Author: "Faraldo, Beatrice" / Topic: medicine - Searchworks@Jio Institute Digital Library Search Results

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55 results on '"Faraldo, Beatrice"'

1. Cleaners and airway diseases

Author: Orianne Dumas, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, and Faraldo, Beatrice
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Detergents, occupational airway diseases, Immunology, DCPS, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Occupational Exposure, Health care, Epidemiology, medicine, Humans, COPD, Immunology and Allergy, 030212 general & internal medicine, Intensive care medicine, Lung function, Rhinitis, Asthma, business.industry, Chronic rhinitis, asthma, medicine.disease, respiratory tract diseases, 3. Good health, [SDV] Life Sciences [q-bio], Occupational Diseases, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, cleaning products, disinfectants, business, Airway
Abstract: International audience; Purpose of review: Evidence for adverse respiratory effects of occupational exposure to disinfectants and cleaning products (DCPs) has grown in the last two decades. The relationship between DCPs and asthma is well-documented, but questions remain regarding specific causal agents. Beyond asthma, associations between DCPs and COPD or chronic rhinitis are plausible and have been examined recently. The purpose of this review is to summarize recent advances on the effect of occupational exposure to DCP and chronic airway diseases. Recent findings: Recent epidemiological studies have often focused on healthcare workers and are characterized by efforts to improve assessment of exposure to specific DCPs. Despite increasing knowledge on the effect of DCPs on asthma, the burden of work-related asthma caused by DCPs has not decreased in the past decade, emphasizing the need to strengthen prevention efforts. Novel data suggest an association between occupational exposure to DCPs and other chronic airway diseases, such as rhinitis, COPD and poor lung function. Summary: Epidemiological and experimental data showed that many chemicals contained in DCPs are likely to cause airway damages, indicating that prevention strategies should target multiple products. Further research is needed to evaluate the impact of DCPs exposure on occupational airway diseases beyond asthma.
Published: 2020

2. Association Between Life‐Course Obesity and Frailty in Older Adults: Findings in the GAZEL Cohort

Author: Joël Ankri, Marie Zins, Sébastien Czernichow, Benjamin Landré, Marie Herr, Marcel Goldberg, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Cité - UFR Médecine [Santé] (UPCité UFR Médecine), Université Paris Cité (UPCité), Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Faraldo, Beatrice, Université de Paris - UFR Médecine Paris Centre [Santé] (UP Médecine Paris Centre), Université de Paris (UP), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP)
Subjects: Male, Weakness, life-course, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), 030209 endocrinology & metabolism, frailty, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Weight loss, Weight management, medicine, Humans, Obesity, 030212 general & internal medicine, Aged, 2. Zero hunger, Nutrition and Dietetics, business.industry, Odds ratio, Middle Aged, medicine.disease, [SDV] Life Sciences [q-bio], [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, Life course approach, Female, epidemiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, business, Demography, Cohort study
Abstract: International audience; Objective: This study aimed to assess the relationship between weight history during adulthood and frailty in late life in men and women participating in the GAZEL (GAZ and ELectricité) cohort.Methods: This cohort study included 8,751 men and 3,033 women (aged 61 to 76 years) followed up since 1989. Modified Fried's frailty criteria (weakness, fatigue, unintentional weight loss, low physical activity, and impaired mobility) were assessed in 2015. Reported BMI was determined each year to characterize: obesity status in 2015, obesity duration over the 1990 to 2015 period, and trajectories of BMI. Associations between frailty and weight history were assessed using multinomial regression.Results: In 2015, 12% of men had obesity, 1.8% severe obesity, and 0.4% morbid obesity; for women, these percentages were 11%, 2.2%, and 0.8%, respectively. Individuals with obesity were more likely to be frail than those with normal BMI and the risk of frailty increased with each additional year of obesity (adjusted odds ratio 1.04 [1.00-1.08] for men and 1.07 [1.02-1.13] for women). Trajectories of BMI revealed that both long-term obesity and onset of obesity in late adulthood were associated with frailty.Conclusions: Current and past obesity appear to be important determinants of frailty. Early weight management may be beneficial in old age.
Published: 2020

3. Damaging effects of household cleaning products on the lungs

Author: Nicole Le Moual, Orianne Dumas, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Faraldo, Beatrice
Subjects: Adult, Lung Diseases, Pulmonary and Respiratory Medicine, Range (biology), [SDV]Life Sciences [q-bio], media_common.quotation_subject, Fertility, complex mixtures, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Environmental health, COPD, Humans, Immunology and Allergy, Medicine, 030212 general & internal medicine, Chemical exposures, Child, ComputingMilieux_MISCELLANEOUS, Cleaning products, media_common, business.industry, Public Health, Environmental and Occupational Health, Asthma, 3. Good health, [SDV] Life Sciences [q-bio], 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Disinfectants
Abstract: Cleaning products and disinfectants are important contributors to chemical exposures in the indoor environment. Concerns regarding their health effects, which may range from fertility to cardiovasc...
Published: 2019

4. Household cleaning and poor asthma control among elderly women

Author: Valérie Siroux, Marie-Christine Boutron-Ruault, Annabelle Bédard, Sofia Temam, Orianne Dumas, Sébastien Chanoine, Mohammed Sedki, Matthieu Marbac, Nicole Le Moual, Raphaëlle Varraso, Judith Garcia-Aymerich, Gianluca Severi, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Centre de Recherche en Economie et Statistique [Bruz] (CREST), Ecole Nationale de la Statistique et de l'Analyse de l'Information [Bruz] (ENSAI), Fondation d’entreprise MGEN pour la santé publique (FESP MGEN), 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), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), CIBER de Epidemiología y Salud Pública (CIBERESP), Universitat Pompeu Fabra [Barcelona] (UPF), ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010), Faraldo, Beatrice, and Cohortes - Etude Epidémiologique des Enfants de femmes de l'Education Nationale - - E4N2010 - ANR-10-COHO-0006 - COHO - VALID
Subjects: Adult, Household exposure, Women, Detergents, Very frequent, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Occupational Exposure, Asthma control, Sprays, Odds Ratio, Immunology and Allergy, Medicine, Humans, 030212 general & internal medicine, Cleaning products, Asthma, Aged, 2. Zero hunger, business.industry, Environmental exposures, Case-control study, Odds ratio, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Clinical research, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, Cohort, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Chemicals, business, Body mass index, Disinfectants
Abstract: Background Asthma control is suboptimal in nearly half of adults with asthma. Household exposure to disinfectants and cleaning products (DCP) has been associated with adverse respiratory effects, but data on their association with asthma control are scant. Objectives To investigate the association between household use of DCP and asthma control in a large cohort of French elderly women. Methods We used data from a case-control study on asthma (2011-2013) nested in the E3N cohort. Among 3023 women with current asthma, asthma control was defined by the Asthma Control Test (ACT). We used a standardized questionnaire to assess the frequency of cleaning tasks and DCP use. We also identified household cleaning patterns using a clustering approach. Associations between DCP and ACT were adjusted for age, smoking status, body mass index, and education. Results Data on ACT and DCP use were available for 2223 women (70 ± 6 years old). Asthma was controlled (ACT = 25), partly controlled (ACT = 20-24), and poorly controlled (ACT ≤ 19) in 29%, 46%, and 25% of the participants, respectively. Weekly use of sprays and chemicals was associated with poorly controlled asthma (odds ratio [95% confidence interval]: 1 spray: 1.31 [0.94-1.84], ≥2 sprays: 1.65 [1.07-2.53], P trend: .01; 1 chemical: 1.24 [0.94-1.64], ≥2 chemicals: 1.47 [1.03-2.09], P trend: .02). Risk for poor asthma control increased with the patterns “very frequent use of products” (1.74 [1.13-2.70]) and “infrequent cleaning tasks and intermediate use of products” (1.62 [1.05-2.51]). Conclusion Regular use of DCP may contribute to poor asthma control in elderly women. Limiting their use may help improve asthma management.
Published: 2021

5. Comparison of a Barcode-Based Smartphone Application to a Questionnaire to Assess the Use of Cleaning Products at Home and Their Association with Asthma Symptoms

Author: Lemire, Pierre, Temam, Sofia, Quinot, Catherine, Sévin, Etienne, Remacle, Sophie, Supernant, Karine, Dumas, Orianne, Le Moual, Nicole, Eyriey, E., Licinia, A., Vellement, A., Pin, Isabelle, Hofmann, P., Hullo, Églantine, Llerena, Catherine, Morin, X., Morlot, A., Lepeule, Johanna, Lyon-Caen, Sarah, Philippat, Claire, Quentin, Joane, Siroux, Valérie, Slama, Rémy, Faraldo, Beatrice, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, MGEN Foundation for Public Health [Paris] (FESP-MGEN), 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), EpiConcept [Paris], The Sepages Study Group., Fondation d’entreprise MGEN pour la santé publique (FESP MGEN), Anses-PNR-EST-2015-1-022/Ademe-1594C0091, Anses-PNR-EST-2017-1-101/Ademe-1762C0021 Seventh Framework Programme, FP7: FP7/2007-206, N308333-HELIX European Research Council, ERC: N 311765-E-DOHaD Agence Nationale de la Recherche, ANR: 14-CE21-0007-01, 19-CE36-0003-01, ANR 18-CE36-005, ANR-12-PDOC-0029-01, ANR-15-IDEX, ANR-15-IDEX-02 Institut National de la Santé et de la Recherche Médicale, Inserm Fondation de France: CLI-MATHES—00081169 Commissariat Général à l'Investissement, CGI Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail, ANSES: PNR-EST-2018-1-264 Agir pour les Maladies Chroniques, Acknowledgments: We acknowledge the role of SEPAGES cohort study group: E. Eyriey, A. Licinia, A. Vellement (Groupe Hospitalier Mutualiste, Grenoble), I. Pin, P. Hofmann, E. Hullo, C. Llerena (Grenoble University Hospital, La Tronche), X. Morin (Clinique des Cèdres, Echirolles), A. Morlot (Clinique Belledonne, Saint-Martin d’Hères), J. Lepeule, S. Lyon-Caen, C. Philippat, I. Pin, J. Quentin, V. Siroux, R. Slama (Inserm, CNRS, University Grenoble Alpes IAB research center). We thank A. Benlakhryfa, L. Borges, Y. Gioria, clinical research assistants, J. Giraud, M. Marceau, M.-P. Martin, nurses, E. Charvet, A. Putod, midwives, M. Graca, K. Gridel, C. Pelini, fieldworkers, K. Guichardet, A. Levanic, C. Martel, E. Quinteiro neuropsychologists, the sta↵ from Grenoble Center for Clinical Investigation (CIC): J.-L. Cracowski, C. Cracowski, E. Hodaj, D. Abry, N. Gonnet and A. Tournier. A warm thank you also to M. Althuser, S. Althuser, F. Camus-Chauvet, P. Dusonchet, S. Dusonchet, L. Emery, P. Fabbrizio, P. Ho↵mann, D. Marchal André, X. Morin, E. Opoix, L. Pacteau, P. Rivoire, A. Royannais, C. Tomasella, T. Tomasella, D. Tournadre, P. Viossat, E. Volpi, S. Rey, E. Warembourg and clinicians from Grenoble University Hospital for their support in the recruitment of the study volunteers. We also thank A. Buchet, S.F. Caraby, J.-N. Canonica, J. Dujourdil, E. Eyriey, P. Hofmann, M. Jeannin, A. Licina, X. Morin, A. Nicolas, and all midwives from the four maternity wards of Grenoble urban areas. We thank B. Chevolon, C. Cornes, A.S. Gauchez, D. Guergour, P. Faure, J. Arnaud for thyroid hormones assessment. We thank the team of L. Chaperod (EFS) for its implication on the immunological aspects of the project. We thank G. Uzu (IRD) and J.-L. Ja↵rezo (CNRS) for their implication on PM oxidative potential assessment. We thank F.-X. Leupert, O. Bonnet and L. Goirand for the access to the birth certificate database from the Conseil Général de l’Isère. Sépages biospecimens are stored at Grenoble University Hospital (CHU-GA) biobank (bb-0033-00069), we would like to thank the whole CRB team, led by P. Mossuz and P. Lorimier, and in particular the technicians for the huge work of biospecimens processing and pooling: W. Jayar and L. Than, as well as G. Schummer. The Internet platform for secured data collection was developed by Epiconcept Paris (E. Sevin, S. Ployart, A. Polaert). SEPAGES data are stored thanks to Inserm RE-CO-NAI platform funded by Commissariat Général à l’Investissement, with the implication of Sophie de Visme (Inserm DSI). Many thanks to M.A. Charles, RE-CO-NAI coordinator, for her support. Finally, and importantly, we would like to express our sincere thanks to participants of the SEPAGES study. The authors are grateful for the help received from Ines Taarit and Mathias Clément to update the cleaning products ingredients database., Funding: The cohort was supported by the European Research Council (consolidator grant N 311765-E-DOHaD, PI, R. Slama), by the European Community’s Seventh Framework Programme (FP7/2007-206, grant N308333-HELIX, PI, M. Vrijheid), by ANR, the French Research Agency (PAPER project ANR-12-PDOC-0029-01, PI, J. Lepeule, SHALCOH project, 14-CE21-0007-01, PI, R. Slama, GUMME project, PI, R. Slama, ETAPE ANR 18-CE36-005, PI, J. Lepeule, EDeN project 19-CE36-0003-01, SYMER project, ANR-15-IDEX-02, PI, U. Schlattner, Mobil’Air project, ANR-15-IDEX, PI, S. Mathy, supported by University Grenoble-3Alpes), by ANSES (CNAP and HYPAXE projects, PI C. Philippat, PENDORE project, PNR-EST-2018-1-264, PI, V. Siroux), by Plan Cancer (Canc’Air project, PI, P. Guénel), by Association de Recherche sur le Cancer (ARC, PI, P. Guénel), by AGIR pour les maladies chroniques (PI, R. Slama and PRENAPAR project, V. Siroux), and Fonds de Recherche pour la Santé Respiratoire (FRSR, PI, I. Pin) and by Fondation de France (CLI-MATHES—00081169, J. Lepeule). We acknowledge the support of ANSES, Inserm and AGIR pour les maladies chroniques, for SEPAGES feasibility study. The support of 'SCUSI 2017' Région Auvergne-Rhône-Alpes programme is also acknowledged. COBANET-Sepages project was support by Anses and Ademe (COBANET: Anses-PNR-EST-2015-1-022/Ademe-1594C0091, PI: N Le Moual, CRESPINET: Anses-PNR-EST-2017-1-101/Ademe-1762C0021, PI: N Le Moual). Pierre Lemire benefited from a PhD scholarship of the University of Paris-Sud/Paris-Saclay, France., The cohort was supported by the European Research Council (consolidator grant N 311765-E-DOHaD, PI, R. Slama), by the European Community?s Seventh Framework Programme (FP7/2007-206, grant N308333-HELIX, PI, M. Vrijheid), by ANR, the French Research Agency (PAPER project ANR-12-PDOC-0029-01, PI, J. Lepeule, and EDeN project 19-CE36-0003-01, SYMER project, ANR-15-IDEX-02, PI, U. Schlattner, Mobil?Air project, ANR-15-IDEX, PI, S. Mathy, supported by University Grenoble-3Alpes), by ANSES (CNAP and HYPAXE projects, PI C. Philippat, PENDORE project, PNR-EST-2018-1-264, PI, V. Siroux), by Plan Cancer (Canc?Air project, PI, P. Gu?nel), by Association de Recherche sur le Cancer (ARC, PI, P. Gu?nel), by AGIR pour les maladies chroniques (PI, R. Slama and PRENAPAR project, V. Siroux), and Fonds de Recherche pour la Sant? Respiratoire (FRSR, PI, I. Pin) and by Fondation de France (CLIMATHES?00081169, J. Lepeule). We acknowledge the support of ANSES, Inserm and AGIR pour les maladies chroniques, for SEPAGES feasibility study. The support of ?SCUSI 2017? R?gion Auvergne-Rh?ne-Alpes programme is also acknowledged. COBANET-Sepages project was support by Anses and Ademe (COBANET: Anses-PNR-EST-2015-1-022/Ademe-1594C0091, PI: N Le Moual
Subjects: medicine.medical_specialty, Health, Toxicology and Mutagenesis, [SDV]Life Sciences [q-bio], lcsh:Medicine, Smartphone application, Logistic regression, Article, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Environmental health, Epidemiology, Odds Ratio, medicine, Humans, 030212 general & internal medicine, Association (psychology), smartphone application, Asthma, household cleaning products, business.industry, lcsh:R, Public Health, Environmental and Occupational Health, Asthma symptoms, Odds ratio, asthma, medicine.disease, 3. Good health, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Smartphone, business, Kappa, Disinfectants
Abstract: International audience; Household disinfectant and cleaning products (HDCPs) assessment is challenging in epidemiological research. We hypothesized that a newly-developed smartphone application was more objective than questionnaires in assessing HDCPs. Therefore, we aimed to compare both methods, in terms of exposure assessments and respiratory health effects estimates. The women of the SEPAGES birth cohort completed repeated validated questionnaires on HDCPs and respiratory health and used an application to report HDCPs and scan products barcodes, subsequently linked with an ingredients database. Agreements between the two methods were assessed by Kappa coefficients. Logistic regression models estimated associations of HDCP with asthma symptom score. The 101 participants (18 with asthma symptom score ≥1) scanned 617 different products (580 with available ingredients list). Slight to fair agreements for sprays, bleach and scented HDCP were observed (Kappa: 0.35, 0.25, 0.11, respectively). Strength of the associations between HDCP and asthma symptom score varied between both methods but all odds ratios (OR) were greater than one. The number of scanned products used weekly was significantly associated with the asthma symptom score (adjusted-OR [CI 95%]: 1.15 [1.00–1.32]). This study shows the importance of using novel tools in epidemiological research to objectively assess HDCP and therefore reduce exposure measurement errors.
Published: 2021

6. Occupational use of high-level disinfectants and asthma incidence in early- to mid-career female nurses: a prospective cohort study

Author: Nicole Le Moual, Orianne Dumas, Scott A. Henn, Jorge E. Chavarro, Audrey J. Gaskins, Raphaëlle Varraso, Krislyn M. Boggs, Carlos A. Camargo, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Harvard T.H. Chan School of Public Health, Emory University [Atlanta, GA], Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), Massachusetts General Hospital [Boston], National Institute for Occupational Safety and Health [Cincinnati] (NIOSH), Centers for Disease Control and Prevention (CDC), and Faraldo, Beatrice
Subjects: Adult, medicine.medical_specialty, Canada, [SDV]Life Sciences [q-bio], Ethnic group, Nurses, occupational asthma, Article, health care workers, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Occupational Exposure, Health care, medicine, Humans, longitudinal studies, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Asthma incidence, Asthma, business.industry, Incidence, Public Health, Environmental and Occupational Health, asthma, medicine.disease, 030210 environmental & occupational health, United States, 3. Good health, [SDV] Life Sciences [q-bio], [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Body mass index, Occupational asthma, Disinfectants
Abstract: ObjectivesOccupational use of disinfectants among healthcare workers has been associated with asthma. However, most studies are cross-sectional, and longitudinal studies are not entirely consistent. To limit the healthy worker effect, it is important to conduct studies among early- to mid-career workers. We investigated the prospective association between use of disinfectants and asthma incidence in a large cohort of early- to mid-career female nurses.MethodsThe Nurses’ Health Study 3 is an ongoing, prospective, internet-based cohort of female nurses in the USA and Canada (2010–present). Analyses included 17 280 participants without a history of asthma at study entry (mean age: 34 years) and who had completed ≥1 follow-up questionnaire (sent every 6 months). Occupational use of high-level disinfectants (HLDs) was evaluated by questionnaire. We examined the association between HLD use and asthma development, adjusted for age, race, ethnicity, smoking status and body mass index.ResultsDuring 67 392 person-years of follow-up, 391 nurses reported incident clinician-diagnosed asthma. Compared with nurses who reported ≤5 years of HLD use (89%), those with >5 years of HLD use (11%) had increased risk of incident asthma (adjusted HR (95% CI), 1.39 (1.04 to 1.86)). The risk of incident asthma was elevated but not statistically significant in those reporting >5 years of HLD use and current use of ≥2 products (1.72 (0.88 to 3.34)); asthma risk was significantly elevated in women with >5 years of HLD use but no current use (1.46 (1.00 to 2.12)).ConclusionsOccupational use of HLDs was prospectively associated with increased asthma incidence in early- to mid-career nurses.
Published: 2021

7. Severe bronchiolitis profiles and risk of asthma development in Finnish children

Author: Riku Erkkola, Orianne Dumas, Eija Bergroth, Kohei Hasegawa, Pedro A. Piedra, Jonathan M. Mansbach, Tuomas Jartti, Carlos A. Camargo, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Turku University Hospital (TYKS), University of Turku, Central Hospital of Central Finland [Jyväskylä, Finland] (CHCF), University of Kuopio, Massachusetts General Hospital [Boston], Boston Children's Hospital, Harvard Medical School [Boston] (HMS), Baylor College of Medicine (BCM), Baylor University, University of Oulu, Oulu University Hospital [Oulu], Supported by the Allergy Research Foundation, the Sigrid Juselius Foundation, and thePediatric Research Foundation, all in Helsinki, Finland, and Faraldo, Beatrice
Subjects: Pediatrics, medicine.medical_specialty, Rhinovirus, respiratory syncytial virus, Immunology, Eczema, Respiratory Syncytial Virus Infections, medicine.disease_cause, Odds, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Humans, Cluster Analysis, Immunology and Allergy, Medicine, Child, Finland, Respiratory Sounds, Asthma, Childhood asthma, business.industry, Significant difference, Infant, Respiratory infections, Odds ratio, asthma, medicine.disease, 3. Good health, rhinovirus, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Bronchiolitis, Clinical diagnosis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Respiratory Syncytial Virus, business, cluster analysis
Abstract: Background: Recent studies support the existence of several entities under the clinical diagnosis of bronchiolitis. Among infants with severe bronchiolitis, distinct profiles have been differentially associated with development of recurrent wheezing by age 3 years. However, their associations with actual asthma remain unclear. Objectives: Our aim was to study the association between severe bronchiolitis profiles identified by using a clustering approach and childhood asthma. Methods: Among 408 children (aged
Published: 2022

8. Domestic exposure to irritant cleaning agents and asthma in women

Author: Sébastien Chanoine, Nicole Le Moual, Valérie Siroux, Raphaëlle Varraso, Jan-Paul Zock, Orianne Dumas, Sofia Temam, Gianluca Severi, Pierre Lemire, Marie-Christine Boutron-Ruault, 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), 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), Fondation d’entreprise MGEN pour la santé publique (FESP MGEN), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), ANR-10-COHO-0006,E4N,Etude Epidémiologique des Enfants de femmes de l'Education Nationale(2010), 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), Faraldo, Beatrice, and Cohortes - Etude Epidémiologique des Enfants de femmes de l'Education Nationale - - E4N2010 - ANR-10-COHO-0006 - COHO - VALID
Subjects: Cleaning agent, Irritants, medicine.medical_specialty, Allergy, Domestic cleaning, 010504 meteorology & atmospheric sciences, Low education, [SDV]Life Sciences [q-bio], Detergents, Frequency of use, 010501 environmental sciences, Logistic regression, 01 natural sciences, Internal medicine, Environmental health, Occupational Exposure, Medicine, Humans, Respiratory health, lcsh:Environmental sciences, 0105 earth and related environmental sciences, General Environmental Science, Asthma, Aged, lcsh:GE1-350, 2. Zero hunger, Response rate (survey), business.industry, Asthma treatment, medicine.disease, respiratory tract diseases, 3. Good health, [SDV] Life Sciences [q-bio], Occupational Diseases, Increased risk, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, Smoking status, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Asthma, asthma treatment, domestic cleaning, allergy, irritants, business, Body mass index
Abstract: International audience; An adverse role of frequent domestic use of cleaning agents, especially in spray form, on asthma has been reported. However, sparse studies have investigated respiratory health effects of chronic domestic exposure to irritant cleaning agents. This study aims to investigate associations between weekly use of irritant domestic cleaning products and current allergic and non-allergic asthma in a large cohort of elderly women. We used data from the Asthma-E3N nested case-control study on asthma (n = 19,404 women, response rate: 91%, 2011), in which participants completed standardized questionnaires on asthma and on the use of domestic cleaning products including irritants (bleach, ammonia, solvents and acids). Allergic multimorbidity in asthma was assessed from allergic-related medications recorded in drug refunds database. The association between use of irritants and current asthma was estimated by logistic regression (current vs. never asthma) and multinomial logistic regression (never asthma, non-allergic asthma, allergic asthma) adjusted on age, smoking status and body mass index (BMI). In the 12,758 women included in the analysis (mean age: 70 years, current smokers: 4%, BMI ≥ 25 kg/m2: 32%, low education: 11%, current asthma: 23%), 47% reported weekly use of at least one irritant cleaning product at home. Weekly use of irritant products was associated with a higher risk of current asthma (adjusted Odds-Ratio: 1.17, 1.07-1.27). A statistically significant dose-response association was reported (p trend < 0.0001), with both the number of irritant products used weekly (1 irritant: 1.12, 1.02-1.23; 2 irritants: 1.21, 1.05-1.39; 3 irritants or more: 2.08, 1.57-2.75) and the frequency of use (1-3 days/week: 1.12, 1.02-1.23; 4-7 days/week: 1.41,1.22-1.64). A dose-response association was observed with the frequency of products used (p trend < 0.05), for both non-allergic (4-7 days/week: 1.27, 1.02-1.57) and allergic asthma (1.52, 1.27-1.82). In conclusion, weekly use of common cleaning irritants was associated with an increased risk of current asthma, whatever the allergic status.
Published: 2020

9. High level of fluorescent oxidation products and worsening of asthma control over time

Author: Zeina Akiki, Nicole Le Moual, Valérie Siroux, Miora Andrianjafimasy, Régis Matran, Rachel Nadif, Orianne Dumas, Farid Zerimech, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie [Beyrouth, Liban] (INSPECT-LB), Impact de l'environnement chimique sur la santé humaine - ULR 4483 (IMPECS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire de Biochimie et Biologie Moléculaire [CHRU Lille] (Pôle de Biologie Pathologie Génétique), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), 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 [2016-2019] (UGA [2016-2019]), Université Lille Nord de France (COMUE), ANR-05-SEST-0020,Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie(2005), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Faraldo, Beatrice, and Programme Santé-environnement et Santé-travail - Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie - 2005 - ANR-05-SEST-0020 - SEST - VALID
Subjects: Adult, Male, 0301 basic medicine, Longitudinal study, medicine.medical_specialty, Epidemiology, [SDV]Life Sciences [q-bio], Asthma management, Cohort Studies, Young Adult, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, Asthma control, Internal medicine, medicine, Humans, Adult asthma, Letter to the Editor, ComputingMilieux_MISCELLANEOUS, Asthma, lcsh:RC705-779, business.industry, Fluorescent oxidation products, lcsh:Diseases of the respiratory system, Middle Aged, medicine.disease, respiratory tract diseases, 3. Good health, [SDV] Life Sciences [q-bio], 030104 developmental biology, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Oxidative stress, Disease Progression, Biomarker (medicine), Female, Smoking status, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Oxidation-Reduction, Cohort study
Abstract: High Fluorescent oxidation products level (FlOPs), a global oxidative stress biomarker, was associated cross-sectionally with poor asthma outcomes but its longitudinal association with asthma evolution has never been examined. We aimed to study the associations between FlOPs level at baseline and changes in current asthma, asthma attacks and asthma control status over 8 years. We used data from the second survey of the French EGEA cohort study as baseline and the third survey as follow-up. At baseline, the mean age of the 489 participants with ever asthma was 39 (± 16) years, 49% were women. Among participants with controlled asthma at baseline, high FlOPs level was significantly associated with worsening of asthma control at follow-up (odds-ratio adjusted for age, sex and smoking status (95% CI): 2.27 (1.32–3.90). No other significant associations were observed. In conclusion, results suggest FlOPs as a predictor of asthma evolution in adults and a good candidate marker in asthma management.
Published: 2019

10. Association between Hospitalization and Change of Frailty Status in the GAZEL Cohort

Author: Marie Zins, Philippe Aegerter, Benjamin Landré, Marcel Goldberg, Joël Ankri, Marie Herr, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), GIRCI-IF - Cellule Méthodologie – Fondation A. de Rothschild, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP), Département Hospitalier d’Epidémiologie et de Santé Publique [Hôpitaux Universitaires de Paris Ile-de-France Ouest], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), and Faraldo, Beatrice
Subjects: Gerontology, Male, 030309 nutrition & dietetics, [SDV]Life Sciences [q-bio], Frail Elderly, Medicine (miscellaneous), Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, 030212 general & internal medicine, Quality of Life Research, Aged, National health, 0303 health sciences, Nutrition and Dietetics, Main diagnosis, Frailty, business.industry, Geriatrics gerontology, aging, transition, Emergency department, cohort, 3. Good health, [SDV] Life Sciences [q-bio], Hospitalization, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Geriatrics and Gerontology, business, Cohort study
Abstract: International audience; Objectives: To assess the relationship between changes of frailty status and intervening hospitalizations, using information of the GAZEL cohort, matched with the data of the French National Health Data System.Design: Observational cohort study.Participants: Community-dwelling adults of the GAZEL cohort (n = 12145; aged between 58 and 73 years in 2012).Measurements: Frailty was determined with the Strawbridge questionnaire in 2012, 2013 and 2014. Data regarding hospitalizations (notably their number, length of stay, emergency department use, and main diagnosis) were collected from the French National Health Data System. The relationship between intervening hospitalizations and changes of frailty status over time was assessed with multivariate Markov models.Results: The prevalence of frailty was 14% in 2012 and 2013 and 17% in 2014. A total of 2715 changes in frailty status were observed from 2012 to 2014. At least one hospitalization was recorded for 1453 people (12%) between the 2012 and 2013 questionnaires, and 1472 (13%) between the 2013 and 2014 questionnaires. No association was found between intervening hospitalizations and changes of frailty status (aHR 1.14 [0.97-1.35] for robust to frail transition and aHR 0.89 [0.73-1.08] for frail to robust transition). However, repeated hospitalizations, hospitalizations after emergency department use, surgery and several diagnosis groups were significantly associated with transitions towards frailty or its recovery.Conclusion: Hospitalizations encompass a wide range of clinical situations, some of them being associated with incident frailty. An early recognition of these situations could help to better prevent and manage frailty in the early old age.
Published: 2019

11. Low socioeconomic position and neighborhood deprivation are associated with uncontrolled asthma in elderly

Author: Stéphane Rican, Margaux Sanchez, Valérie Siroux, Marie-Christine Boutron-Ruault, Nicole Le Moual, Orianne Dumas, Sofia Temam, Annabelle Bédard, Raphaëlle Varraso, Sébastien Chanoine, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), 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 [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), 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), Laboratoire Dynamiques Sociales et Recomposition des Espaces (LADYSS), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris 8 Vincennes-Saint-Denis (UP8)-Université Paris Nanterre (UPN)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Faraldo, Beatrice, 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)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université Paris-Sud 11 - Faculté de médecine (UP11 UFR Médecine), 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 de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris Diderot - Paris 7 (UPD7)-Université Paris Nanterre (UPN)-Université Paris 8 Vincennes-Saint-Denis (UP8)-Université Panthéon-Sorbonne (UP1)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, Pulmonary and Respiratory Medicine, Socioeconomic position, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Residence Characteristics, immune system diseases, Humans, Medicine, 030212 general & internal medicine, Socioeconomic status, Aged, Asthma, Aged, 80 and over, business.industry, social sciences, Odds ratio, medicine.disease, Confidence interval, 3. Good health, Uncontrolled asthma, Disadvantaged, respiratory tract diseases, Socioeconomic Factors, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Demography
Abstract: Background While uncontrolled asthma in adults is frequent in Europe, the impact of socioeconomic position (SEP) was little investigated. We aimed to investigate the respective association of individual- and area-level SEP with uncontrolled asthma among French elderly women. Methods Analyses were conducted in the Asthma-E3N study, among participants with current asthma (i.e., asthma attacks, treatment, or symptoms in previous year). Asthma control was evaluated using Asthma Control Test (uncontrolled: score ≤19); SEP was defined at both individual- and area-level, using educational level (low, medium, high), the French Deprivation index (tertiles defined at national level), and by merging them in a combined-SEP index. Associations between SEP and asthma control were estimated for 2258 women by logistic regression adjusted for age. Analyses were stratified by asthma controller medication use estimated through a drug reimbursement database. Results Women were 70 years on average and 24% had uncontrolled asthma. A low educational level (11%) was associated with an increased risk of uncontrolled asthma [odds ratio (95% confidence interval) = 1.9 (1.4,2.6)], especially among women not using controller medication [3.1 (1.9,5.1)]. Using the combined-SEP index, the highest risk of uncontrolled asthma was observed among women with the most disadvantaged socioeconomic profile (low educational level and low-SEP neighborhood) [2.5 (1.5,4.2)]. Conclusions Women with low SEP had more often uncontrolled asthma, which might be partly explained by inadequate asthma treatment. To achieve the best management of asthma for elderly patients, a specific attention should be given not only to disadvantaged population and neighborhoods, but also to disadvantaged populations in affluent neighborhoods.
Published: 2019

12. Association of occupational exposure to disinfectants with incidence of chronic obstructive pulmonary disease among US female nurses

Author: Nicole Le Moual, Jan-Paul Zock, Krislyn M. Boggs, Paul K. Henneberger, Catherine Quinot, Orianne Dumas, Frank E. Speizer, Raphaëlle Varraso, Carlos A. Camargo, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Channing Division of Network Medicine [Boston, USA] (Department of Medicine), Harvard Medical School [Boston] (HMS)-Brigham and Women's Hospital [Boston], Department of Emergency Medicine, Massachusetts General Hospital [Boston], Barcelona Institute for Global Health [Barcelona, Spain] (ISGlobal), University of Barcelona-Hospital Clinic [Barcelona, Spain], CIBER de Epidemiología y Salud Pública (CIBERESP), National Institute for Occupational Safety and Health, and Faraldo, Beatrice
Subjects: medicine.medical_specialty, Sodium Hypochlorite, [SDV]Life Sciences [q-bio], Nurses, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Formaldehyde, Occupational Exposure, Internal medicine, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Risk factor, Prospective cohort study, Occupational Health, Original Investigation, Asthma, 2. Zero hunger, COPD, business.industry, Research, Incidence, Incidence (epidemiology), Hazard ratio, Hydrogen Peroxide, General Medicine, Middle Aged, medicine.disease, Health Surveys, United States, respiratory tract diseases, 3. Good health, [SDV] Life Sciences [q-bio], Occupational Diseases, Quaternary Ammonium Compounds, Online Only, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Glutaral, Female, Nurses' Health Study, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Body mass index, Disinfectants, Follow-Up Studies
Abstract: This cohort study evaluates data from the Nurses’ Health Study II to investigate the association of occupational exposure to disinfectants and other cleaning products with the incidence of chronic obstructive pulmonary disease (COPD) among female US registered nurses with no history of COPD at baseline., Key Points Question Is exposure to disinfectants and cleaning products associated with incidence of chronic obstructive pulmonary disease among health care workers? Findings In a cohort study of 73 262 US female nurses participating in the Nurses’ Health Study II who were followed up from 2009 to 2015, occupational exposure to cleaning products and disinfectants was significantly associated with a 25% to 38% increased risk of developing chronic obstructive pulmonary disease independent of asthma and smoking. Meaning This study’s findings suggest that regular use of chemical disinfectants among nurses may be a risk factor for developing chronic obstructive pulmonary disease., Importance Exposure to disinfectants in health care workers has been associated with respiratory health outcomes, including asthma. Despite the biological plausibility of an association between disinfectants (irritant chemicals) and risk of chronic obstructive pulmonary disease (COPD), available data are sparse. Objective To investigate the association between exposure to disinfectants and COPD incidence in a large cohort of US female nurses. Design, Setting, and Participants The Nurses’ Health Study II is a US prospective cohort study of 116 429 female registered nurses from 14 US states who were enrolled in 1989 and followed up through questionnaires every 2 years since. The present study included women who were still in a nursing job and had no history of COPD in 2009, and used data from the 2009 through 2015 questionnaires. Clean and complete data used for this analysis were available in July 2018, and analyses were conducted from September 2018 through August 2019. Exposures Occupational exposure to disinfectants, evaluated by questionnaire and a job-task-exposure matrix (JTEM). Main Outcomes and Measures Incident physician-diagnosed COPD evaluated by questionnaire. Results Among the 73 262 women included in the analyses, mean (SD) age at baseline was 54.7 (4.6) years and 70 311 (96.0%) were white, 1235 (1.7%) black, and 1716 (2.3%) other; and 1345 (1.8%) Hispanic, and 71 917 (98.2%) non-Hispanic. Based on 368 145 person-years of follow-up, 582 nurses reported incident physician-diagnosed COPD. Weekly use of disinfectants to clean surfaces only (16 786 [22.9%] of participants exposed) and to clean medical instruments (13 899 [19.0%] exposed) was associated with COPD incidence, with adjusted hazard ratios of 1.38 (95% CI, 1.13-1.68) for cleaning surfaces only and 1.31 (95% CI, 1.07-1.61) for cleaning medical instruments after adjustment for age, smoking (pack-years), race, ethnicity, and body mass index. High-level exposure, evaluated by the JTEM, to several specific disinfectants (ie, glutaraldehyde, bleach, hydrogen peroxide, alcohol, and quaternary ammonium compounds) was significantly associated with COPD incidence, with adjusted hazard ratios ranging from 1.25 (95% CI, 1.04-1.51) to 1.36 (95% CI, 1.13-1.64). Associations were not modified by smoking or asthma status (P for interaction > .15). Conclusions and Relevance These longitudinal results suggest that regular use of chemical disinfectants among nurses may be a risk factor for developing COPD. If future studies confirm these results, exposure-reduction strategies that are compatible with infection control in health care settings should be developed.
Published: 2019

13. Interactive effect between ATPase-related genes and early-life tobacco smoke exposure on bronchial hyper-responsiveness detected in asthma-ascertained families

Author: Marie-Claude Babron, Emmanuelle Bouzigon, Patricia Margaritte-Jeannin, Myriam Brossard, Florence Demenais, Mark Lathrop, Rachel Nadif, Nolwenn Lavielle, Jocelyne Just, Chloé Sarnowski, Marie-Hélène Dizier, Lucile Pain, Catherine Laprise, Hamida Mohamdi, Faraldo, Beatrice, Variabilité Génétique et Maladies Humaines, Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UPD7), Département des Sciences Fondamentales [Chicoutimi] (DSF), Université du Québec à Chicoutimi (UQAC), Centre de l'Asthme et des Allergies [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Department of Human Genetics [Montréal], McGill University = Université McGill [Montréal, Canada], Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, Pulmonary and Respiratory Medicine, Adult, Male, Positional cloning, Adolescent, [SDV]Life Sciences [q-bio], BHR, Locus (genetics), Single-nucleotide polymorphism, FBAT, Polymorphism, Single Nucleotide, Tobacco smoke, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Medicine, SNP, Humans, Genetic Predisposition to Disease, Phospholipid Transfer Proteins, Child, Gene, Asthma, Genetics, Adenosine Triphosphatases, business.industry, Age Factors, Axonemal Dyneins, asthma, medicine.disease, GxE interaction, ATP, [SDV] Life Sciences [q-bio], 030104 developmental biology, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Motile cilium, Female, Tobacco Smoke Pollution, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Bronchial Hyperreactivity, business, ATP Binding Cassette Transporter 1, ETS
Abstract: BackgroundA positional cloning study of bronchial hyper-responsiveness (BHR) at the 17p11 locus in the French Epidemiological study on the Genetics and Environment of Asthma (EGEA) families showed significant interaction between early-life environmental tobacco smoke (ETS) exposure and genetic variants located in DNAH9. This gene encodes the heavy chain subunit of axonemal dynein, which is involved with ATP in the motile cilia function.Our goal was to identify genetic variants at other genes interacting with ETS in BHR by investigating all genes belonging to the ‘ATP-binding’ and ‘ATPase activity’ pathways which include DNAH9, are targets of cigarette smoke and play a crucial role in the airway inflammation.MethodsFamily-based interaction tests between ETS-exposed and unexposed BHR siblings were conducted in 388 EGEA families. Twenty single-nucleotide polymorphisms (SNP) showing interaction signals (p≤5.10−3) were tested in the 253 Saguenay-Lac-Saint-Jean (SLSJ) families.ResultsOne of these SNPs was significantly replicated for interaction with ETS in SLSJ families (p=0.003). Another SNP reached the significance threshold after correction for multiple testing in the combined analysis of the two samples (p=10−5). Results were confirmed using both a robust log-linear test and a gene-based interaction test.ConclusionThe SNPs showing interaction with ETS belong to the ATP8A1 and ABCA1 genes, which play a role in the maintenance of asymmetry and homeostasis of lung membrane lipids.
Published: 2019

14. Influence of Childhood Asthma and Allergies on Occupational Exposure in Early Adulthood: A Prospective Cohort Study

Author: Jan-Paul Zock, Caroline J Lodge, Jennifer L. Perret, Michael J. Abramson, Bircan Erbas, Nicole Le Moual, Adrian J. Lowe, Orianne Dumas, Shyamali C. Dharmage, Hans Kromhout, Geza Benke, Faraldo, Beatrice, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Melbourne School of Population and Global Health [Melbourne], University of Melbourne, Murdoch Children's Research Institute (MCRI), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Institute for Risk Assessment Sciences, Utrecht University [Utrecht], School of Psychology and Public Health [Melbourne], La Trobe University [Melbourne], and Monash University [Melbourne]
Subjects: Adult, Male, Longitudinal study, Allergy, Health, Toxicology and Mutagenesis, [SDV]Life Sciences [q-bio], lcsh:Medicine, Air Pollutants, Occupational, Logistic regression, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Environmental health, Hypersensitivity, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Young adult, Child, Prospective cohort study, healthy worker hire effect, Asthma, business.industry, allergies, Communication, lcsh:R, Australia, Public Health, Environmental and Occupational Health, longitudinal study, occupational exposure, Middle Aged, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Logistic Models, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, Hay fever, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Asthmagen, Demography, Cohort study
Abstract: Background: Few studies have examined whether childhood asthma/allergies prevented young adults entering jobs with exposure to asthmagens. Aims: To determine whether history of asthma/allergies in childhood was associated with avoidance of exposed jobs in early adulthood. Methods: The Melbourne Atopic Cohort Study recruited 620 children at high risk of allergic diseases at birth (1990-94). Asthma, hay fever and eczema were evaluated by questionnaires at ages 6-7 and 12 years. A follow-up in early adulthood (mean age: 18 years) collected information on the current job. Occupational exposure to asthmagens was evaluated by a revised asthma specific job-exposure-matrix. The association between history of asthma/allergies in childhood and working in a job with exposure to asthmagens (vs. not working or non-exposed job) was evaluated by logistic regression, adjusted for age, sex and parental education. Results: Among 363 participants followed-up until early adulthood, 17% worked in a job with exposure to asthmagens. History of asthma (35%) was not associated with working in an exposed job (adjusted OR: 1.16, 95%CI: 0.65-2.09). Subjects with history of hay fever (37%) and eczema (40%) were more likely to enter exposed jobs (significant for hay fever: 1.87, 1.05-3.33; but not eczema: 1.65, 0.93-2.93). The association for hay fever was more pronounced in those with less parental education (2.97, 1.06-8.38; p for interaction: p=0.24). Conclusion: In this Australian cohort, young adults with history of allergies were more likely to enter exposed jobs, suggesting no asthmagen avoidance. Improved counseling against high risk jobs may be needed for young adults with these conditions.
Published: 2019

15. Risk of Asthma Onset After Natural and Surgical Menopause: Results From the French E3N Cohort

Author: Dominique Courbon, Sylvie Mesrine, Gianluca Severi, Annabelle Bédard, Camille Taillé, Raphaëlle Varraso, Bobette Matulonga-Diakiese, Agnès Fournier, Margaux Sanchez, Bénédicte Leynaert, Gabriel Thabut, Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), 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), Institut Gustave Roussy (IGR), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Pneumologie A [Paris], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), and Faraldo, Beatrice
Subjects: Adult, Pediatrics, medicine.medical_specialty, Epidemiology, Ovariectomy, Menopause, Premature, Overweight, General Biochemistry, Genetics and Molecular Biology, Cohort Studies, 03 medical and health sciences, Surgical Menopause, 0302 clinical medicine, Risk Factors, medicine, Reproductive aging, Humans, Sex hormones, Obesity, Body mass index, Aged, Proportional Hazards Models, Asthma, 030219 obstetrics & reproductive medicine, Proportional hazards model, business.industry, Incidence, Hazard ratio, Obstetrics and Gynecology, Middle Aged, medicine.disease, 3. Good health, respiratory tract diseases, Postmenopause, Menopause, Premenopause, 030228 respiratory system, E3N, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, medicine.symptom, business
Abstract: International audience; Background: The gender switch in asthma incidence around puberty has been put forward to suggest a role of sex hormones in asthma. However, there are limited and inconsistent findings on change in asthma incidence with menopause. We aimed to investigate the associations between menopause and asthma incidence, and interactions with overweight/obesity.Methods: Asthma incidence was assessed in 67,872 women free of asthma at baseline (aged 41-68 years) and regularly followed up as a part of the French E3N cohort. Adjusted hazard ratios (aHR) were derived from Cox models considering age as the time-scale, menopausal status as a time-varying covariate and taking into account menopausal treatment.Results: During 843,243 person-years of follow-up, 1205 new-onset asthma cases were identified. Compared with pre-menopause, surgical menopause was associated with an increased risk of asthma onset (aHR = 1.33 [95%CI 1.01-1.75]) but no association was observed for natural menopause (aHR = 1.05 [0.84-1.32]). In women with natural menopause, a further analysis separating the transition through menopause and the later post-menopausal period did not show any change in asthma incidence with menopause in the total sample or in normal-weight women alone. However, in overweight/obese women, peri-menopausal and post-menopausal women had an increased risk of developing asthma compared with pre-menopausal women of the same age (aHR = 1.91 [1.00-3.66] and aHR = 2.08 [1.07-4.06] respectively).Conclusion: Surgical menopause was associated with an increased risk of asthma onset. For natural menopause, no change in asthma incidence was observed in normal-weight women. However, overweight/obese women had an increased risk of developing asthma after natural menopause.
Published: 2018

16. Asthma is associated with frailty among community-dwelling adults: the GAZEL cohort

Author: Rachel Nadif, Julie Gourmelen, Marie Herr, Marie Zins, Marcel Goldberg, Benjamin Landré, Joël Ankri, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP), ANR-08-BLAN-0028,WORKAGE,Vieillissement prématuré, inégalités sociales de santé et environnement professionnel dans la cohorte GAZEL.(2008), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Faraldo, Beatrice, and Blanc - Vieillissement prématuré, inégalités sociales de santé et environnement professionnel dans la cohorte GAZEL. - - WORKAGE2008 - ANR-08-BLAN-0028 - BLANC - VALID
Subjects: Male, Pulmonary and Respiratory Medicine, Gerontology, Weakness, Frail Elderly, Physical activity, lcsh:Medicine, Comorbidity, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Weight loss, medicine, Humans, 030212 general & internal medicine, Geriatric Assessment, Aged, Asthma, Multinomial logistic regression, lcsh:RC705-779, 2. Zero hunger, asthma, asthma epidemiology, business.industry, lcsh:R, lcsh:Diseases of the respiratory system, Middle Aged, medicine.disease, 3. Good health, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, Regression Analysis, Marital status, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Independent Living, Self Report, medicine.symptom, business, Body mass index
Abstract: IntroductionEarly management of chronic respiratory diseases (CRDs) and frailty have been identified as key targets towards healthy ageing, but the association between CRDs and frailty has been poorly investigated. We studied the association between asthma and frailty in adults of the GAZEL cohort using different definitions of asthma over the 26 years of follow-up.MethodsCurrent asthma definitions are based on yearly self-reports of symptoms or medication (in 2015, constant reports or at least one report between 1990 and 2015), or on a detailed respiratory symptoms questionnaire in 2002. Frailty definition is based on weakness, fatigue, unintentional weight loss, low physical activity and mobility in 2015. Frail participants had three criteria or more, pre-frail 1 or 2, and robust 0. Multinomial regression models adjusted for age, sex, body mass index, smoking, education, marital status and comorbidities were performed.ResultsIn 2015, 12 345 adults (73% men, 61 to 77 years old) were included: 3% of them reported current asthma, 1.6% had constant reports during the follow-up and 9% reported current asthma at least once. In 2015, 6% were frail, 34% pre-frail and 13% of current asthmatics and 6% of non-asthmatics were frail (adjusted OR (aOR) 2.19 (1.44 to 3.34)). Significant associations were also found with the 2002 definition (aOR 2.24 (1.73 to 2.90)), constant reports (aOR 3.67 (1.70 to 7.93)) or at least once (aOR 1.50 (1.15 to 1.98)). Current asthma was also associated with pre-frailty with the 2002 definition (aOR 1.46 (1.26 to 1.68)).DiscussionParticipants with asthma had increased risk of frailty. A better understanding of their relationship could help to define and evaluate strategies for a better ageing of asthmatics.
Published: 2020

17. Patterns of cleaning product exposures using a novel clustering approach for data with correlated variables

Author: Marie-Christine Boutron-Ruault, Matthieu Marbac, Orianne Dumas, Mohammed Sedki, Centre de Recherche en Economie et Statistique [Bruz] (CREST), Ecole Nationale de la Statistique et de l'Analyse de l'Information [Bruz] (ENSAI), Université Paris-Sud - Paris 11 (UP11), Biostatistique, Biomathématique, Pharmacoépidémiologie et Maladies Infectieuses (B2PHI), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en épidémiologie et santé des populations (CESP), 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 Gustave Roussy (IGR), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Faraldo, Beatrice, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Exposome, Dependency (UML), Epidemiology, media_common.quotation_subject, [SDV]Life Sciences [q-bio], Detergents, Context (language use), Machine learning, computer.software_genre, 03 medical and health sciences, 0302 clinical medicine, Cluster analysis, Occupational Exposure, Medicine, Humans, 030212 general & internal medicine, media_common, Aged, 80 and over, Variables, business.industry, Household Products, Environmental Exposure, Middle Aged, Mixture model, Classification, Latent class model, Asthma, Occupational Diseases, [SDV] Life Sciences [q-bio], Household Work, 030228 respiratory system, Conditional independence, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Artificial intelligence, Household cleaning, business, computer, Latent class, Disinfectants
Abstract: Purpose Clustering methods may be useful in epidemiology to better characterize exposures and account for their multidimensional aspects. In this context, application of clustering models allowing for highly dependent variables is of particular interest. We aimed to characterize patterns of domestic exposure to cleaning products using a novel clustering model allowing for highly dependent variables. Methods To identify domestic cleaning patterns in a large population of French women, we used a mixture model of dependency blocks. This novel approach specifically models within-class dependencies, and is an alternative to the latent class model, which assumes conditional independence. Analyses were conducted in 19,398 participants of the E3N study (women aged 61–88 years) who completed a questionnaire regarding household cleaning habits. Results Seven classes were identified, which differed with the frequency of cleaning tasks (e.g., dusting/sweeping/hoovering) and use of specific products (e.g., bleach, sprays). The model also grouped the variables into conditionally independent blocks, providing a summary of the main dependencies among the variables. Conclusions The mixture model of dependency blocks, a useful alternative to the latent class model, may have broader application in epidemiology, in particular, in the context of exposome research and growing need for data-reduction methods.
Published: 2018

18. Impacts on health outcomes and on resource utilisation of home-based parenteral chemotherapy administration: a systematic review protocol

Author: Emmanuel Bagaragaza, Philippe Aegerter, Joël Ankri, Matthieu de Stampa, Benedicte Mittaine-Marzac, Pharmacie à Usage intérieure [Assistance Publique des Hôpitaux de Paris] (Hospitalisation à Domicile ), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Soins Palliatifs En Société – Ethique et Pratique Clinique [Paris] (Pôle Recherche et Enseignement Universitaire SPES), Maison Médicale Jeanne Garnier [Paris], Hôpital Sainte Perine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), This work is supported by the Hospitalisation At Home, Assistance Publique des Hôpitaux de Paris., Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Pharmacie à Usage intérieure [Assistance Publique des Hôpitaux de Paris] ( Hospitalisation à Domicile ), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique ( VIMA ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Soins Palliatifs En Société – Ethique et Pratique Clinique [Paris] ( Pôle Recherche et Enseignement Universitaire SPES ), AP-HP Hôpital Sainte Perine, Département d'information hospitalière et santé publique, Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Ambroise Paré, and Faraldo, Beatrice
Subjects: medicine.medical_specialty, chemotherapy, organisation of health services, 03 medical and health sciences, 0302 clinical medicine, Resource (project management), Neoplasms, Protocol, Medicine, Humans, health economics, Infusions, Parenteral, 030212 general & internal medicine, Protocol (science), Health economics, business.industry, Public health, public health, hospital at home, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, Grey literature, Patient Acceptance of Health Care, Home Care Services, 3. Good health, Patient Outcome Assessment, Systematic review, Research Design, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 030220 oncology & carcinogenesis, Family medicine, Economic evaluation, Health Resources, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Health Services Research, business, qualitative research, Qualitative research, Systematic Reviews as Topic
Abstract: International audience; INTRODUCTION:Despite the demonstrated feasibility and policies to enable more to receive chemotherapy at home, in a few countries, parenteral chemotherapy administration at home remains currently marginal. Of note, findings of different studies on health outcomes and resources utilisation vary, leading to conflicting results. This protocol outlines a systematic review that seeks to synthesise and critically appraise the current state of evidence on the comparison between home setting and hospital setting for parenteral chemotherapy administration within the same high standards of clinical care.METHODS AND ANALYSIS:This protocol has been prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols approach. Electronic searches will be conducted on bibliographic databases selected from the earliest available data through 15 November 2017 published in French and English languages. Additional potential papers in the selected studies and grey literature will be also included in the review. The review will include all types of studies exploring patients receiving anticancer drugs for injection at home compared with patients receiving the drugs in a hospital setting, and will assess at least one of the following criteria: patients' health outcomes, patients' or caregivers' satisfaction, resource utilisation with cost savings, and incentives and/or barriers of each admission setting according to patients' and relatives' points of view. Two reviewers will independently screen studies and extract relevant data from the included studies. Methodological quality of studies will be assessed using the 'Quality Assessment Tool for Quantitative Studies' developed by the Effective Public Health Practice Project tool, in addition to the Consolidated Health Economic Evaluation Reporting Standards statement for economic studies.ETHICS AND DISSEMINATION:As the review is focused on the analysis of secondary data, it does not require ethics approval. The results of the study will be disseminated through articles in peer-reviewed journals and trade publications, as well as presentations at relevant conferences.PROSPERO REGISTRATION NUMBER:CRD42017068164.
Published: 2018

19. Association of hand and arm disinfection with asthma control in US nurses

Author: Alexis Descatha, Orianne Dumas, Nicole Le Moual, Carlos A. Camargo, Jan-Paul Zock, Paul K. Henneberger, Frank E. Speizer, Catherine Quinot, Raphaëlle Varraso, Krislyn M. Boggs, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Channing Division of Network Medicine [Boston, USA] (Department of Medicine), Harvard Medical School [Boston] (HMS)-Brigham and Women's Hospital [Boston], Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Respiratory Health Division [Morgantown, WV, USA], National Institute for Occupational Safety and Health [Morgantown, WV, USA] (NIOSH), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Instituto de Salud Carlos III [Madrid] (ISC), Department of Emergency Medicine [Boston, USA], Harvard Medical School [Boston] (HMS)-Massachusetts General Hospital [Boston], Centers for Disease Control and Prevention R01 OH-10359, National Institutes of Health 12 UM1 CA176726. The research leading to these results has received funding from the People Program (Marie Curie Actions) of the European Union’s Seventh Framework Program (FP7/2007-2013) under REA grant agreement n. PCOFUND-GA-2013-609102, through the PRESTIGE program coordinated by Campus France., European Project: 609102,EC:FP7:PEOPLE,FP7-PEOPLE-2013-COFUND,PRESTIGE(2014), Faraldo, Beatrice, PRES Towards International Gain of Excellence - PRESTIGE - - EC:FP7:PEOPLE2014-09-01 - 2019-08-31 - 609102 - VALID, Brigham and Women's Hospital [Boston]-Harvard Medical School [Boston] (HMS), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP), UMS011 Cohortes épidémiologiques en population (CONSTANCES), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, and Instituto de Salud Carlos III (ISC)
Subjects: medicine.medical_specialty, media_common.quotation_subject, Nurses, Article, health care workers, 03 medical and health sciences, 0302 clinical medicine, Hand sanitizer, Hygiene, Epidemiology, medicine, Humans, 030212 general & internal medicine, Adverse effect, media_common, Asthma, Response rate (survey), business.industry, Public Health, Environmental and Occupational Health, Middle Aged, asthma, medicine.disease, Hand, 030210 environmental & occupational health, United States, 3. Good health, respiratory tract diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Physical therapy, Arm, Female, epidemiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, women, business, occupational asthma, Occupational asthma, Body mass index, Hand Disinfection
Abstract: ObjectivesTo investigate the association between occupational exposure to disinfectants/antiseptics used for hand hygiene and asthma control in nurses.MethodsIn 2014, we invited female nurses with asthma drawn from the Nurses’ Health Study II to complete two supplemental questionnaires on their occupation and asthma (cross-sectional study, response rate: 80%). Among 4055 nurses (mean age: 59 years) with physician-diagnosed asthma and asthma medication use in the past year, we examined asthma control, as defined by the Asthma Control Test (ACT). Nurses were asked about the daily frequency of hand hygiene tasks: ‘wash/scrub hands with disinfectants/hand sanitizers’ (hand hygiene) and ‘wash/scrub arms with disinfecting products’ (surrogate of surgical hand/arm antisepsis). Analyses were adjusted for age, race, ethnicity, smoking status and body mass index.ResultsNurses with partly controlled asthma (ACT: 20–24, 50%) and poorly controlled asthma (ACT ≤19, 18%) were compared with nurses with controlled asthma (ACT=25, 32%). In separate models, both hand and arm hygiene were associated with poorly controlled asthma. After mutual adjustment, only arm hygiene was associated with poorly controlled asthma: OR (95% CI) for 10 times/day) and poor asthma control. Associations persisted after further adjustment for surfaces/instruments disinfection tasks.ConclusionsFrequency of hand/arm hygiene tasks in nurses was associated with poor asthma control. The results suggest an adverse effect of products used for surgical hand/arm antisepsis. This potential new occupational risk factor for asthma warrants further study.
Published: 2018

20. Multimorbidity medications and poor asthma prognosis

Author: Margaux Sanchez, Marie-Christine Boutron-Ruault, Sébastien Chanoine, Sofia Temam, Pierrick Bedouch, Jean Bousquet, Valérie Siroux, Raphaëlle Varraso, Christophe Pison, Isabelle Pin, Agnès Fournier, Nicole Le Moual, Pôle Pharmacie [CHU Grenoble Alpes], Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Centre Hospitalier Universitaire Grenoble Alpes (CHU Grenoble Alpes), Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health (IAB - INSERM U1209 - CNRS UMR5309), 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)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Clinique Universitaire de Pédiatrie [CHU Grenoble Alpes], Hôpital Sud, CHU de Grenoble-Hôpital Couple Enfant de Grenoble, Université Paris-Sud [Le Kremlin-Bicêtre] (Faculté de Médecine), 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), Institut Gustave Roussy (IGR), Service Hospitalier Universitaire Pneumologie-Physiologie [CHU Grenoble Alpes] (Pôle Thorax et Vaisseaux), Centre Hospitalier Universitaire Grenoble Alpes (CHU Grenoble Alpes), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Clinique de pneumologie, CHU Grenoble, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), 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]), This work was supported by a grant of the Institut pour la Recherche en Santé Publique (IReSP), and of the joint support of Direction Générale de la Santé (DGS), Mission recherche de la Direction de la recherche, des études, de l’évaluation et des statistiques (Mire-DREES), Caisse nationale d’assurance maladie des travailleurs salariés (CNAMTS), Régime Social des Indépendants (RSI), and Caisse nationale de solidarité pour l’autonomie (CNSA). In addition, the work was supported by a state grant ANR-10-COHO-0006 from the Agence Nationale de la Recherche within the Investissement d’Avenir program. The research was performed using data from the Inserm E3N cohort and support from the Mutuelle Générale de l’Education Nationale (MGEN), the Gustave Roussy Institute (IGR), the French League against Cancer (LNCC), and the National Institute for Health and Medical Research (Inserm) for setting up and maintaining the cohort., Centre Hospitalier Universitaire Grenoble Alpes ( CHU Grenoble Alpes ) -Université Grenoble Alpes ( UGA ), Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health ( IAB - INSERM U1209 - CNRS UMR5309 ), 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 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 ), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique ( VIMA ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris-Sud [Le Kremlin-Bicêtre] ( Faculté de Médecine ), Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut Gustave Roussy [Villejuif], Service Hospitalier Universitaire Pneumologie-Physiologie [CHU Grenoble Alpes] ( Pôle Thorax et Vaisseaux ), Centre Hospitalier Universitaire Grenoble Alpes ( CHU Grenoble Alpes ), Laboratoire de bioénergétique fondamentale et appliquée ( LBFA ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Grenoble Alpes ( UGA ), Contre les Maladies Chroniques pour un VIeillissement Actif en France ( MACVIA-France ), Centre Hospitalier Universitaire de Montpellier ( CHU Montpellier ), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ), Centre Hospitalier Universitaire [Grenoble] (CHU)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), 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 [2016-2019] (UGA [2016-2019])-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 [2016-2019] (UGA [2016-2019]), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-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), Centre Hospitalier Universitaire [Grenoble] (CHU), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), and Faraldo, Beatrice
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Databases, Factual, multimorbidity, [SDV]Life Sciences [q-bio], MEDLINE, 03 medical and health sciences, 0302 clinical medicine, medications, Quality of life, immune system diseases, Internal medicine, Surveys and Questionnaires, Medicine, Multimorbidity, Cluster Analysis, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Adverse effect, Asthma, Aged, Polypharmacy, Aged, 80 and over, [ SDV ] Life Sciences [q-bio], business.industry, Case-control study, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Original Articles, Middle Aged, asthma, medicine.disease, Prognosis, adverse events, 3. Good health, respiratory tract diseases, [SDV] Life Sciences [q-bio], 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, Quality of Life, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business
Abstract: Multimedication related to multimorbidity is common in the elderly with asthma. We aimed at comprehensively characterising medications used by elderly women and assessing how multimedication impacts on asthma prognosis. We performed network-based analyses on drug administrative databases to visualise the prevalence of drug classes and their interconnections among 17 458 elderly women from the Asthma-E3N study, including 4328 women with asthma. Asthma groups sharing similar medication profiles were identified by a clustering method relying on all medications and were studied in association with adverse asthma events (uncontrolled asthma, attacks/exacerbations and poor asthma-related quality of life). The network-based analysis showed more multimedication in women with asthma than in those without asthma. The clustering method identified three multimedication profiles in asthma: “Few multimorbidity-related medications” (43.5%), “Predominantly allergic multimorbidity-related medications” (32.8%) and “Predominantly metabolic multimorbidity-related medications” (23.7%). Compared with women belonging to the “Few multimorbidity-related medications” profile, women belonging to the two other profiles had an increased risk of uncontrolled asthma and asthma attacks/exacerbations, and had lower asthma-related quality of life. The integrative data-driven approach on drug administrative databases identified specific multimorbidity-related medication profiles that were associated with poor asthma prognosis. These findings support the importance of multimorbidity in the unmet needs in asthma management., Asthma phenotypes identified by multimorbidity medications are associated with asthma prognosis http://ow.ly/Phfq30iR1Qh
Published: 2018

21. Update of an occupational asthma-specific job exposure matrix to assess exposure to 30 specific agents

Author: Le Moual, Nicole, Zock, Jan-Paul, Dumas, Orianne, Lytras, Theodore, Andersson, Eva, Lillienberg, Linnéa, Schlünssen, Vivi, Benke, Geza, Kromhout, Hans, One Health Chemisch, dIRAS RA-2, Dep IRAS, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidemiology & Pulmonology [Barcelona, Spain] (ISGlobal), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal)-Centre de Recerca en Epidemiologia Ambiental - CREAL [Barcelona, Spain]-Universitat Pompeu Fabra [Barcelona] (UPF), Instituto de Salud Carlos III [Madrid] (ISC), Department of Occupational and Environmental Medicine [Gothenburg, Sweden], Sahlgrenska University Hospital [Gothenburg], Department of Public Health [Copenhagen, Denmark] (Danish Ramazzini Centre), Aarhus University [Aarhus]-The National Research Center for Work Environment [Copenhagen, Denmark], Monash Centre for Occupation and Environmental Health [Melbourne, Australia], School of Public Health and Preventive Medicine [Melbourne, Australia]-Monash University [Melbourne, Australia], Department of Environmental Epidemiology [Utrecht, the Netherlands], Utrecht University [Utrecht]-Institute for Risk Assessment Sciences [Utrecht, the Netherlands], PHC Van Gogh programme, EP-Nuffic, Campus France 33653RF (2015-2016), 7th programme-EU (Marie-Curie) [FP7/2007-2013], REA (PCOFUND-GA-2013-609102), PRESTIGE-2015-3-0029 - Campus France. ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya., European Project: 609102,EC:FP7:PEOPLE,FP7-PEOPLE-2013-COFUND,PRESTIGE(2014), One Health Chemisch, dIRAS RA-2, Dep IRAS, Universitat Pompeu Fabra [Barcelona] (UPF)-Centre de Recerca en Epidemiologia Ambiental - CREAL [Barcelona, Spain]-Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Faraldo, Beatrice, and PRES Towards International Gain of Excellence - PRESTIGE - - EC:FP7:PEOPLE2014-09-01 - 2019-08-31 - 609102 - VALID
Subjects: medicine.medical_specialty, asthmagens, [SDV]Life Sciences [q-bio], Job-exposure matrix, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Occupational Exposure, Environmental health, Epidemiology, medicine, Humans, 030212 general & internal medicine, Asthma, Occupational, Occupations, occupational exposure assessment, Asthma, High probability, Sulfates, business.industry, Public Health, Environmental and Occupational Health, job-exposure matrix, International Standard Classification of Occupations, asthma, medicine.disease, [SDV] Life Sciences [q-bio], 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Irritants, Solvents, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Occupational exposure, business, Occupational asthma
Abstract: ObjectivesWe aimed to update an asthmagen job exposure matrix (JEM) developed in the late 1990s. Main reasons were: the number of suspected and recognised asthmagens has since tripled; understanding of the aetiological role of irritants in asthma and methodological insights in application of JEMs have emerged in the period.MethodsFor each agent of the new occupational asthma-specific JEM (OAsJEM), a working group of three experts out of eight evaluated exposure for each International Standard Classification of Occupations, 1988 (ISCO-88) job code into three categories: ‘high’ (high probability of exposure and moderate-to-high intensity), ‘medium’ (low-to-moderate probability or low intensity) and ‘unexposed’. Within a working group, experts evaluated exposures independently from each other. If expert assessments were inconsistent the final decision was taken by consensus. Specificity was favoured over sensitivity, that is, jobs were classified with high exposure only if the probability of exposure was high and the intensity moderate-to-high. In the final review, all experts checked assigned exposures and proposed/improved recommendations for expert re-evaluation after default application of the JEM.ResultsThe OAsJEM covers exposures to 30 sensitisers/irritants, including 12 newly recognised, classified into seven broad groups. Initial agreement between the three experts was mostly fair to moderate (κ values 0.2–0.5). Out of 506 ISCO-88 codes, the majority was classified as unexposed (from 82.6% (organic solvents) to 99.8% (persulfates)) and a minority as ‘high-exposed’ (0.2% (persulfates) to 2.6% (organic solvents)).ConclusionsThe OAsJEM developed to improve occupational exposure assessment may improve evaluations of associations with asthma in epidemiological studies and contribute to assessment of the burden of work-related asthma.
Published: 2018

22. The asthma-rhinitis multimorbidity is associated with IgE polysensitization in adolescents and adults

Author: Rachel Nadif, Magnus Wickman, M. Soler, Natalia Ballardini, Josep M. Antó, Anne Boudier, Valérie Siroux, Rudolf Valenta, Jean Bousquet, Erik Melén, Jocelyne Just, Isabelle Pin, Christian Lupinek, Faraldo, Beatrice, 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 [2016-2019] (UGA [2016-2019]), The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], Sachs’ Children and Youth Hospital [Stockholm, Sweden], St. John's Institute of Dermatology, King‘s College London, Department of Pathophysiology and Allergy Research [Vienna, Austria] (Division of Immunopathology), Medizinische Universität Wien = Medical University of Vienna, Service de pédiatrie générale et maladies infectieuses, CHU Grenoble, Centre de l'Asthme et des Allergies [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Epidémiologie, Systèmes d'Information, Modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Institute of Environmental Medicine, Karolinska Institutet [Stockholm]-Karolinska University Hospital [Stockholm]-Astrid Lindgren Children's Hospital, NRC Institute of immunology FMBA, Moscow Russian federation, Uppsala University, Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: 0301 basic medicine, Male, Epidemiology, Comorbidity, medicine.disease_cause, Immunoglobulin E, Ige reactivity, 0302 clinical medicine, Allergen, Odds Ratio, Immunology and Allergy, Public Health Surveillance, Sensitization, Rhinitis, biology, Middle Aged, Polysensitization, Specific IgE, medicine.anatomical_structure, Phenotype, epidemiology, Female, Birth cohort, Adult, multimorbidity, Adolescent, Immunology, specific IgE, Cross Reactions, 03 medical and health sciences, Young Adult, Swedish population, medicine, Humans, Asthma, Sweden, business.industry, Multimorbidity, Aeroallergen, Allergens, medicine.disease, 030104 developmental biology, 030228 respiratory system, polysensitization, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, biology.protein, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Immunization, business
Abstract: International audience; BACKGROUND:Children with multimorbid asthma and rhinitis show IgE polysensitization to several allergen sources. This association remains poorly studied in adolescents and adults using defined allergen molecules. We investigated IgE sensitization patterns towards a broad panel of aeroallergen components in adults and adolescents with a focus on individuals with asthma and rhinitis multimorbidity.METHODS:IgE reactivity to 64 micro-arrayed aeroallergen molecules was determined with the MeDALL-chip in samples from the French EGEA study (n = 840, age = 40.7 ± 17.1) and the Swedish population-based birth cohort BAMSE (n = 786, age = 16 ± 0.26). The age- and sex-adjusted associations between the number of IgE-reactive allergen molecules (≥0.3 ISU) and the asthma-rhinitis phenotypes were assessed using a negative binomial model.RESULTS:Groups representing 4 phenotypes were identified: no asthma-no rhinitis (A-R-; 30% in EGEA and 54% in BAMSE), asthma alone (A+R-; 11% and 8%), rhinitis alone (A-R+; 15% and 24%) and asthma-rhinitis (A+R+; 44% and 14%). The numbers of IgE-reactive aeroallergen molecules significantly differed between phenotypes (median in A-R-, A+R-, A-R+ and A+R+: 0, 1, 2 and 7 in EGEA and 0, 0, 3 and 5 in BAMSE). As compared to A-R- subjects, the adjusted ratio of the mean number of IgE-reactive molecules was higher in A+R+ than in A+R- or A-R+ (10.0, 5.4 and 5.0 in EGEA and 7.2, 0.7 and 4.8 in BAMSE).CONCLUSION:The A+R+ phenotype combined the sensitization pattern of both the A-R+ and A+R- phenotypes. This multimorbid polysensitized phenotype seems to be generalizable to various ages and allergenic environments and may be associated with specific mechanisms.
Published: 2018

23. Oxidative stress biomarkers and asthma characteristics in adults of the EGEA study

Author: Rachel Nadif, Nicole Le Moual, Orianne Dumas, Hélène Huyvaert, Farid Zerimech, Miora Andrianjafimasy, Zeina Akiki, Régis Matran, Valérie Siroux, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Laboratoire de Biochimie et Biologie Moléculaire [CHRU Lille] (Pôle de Biologie Pathologie Génétique), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Impact de l'environnement chimique sur la santé humaine - ULR 4483 (IMPECS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), 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)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Lille Nord de France (COMUE), Research was funded in part by the National Hospital program of clinical research (PHRCnational 2012, EvAdA), ANR-CES-2009, Region Nord Pas-de-Calais, Merck Sharp & Dohme (MSD), the GA2LEN project, Global Allergy and Asthma European Network, the Fonds AGIR pour les maladies chroniques, the People Programme (Marie Curie Actions) of the European Union’s Seventh Framework Programme (FP7/2007-2013) under REA grant agreement n. PCOFUND-GA-2013-609102 through the PRESTIGE programme coordinated by Campus France, and by University of Versailles Saint-Quentin-en-Yvelines EDSP doctoral grant., European Project: 609102,EC:FP7:PEOPLE,FP7-PEOPLE-2013-COFUND,PRESTIGE(2014), Faraldo, Beatrice, PRES Towards International Gain of Excellence - PRESTIGE - - EC:FP7:PEOPLE2014-09-01 - 2019-08-31 - 609102 - VALID, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), and 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 [2016-2019] (UGA [2016-2019])
Subjects: Adult, Male, 0301 basic medicine, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Cross-sectional study, Dinoprost, Nitric Oxide, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, immune system diseases, Forced Expiratory Volume, Internal medicine, Epidemiology, medicine, Humans, Exhaled breath condensate, Age of Onset, Asthma, business.industry, Odds ratio, Middle Aged, medicine.disease, 3. Good health, respiratory tract diseases, Oxygen, Oxidative Stress, Cross-Sectional Studies, 030104 developmental biology, Breath Tests, 030228 respiratory system, Exhalation, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Regression Analysis, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Age of onset, business, Biomarkers, Cohort study
Abstract: Asthma is an oxidative stress related disease, but associations with asthma outcomes are poorly studied in adults. We aimed to study the associations between several biomarkers related to oxidative stress and various asthma outcomes.Cross-sectional analyses were conducted in 1388 adults (mean age 43 years, 44% with asthma) from the Epidemiological Study of the Genetics and Environment of Asthma (EGEA2). Three blood antioxidant enzyme activities (biomarkers of response to oxidative stress) and exhaled breath condensate 8-isoprostanes and plasma fluorescent oxidation products (FlOPs) levels (two biomarkers of damage) were measured. Associations between biomarkers and 1) ever asthma and 2) asthma attacks, asthma control and lung function in participants with asthma were evaluated using regression models adjusted for age, sex and smoking.Biomarkers of response were unrelated to asthma outcomes. Higher 8-isoprostane levels were significantly associated with ever asthma (odds ratio for one interquartile range increase 1.28 (95% CI 1.06–1.67). Among participants with asthma, 8-isoprostane levels were negatively associated with adult-onset asthma (0.63, 0.41–0.97) and FlOPs levels were positively associated with asthma attacks (1.33, 1.07–1.65), poor asthma control (1.30, 1.02–1.66) and poor lung function (1.34, 1.04–1.74).Our results suggest that 8-isoprostanes are involved in childhood-onset asthma and FlOPs are linked to asthma expression.
Published: 2017

24. Potentially inappropriate prescription of antidepressants in old people: characteristics, associated factors, and impact on mortality

Author: Florence Muller de Schongor, Laurent Lechowski, Jean-Marie Robine, Marie Herr, Laurent Teillet, Joël Ankri, Jean-Jacques Arvieu, Anne Hiance-Delahaye, Service de gériatrie [AP-HP Hôpital Sainté Périne], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpital Sainte Perine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Département Hospitalier d’Epidémiologie et de Santé Publique [Hôpitaux Universitaires de Paris Ile-de-France Ouest], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Mécanismes moléculaires dans les démences neurodégénératives (MMDN), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), École des hautes études en sciences sociales (EHESS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Faraldo, Beatrice, Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-AP-HP Hôpital Sainte Perine, Biologie du Développement et Reproduction (BDR), Institut National de la Recherche Agronomique (INRA)-Institut National Agronomique Paris-Grignon (INA P-G), COordination pour la Mesure de la Performance et l'Amélioration de la Qualité ( Hôpital, Patient, Sécurité, Territoire) (COMPAQ(HSPT) - U988), École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR), AG2R La Mondiale [Paris] (Direction des Etudes), Prévoyance Individuelle et IARD [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-École pratique des hautes études (EPHE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)
Subjects: Male, Databases, Factual, [SDV]Life Sciences [q-bio], Inappropriate Prescribing, Comorbidity, community care, 0302 clinical medicine, Epidemiology, Risk of mortality, Prevalence, Drug Interactions, 030212 general & internal medicine, Aged, 80 and over, Antidepressive Agents, 3. Good health, [SDV] Life Sciences [q-bio], Psychiatry and Mental health, Clinical Psychology, antidepressants, Population study, epidemiology, Female, France, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, medicine, Humans, Medical prescription, Mortality, Adverse effect, Geriatric Assessment, Aged, Polypharmacy, Psychiatric Status Rating Scales, Depressive Disorder, Proportional hazards model, business.industry, medicine.disease, adverse events, 030227 psychiatry, Cross-Sectional Studies, Logistic Models, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Multivariate Analysis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Geriatrics and Gerontology, business, Gerontology
Abstract: Background:The increasing use of antidepressants (ADs) has raised concerns about their inappropriate use in old people.Objective:To examine the prevalence of potentially inappropriate prescribing (PIP) of ADs, their associated factors, and their impact on mortality in a sample of old people in France.Methods:The analysis used data from the SIPAF study, a cross-sectional study consisting of 2,350 people aged ≥ 70 years. Trained nurses interviewed participants at home between 2008 and 2010. Information was collected concerning socio-demographic and health characteristics, including medication use. The study population consisted of the 318 AD users from the SIPAF study (13.5%). PIP of ADs was defined according to national and international criteria. Factors associated with PIP of ADs were assessed using a multivariate logistic regression model. The influence of PIP of ADs on mortality was assessed using a Cox model (median follow-up 2.8 years).Results:Among the SIPAF study, 71% of AD users were female and the mean age was 84 ± 7 years. Selective serotonin reuptake inhibitors (SSRIs) were the most prescribed ADs (19.8%). We found PIP of ADs in 36.8% of the study population, mainly the co-prescription of diuretics with SSRIs (17.6%) and the prescription of tricyclics (12.9%). PIP of ADs was associated with polypharmacy (aOR5-9 drugs 2. 61, 95% CI 1.11–6.16 and aOR≥10 drugs 2.69, 95% CI 1.06–6.87) and comorbidity (aOR3-4 chronic diseases 2.59, 95%CI 1.04–6.44 and aOR≥5 chronic diseases 2.33, 95%CI 0.94–5.79), and increased the risk of mortality during follow-up (aHR 2.30, 95%CI 1.28–4.12).Conclusions:This study shows that more than one third of AD prescriptions may be inappropriate in old people. PIP of ADs was related to polypharmacy and comorbidity and increased mortality among AD users.
Published: 2017

25. Association between air pollution and rhinitis incidence in two European cohorts

Author: Burte, Emilie, Leynaert, Bénédicte, Bono, Roberto, Brunekreef, Bert, Bousquet, Jean, Carsin, Anne-Elie, De Hoogh, Kees, Forsberg, Bertil, Gormand, Frédéric, Heinrich, Joachim, Just, Jocelyne, Marcon, Alessandro, Künzli, Nino, Nieuwenhuijsen, Mark, Pin, Isabelle, Stempfelet, Morgane, Sunyer, Jordi, Villani, Simona, Siroux, Valérie, Jarvis, Deborah, Nadif, Rachel, Jacquemin, Bénédicte, One Health Chemisch, dIRAS RA-2, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidemiology & Pulmonology [Barcelona, Spain] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF)-Centre de Recerca en Epidemiologia Ambiental - CREAL [Barcelona, Spain]-Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Public Health and Pediatrics [Turin, Italy], University of Turin, Institute for Risk Assessment Sciences [Utrecht, The Netherlands] (IRAS), Utrecht University [Utrecht], Julius Center for Health Sciences and Primary Care [Utrecht, The Netherlands], University Medical Center [Utrecht], Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CIBER de Epidemiología y Salud Pública (CIBERESP), Hospital del Mar Medical Research Institute [Barcelona, Spain] (IMIM), Universitat Pompeu Fabra [Barcelona] (UPF), Swiss Tropical and Public Health Institute [Basel], University of Basel (Unibas), Department of Public Health and Clinical Medicine [Umeå, Sweden] (Environmental and Occupational Medicine), Umeå University, Service de pneumologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Social and Environmental Medicine [Munich, Germany] (Institute and Outpatient Clinic for Occupational), Ludwig-Maximilians University [Munich] (LMU)-University Hospital Munich [Munich, Germany], Centre de l'Asthme et des Allergies [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Department of Diagnostics and Public Health [Verona] (UNIVR | DDSP), University of Verona (UNIVR), Unit of Epidemiology and Medical Statistics [Verona, Italy] (Dept of Diagnostics and Public Health), Service de pédiatrie générale et maladies infectieuses [CHU Grenoble], CHU Grenoble, 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 [2016-2019] (UGA [2016-2019]), Institut de Veille Sanitaire (INVS), Unit of Biostatistics and Clinical Epidemiology [Pavia, Italy] (Dept of Public Health), University of Pavia-Experimental and Forensic Medicine [Pavia, Italy], School of Public Health [London, UK] (Faculty of Medicine), Imperial College London, Medical Research Council (MRC), One Health Chemisch, dIRAS RA-2, Università degli studi di Torino = University of Turin (UNITO), Ludwig-Maximilians-Universität München (LMU)-University Hospital Munich [Munich, Germany], Università degli studi di Verona = University of Verona (UNIVR), Università degli Studi di Pavia = University of Pavia (UNIPV)-Experimental and Forensic Medicine [Pavia, Italy], and Faraldo, Beatrice
Subjects: medicine.medical_specialty, Air pollution, MEDLINE, 010501 environmental sciences, medicine.disease_cause, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, Environmental health, air pollution, rhinitis, epidemiology, Air Pollution, Epidemiology, MD Multidisciplinary, medicine, Humans, lcsh:Environmental sciences, 0105 earth and related environmental sciences, General Environmental Science, Retrospective Studies, Rhinitis, lcsh:GE1-350, Air Pollutants, business.industry, Incidence (epidemiology), Incidence, Retrospective cohort study, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 13. Climate action, epidemiology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Environmental Sciences
Abstract: International audience; BACKGROUND:The association between air pollution and rhinitis is not well established.AIM:The aim of this longitudinal analysis was to study the association between modeled air pollution at the subjects' home addresses and self-reported incidence of rhinitis.METHODS:We used data from 1533 adults from two multicentre cohorts' studies (EGEA and ECRHS). Rhinitis incidence was defined as reporting rhinitis at the second follow-up (2011 to 2013) but not at the first follow-up (2000 to 2007). Annual exposure to NO2, PM10 and PM2.5 at the participants' home addresses was estimated using land-use regression models developed by the ESCAPE project for the 2009-2010 period. Incidence rate ratios (IRR) were computed using Poisson regression. Pooled analysis, analyses by city and meta-regression testing for heterogeneity were carried out.RESULTS:No association between long-term air pollution exposure and incidence of rhinitis was found (adjusted IRR (aIRR) for an increase of 10 μg·m-3 of NO2: 1.00 [0.91-1.09], for an increase of 5 μg·m-3 of PM2.5: 0.88 [0.73-1.04]). Similar results were found in the two-pollutant model (aIRR for an increase of 10 μg·m-3 of NO2: 1.01 [0.87-1.17], for an increase of 5 μg·m-3 of PM2.5: 0.87 [0.68-1.08]). Results differed depending on the city, but no regional pattern emerged for any of the pollutants.CONCLUSIONS:This study did not find any consistent evidence of an association between long-term air pollution and incident rhinitis.
Published: 2017

26. Occupational exposure to disinfectants and asthma control in US nurses

Author: Jan-Paul Zock, Catherine Quinot, Paul K. Henneberger, Orianne Dumas, Frank E. Speizer, Carlos A. Camargo, Raphaëlle Varraso, Aleta Wiley, Nicole Le Moual, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Brigham and Women's Hospital [Boston], Harvard Medical School [Boston] (HMS), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, CIBER de Epidemiología y Salud Pública (CIBERESP), National Institute for Occupational Safety and Health, Channing Laboratory, Massachusetts General Hospital [Boston], and Faraldo, Beatrice
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Disinfectant, [SDV]Life Sciences [q-bio], Respiratory System, Nursing, 03 medical and health sciences, 0302 clinical medicine, Occupational Exposure, Surveys and Questionnaires, Internal medicine, Asthma control, Preventive Health Services, medicine, Humans, 030212 general & internal medicine, book, Occupational Health, Asthma, Response rate (survey), business.industry, Confounding, Middle Aged, medicine.disease, Quality Improvement, 030210 environmental & occupational health, Nursing standard, 3. Good health, respiratory tract diseases, [SDV] Life Sciences [q-bio], [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, book.journal, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Medical emergency, Occupational exposure, business, Asthma Control Test, Disinfectants
Abstract: Disinfectant use has been associated with adverse respiratory effects among healthcare workers. However, the specific harmful agents have not been elucidated. We examined the association between occupational exposure to disinfectants and asthma control in the Nurses' Health Study II, a large cohort of female nurses.Nurses with asthma were invited in 2014 to complete two questionnaires on their current occupation and asthma (response rate 80%). Asthma control was defined by the Asthma Control Test (ACT). Exposure to major disinfectants was evaluated by a job–task–exposure matrix (JTEM).Analyses included 4102 nurses with asthma (mean age 58 years). Asthma control was poor (ACT score 16–19) in 12% of nurses and very poor (ACT score ≤15) in 6% of nurses. Use of disinfectants to clean medical instruments (19% exposed) was associated with poorly (OR 1.37; 95% CI 1.05–1.79) and very poorly (OR 1.88, 95% CI 1.38–2.56) controlled asthma (ptrend=0.004, after adjustment for potential confounders). Using JTEM estimates, exposure to formaldehyde, glutaraldehyde, hypochlorite bleach, hydrogen peroxide and enzymatic cleaners was associated with poor asthma control (all ptrendUse of several disinfectants was associated with poor asthma control. Our findings suggest targets for future efforts to prevent worsening of asthma control in healthcare workers.
Published: 2017

27. Development of a bar code-based exposure assessment method to evaluate occupational exposure to disinfectants and cleaning products: a pilot study

Author: Raphaële Girard, Valérie Siroux, Alexis Descatha, Catherine Quinot, Etienne Sevin, Sofia Temam, Orianne Dumas, Arzu Tackin, Nicole Le Moual, Sarah Lyon-Caen, Christine Barreto, Sylvie Amsellem-Dubourget, Jérémy Félicité, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), ProdHyBase [Hôpital Henry Gabrielle, Saint-Genis-Laval], Hôpital Henry Gabrielle [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-CCLIN Sud-Est – Centre de Coordination de la Lutte contre les Infections Nosocomiales Sud-Est, EpiConcept [Paris], Unité d'hygiène et d'épidémiologie [GHE, Lyon] (ProdHyBase), hospices civils de Lyon, Equipe opérationnelle d’hygiène hospitalière [AP-HP Hôpital Raymond-Poincaré], AP-HP Hôpital Raymond Poincaré [Garches], 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), UMS011 Cohortes épidémiologiques en population (CONSTANCES), Population-Based Epidemiological Cohorts, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AP-HP Hôpital Paul Brousse, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Anses-PNR-EST-2015-1-022/Ademe-1594C0091, UniversityParis-Sud/IRESP, University of Versailles St-Quentin en Yvelines EDSP doctoral grant, Open Health Institute grant., Faraldo, Beatrice, Hôpital Raymond Poincaré [AP-HP], 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 [2016-2019] (UGA [2016-2019]), Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), 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)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP), and 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)
Subjects: Adult, Male, Detergents, Pilot Projects, Smartphone application, Hospital hygiene, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Occupational Exposure, Medicine, Humans, 030212 general & internal medicine, smartphone application, Exposure assessment, Electronic Data Processing, business.industry, Public Health, Environmental and Occupational Health, Middle Aged, 030210 environmental & occupational health, Mobile Applications, Ammonium compounds, 3. Good health, Personnel, Hospital, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, hospital workers, Feasibility Studies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, cleaning products, Occupational exposure, business, Disinfectants
Abstract: ObjectiveHealthcare workers are highly exposed to various types of disinfectants and cleaning products. Assessment of exposure to these products remains a challenge. We aimed to investigate the feasibility of a method, based on a smartphone application and bar codes, to improve occupational exposure assessment among hospital/cleaning workers in epidemiological studies.MethodsA database of disinfectants and cleaning products used in French hospitals, including their names, bar codes and composition, was developed using several sources: ProdHyBase (a database of disinfectants managed by hospital hygiene experts), and specific regulatory agencies and industrial websites. A smartphone application has been created to scan bar codes of products and fill a short questionnaire. The application was tested in a French hospital. The ease of use and the ability to record information through this new approach were estimated.ResultsThe method was tested in a French hospital (7 units, 14 participants). Through the application, 126 records (one record referred to one product entered by one participant/unit) were registered, majority of which were liquids (55.5%) or sprays (23.8%); 20.6% were used to clean surfaces and 15.9% to clean toilets. Workers used mostly products with alcohol and quaternary ammonium compounds (>90% with weekly use), followed by hypochlorite bleach and hydrogen peroxide (28.6%). For most records, information was available on the name (93.7%) and bar code (77.0%). Information on product compounds was available for all products and recorded in the database.ConclusionThis innovative and easy-to-use method could help to improve the assessment of occupational exposure to disinfectants/cleaning products in epidemiological studies.
Published: 2017

28. What is the duration of life expectancy in the state of frailty? Estimates in the SIPAF study

Author: Jean-Marie Robine, Jean-Jacques Arvieu, Joël Ankri, Marie Herr, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Département Hospitalier d’Epidémiologie et de Santé Publique [Hôpitaux Universitaires de Paris Ile-de-France Ouest], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Biologie du Développement et Reproduction (BDR), Institut National de la Recherche Agronomique (INRA)-Institut National Agronomique Paris-Grignon (INA P-G), Mécanismes moléculaires dans les démences neurodégénératives (MMDN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Université de Montpellier (UM)-École pratique des hautes études (EPHE), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Montpellier 2 - Sciences et Techniques (UM2)-École pratique des hautes études (EPHE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), 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), Université de Montpellier (UM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), École des hautes études en sciences sociales (EHESS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Faraldo, Beatrice, 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), École pratique des hautes études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: Gerontology, medicine.medical_specialty, Health (social science), Activities of daily living, business.industry, Public health, Physical activity, Psychological intervention, Mean age, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Time windows, Life expectancy, Medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030212 general & internal medicine, Geriatrics and Gerontology, Older people, business, 030217 neurology & neurosurgery, ComputingMilieux_MISCELLANEOUS, Demography, Original Investigation
Abstract: The screening of frailty can trigger interventions aiming to delay disability in older people. Whereas the prevalence, the consequences, and the factors associated with frailty are well described, little is known about the duration of the state of frailty. This study aimed to estimate the time spent in the state of frailty in men and women using the Sullivan method. Data used were the age- and sex-specific prevalence of frailty found in SIPAF study (“Systeme d’Information sur la Perte d’Autonomie Fonctionnelle de la personne âgee”) and statistics of mortality from the Human Mortality Database. The SIPAF study included 2350 individuals aged 70 and over and living in France. Participants were interviewed at home by trained nurses. Frailty was defined as impairment in three domains or more among nutrition, energy, physical activity, strength, and mobility. People requiring assistance in basic activities of daily living were considered in a separate category. Mean age of the study sample was 83.3 ± 7.5 years, with 59.4% of women. Overall, the prevalence of pre-frailty, frailty, and dependency was 39.1, 17.0, and 15.4%, respectively. Life expectancy at age 70 was 18.3 years for women, of which 7.4 years (95% CI 6.9–7.9) were pre-frail, 3.4 years (95% CI 3.0–3.8) frail, and 2.4 (95% CI 2.1–2.7) with disability. In contrast, LE for men at 70 was 14.8 years, of which pre-frail, frail, and disabled years were 6.0 years (95% CI 5.5–6.5), 1.2 years (95% CI 1.0–1.5), and 1.2 (95% CI 1.0–1.5), respectively. In conclusion, frailty is a transition state that is relatively limited in time compared to pre-frailty that may represent a larger time window for prevention.
Published: 2017

29. Specific IgE and IgG measured by the MeDALL allergen-chip depend on allergen and route of exposure: The EGEA study

Author: Isabelle Pin, M. Wickman, Mirela Curin, Christian Lupinek, Karin C. Lødrup Carlsen, Jean Bousquet, Rudolf Valenta, Yvonne Resch, Renata Kiss, I. Skrindo, Valérie Siroux, Jocelyne Just, Rachel Nadif, Susanne Vrtala, Thomas Keil, Josep M. Antó, Erik Melén, 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 ), Service d'allergologie [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Trousseau [APHP], Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique ( VIMA ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), 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 [2016-2019] (UGA [2016-2019]), Department of Pathophysiology and Allergy Research [Vienna, Austria] (Division of Immunopathology), Medizinische Universität Wien = Medical University of Vienna, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Epidemiology and Health Economics [Berlin, Germany] (Institute of Social Medicine), Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Institute for Clinical Epidemiology and Biometry [Würzburg, Germany], Julius-Maximilians-Universität Würzburg (JMU), Department of Paediatrics [Oslo, Norway], Oslo University Hospital [Oslo], Institute of Clinical Medicine [Oslo], Faculty of Medicine [Oslo], University of Oslo (UiO)-University of Oslo (UiO), Institute of Environmental Medicine [Stockholm, Sweden], Karolinska Institutet [Stockholm]-Karolinska University Hospital [Stockholm]-Astrid Lindgren Children's Hospital, Sachs’ Children and Youth Hospital [Stockholm, Sweden], Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Otorhinolaryngology [Lørenskog, Norway], Akershus University Hospital [Lørenskog], Christian Doppler Laboratory for the Development of Allergen chips [Vienna, Austria] (Department of Pathophysiology & Allergy Research), Medizinische Universität Wien = Medical University of Vienna-Center for Pathophysiology, Infectiology and Immunology [Vienna, Austria], Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Hospital del Mar Medical Research Institute [Barcelona, Spain] (IMIM), Universitat Pompeu Fabra [Barcelona] (UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Mechanisms of the Development of Allergy (MeDALL-FP7), University of Groningen [Groningen]-Uppsala Universitet [Uppsala]-Universiteit Gent = Ghent University (UGENT)-Georg-August-University = Georg-August-Universität Göttingen, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), The study was supported in part by Inserm Aviesan Itmo santé publique, the Scientific committee 'AGIR for chronic diseases', grant F4605 of the Austrian Science Fund (FWF) to RV and by the European Commission’s Seventh Framework 29 Program MeDALL under grant agreement no. 261357., European Project: 261357,EC:FP7:HEALTH,FP7-HEALTH-2010-single-stage,MEDALL(2010), Centre de l'Asthme et des Allergies [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Julius-Maximilians-Universität Würzburg [Wurtzbourg, Allemagne] (JMU), Oslo University Hospital [Oslo, Norway], Georg-August-University [Göttingen]-University of Groningen [Groningen]-Uppsala Universitet [Uppsala]-Universiteit Gent = Ghent University [Belgium] (UGENT), Faraldo, Beatrice, Mechanisms of the Development of ALLergy - MEDALL - - EC:FP7:HEALTH2010-12-01 - 2015-05-31 - 261357 - VALID, Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université
Subjects: 0301 basic medicine, Male, Epidemiology, [SDV]Life Sciences [q-bio], Microarray, medicine.disease_cause, Immunoglobulin E, Airborne allergen, Atopy, Cohort Studies, food allergens, 0302 clinical medicine, Allergen, immune system diseases, MeDALL, Immunology and Allergy, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, education.field_of_study, biology, Cohort, Environmental exposure, cohort, Middle Aged, respiratory system, Allergen components, 3. Good health, [SDV] Life Sciences [q-bio], EGEA, Female, epidemiology, France, IgE, Respiratory allergens, microarray, Ragweed, Adult, Allergen immunotherapy, IgG, Immunology, Population, Cross Reactions, 03 medical and health sciences, [ SDV.IMM.ALL ] Life Sciences [q-bio]/Immunology/Allergology, medicine, otorhinolaryngologic diseases, Humans, allergen components, education, Skin Tests, Environmental Exposure, Allergens, medicine.disease, biology.organism_classification, Asthma, respiratory tract diseases, 030104 developmental biology, Cross-Sectional Studies, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunoglobulin G, biology.protein, Food allergens, Immunization, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Follow-Up Studies, respiratory allergens
Abstract: Background: The nature of allergens and route and dose of exposure may affect the natural development of IgE and IgG responses. Objective: We sought to investigate the natural IgE and IgG responses toward a large panel of respiratory and food allergens in subjects exposed to different respiratory allergen loads. Methods: A cross-sectional analysis was conducted in 340 adults of the EGEA (Epidemiological study of the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy) (170 with and 170 without asthma) cohort. IgE and IgG responses to 47 inhalant and food allergen components were analyzed in sera using allergen microarray and compared between 5 French regions according to the route of allergen exposure (inhaled vs food allergens). Results: Overall 48.8% of the population had allergen-specific IgE levels of 0.3 ISAC standardized units (ISU) or more to at least 1 of the 47 allergens with no significant differences across the regions. For ubiquitous respiratory allergens (ie, grass, olive/ash pollen, house dust mites), specific IgE did not show marked differences between regions and specific IgG (≥0.5 ISU) was present in most subjects everywhere. For regionally occurring pollen allergens (ragweed, birch, cypress), IgE sensitization was significantly associated with regional pollen exposure. For airborne allergens cross-reacting with food allergens, frequent IgG recognition was observed even in regions with low allergen prevalence (Bet v 1) or for allergens less frequently recognized by IgE (profilins). Conclusions: The variability in allergen-specific IgE and IgG frequencies depends on exposure, route of exposure, and overall immunogenicity of the allergen. Allergen contact by the oral route might preferentially induce IgG responses. The study was supported in part by Inserm Aviesan Itmo santé publique, the Scientific committee “AGIR for chronic diseases,” grant F4605 of the Austrian Science Fund (FWF [Fonds zur Förderung der wissenschaftlichen Forschung]) to R.V. and by the European Commission's Seventh Framework 29 Program MeDALL under grant agreement no. 261357.
Published: 2017

30. Prospective study of body mass index and risk of sarcoidosis in US women

Author: Carlos A. Camargo, Orianne Dumas, Krislyn M. Boggs, Meir J. Stampfer, Yvette C. Cozier, Faraldo, Beatrice, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Channing Division of Network Medicine [Boston, USA] (Department of Medicine), Harvard Medical School [Boston] (HMS)-Brigham and Women's Hospital [Boston], Slone Epidemiology Center [Boston, USA], Boston University [Boston] (BU), Department of Emergency Medicine [Boston, USA], Harvard Medical School [Boston] (HMS)-Massachusetts General Hospital [Boston], and National Institutes of Health UM1 CA176726.
Subjects: Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Sarcoidosis, Weight Gain, Article, Body Mass Index, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Obesity, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Adiposity, Proportional Hazards Models, Inflammation, 2. Zero hunger, Proportional hazards model, business.industry, Incidence, Incidence (epidemiology), Middle Aged, medicine.disease, United States, 3. Good health, Increased risk, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Physical therapy, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.symptom, business, Weight gain, Body mass index, Cohort study
Abstract: A higher BMI is prospectively associated with an increased risk of developing sarcoidosis in women http://ow.ly/OQ6k30f7XaQ
Published: 2017

31. The sensitization pattern differs according to rhinitis and asthma multimorbidity in adults: the EGEA study

Author: Valérie Siroux, Bénédicte Jacquemin, Jocelyne Just, Rachel Nadif, Emilie Burte, Jean Bousquet, Faraldo, Beatrice, Universitat Pompeu Fabra [Barcelona] (UPF), Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), University Hospital of Montpellier, Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Pierre et Marie Curie - Paris 6 (UPMC), Centre de l'Asthme et des Allergies [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centros de Investigación Biomédica en Red (CIBER), CIBER de Epidemiología y Salud Pública (CIBERESP), Epidemiology & Pulmonology [Barcelona, Spain] (ISGlobal), Universitat Pompeu Fabra [Barcelona] (UPF)-Centre de Recerca en Epidemiologia Ambiental - CREAL [Barcelona, Spain]-Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), The EGEA study was funded in part by Merck Sharp & Dohme (MSD), as well as by the GA2LEN (Global Allergy and Asthma European Network ) project., Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal)-Centre de Recerca en Epidemiologia Ambiental - CREAL [Barcelona, Spain]-Universitat Pompeu Fabra [Barcelona] (UPF), CHU Trousseau [APHP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Adult, Male, multimorbidity, Immunology, allergic sensitization, Comorbidity, Severity of Illness Index, Allergic sensitization, 03 medical and health sciences, Leukocyte Count, 0302 clinical medicine, rhinitis, Risk Factors, immune system diseases, medicine, Odds Ratio, Immunology and Allergy, Humans, 030212 general & internal medicine, monosensitization, Sensitization, Asthma, Skin Tests, business.industry, Allergic asthma, Allergens, Immunoglobulin E, Middle Aged, asthma, medicine.disease, 3. Good health, respiratory tract diseases, Eosinophils, medicine.anatomical_structure, Phenotype, 030228 respiratory system, polysensitization, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, Female, Immunization, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business
Abstract: Mono- and polysensitization are different IgE-mediated allergic phenotypes in children. Allergic sensitization is associated with both allergic asthma and allergic rhinitis, however, associations between the sensitization pattern and particularly polysensitization with asthma and rhinitis remains poorly studied in adults., The aim of this study was to assess how the allergic sensitization pattern associates with asthma, rhinitis and their multimorbidity., 1199 adults from the EGEA study, with extensive phenotypic characterization and all data available on skin prick tests to 10 allergens, total IgE and blood eosinophils were included. Using questionnaires only, participants were classified into 6 groups: asymptomatic (no asthma, no rhinitis), non-allergic rhinitis alone, allergic rhinitis alone, asthma alone, asthma+non-allergic rhinitis and asthma+allergic rhinitis. Mono- and polysensitization were defined by a positive skin prick test to one or more than one allergen respectively., Asymptomatic participants and those with non-allergic rhinitis alone were mostly non-sensitized (around 72%) while around 12% were polysensitized. Between 32% and 43% of participants with allergic rhinitis alone, asthma alone and asthma+non-allergic rhinitis were non-sensitized and between 37% and 46% of them were polysensitized. 65% of the participants with asthma+allergic rhinitis were polysensitized. The level of total IgE followed a similar trend to that of allergic sensitization. Eosinophils were increased in asthma, especially when associated with rhinitis. Nasal symptoms were more severe and eczema more common in participants with both asthma and allergic rhinitis than in the other groups., Allergic sensitization and particularly polysensitization rates widely differ according to asthma and rhinitis status. This study emphasized the importance of taking into account multimorbidity between asthma and rhinitis and showed that allergic sensitization is not a dichotomic variable.
Published: 2017

32. Polypharmacy and potentially inappropriate medications: a cross-sectional analysis among 451 nursing homes in France

Author: Philippe Denormandie, Stéphane Sanchez, Caroline Blochet, Didier Armaingaud, Joël Ankri, Helene Grondin, Antoine Vial, Marie Herr, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), DéDépartement Hospitalier d’Epidémiologie et de Santé Publique [AP-HP Hôpital Sainte Périne], Hôpital Sainte Perine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Pôle Information Médicale Evaluation Performance |[CH de Troye], CH de Troyes, Institut du Bien Vieillir [Paris], Korian [Paris], Medissimo [Poissy], AVL [Paris], Centre de recherche en épidémiologie et santé des populations (CESP), 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), Faraldo, Beatrice, and 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)
Subjects: Male, medicine.medical_specialty, medicine.drug_class, Cross-sectional study, [SDV]Life Sciences [q-bio], Inappropriate prescribing, Pharmacy, 030226 pharmacology & pharmacy, Information system, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, hemic and lymphatic diseases, medicine, Anticholinergic, Humans, Pharmacology (medical), 030212 general & internal medicine, Intensive care medicine, Aged, Pharmacology, Polypharmacy, Aged, 80 and over, business.industry, Potentially Inappropriate Medications, General Medicine, Frail elderly, 3. Good health, Nursing Homes, [SDV] Life Sciences [q-bio], Cross-Sectional Studies, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, Pill, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, France, Nursing homes, business
Abstract: International audience; PURPOSE:The quality of drug therapy is an important issue for nursing homes. This study aimed to assess the prevalence of polypharmacy and potentially inappropriate medications (PIMs) in a large sample of nursing home residents by using the data recorded during the preparation of pill dispensers.METHODS:This is a cross-sectional study that included 451 nursing homes across France. Information about the medications received by the 30,702 residents (73.8% women) living in these nursing homes was extracted from the system that assists in the preparation of pill dispensers in pharmacies. The anonymized database included age, sex, and medications prescribed to residents, as well as nursing home characteristics (capacity, legal status). Factors associated with excessive polypharmacy (≥10 different drugs) and PIMs according to the Laroche list were studied using multilevel regression models.RESULTS:The average number of drugs prescribed was 6.9 ± 3.3, and excessive polypharmacy concerned 21.1% of the residents (n = 6468). According to the Laroche list, 47.4% of residents (n = 14,547) received at least one PIM. Benzodiazepines (excessive doses, long-acting benzodiazepines, and combination of benzodiazepines) and anticholinergic medications (hydroxyzine, cyamemazine, alimemazine) accounted for a large part of PIMs. Individual characteristics (age, gender) influenced the risk of receiving PIMs whereas nursing home characteristics (capacity, legal status) influenced the risk of excessive polypharmacy.CONCLUSIONS:This study shows that polypharmacy and PIMs remain highly prevalent among nursing home residents. Main PIMs concerned psychotropic and anticholinergic medications.
Published: 2016

33. Blood granulocyte patterns as predictors of asthma phenotypes in adults from the EGEA study

Author: Valérie Siroux, Rachel Nadif, Christophe Pison, Régis Matran, Jocelyne Just, Isabelle Pin, Nicole Le Moual, Anne Boudier, Frédéric Gormand, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe d'Épidémiologie Environnementale appliquée à la Reproduction et la Santé Respiratoire (CRI INSERM/UJF - U823 ), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de l'Asthme et des Allergies [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de pneumologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Clinique Universitaire de Pneumologie, Pôle Thorax et Vaisseaux [CHU Grenoble], Centre Hospitalier Universitaire de Grenoble, Université Lille Nord de France (COMUE), Research was funded in part by the National Hospital Programme of Clinical Research (PHRC-national 2012, EvAdA), ANR-CES-2009, Region Nord Pas-de-Calais, Merck Sharp & Dohme, and the GA2LEN project, Global Allergy and Asthma European Network, and the Fonds AGIR pour les Maladies Chroniques., Faraldo, Beatrice, and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Neutrophils, Asthma phenotypes, [SDV]Life Sciences [q-bio], Body Mass Index, Cohort Studies, Leukocyte Count, 0302 clinical medicine, Adrenal Cortex Hormones, Asthma control, Epidemiology, adults, Eosinophilia, 030212 general & internal medicine, Smoking, neutrophil, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Phenotype, Treatment Outcome, Bronchial hyperresponsiveness, Female, medicine.symptom, Bronchial Hyperreactivity, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, longitudinal, Granulocyte, 03 medical and health sciences, blood, Internal medicine, medicine, Humans, eosinophil, Asthma, business.industry, Immunoglobulin E, medicine.disease, Neutrophilia, respiratory tract diseases, asthma control, Eosinophils, Cross-Sectional Studies, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Granulocytes
Abstract: To what extent blood granulocyte patterns may predict asthma control remains under-studied. Our aim was to study associations between blood neutrophilia and eosinophilia and asthma control outcomes in adults.Analyses were conducted in 474 asthmatics from the first follow-up of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA2), including 242 asthmatics who were adults a decade earlier (EGEA1). At EGEA2, asthma control was assessed using the Global Initiative for Asthma definition (2015), and asthma exacerbations by use of urgent care or courses of oral corticosteroids in the past year. Blood EOSlo/EOShi was defined as −3, respectively, and NEUlo/NEUhi as −3, respectively. Estimates were adjusted for age, sex and smoking.At EGEA2, NEUhi was associated with asthma exacerbations and poor asthma control (OR >2.10). EOShi was associated with higher bronchial hyperresponsiveness (BHR) (OR (95% CI) 2.21 (1.24–3.97)), poor lung function (p=0.02) and higher total IgE level (p=0.002). Almost 50% of asthmatics had a persistent pattern between surveys. Persistent NEUhi was associated with poor asthma control at EGEA2 (OR (95% CI) 3.09 (1.18–7.05)). EOShi at EGEA1 and persistent EOShi were associated with higher BHR (OR (95% CI) 2.36 (1.10–5.07) and 3.85 (1.11–13.34), respectively), poor lung function (p−4) at EGEA2.Granulocyte patterns were differently associated with asthma outcomes, suggesting specific roles for each one, which could be tested as predictive signatures.
Published: 2016

34. Should sensory impairment be considered in frailty assessment? A study in the GAZEL cohort

Author: Joël Ankri, Marcel Goldberg, Morgane Linard, Marie Herr, Philippe Aegerter, Marie Zins, Sébastien Czernichow, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Faraldo, Beatrice, and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université de Paris (UP)
Subjects: Gerontology, Male, Risk, Aging, Activities of daily living, Frail Elderly, [SDV]Life Sciences [q-bio], Medicine (miscellaneous), frailty, Logistic regression, Body Mass Index, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, 030502 gerontology, Surveys and Questionnaires, Activities of Daily Living, Medicine, Humans, definition, 030212 general & internal medicine, Prospective Studies, 10. No inequality, Prospective cohort study, Geriatric Assessment, Proportional Hazards Models, Nutrition and Dietetics, predictive value, Proportional hazards model, business.industry, Hazard ratio, Odds ratio, Middle Aged, 3. Good health, Hospitalization, [SDV] Life Sciences [q-bio], aged, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, Sensation Disorders, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Geriatrics and Gerontology, 0305 other medical science, business, Cohort study, sensory difficulties
Abstract: International audience; OBJECTIVES:The assessment of sensory difficulties is sometimes included in the screening of frailty in ageing population. This study aimed to compare the prevalence of frailty and associated risk of adverse outcomes depending on whether sensory difficulties participated in the definition of frailty.DESIGN:Prospective cohort study - GAZEL cohort.SETTING:France.PARTICIPANTS:The 13,128 subjects who completed a questionnaire in 2012.MEASUREMENTS:According to the Strawbridge questionnaire, subjects were considered frail if they reported difficulties in two domains or more among physical, nutritive, cognitive and sensory domains. The risk of adverse health outcomes was assessed by using logistic regression models (hospitalisations, onset of difficulty in performing movements of everyday life) and multivariate Cox proportional hazards models (mortality).RESULTS:Mean age was 66.8 +/- 3.4 years and 73.8% were males. The prevalence of frailty varied from 4.4 to 14.2% depending on whether the sensory domain was excluded or included. During follow-up, 182 deaths (1.4%), 479 hospitalisations (3.6%) and 703 cases of new disability (8.0%) were observed. Both definitions of frailty predicted the onset of difficulties to perform everyday movements, with 2 to 3-fold increase in the risk. The inclusion of the sensory domain in the definition made frailty predictive of hospitalisations (Odds Ratio 1.31 [1.01-1.70]) but the association with mortality was only observed when sensory difficulties were ignored (Hazard Ratio 2.28 [1.32-3.92]).CONCLUSION:The inclusion of a sensory domain into a frailty screening instrument has a major impact in terms of prevalence and modifies the risk profile associated with frailty. In order to develop the use of frailty screening instruments in clinical practice, further researches will need to carefully evaluate the impact on risk prediction of the different domains involved.
Published: 2016

35. Total serum IgE levels are associated with ambient ozone concentration in asthmatic adults

Author: Nino Künzli, Bénédicte Jacquemin, Rachel Nadif, Valérie Siroux, Marie-Pierre Oryszczyn, Francine Kauffmann, Inmaculada Aguilera, Estelle Rage, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), ministerio de ciencia e innovacion, Institució Catalana de Recerca i Estudis Avançats (ICREA), ADEME, AFSSET, ANR-SEST, EGEA Cooperative group, and Faraldo, Beatrice
Subjects: Male, MESH: Asthma, Air pollution, [SDV.GEN] Life Sciences [q-bio]/Genetics, medicine.disease_cause, Immunoglobulin E, chemistry.chemical_compound, 0302 clinical medicine, Immunology and Allergy, 0303 health sciences, MESH: Middle Aged, biology, MESH: Immunoglobulin E, Middle Aged, 3. Good health, MESH: Young Adult, MESH: Ozone, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, IgE, Adult, MESH: Air Pollution, Ozone, [SDV.IMM] Life Sciences [q-bio]/Immunology, Immunology, MESH: Oxidants, Photochemical, Serum ige, ozone, Young Adult, 03 medical and health sciences, Oxidants, Photochemical, Animal science, Air Pollution, medicine, Humans, Nitrogen dioxide, 030304 developmental biology, Asthma, Family Health, Pollutant, [SDV.GEN]Life Sciences [q-bio]/Genetics, MESH: Humans, business.industry, MESH: Adult, asthma, medicine.disease, MESH: Male, 030228 respiratory system, chemistry, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 13. Climate action, MESH: Family Health, biology.protein, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Geometric mean, business, MESH: Female
Abstract: International audience; BACKGROUND: Effects of air pollution exposure on IgE-mediated response in asthmatics are poorly investigated. The aim was to examine the relationship between air pollution concentrations and total IgE levels in adult asthmatics. METHODS: The present study relates to the 369 asthmatic adults from the French Epidemiological study on Genetics and Environment of Asthma (EGEA), with availability of data on both total serum IgE measurements and air pollution concentrations. Geo-statistical models were performed on 4 x 4 km grids to assess individual outdoor air pollution exposure. Annual outdoor concentrations of ozone (O(3)), nitrogen dioxide (NO(2)), sulphur dioxide (SO(2)), and particulate matter smaller than 10 microm size (PM(10)), and concentrations of summer ozone were assigned to subject's home address. RESULTS: The geometric mean of total IgE was 161 IU/ml and the average of O(3) exposure was 44.9 +/- 9.5 microg/m(3). Ozone concentrations were positively related to total IgE levels and an increase of 10 microg/m(3) of O(3) resulted in an increase of 20.4% (95% CI = 3.0-40.7) in total IgE levels. Adjustment for age, gender, smoking habits and previous life in the countryside did not change the results, and an increase of 19.1% (2.4-38.6) in total IgE was observed with O(3). Negative associations observed between NO(2) and total IgE levels disappeared after including O(3) in the models. Neither SO(2) nor PM(10) were correlated with total IgE levels. CONCLUSIONS: Results suggest that O(3) or related ambient pollutants may up-regulate total IgE levels among asthmatic adults.
Published: 2009

36. Confirmatory Factor Analysis Compared with Principal Component Analysis to Derive Dietary Patterns: A Longitudinal Study in Adult Women

Author: Nicole Le Moual, Jean Maccario, Raphaëlle Varraso, Margaux Sanchez, Françoise Clavel-Chapelon, Judith Garcia-Aymerich, Marie-Christine Boutron-Ruault, Annabelle Bédard, Vieillissement et Maladies chroniques : approches épidémiologique et de santé publique (VIMA), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre for Research in Environmental Epidemiology (CREAL), CIBER de Epidemiología y Salud Pública (CIBERESP), IMIM-Hospital del Mar, Generalitat de Catalunya, Universitat Pompeu Fabra [Barcelona] (UPF), Mode de vie, génétique et santé : études intégratives et transgénérationnelles (U1018 (Équipe 9)), 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)-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)-Institut Gustave Roussy (IGR), The E3N study is supported by the Mutuelle Générale de l’Education Nationale (MGEN), the French League against Cancer (LNCC), the Gustave Roussy Institute (IGR) and the National Institute for Health and Medical Research (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)-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 Gustave Roussy (IGR), and Faraldo, Beatrice
Subjects: Longitudinal study, Multivariate statistics, MESH: Asthma, 030309 nutrition & dietetics, Epidemiology, Medicine (miscellaneous), MESH: Energy Intake, Body Mass Index, Food group, MESH: Proportional Hazards Models, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Surveys and Questionnaires, Medicine, Longitudinal Studies, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, MESH: Longitudinal Studies, 2. Zero hunger, Principal Component Analysis, 0303 health sciences, Nutrition and Dietetics, MESH: Middle Aged, MESH: Follow-Up Studies, Middle Aged, Confirmatory factor analysis, MESH: Motor Activity, MESH: Reproducibility of Results, Principal component analysis, Female, France, MESH: Factor Analysis, Statistical, Context (language use), Motor Activity, MESH: Body Mass Index, 03 medical and health sciences, MESH: Diet, A posteriori dietary patterns, Humans, MESH: Surveys and Questionnaires, Proportional Hazards Models, MESH: Principal Component Analysis, MESH: Humans, business.industry, Proportional hazards model, Methodology, Reproducibility of Results, Asthma, MESH: Prospective Studies, Diet, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Energy Intake, Factor Analysis, Statistical, business, MESH: Female, Follow-Up Studies, Demography
Abstract: International audience; Principal component analysis (PCA) has been used extensively to derive dietary patterns. We proposed to use confirmatory factor analysis (CFA) in the same context as PCA--as a one-step approach--to derive dietary patterns. The first aim of this study was methodologic and was to compare dietary patterns derived with the use of PCA and CFA, used as equivalent one-step approaches. The second aim of this study was to study these patterns in association with individual characteristics and new adult-onset asthma. We included 30,589 French women from the E3N (epidemiologic prospective cohort study of women from the MGEN national insurance plan) with 1177 reported cases of adult-onset asthma between 1993 and 2005. PCA and CFA were used in the same context, on 27 food groups, to derive dietary patterns. Associations between dietary patterns and adult-onset asthma were assessed by Cox proportional hazards models. Whether we used PCA or CFA, 3 similar factors were found and labeled "Prudent," "Western," and "Aperitif." Correlations between patterns derived with the use of PCA and CFA were high. For the "Prudent" and "Aperitif" patterns, we observed comparable patterns in terms of associations with food groups, individual characteristics, and the onset of asthma. For the "Western" patterns, the one derived with the use of CFA was more related to an unhealthy diet than the one derived with the use of PCA, with higher correlations with the food groups "processed meat" (0.73 vs. 0.51) and "dough and pastry" (0.63 vs. 0.40), and negative associations with physical activity and with having parents who were farmers. Regarding associations with adult-onset asthma, a significant positive association was observed for the "Western" pattern derived with the use of CFA [multivariate RR for highest vs. lowest quintile: 1.30 (1.02, 1.67), P-trend: 0.03], whereas no association was reported when using PCA [RR: 1.14 (0.89, 1.47), P-trend: 0.40]. Although quite similar dietary patterns were derived with the use of PCA and CFA, this study supports the alternative use of CFA to PCA for the identification of dietary patterns in epidemiologic studies.
Published: 2015

37. Exhaled nitric oxide, nitrite/nitrate levels, allergy, rhinitis and asthma in the EGEA study

Author: Rachel Nadif, Brigitte Decoster, Jean Bousquet, Isabelle Pin, Régis Matran, Marta Rava, Nicole Le Moual, Hélène Huyvaert, Farid Zerimech, Valérie Siroux, Raphaëlle Varraso, Faraldo, Beatrice, Programme Santé-environnement et Santé-travail - Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie - 2005 - ANR-05-SEST-0020 - SEST - VALID, Centre de recherche en épidémiologie et santé des populations (CESP), 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), Université Lille Nord de France (COMUE), Laboratoire de biochimie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), INSERM U823, équipe 12 (Epidémiologie Environnementale appliquée à la Reproduction et la Santé Respiratoire), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de pédiatrie, CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Research funded in part by PHRC-Paris, PHRC-Grenoble, ANR 05-SEST-020-02/05-9-97, ANR-06-CEBS, ANR-CES-2009, Region Nord Pas-de-Calais, Merck Sharp & Dohme (MSD), and the GA2LEN project, Global Allergy and Asthma European Network., ANR-05-SEST-0020,Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie(2005), and 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)
Subjects: exhaled breath condensate, Male, Allergy, [SDV]Life Sciences [q-bio], medicine.disease_cause, Allergic sensitization, chemistry.chemical_compound, 0302 clinical medicine, Forced Expiratory Volume, Surveys and Questionnaires, adults, Exhaled breath condensate, Rhinitis, 0303 health sciences, respiratory system, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Phenotype, Exhalation, Female, France, Pulmonary and Respiratory Medicine, inorganic chemicals, Adult, allergic sensitization, Nitric Oxide, Nitric oxide, 03 medical and health sciences, medicine, Hypersensitivity, Humans, NO metabolism, Nitrites, 030304 developmental biology, Asthma, Models, Statistical, Nitrates, business.industry, Aeroallergen, Allergens, medicine.disease, exhaled fraction of NO, respiratory tract diseases, Eosinophils, 030228 respiratory system, chemistry, Immunology, Exhaled nitric oxide, business, Biomarkers, total nitrite/nitrate
Abstract: International audience; Although interest in biomarkers in the nitrate-nitrite-NO pathway has recently increased, associations between nitrite (NO2(-)) and nitrate (NO3(-)), and asthma, allergic sensitisation and rhinitis remain unclear. The study aimed to evaluate the associations between NO2(-)/NO3(-) and exhaled fraction of nitric oxide (FeNO) levels with asthma, allergic sensitisation and rhinitis. Plasma and exhaled breath condensate (EBC) NO2(-)/NO3(-) and FeNO levels were measured in 523 adults of the French Epidemiological study on Genetics and Environment of Asthma. Allergic sensitisation was defined by a positive skin prick test for at least one aeroallergen. Subjects were classified as non-sensitised, sensitised and as having allergic rhinitis. Plasma NO2 (-)/NO3(-) level was unrelated to any disease phenotypes. EBC NO2(-)/NO3(-) level was unrelated to any asthma phenotypes. EBC NO2(-)/NO3(-) and FeNO levels were correlated in sensitised subjects only (r = 0.21 ± 0.10, p=0.01). EBC NO2(-)/NO3(-) and FeNO levels were higher in sensitised than in non-sensitised subjects (adjusted geometric mean (95% CI): 2.36 (1.96-2.84) versus 1.72 (1.38-2.14) μmol per mg proteins, p=0.008; and 18.3 (16.7-20.0) versus 14.8 (13.3-16.5) ppb, p=0.0006, respectively), with gradual relationships from sensitised subjects to those with allergic rhinitis (p
Published: 2014

38. Occupational irritants and asthma: an Estonian cross-sectional study of 34,000 adults

Author: Francine Kauffmann, Lili Milani, Jean Bousquet, Nicole Le Moual, Orianne Dumas, Andres Metspalu, Emeline Laurent, 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), Hôpital Arnaud de Villeneuve [CHRU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), The Estonian Genome Center, University of Tartu, A.M and L.M. received financing from the Estonian GovernmentSF0180142s08, Center of Excellence in Genomics (EXCEGEN) and from the University ofTartu (SP1GVARENG)., ANR-10-PRSP-0003,IAGO(2010), 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), Faraldo, Beatrice, and PROGRAMME DE RECHERCHE EN SANTE PUBLIQUE - - IAGO2010 - ANR-10-PRSP-0003 - PRSP - VALID
Subjects: Male, Pediatrics, MESH: Asthma, Databases, Factual, Epidemiology, Cross-sectional study, Health Status, MESH: Occupational Exposure, Atopy, Cohort Studies, 0302 clinical medicine, Surveys and Questionnaires, 030212 general & internal medicine, MESH: Cohort Studies, MESH: Health Status, MESH: Aged, MESH: Middle Aged, Smoking, Middle Aged, Occupational, 3. Good health, MESH: Irritants, Eastern european, Occupational Diseases, MESH: Young Adult, Irritants, Female, Occupational exposure, MESH: Occupational Diseases, Pulmonary and Respiratory Medicine, Adult, Estonia, MESH: Smoking, medicine.medical_specialty, Adolescent, Smoking habit, 03 medical and health sciences, Young Adult, MESH: Cross-Sectional Studies, Environmental health, Occupational Exposure, medicine, Humans, MESH: Surveys and Questionnaires, MESH: Estonia, Asthma, Aged, MESH: Adolescent, MESH: Humans, business.industry, Moderate level, MESH: Adult, medicine.disease, MESH: Databases, Factual, MESH: Male, Cross-Sectional Studies, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: International audience; Occupational exposures make important contributions to asthma morbidity. The role of low/moderate level irritant exposures remains unclear. We aimed to determine which occupational exposures are associated with asthma in an eastern European country with low asthma prevalence. The Estonian Genome Center of University of Tartu collected data from 50 077 adults in 2002-2011. Asthma was assessed through a questionnaire regarding diagnosed diseases, current health status and medication. Exposures to 22 agents during the current and longest held jobs were estimated using an asthma-specific job-exposure matrix. Analyses included 34 015 subjects (aged 18-65 years, 67.0% females), of which 1209 (3.6%) reported asthma (608 with physician-confirmed diagnosis). After adjusting for age, sex and smoking habits, lifetime occupational exposure to known asthmagens (20.4%) was significantly associated with physician-diagnosed asthma (OR 1.28, 95% CI 1.03-1.59), especially high molecular weight agents (flour: OR 2.36, 95% CI 1.31-4.27; animals: OR 1.62, 95% CI 1.00-2.60). Exposure to low/moderate levels of irritants (17.4%) was associated with physician-diagnosed asthma (OR 1.88, 95% CI 1.48-2.37). More pronounced associations were observed in subjects reporting current treated asthma. Beyond confirming the effect of known asthmagens (which are well-known, mostly from observations in western countries), the results provide evidence for a role of low/moderate exposure to irritants. This finding, observed in a country with a low prevalence of asthma and atopy, provides new insight into the understanding of asthma heterogeneity.
Published: 2014

39. The role of eosinophils and basophils in allergic diseases considering genetic findings

Author: Rachel Nadif, Farid Zerimech, Régis Matran, Emmanuelle Bouzigon, Epidémiologie Respiratoire et Environnementale, 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)-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), Service de Biochimie, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Physiologie, PRES Université Lille Nord de France, Variabilité Génétique et Maladies Humaines, Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Diderot - Paris 7 (UPD7), 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)-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), and Faraldo, Beatrice
Subjects: Allergy, MESH: Asthma, IL1RL1, Basophil, Cell Degranulation, MESH: Basophils, basophil, 0302 clinical medicine, IL-25, Cell Movement, MESH: Respiratory Mucosa, Immunology and Allergy, MESH: Animals, CCL13, MESH: Cell Movement, 0303 health sciences, MESH: Cytokines, MESH: Genetic Predisposition to Disease, MESH: Integrins, 3. Good health, Basophils, medicine.anatomical_structure, TSLP, MESH: Cell Degranulation, Cytokines, MESH: Hypersensitivity, MESH: Trans-Activators, Immunology, Respiratory Mucosa, Biology, Allergic inflammation, 03 medical and health sciences, MESH: Eosinophils, Proto-Oncogene Proteins, MESH: Polymorphism, Genetic, medicine, Hypersensitivity, Animals, Humans, Genetic Predisposition to Disease, eosinophil, 030304 developmental biology, Polymorphism, Genetic, MESH: Humans, Eosinophil, asthma, medicine.disease, allergy, Interleukin 33, Eosinophils, MESH: Proto-Oncogene Proteins, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Genome-Wide Association Study, Trans-Activators, IL-33, integrins, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 030215 immunology, Genome-Wide Association Study
Abstract: International audience; PURPOSE OF REVIEW: Basophils and eosinophils represent less than 1 and 5% of white blood cells, respectively. Their role in asthma and allergic inflammation remains incompletely defined. The present review addresses recent advances regarding the role of these two cell populations in allergic inflammation and asthma regarding both biological and genetic point of view. RECENT FINDINGS: Regarding eosinophils, the role of interleukin(IL)-25, IL-33 and thymic stromal lymphoprotein (TSLP) have been evidenced, and activation states of eosinophil β1 and β2 integrins have been found to correlate with the measurement of eosinophil recruitment and pulmonary function in asthma. New insights into the biology of basophils concern their role as regulators of Th2 cell response through IL-4 expression or the differentiation of monocytes to macrophages, and their population heterogeneity in human. The transcription factor PU.1 was reported to be involved in controlling transcription of specific genes both in eosinophils and basophils. Candidate genetic studies on eosinophils have explored genes involved in the intracellular calcium influx and apoptosis. At the genome-wide level, studies identified genetic variants belonging to IL1RL1, TSLP and IL-33, and four loci with pleiotropic effects on eosinophil and basophil counts [GATA2 (3q21), MHC (6p21), HBS1L-MYB (6q23), and ERG (21q22)]. SUMMARY: Recent findings from biological and genetic studies on eosinophils and basophils highlight the role of epithelial cell-derived cytokines such as TSLP and IL-33 in asthma and allergic diseases.
Published: 2013

40. Work related asthma. A causal analysis controlling the healthy worker effect

Author: Dumas, O., Le Moual, N., Siroux, V., Heederik, D., Garcia-Aymerich, J., Varraso, R., Kauffmann, F., Basagaña, X., Risk Assessment of Toxic and Immunomodulatory Agents, Dep IRAS, Faraldo, Beatrice, Centre de recherche en épidémiologie et santé des populations (CESP), 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 d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Division of Occupational and Environmental Health, Institute for Risk Assessment (IRAS), Utrecht University [Utrecht], CIBER de Epidemiología y Salud Pública (CIBERESP), IMIM-Hospital del Mar, Generalitat de Catalunya, Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Universitat Pompeu Fabra [Barcelona] (UPF), French Agency of health safety, environment and work (AFSSET-EST-09-15), Hospitalprogram of clinical research (PHRC)-Paris, National Research Agency - Health environment,health-work program (ANR-SEST 2005), National Research Agency (ANR- 2010-PRSP-003), Merck Sharp & Dohme (MSD), Isere committee against respiratory diseases(COMARES), French Ministry of foreign and European affairs / Netherland organization forscientific research (NWO) Van Gogh program for French Dutch cooperation, and theUniversity Paris Sud 11 - ED420 doctoral grant., 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), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Risk Assessment of Toxic and Immunomodulatory Agents, and Dep IRAS
Subjects: Male, Pediatrics, Longitudinal study, Marginal structural model, Severity of Illness Index, MESH: Occupational Exposure, 0302 clinical medicine, Healthy worker effect, Reference Values, Epidemiology, Odds Ratio, Medicine, Longitudinal Studies, MESH: Incidence, 030212 general & internal medicine, Asthma, Occupational, MESH: Longitudinal Studies, MESH: Aged, MESH: Middle Aged, Incidence, Incidence (epidemiology), MESH: Sex Distribution, MESH: Reference Values, Middle Aged, MESH: Confidence Intervals, MESH: Case-Control Studies, 3. Good health, MESH: Young Adult, Female, France, Adult, MESH: Healthy Worker Effect, medicine.medical_specialty, Adolescent, Coronacrisis-Taverne, Young Adult, 03 medical and health sciences, Age Distribution, Occupational Exposure, MESH: Severity of Illness Index, Environmental health, Confidence Intervals, Humans, Marginal structural models, Occupations, Sex Distribution, MESH: Age Distribution, Aged, Asthma, MESH: Adolescent, MESH: Asthma, Occupational, MESH: Humans, MESH: Occupations, business.industry, Public Health, Environmental and Occupational Health, Case-control study, MESH: Adult, Odds ratio, medicine.disease, MESH: Male, MESH: Odds Ratio, Confidence interval, MESH: France, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: Objectives The healthy worker effect usually leads to underestimation of the association between occupational exposure and asthma. The role of irritants in work-related asthma is disputed. We estimated the effect of occupational exposure on asthma expression in a longitudinal study, using marginal structural modelling to control for the healthy worker effect. Methods Analyses included 1284 participants (17–79 years, 48% men) from the follow-up (2003–2007) of the French Epidemiological study on the Genetics and Environment of Asthma (case-control study). Age at asthma onset, periods with/without attacks over lifetime and occupational history were recorded retrospectively. Exposures to known asthmagens, irritants or low level of chemicals/allergens were evaluated through a job-exposure matrix. The job history was reconstructed into 5-year intervals. Results Thirty-one per cent of subjects had ever been exposed to occupational asthmagens. Among the 38% of subjects who had asthma (ever), presence of attacks was reported in 52% of all time periods. Using standard analyses, no association was observed between exposure to known asthmagens (OR (95% CI): 0.99 (0.72 to 1.36)) or to irritants/low level of chemicals/allergens (0.82 (0.56 to 1.20)) and asthma attacks. Using a marginal structural model, all associations increased with suggestive evidence for known asthmagens (1.26 (0.90 to 1.76)), and reaching statistical significance for irritants/low level of chemicals/allergens (1.56 (1.02 to 2.40)). Conclusions The healthy worker effect has an important impact in risk assessment in work-related asthma studies. Marginal structural models are useful to eliminate imbalances in exposure due to disease-driven selection. Results support the role of irritants in work-related asthma.
Published: 2013

41. Occupational exposure to cleaning products and asthma in hospital workers

Author: Nicole Le Moual, C. Donnay, Francine Kauffmann, Orianne Dumas, Dick Heederik, M. Hery, Dominique Choudat, Centre de recherche en épidémiologie et santé des populations (CESP), 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), Université Paris Descartes - Paris 5 (UPD5), Institute for Risk Assessment Sciences [Utrecht, The Netherlands] (IRAS), Utrecht University [Utrecht], Institut national de recherche et de sécurité (Vandoeuvre lès Nancy) (INRS ( Vandoeuvre lès Nancy)), French Agency of health safety, environment and work (AFSSET-EST-09-15), Hospital program ofclinicalresearch(PHRC)-Paris, NationalResearchAgency- Healthenvironment,health-workprogram(ANR-SEST 2005), Merck Sharp & Dohme (MSD), Isere committee against respiratory diseases(COMARES), FrenchMinistryofforeignandEuropeanaffairs/Netherlandorganizationforscientificresearch(NWO)VanGoghprogramforFrenchDutchcooperation, andtheUniversityParisSud11-ED420doctoralgrant., Faraldo, Beatrice, Risk Assessment of Toxic and Immunomodulatory Agents, Dep IRAS, Université Paris-Sud - Paris 11 (UP11) - Université de Versailles Saint-Quentin-en-Yvelines (UVSQ) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Hôpital Paul Brousse - Assistance publique - Hôpitaux de Paris (AP-HP), Institute for Risk Assessment (IRAS), and 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)
Subjects: Male, MESH: Asthma, Logistic regression, MESH: Occupational Exposure, 0302 clinical medicine, MESH: Disinfection, Risk Factors, MESH: Risk Factors, Epidemiology, Odds Ratio, Medicine, Young adult, Workplace, MESH: Workplace, Middle Aged, MESH: Hospitals, 030210 environmental & occupational health, MESH: Case-Control Studies, Hospitals, 3. Good health, Occupational Diseases, Female, France, Occupational exposure, Adult, medicine.medical_specialty, Adolescent, cleaning agents, Coronacrisis-Taverne, Young Adult, 03 medical and health sciences, Sex Factors, Ammonia, Occupational Exposure, Environmental health, Humans, Occupations, Adverse effect, Aged, Asthma, MESH: Occupations, business.industry, healthcare workers, MESH: Disinfectants, Public Health, Environmental and Occupational Health, Case-control study, MESH: Adult, Odds ratio, medicine.disease, Disinfection, Logistic Models, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, Calcium, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Disinfectants
Abstract: International audience; Cleaning products may cause work-related asthma, but information regarding the specific exposures involved is scarce. We aimed to determine the associations between asthma and occupational exposure to cleaning agents in hospital workers. Analyses were conducted in 179 (136 women) hospital workers and a reference population of 545 subjects (18-79 years) from the French case-control and familial Epidemiological study on the Genetics and Environment of Asthma (2003-2007). Exposures to cleaning agents were estimated using three methods: self-report, expert assessment and an asthma-specific job-exposure matrix (JEM). Associations between cleaning products and current asthma were evaluated by logistic regressions, stratified by sex and adjusted for age and smoking status. According to expert assessment, 55% of male and 81% of female hospital workers were exposed to cleaning/disinfecting tasks weekly (p
Published: 2012

42. 17q21 variants modify the association between early respiratory infections and asthma

Author: Smit, L.A., Bouzigon, E., Pin, V., Siroux, V., Monier, F., Aschard, H., Bousquet, J., Gormand, F., Just, J., le Moual, N., Nadif, R., Scheinmann, P., Vervloet, D., Lathrop, M., Demenais, F., Kauffmann, F., Risk Assessment of Toxic and Immunomodulatory Agents, Dep IRAS, Faraldo, Beatrice, Programme Santé-environnement et Santé-travail - Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie - 2005 - ANR-05-SEST-0020 - SEST - VALID, Division of Environmental Epidemiology, Utrecht University [Utrecht]-Institute of Risk Assessment Sciences, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Etude du Polymorphisme Humain (CEPH), Université Paris Diderot - Paris 7 (UPD7)-Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Fondation Jean Dausset, Variabilité Génétique et Maladies Humaines, Institut Universitaire d'Hématologie (IUH), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de pédiatrie, CHU Grenoble-Hôpital Michallon, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Service de pneumologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Pneumologie Allergologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Pneumo-Allergologie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre National de Génotypage (CNG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Supported by the French Ministry of Higher Education and Research, University Paris Diderot-Paris 7, grants from the French Agency for Environmental and Occupational Health Safety (grant AFSSET-APR-SE-2004), the French National Agency for Research (grants ANR 05-SEST-020-02/05-9-97 and ANR 06-CEBS), Merck Sharp & Dohme (MSD), Hospital program of clinical research (PHRC)-Paris, and GABRIEL, a multidisciplinary study to identify the genetic and environmental causes of asthma in the European Community (contract n° 01896 under the Integrated Programme LSH-2004-1.2.5-1 Post genomic approaches to understand the molecular bias of asthma aiming at a preventive or therapeutic control). Lidwien Smit is supported by a European Academy of Allergology and Clinical Immunology- Global Allergy and Asthma European Network (EAACI-GA2LEN) exchange fellowship award., ANR-05-SEST-0020,Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie(2005), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre d'Etude du Polymorphisme Humain ( CEPH ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut Universitaire d'Hématologie ( IUH ), Université Paris Diderot - Paris 7 ( UPD7 ) -Fondation Jean Dausset, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut d'oncologie/développement Albert Bonniot de Grenoble ( INSERM U823 ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Arnaud de Villeneuve, Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Centre de l'asthme et de l'allergologie, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), Centre National de Génotypage ( CNG ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ), ANR-06-CEBS,ANR-06-CEBS, Risk Assessment of Toxic and Immunomodulatory Agents, and Dep IRAS
Subjects: Male, MESH: Neoplasm Proteins, MESH : Retrospective Studies, MESH: Asthma, MESH : Respiratory Tract Infections, 0302 clinical medicine, MESH : Child, Risk Factors, immune system diseases, respiratory infection, MESH: Risk Factors, MESH: Child, Epidemiology, MESH : Female, Age of Onset, Young adult, Child, Respiratory Tract Infections, MESH: Genetic Association Studies, 0303 health sciences, MESH: Polymorphism, Single Nucleotide, MESH : Polymorphism, Single Nucleotide, Respiratory disease, ORMDL3, MESH: Genetic Predisposition to Disease, Respiratory infection, MESH : Chromosomes, Human, Pair 17, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Follow-Up Studies, MESH : Risk Factors, Neoplasm Proteins, MESH : Age of Onset, 3. Good health, MESH: Tobacco Smoke Pollution, Female, epidemiology, MESH: Membrane Proteins, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, MESH : Male, MESH : Sex Factors, MESH: Age of Onset, Single-nucleotide polymorphism, MESH : Asthma, Polymorphism, Single Nucleotide, MESH : Tobacco Smoke Pollution, 03 medical and health sciences, Sex Factors, MESH : Neoplasm Proteins, MESH: Sex Factors, MESH : Adolescent, Internal medicine, medicine, Humans, Genetic Predisposition to Disease, Genetic Association Studies, Retrospective Studies, 030304 developmental biology, Asthma, Genetic association, MESH: Adolescent, MESH: Humans, business.industry, MESH : Humans, environmental tobacco smoke exposure, Membrane Proteins, MESH : Follow-Up Studies, MESH: Retrospective Studies, MESH : Genetic Association Studies, Odds ratio, medicine.disease, MESH: Male, respiratory tract diseases, gene-environment interaction, 030228 respiratory system, GSDML, MESH : Membrane Proteins, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, MESH: Respiratory Tract Infections, Tobacco Smoke Pollution, MESH : Genetic Predisposition to Disease, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Chromosomes, Human, Pair 17, MESH: Female, Chromosomes, Human, Pair 17, Follow-Up Studies
Abstract: Single nucleotide polymorphisms (SNPs) at chromosome 17q21 confer an increased risk of early-onset asthma. The objective was to study whether 17q21 SNPs modify associations between early respiratory infections and asthma. Association analysis was conducted in 499 children (268 with asthma, median age 11 yrs) from the Epidemiological Study on the Genetics and Environment of Asthma (EGEA). The 12-yr follow-up data were used to assess persistent or remittent asthma in young adulthood. Respiratory infection before 2 yrs of age was assessed retrospectively. For the 12 17q21 SNPs studied, the odds ratios (OR) for association between infection and early-onset asthma (age at onsetor=4 yrs) were higher in carriers of risk genotypes (OR 3.42-6.36) than in noncarriers (OR 1.84-2.44; p-value for interaction 0.02-0.04 for five SNPs). Risk genotypes also increased the association between infection and childhood asthma that remits in adulthood (OR 4.84-7.16 in carriers and 1.74-2.25 in noncarriers; p-value for interaction 0.008-0.05 for 10 SNPs). In children with 17q21 risk genotypes and early-life environmental tobacco smoke (ETS) exposure, associations between infection and asthma were further enhanced. 17q21 genetic variants and early ETS exposure enhance the association between early respiratory infections and early-onset asthma and childhood asthma that remits in adulthood.
Published: 2010

43. Heterogeneity of asthma according to blood inflammatory patterns

Author: R, Nadif, V, Siroux, M-P, Oryszczyn, C, Ravault, C, Pison, I, Pin, F, Kauffmann, J, Ferran, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Département d'information médicale / Hôpital Plaisir-Grignon (DIM), Hôpital gérontologique et médico-social de Plaisir-Grignon, Service de Pédiatrie, CHU Grenoble, GA2LEN project, Global Allergy and Asthma European Network., EGEA, ANR 05-SEST-020- 02/05-9-97, ANR-06-CEBS,ANR 05-SEST-020- 02/05-9-97, ANR-06-CEBS, Faraldo, Beatrice, Programme Santé-environnement et Santé-travail - Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie - 2005 - ANR-05-SEST-0020 - SEST - VALID, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), and ANR-05-SEST-0020,Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie(2005)
Subjects: Male, MESH: Pulmonary Eosinophilia, MESH: Asthma, Neutrophils, MESH: Pulmonary Disease, Chronic Obstructive, Disease, MESH: Neutrophils, Immunoglobulin E, Leukocyte Count, Pulmonary Disease, Chronic Obstructive, 0302 clinical medicine, MESH: Cough, Eosinophilia, 030212 general & internal medicine, COPD, MESH: Bronchitis, biology, Respiratory disease, Age Factors, neutrophil, 3. Good health, Phenotype, medicine.anatomical_structure, MESH: Young Adult, Female, medicine.symptom, Adult, Pulmonary and Respiratory Medicine, Inflammation, MESH: Phenotype, Young Adult, 03 medical and health sciences, Sex Factors, MESH: Sex Factors, MESH: Eosinophils, medicine, Humans, eosinophil, Pulmonary Eosinophilia, Bronchitis, Asthma, MESH: Age Factors, MESH: Humans, business.industry, MESH: Chronic Disease, MESH: Adult, Eosinophil, medicine.disease, respiratory, MESH: Male, respiratory tract diseases, Eosinophils, signs and symptoms, Cough, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Leukocyte Count, Chronic Disease, Immunology, biology.protein, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract: Word count: 3032.; International audience; RATIONALE: There is increasing interest regarding asthma heterogeneity in relation to inflammatory patterns. OBJECTIVES: To assess phenotypic characteristics, in particular clinical presentation of the disease, in 381 well-characterised adults with asthma from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA) according to their blood inflammatory pattern. METHODS: Four blood inflammatory patterns were defined according to eosinophil (EOS) and neutrophil (NEU) count cut-off points. Samples with > or =250 EOS/mm(3) were classified as EOS(hi) and those with > or =5000 NEU/mm(3) as NEU(hi). Clinical characteristics include typical asthma and chronic obstructive pulmonary disease (COPD)-like symptoms, as well as composite quantitative scores addressing the activity of the disease. RESULTS: A substantial number of those with asthma (56.2%) had the EOS(lo) pattern (
Published: 2009

44. Cat sensitization according to cat window of exposure in adult asthmatics

Author: R. van Ree, Francine Kauffmann, Jean Maccario, Rachel Nadif, Marie-Pierre Oryszczyn, Amsterdam institute for Infection and Immunity, Amsterdam Public Health, Experimental Immunology, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Experimental Immunology (AMC-UvA), Academic Medical Center [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA) - University of Amsterdam [Amsterdam] (UvA), Faculté des sciences pharmaceutiques et biologiques, Université Paris Descartes - Paris 5 (UPD5), Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Academic Medical Center - Academisch Medisch Centrum [Amsterdam] (AMC), University of Amsterdam [Amsterdam] (UvA)-University of Amsterdam [Amsterdam] (UvA), and Faraldo, Beatrice
Subjects: Male, Allergy, MESH: Asthma, Immunoglobulin E, Immunoglobulin G, 0302 clinical medicine, Fel d 1, Immunopathology, Immunology and Allergy, MESH: Animals, MESH : Female, Respiratory system, Sensitization, MESH : Allergens, MESH: Immunoglobulin G, biology, MESH: Immunoglobulin E, MESH : Adult, MESH: Case-Control Studies, 3. Good health, medicine.anatomical_structure, Female, France, MESH: Cats, MESH : Cats, Adult, MESH : Case-Control Studies, MESH: Allergens, MESH : Immunoglobulin G, MESH : Male, MESH : Sex Factors, Immunology, MESH: Glycoproteins, MESH : Asthma, MESH : Immunoglobulin E, Article, 03 medical and health sciences, Sex Factors, MESH: Sex Factors, medicine, Animals, Humans, MESH : France, Glycoproteins, Asthma, MESH: Humans, business.industry, MESH : Humans, MESH: Adult, Allergens, medicine.disease, MESH : Glycoproteins, MESH: Male, MESH: France, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, Cats, biology.protein, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Animals, business, MESH: Female, 030215 immunology
Abstract: P>Background In adults, there is limited information on tolerance to cat, which may be reflected by high IgG(4) without IgE sensitization. Early exposure to cat may play a critical role. Objective The aim was to assess among adults the association of Fel d 1 IgG(4), Fel d 1 IgE, skin prick test (SPT) response to cat and pet-related symptoms in relation to exposure to cat considering the period of exposure. Methods SPT response to cat, specific IgE and IgG(4) to Fel d 1 were assessed in 167 asthmatics recruited in chest clinics (40 years of age in average) from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA). Childhood and/or current exposure to cat were studied retrospectively. Results IgG(4) was higher in relation to current cat exposure (0.53 vs. 0.09 ng/mL; P
Published: 2009

45. Air pollution and asthma severity in adults

Author: Francine Kauffmann, Nino Künzli, Isabelle Pin, Estelle Rage, Valérie Siroux, Faraldo, Beatrice, Programme Santé-environnement et Santé-travail - Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie - 2005 - ANR-05-SEST-0020 - SEST - VALID, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Institució Catalana de Recerca i Estudis Avançats (ICREA), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), ministerio de ciencia e innovacion, Clinique de pneumologie, CHU Grenoble, Supported in part by Inserm, ADEME (French Environment and Energy Management Agency), AFSSET (French Agency for Environmental & Occupational Health Safety) N° ES- 2005-015, European Commission as part of the Ga2len project, Global Allergy and Asthma European Network (contract n° FOOD-CT-2004-506378), EGEA Cooperative group, ANR-05-SEST-0020,Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie(2005), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), and ANR: 05-SEST-020-02/05-9-97,05-SEST-020-02/05-9-97
Subjects: Adult, Male, Risk, medicine.medical_specialty, Nitrogen Dioxide, Air pollution, medicine.disease_cause, Severity of Illness Index, Article, 03 medical and health sciences, 0302 clinical medicine, Ozone, Interquartile range, Residence Characteristics, Environmental health, Statistical significance, Air Pollution, Severity of illness, medicine, Odds Ratio, Humans, Sulfur Dioxide, 030212 general & internal medicine, Prospective Studies, Lung, Exposure assessment, Asthma, Air Pollutants, asthma severity, business.industry, Public Health, Environmental and Occupational Health, Odds ratio, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Surgery, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Air Pollution, Indoor, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Female, Seasons, business, Environmental Monitoring
Abstract: 21 pages; International audience; BACKGROUND/OBJECTIVES: There is evidence that exposure to air pollution affects asthma, but the effect of air pollution on asthma severity has not been addressed. The aim was to assess the relation between asthma severity during the past 12 months and home outdoor concentrations of air pollution. METHODS: Asthma severity over the past 12 months was assessed in two complementary ways among 328 adult asthmatics from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA) examined between 1991 and 1995. The four-class severity score integrated clinical events and type of treatment. The five-level asthma score is based only on the occurrence of symptoms. Nitrogen dioxide (NO(2)), sulphur dioxide (SO(2)) and ozone (O(3)) concentrations were assigned to each residence using two different methods. The first was based on the closest monitor data from 1991 to 1995. The second consisted of spatial models that used geostatistical interpolations and then assigned air pollutants to the geo-coded residences (1998). RESULTS: Higher asthma severity score was significantly related to the 8-hour average of ozone during April-September (O(3)-8 h) and the number of days (O(3)-days) with 8-hour ozone averages above 110 microg.m(-3) (for a 36-day increase, equivalent to the interquartile range, in O(3)-days, odds ratio 2.22 (95% confidence interval 1.61 to 3.07) for one class difference in score). Adjustment for age, sex, smoking habits, occupational exposure, and educational level did not alter results. Asthma severity was unrelated to NO(2). Both exposure assessment methods and severity scores resulted in very similar findings. SO(2) correlated with severity but reached statistical significance only for the model-based assignment of exposure. CONCLUSIONS: The observed associations between asthma severity and air pollution, in particular O(3), support the hypothesis that air pollution at levels far below current standards increases asthma severity.
Published: 2008

46. Impact of nutritional status on body functioning in chronic obstructive pulmonary disease and how to intervene

Author: Noël Cano, Wahju Aniwidyaningsih, Raphaëlle Varraso, Christophe Pison, Clinique de pneumologie, CHU Grenoble, Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Pulmonology and Respiratory Medicine, Faculty of Medicine University of Indonesia, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Emergency Medicine, Massachusetts General Hospital [Boston], Centre de Recherche en Nutrition Humaine Auvergne [CHU Clermont-Ferrand] (CRNH A), Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, Métabolisme protéino-énergétique (UMPE), Institut National de la Recherche Agronomique (INRA)-Université d'Auvergne - Clermont-Ferrand I (UdA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF), Université Grenoble Alpes (UGA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF), Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche en Nutrition Humaine (CRNH), CHU Clermont-Ferrand, Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Recherche Agronomique (INRA), and Faraldo, Beatrice
Subjects: medicine.medical_specialty, Cachexia, Copd patients, medicine.medical_treatment, Protective factor, Nutritional Status, Medicine (miscellaneous), Pulmonary disease, Article, oral nutrition supplement, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Humans, Medicine, COPD, Pulmonary rehabilitation, Nutrition disorders, 030212 general & internal medicine, anabolic agents, Intensive care medicine, 2. Zero hunger, Nutrition and Dietetics, Nutritional Support, business.industry, Nutrition Disorders, Nutritional status, medicine.disease, pulmonary rehabilitation, respiratory tract diseases, 3. Good health, Oxidative Stress, Malnutrition, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, inflammation, Physical therapy, enteral feeding, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Inflammation Mediators, business, diet
Abstract: This is a non-final version of an article published in final form in Current Opinion in Clinical Nutrition & Metabolic Care; International audience; PURPOSE OF REVIEW: Chronic obstructive pulmonary disease is the fifth leading cause of mortality in the world. This study reviews diet as a risk or protective factor for chronic obstructive pulmonary disease, mechanisms of malnutrition, undernutrition consequences on body functioning and how to modulate nutritional status of patients with chronic obstructive pulmonary disease. RECENT FINDINGS: Different dietary factors (dietary pattern, foods, nutrients) have been associated with chronic obstructive pulmonary disease and the course of the disease. Mechanical disadvantage, energy imbalance, disuse muscle atrophy, hypoxemia, systemic inflammation and oxidative stress have been reported to cause systemic consequences such as cachexia and compromise whole body functioning. Nutritional intervention makes it possible to modify the natural course of the disease provided that it is included in respiratory rehabilitation combining bronchodilators optimization, infection control, exercise and, in some patients, correction of hypogonadism. SUMMARY: Diet, as a modifiable risk factor, appears more as an option to prevent and modify the course of chronic obstructive pulmonary disease. Reduction of mechanical disadvantage, physical training and anabolic agents should be used conjointly with oral nutrition supplements to overcome undernutrition and might change the prognosis of the disease in some cases. Major research challenges address the role of systemic inflammation and the best interventions for controlling it besides smoking cessation.
Published: 2008

47. Are asymptomatic airway hyperresponsiveness and allergy risk factors for asthma? A longitudinal study

Author: Reinier Akkermans, L. van den Nieuwenhof, Yvonne F. Heijdra, Tjard Schermer, Ben Bottema, Hans Th.M. Folgering, C. van Weel, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), ANR-SEST, ANR-CEBS, AFSSET, PHRC Paris, EGEA Cooperative group, Faraldo, Beatrice, and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Longitudinal study, Allergy, MESH: Asthma, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, MESH: Child, Effective Primary Care and Public Health [EBP 3], Epidemiology, Odds Ratio, 030212 general & internal medicine, Family history, Child, MESH: Longitudinal Studies, ComputingMilieux_MISCELLANEOUS, medicine.diagnostic_test, Cardiovascular diseases [NCEBP 14], Effective primary care and public health [NCEBP 7], respiratory system, 3. Good health, Pathogenesis and modulation of inflammation [N4i 1], MESH: Young Adult, Female, Disease Susceptibility, Bronchial Hyperreactivity, medicine.symptom, medicine.drug, Spirometry, Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, MESH: Hypersensitivity, Implementation Science [NCEBP 3], Asymptomatic, Bronchial Provocation Tests, 03 medical and health sciences, Internal medicine, Wheeze, Hypersensitivity, medicine, Humans, Risk factor, Asthma, MESH: Adolescent, MESH: Humans, business.industry, MESH: Bronchial Hyperreactivity, MESH: Adult, Odds ratio, Airway obstruction, medicine.disease, Health Surveys, respiratory tract diseases, Cross-Sectional Studies, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Physical therapy, Methacholine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Microbial pathogenesis and host defense [UMCN 4.1], business, Follow-Up Studies
Abstract: Contains fulltext : 69913.pdf (Publisher’s version ) (Closed access) Airway hyperresponsiveness (AHR) is a characteristic feature of asthma, but it is unclear whether asymptomatic AHR is associated with a higher risk of asthma. The present study assessed whether there is an association between asymptomatic AHR in adolescence and asthma in adulthood. The association between allergy and development of asthma was also investigated. A follow-up study of a general population cohort of adolescents was performed 14 yrs after baseline. Respiratory status was assessed at baseline in 1989 and at follow-up in 2003-2004 by a respiratory symptoms questionnaire, spirometry and histamine challenge. Allergy status was also assessed. The respiratory status of 199 subjects was assessed twice. In total, 91 (46%) subjects had the same AHR status in combination with respiratory symptoms at follow-up as at baseline. Adjusted for age, sex, allergy, family history of asthma and smoking history, having asymptomatic AHR was not significantly related to having asthma 14 yrs later (odds ratio (OR) 2.15, 95% confidence interval (CI) 0.67-6.83). For subjects with allergy at baseline, the OR for developing asthma was 4.45 (95% CI 1.46-13.54). Screening for asymptomatic airway hyperresponsiveness in adolescence does not identify subjects at risk of developing asthma. Conversely, the presence of allergy in adolescence does seem to be a risk factor for asthma development.
Published: 2008

48. Replication of association between ADAM33 polymorphisms and psoriasis

Author: Siroux, Valérie, Bouzigon, Emmanuelle, Dizier, Marie-Hélène, Pin, Isabelle, Demenais, Florence, Kauffmann, Francine, Cooperative Group, Egea, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Méthodologie statistique et épidémiologie génétique de maladies multifactorielles, Université d'Évry-Val-d'Essonne (UEVE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Génétique épidémiologique et structures des populations humaines (Inserm U535), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de pédiatrie, CHU Grenoble-Hôpital Michallon, Merck, PHRC-Paris, EGEA Cooperative group, ANR-05-SEST-0020,Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie(2005), ANR-06-CEBS, ANR-05-SEST-020-02/05-9-97,ANR-06-CEBS, ANR-05-SEST-020-02/05-9-97, Faraldo, Beatrice, and Programme Santé-environnement et Santé-travail - Facteurs environnementaux et interactions gène environnnement dans l'asthme et l'allergie - 2005 - ANR-05-SEST-0020 - SEST - VALID
Subjects: Male, Dermatology/Psoriasis and Other Inflammatory Diseases, Linkage disequilibrium, lcsh:Medicine, Bioinformatics, Linkage Disequilibrium, 030207 dermatology & venereal diseases, 0302 clinical medicine, Surveys and Questionnaires, lcsh:Science, Genetics and Genomics/Genetics of Disease, MESH: Heterozygote, 0303 health sciences, MESH: Psoriasis, Multidisciplinary, MESH: Middle Aged, MESH: Polymorphism, Single Nucleotide, Homozygote, Middle Aged, 3. Good health, MESH: Linkage Disequilibrium, Female, Research Article, MESH: Homozygote, Adult, MESH: ADAM Proteins, medicine.medical_specialty, Heterozygote, Positional cloning, ADAM33, Single-nucleotide polymorphism, Biology, Polymorphism, Single Nucleotide, 03 medical and health sciences, Internal medicine, Psoriasis, medicine, Humans, Alleles, 030304 developmental biology, Genetic association, MESH: Humans, MESH: Questionnaires, MESH: Alleles, lcsh:R, MESH: Adult, medicine.disease, MESH: Male, respiratory tract diseases, Minor allele frequency, ADAM Proteins, Genetic epidemiology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:Q, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female
Abstract: International audience; Polymorphisms in ADAM33, the first gene identified in asthma by positional cloning, have been recently associated with psoriasis. No replication study of this association has been published so far. Data available in the French EGEA study (Epidemiological study on Genetics and Environment of Asthma, bronchial hyperresponsivensess and Atopy) give the opportunity to attempt to replicate the association between ADAM33 and psoriasis in 2002 individuals. Psoriasis (n = 150) has been assessed by questionnaire administered by an interviewer and a sub-sample of subjects with early-onset psoriasis (n = 74) has been identified based on the age of the subjects at time of interview (
Published: 2008

49. The healthy worker effect in asthma: work may cause asthma, but asthma may also influence work

Author: Nicole Le Moual, Ellen A. Eisen, Francine Kauffmann, Susan M. Kennedy, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Environmental Health, Harvard School of Public Health, School of Public Health [Berkeley], University of California [Berkeley], University of California-University of California, School of Occupational and Environmental Hygiene, University of British Columbia (UBC), InVS/Direction of Labor grant n°03-S-ST-A20-08, AFSSET (French Agency of health safety, environment and work) grant N° ES-2005-015 and EU Framework program for research, research, contract n° FOOD-CT-2004-506378, the GA2LEN project, Global Allergy and Asthma European Network, Faraldo, Beatrice, University of California [Berkeley] (UC Berkeley), and University of California (UC)-University of California (UC)
Subjects: Gerontology, MESH: Asthma, Cross-sectional study, Critical Care and Intensive Care Medicine, MESH: Risk Assessment, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Occupational Exposure, Cohort Studies, 0302 clinical medicine, MESH: Child, 030212 general & internal medicine, MESH: Incidence, Longitudinal Studies, MESH: Longitudinal Studies, Child, MESH: Cohort Studies, Healthy Worker Effect, education.field_of_study, Incidence, MESH: Bias (Epidemiology), 030210 environmental & occupational health, 3. Good health, Causality, Occupational Diseases, Population Surveillance, epidemiology, Occupational asthma, Cohort study, Pulmonary and Respiratory Medicine, MESH: Occupational Diseases, Adult, medicine.medical_specialty, MESH: Healthy Worker Effect, Adolescent, Population, Work Capacity Evaluation, MESH: Causality, Risk Assessment, Article, MESH: Population Surveillance, 03 medical and health sciences, MESH: Cross-Sectional Studies, Bias, Intensive care, Occupational Exposure, medicine, Humans, education, Asthma, MESH: Adolescent, MESH: Humans, business.industry, Public health, MESH: Adult, medicine.disease, MESH: Work Capacity Evaluation, respiratory tract diseases, Cross-Sectional Studies, Relative risk, Physical therapy, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Feasibility Studies, business, MESH: Feasibility Studies
Abstract: International audience; Despite the increasing attention to the relationship between asthma and work exposures, occupational asthma remains underrecognized and its population burden underestimated. This may be due, in part, to the fact that traditional approaches to studying asthma in populations cannot adequately take into account the healthy worker effect (HWE). The HWE is the potential bias caused by the phenomenon that sicker individuals may choose work environments in which exposures are low; they may be excluded from being hired; or once hired, they may seek transfer to less exposed jobs or leave work. This article demonstrates that population- and workplace-based asthma studies are particularly subject to HWE bias, which leads to underestimates of relative risks. Our objective is to describe the HWE as it relates to asthma research, and to discuss the significance of taking HWE bias into account in designing and interpreting asthma studies. We also discuss the importance of understanding HWE bias for public health practitioners and for clinicians. Finally, we emphasize the timeliness of this review in light of the many longitudinal "child to young adult" asthma cohort studies currently underway. These prospective studies will soon provide an ideal opportunity to examine the impact of early workplace environments on asthma in young adults. We urge occupational and childhood asthma epidemiologists collaborate to ensure that this opportunity is not lost.
Published: 2007

50. Evidence for linkage of a new region (11p14) to eczema and allergic diseases

Author: Jocelyne Just, Evelyne Paty, Marie-Hélène Dizier, Jean Bousquet, Isabella Annesi-Maesano, Régis Matran, Arnaud Lemainque, Frédéric Gormand, Florence Demenais, J Hochez, Denis Charpin, Françoise Neukirch, Nicole Le Moual, Isabelle Pin, Marie-Pierre Oryszczyn, Michel Guilloud-Bataille, Emmanuelle Bouzigon, Francine Kauffmann, Mark Lathrop, Daniel Vervloet, Génétique épidémiologique et structures des populations humaines ( Inserm U535 ), Epidémiologie, sciences sociales, santé publique ( IFR 69 ), Université Panthéon-Sorbonne ( UP1 ) -Université Paris-Sud - Paris 11 ( UP11 ) -École des hautes études en sciences sociales ( EHESS ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Panthéon-Sorbonne ( UP1 ) -Université Paris-Sud - Paris 11 ( UP11 ) -École des hautes études en sciences sociales ( EHESS ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Méthodologie statistique et épidémiologie génétique de maladies multifactorielles, Université d'Évry-Val-d'Essonne ( UEVE ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Epidémiologie des maladies infectieuses et modélisation ( ESIM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Immunopathologie de l'Inflammation, Université Montpellier 1 ( UM1 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de pneumologie-allergologie, Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital nord, Service de pneumologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Modélisation mathématique et statistique en biologie et médecine, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de l'asthme et de l'allergologie, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Trousseau [APHP], Centre National de Génotypage ( CNG ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ), Laboratoire d'Exploration Fonctionnelle, Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Mécanismes physiopathologiques de l'insuffisance respiratoire et des complications de l'anesthésie, Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Pneumologie Allergologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Département de médecine aiguë spécialisée, CHU Grenoble-Hôpital Michallon, Service de Pneumo-Allergologie, Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital Sainte-Marguerite [CHU - APHM] ( Hôpitaux Sud ), This work was partly supported by EU Framework Programme for Research, contract no. FOOD-CT-2004-506378, the GA2LEN project, Global Allergy and Asthma European Network., Faraldo, Beatrice, Génétique épidémiologique et structures des populations humaines (Inserm U535), Epidémiologie, sciences sociales, santé publique (IFR 69), Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris 1 Panthéon-Sorbonne (UP1)-Université Paris-Sud - Paris 11 (UP11)-École des hautes études en sciences sociales (EHESS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Évry-Val-d'Essonne (UEVE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital nord, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre National de Génotypage (CNG), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Assistance Publique - Hôpitaux de Marseille (APHM), CHU Necker - Enfants Malades [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Male, Allergy, Genetic Linkage, Eczema, Disease, MESH: Genetic Markers, 0302 clinical medicine, MESH: Genetic Screening, MESH : Child, MESH: Child, Surveys and Questionnaires, MESH : Genetic Markers, MESH : Female, Child, Genetics (clinical), Genetics, 0303 health sciences, MESH: Nuclear Family, medicine.diagnostic_test, MESH : Chromosomes, Human, Pair 11, MESH : Questionnaires, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Atopic dermatitis, MESH : Adult, 3. Good health, Female, Adult, Genetic Markers, Adolescent, MESH: Hypersensitivity, MESH : Male, Biology, Article, Nuclear Family, 03 medical and health sciences, Genetic linkage, MESH : Adolescent, medicine, MESH : Eczema, Hypersensitivity, Humans, Genetic Testing, 030304 developmental biology, Genetic testing, Asthma, Genetic association, Linkage (software), MESH: Adolescent, MESH : Genetic Screening, MESH: Humans, MESH : Hypersensitivity, MESH: Questionnaires, Chromosomes, Human, Pair 11, MESH : Humans, MESH: Adult, medicine.disease, MESH: Male, MESH : Lod Score, 030228 respiratory system, MESH: Lod Score, MESH: Eczema, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Immunology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Nuclear Family, MESH: Chromosomes, Human, Pair 11, Lod Score, MESH: Linkage (Genetics), MESH: Female, MESH : Linkage (Genetics)
Abstract: International audience; Asthma, allergic rhinitis (AR) and atopic dermatitis also called eczema are allergic co-morbidites, which are likely to depend on pleiotropic genetic effects as well as on specific genetic factors. After a previous genome-wide linkage screen conducted for asthma and AR in a sample of 295 French EGEA families ascertained through asthmatic subjects, the aim here was to search for genetic factors involved in eczema and more particularly the ones shared by the three allergic diseases using the same EGEA data. In this sake, eczema and phenotypes of "allergic disease" accounting for the joint information on the presence/absence of the three diseases were examined by linkage analyses using the maximum likelihood binomial method. A fine mapping was carried out in regions detected for potential linkage, followed by association studies using the family-based association test (FBAT). Evidence for linkage to 11p14 region was shown for "allergic disease" and eczema. Linkage was also indicated between eczema and 5q13 and between "allergic disease" and both 5p15 and 17q21 regions. Fine mapping supported the evidence of linkage to 11p14 and FBAT analyses showed the association between "allergic disease" and a marker located at the linkage peak on 11p14. Further investigations in this region will allow identifying genetic factor(s) which could have pleiotropic effect in the three allergic diseases.
Published: 2007

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