HAIE (CZ.02.1.01/0.0/0.0/16_019/0000798) which is co-financed by the European Union (European Structural and Investment funds; Operation Programme Research, Development and Education); MYES LO 1508 (EU 46); MICRODIAB Study; ClinicalTrials.org (#NCT02231736) (EU 52); The study was funded by the Italian Ministry for Education, University and Scientific Research (MIUR) - Research No. 2005-062547 (EU14, EU53); Projects financed from Serbian Ministry of Education, Science and Technological Development #11146002, #175035, #173034 (EU 54); Mehr foundation organisation, UK (EU 55); MCTI/CNPQ No. 01/2016-Universal; FAPESC No. 09/2015; MEC/MCTI/CAPES/CNPQ/FAPS/ No. 09/2014, Brazil (CSA 6); the National Nuclear Energy Agency of Indonesia (Badan Tenaga Nuklir Nasional) with contract number 080.01.06 3447.001 001.052.A (AS4); Slovak Grant Agency (APVT-21 013202, APVT-21- 017704); Ministry of Health, Slovak Republic (2005/43-SZU-21, 2006/07- SZU-02 MZ SR, 2005/42-SZU-20

Context The greenspace sector includes a broad range of occupations: gardeners, landscapers, municipal workers, maintenance operators of public facilities, golf-course employees and other sports facilities, horticulturists, plant and tree nursery workers etc. The health impact of occupational pesticide exposure has mainly been studied among farmers. Other professionals such as greenspace workers are also extremely exposed, presenting specific exposure features (practices, types of pesticide used). The aim of this review was to summarize epidemiological literature that examine the relationship between pesticide exposure and the risk of cancer and long-term health effects in greenspace workers. Method Six main groups of greenspace workers were identified and examined through a systematic literature review based on PubMed and Scopus. The studies were then grouped according to their design, health outcomes and the type of population studied. Results Forty-four articles were selected among the 1679 identified. Fifteen studies were conducted exclusively among greenspace workers, while ten also studied these workers with other pesticide applicators. Six were cohorts from the general population in which greenspace workers were identified. Elevated risks were found in several studies for leukaemia, soft-tissue sarcoma, multiple myeloma, non-Hodgkin lymphoma and Parkinson's disease. Discussion The majority of studies used rough parameters for defining exposure such as job titles which could lead to the misclassification of exposure, with the risk of false or positive negative conclusions. Health outcomes were mainly collected through registries or death certificates, and information regarding potential confounders was often missing. Conclusion The review identified only 15 studies conducted exclusively among greenspace workers. Elevated risk was found for several sites of cancer and Parkinson's diseases. Further epidemiological research is needed, conducted specifically on these workers, to better characterize this population, its exposure to pesticides and the related health effects.

International audience; Background:Pesticide exposures are suspected to be implicated in the excess of central nervous system (CNS) tumours observed in farmers, but evidence concerning individual pesticides remains limited. Carbamate insecticides, used on a wide range of crops, have shown evidence of carcinogenicity in some experimental studies. In the cohort AGRICAN (AGRIculture & CANcer), we assessed the associations between potential exposures to carbamate insecticides and the incidence of CNS tumours, overall and by histological subtype.Methods:AGRICAN enrolled 181 842 participants involved in agriculture. Incident CNS tumours were identified by linkage with cancer registries from enrolment (2005-07) until 2013. Carbamate exposure was assessed by combining information on lifetime periods of pesticide use on crop or livestock and the French crop-exposure matrix PESTIMAT, individually for each of the 19 carbamate insecticides registered in France since 1950. Associations were estimated using proportional hazards models with age as the underlying time scale, adjusting for gender, educational level and smoking.Results:During a 6.9-year average follow-up, 381 incident cases of CNS tumours occurred, including 164 gliomas and 134 meningiomas. Analyses showed increased risks of CNS tumours with overall exposure to carbamate insecticides and linear trends with duration of use of each carbamate. Considering tumour subtypes, hazard ratios for gliomas ranged from 1.18 for thiofanox to 4.60 for formetanate, and for meningiomas from 1.51 for carbaryl to 3.67 for thiofanox.Conclusions:Findings reinforce carcinogenicity evidence for already suspected active ingredients and draw attention to additional active ingredients, notably used on fruit trees, vineyards, potatoes and beets.

The effect of ELF-MF on human health is still controversial, particularly as regards long-term health effects like cancer. The literature does suggest, however, that they could be involved in the occurrence of brain tumors, although results concerning residential exposure are scarce. Our objective was to investigate the association between residential proximity to power lines and brain tumors among adults in France by using a geographical information system.CERENAT is a population-based case-control study carried out in France in 2004-2006. We used geographical data sources on power line location to create exposure scores based on distance between residence and power lines, and on the number of lines near residences. Conditional logistic regression for matched sets was used to estimate Odds Ratios (ORs) and 95% confidence intervals (95%CI).We found significant associations between cumulated duration living at50 m to high voltage lines and: i) all brain tumors (OR 2.94; 95%CI 1.28-6.75); ii) glioma (OR 4.96; 95%CI 1.56-15.77). Further investigations are needed, particularly to improve the quality and availability of geographical and technical data on power lines.

International audience; PURPOSE:Epidemiological studies have found an increased risk of multiple myeloma (MM) in farmers. Few studies have investigated the detailed circumstances of occupational pesticide exposure which could explain these increased risks (pesticide use on crops, seeds or on animals, contact with treated crops) and the role of other exposures. In the Agriculture and Cancer cohort (AGRICAN), we assessed the associations between MM and crop- or animal-related activities, with specific attention to pesticide exposure via use on animals and crops or contact with treated crops and to disinfectant exposure.METHODS:Analyses concerned 155,192 participants, including 269 incident MM identified by cancer registries from enrolment (2005-2007) to 2013. Cox models using attained age as time scale were run to calculate hazard ratios (HR) and 95% confidence intervals (CI).RESULTS:MM risk was increased in farmers (i) who started using pesticides on crops in the 1960s, especially among those applying pesticides on corn (≥ 20 years: HR 1.73, 95% CI 1.08, 2.78, p for trend

International audience; Occupational exposure to pesticides concerns a wide population of workers not only in agriculture. The reliability of self-reported information on pesticide use is questionable because of the diversity of use. The PESTIPOP job-exposure matrix has been designed to assess pesticide occupational exposure in the general population. The matrix is composed of two axes: the first axis corresponding to jobs (combinations of occupations and industries) and the second one to pesticide exposure. The estimated exposure metric is the probability of exposure coupled with a reliability assessment (low, medium or high). These metrics were defined by combining different sources: (1) an a priori expert assessment (Agricultural industry experts); (2) data from a multicenter case-control study on brain tumors in the general population (occupational history, specific questionnaires); and (3) an a posteriori expert assessment based on the data of a case-control study. So far, 2559 jobs have been identified and 209 (8%) were found to be exposed to pesticides. Jobs with agricultural exposure had a higher exposure probability than jobs with non-agricultural exposure (wood preservation, park maintenance, pest control). Indirect exposure was more frequent than direct exposure. The PESTIPOP matrix will be transcoded into international classifications for use in epidemiological studies.

Studies in farmers suggest a possible role of pesticides in the occurrence of Central Nervous System (CNS) tumors but scientific evidence is still insufficient. Using data from the French prospective agricultural cohort AGRICAN (Agriculture & Cancer), we investigated the associations between exposure of farmers and pesticide users to various kinds of crops and animal farming and the incidence of CNS tumors, overall and by subtypes. Over the 2005-2007, 181,842 participants completed the enrollment questionnaire that collected a complete job calendar with lifetime history of farming types. Associations were estimated using proportional hazards models with age as underlying timescale. During a 5.2 years average follow-up, 273 incident cases of CNS tumors occurred, including 126 gliomas and 87 meningiomas. Analyses showed several increased risks of CNS tumors in farmers, especially in pesticide users (hazard ratio = 1.96; 95% confidence interval: 1.11-3.47). Associations varied with tumor subtypes and kinds of crop and animal farming. The main increases in risk were observed for meningiomas in pig farmers and in farmers growing sunflowers, beets and potatoes and for gliomas in farmers growing grasslands. In most cases, more pronounced risk excesses were observed among pesticide applicators. Even if we cannot completely rule out the contribution of other factors, pesticide exposures could be of primary concern to explain these findings.

Introduction Le departement de la Manche, 2e producteur francais de lait compte 3100 elevages laitiers soit 59 % des exploitations de ce territoire. Au total, 3451 salaries soit 18,5 % des salaries agricoles travaillent en culture-elevage. Nous nous sommes interesses au risque chimique lors de la traite du fait du poids de ce secteur, d’une part, et de la priorite nationale donnee a la prevention de ce risque, d’autre part. La litterature ne traite pas de ce sujet specifique et il est impossible de connaitre les volumes de produits auxquels ces salaries sont exposes. Materiel et methode Nous avons mene une etude transversale avec auto-questionnaires anonymes de mars a novembre 2019 aupres de 131 salaries agricoles vachers par un infirmier du service lors de visites d’information et de prevention. Ce questionnaire comportait 4 parties : connaissance des produits, antecedents d’accidents, manipulations des produits, et usage d’equipements de protection individuelle et collective. Par ailleurs, les fiches de donnees de securite (FDS) de 34 produits ont ete analysees. Resultats La population enquetee etait essentiellement masculine (80 %), jeune (mediane 23,5 ans) dont l’anciennete etait moderee (mediane 7 ans). Un tiers des salaries declaraient connaitre l’existence des FDS et moins d’un tiers connaissaient le nom des produits utilises. 85 % declaraient avoir vu des pictogrammes sur les emballages mais sans pouvoir les identifier avec certitude. Quatorze pour cent ont presente des symptomes en lien avec ces produits qui pour 55 % etaient des irritations oculaires ou cutanees. Quarante-cinq pour cent ne portaient jamais de gants et 97 % jamais de lunettes de protection. L’analyse des FDS de produits de lavage des circuits de lait, de pre- et post-trempage et de desinfection des faisceaux retrouvait essentiellement des caracteristiques irritantes ou corrosives pour les yeux et la peau. Discussion Cette etude confirme la meconnaissance importante des produits utilises par les salaries de salle de traite. Celle-ci est sans lien avec l’anciennete. La presence de pictogrammes est connue mais il est possible qu’il y ait des confusions avec d’autres produits de l’exploitation, pres d’un quart des salaries indiquant des pictogrammes non retrouves sur les FDS. Il faut remarquer que la moitie des symptomes accidentels correspond a des irritations, corroborant les donnees des FDS. Conclusion Ce travail revele que le risque chimique existe en salle de traite et qu’il doit etre connu et evalue. Des etudes epidemiologiques plus poussees seraient necessaires pour connaitre les consequences a long terme de ces expositions. La meconnaissance du nom des produits est un probleme pour gerer ce risque tant pour les salaries que pour les preventeurs.

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.

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.