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Background: There seems to be a consensus that family influences on dietary habits are important. However, no data relative to breakfast have been published yet. Objective: To investigate whether and how breakfast energy intake aggregates within French families. Design: A total of 398 families of the Stanislas Family Study who filled in a 3 day food consumption diary were selected. Absolute and relative breakfast energy intakes (BEI in kcal/day and RBEI in percentage of daily intake, respectively) were both studied. Results: By using a variance component analysis, no genetic influence was shown in family aggregation of both BEI and RBEI. Intra-generation common environmental contribution to total phenotypic variance of BEI and RBEI was higher than intergeneration; both were increased with frequency of sharing breakfast. Furthermore frequency of sharing breakfast contributed to increase family resemblance in breakfast energy intake, particularly in offspring for BEI and RBEI, and in spouses for RBEI. Smoking habits, alcohol consumption, BMI or physical activity were related to family resemblance, but after adjustment on each factor degrees of resemblance were almost unchanged. Conclusion: General findings of this study were that family aggregation in breakfast absolute and relative energy intakes was significant within Stanislas families. Family resemblance depended on inter- and intra-generation components and was modified by the number of shared breakfasts. Our study confirmed that familial habits act on family resemblance in both absolute and relative breakfast energy intakes, so that family should be a favorite unit for health and diet promotion programs. Sponsorship: Kellogg's PA, France. [ABSTRACT FROM AUTHOR]

Abstract: Background: A recent decline in breast cancer incidence rates has been reported in the United States and in Europe. This decrease has been partly attributed to the reduced use of hormone replacement therapy (HRT). No study in Europe has detailed recent breast cancer incidence trends both by hormonal receptor status and mode of detection at an individual level. Methods: We examined trends in breast cancer incidence rates in the French administrative area of Loire-Atlantique between 1991 and 2007, by age, mode of detection, histological subtype, estrogen/progesterone receptor (ER/PR) status and grade. Annual age-standardized breast cancer incidence rates were estimated using the Loire-Atlantique and Vendée Cancer Registry data. Annual percentage changes (APCs) were estimated using an age-adjusted Poisson regression model. Results: Incidence rates of breast cancer increased 3.5% per year in 1991–2003, dropped −4.3% per year in 2003–2006 and increased in 2007 (9.1%). Stratified analyses by age groups showed that the decrease concerned predominantly women aged 50–64 years, whereas an increasing proportion of cancers detected by organized screening was observed in this age group. Among these women, the decline of incidence particularly concerned positive estrogen and progesterone receptor tumors, lobular subtype tumors, and low-grade tumors. Conclusion: The drop in breast cancer incidence rates observed between 2003 and 2006 in women 50–64 years old was greater for ER+PR+ tumors. During the same period, the incidence of breast cancers diagnosed by organized screening increased. These patterns appear consistent with an impact of the reduced use of HRT. [Copyright &y& Elsevier]

Purpose: Low socioeconomic background (SB) has been associated with lower breast cancer (BC) incidence and higher BC mortality. One explanation of this paradox is the higher frequency of advanced BC observed in deprived women. However, it is still unclear if SB affects similarly BC incidence. This study investigated the link between SB and early/advanced BC incidence from Loire-Atlantique/Vendee Cancer registry data (France)., Materials and Methods: Fourteen thousand three hundred fifty three women living in the geographic area covered by the registry and diagnosed with a primary BC in 2008-2015 were included. SB was approached by a combination of two ecological indexes (French European Deprivation Index and urban/rural residence place). Mixed effects logistic and Poisson regressions were used, respectively, to estimate the odds of advanced (stage ≥ II) BC and the ratio of incidence rates of early (stage 0-I) and advanced BC according to SB, overall and by age group (< 50, 50-74, ≥ 75)., Results: Compared to women living in affluent-urban areas, women living in deprived-urban and deprived-rural areas had a higher proportion of advanced BC [respectively, OR = 1.11 (1.01-1.22), OR = 1.60 (1.25-2.06)] and lower overall (from - 6 to - 15%) and early (from - 9 to - 31%) BC incidences rates Advanced BC incidence rates were not influenced by SB. These patterns were similar in women under 75 years, especially in women living in deprived-rural areas. In the elderly, no association between SB and BC frequency/incidence rates by stage was found., Conclusion: Although advanced BC was more frequent in women living in deprived and rural areas, SB did not influence advanced BC incidence. Therefore, differences observed in overall BC incidence according to SB were only due to higher incidence of early BC in affluent and urban areas. Future research should confirm these results in other French areas., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: District-level cancer incidence estimation is an important issue in countries without a national cancer registry. This study aims to both evaluate the validity of district-level estimations in France for 24 cancer sites, using health insurance data (ALD demands--Affection de Longue Durée) and to provide estimations when considered valid. Incidence is estimated at a district-level by applying the ratio between the number of first ALD demands and incident cases (ALD/I ratio), observed in those districts with cancer registries, to the number of first ALD demands available in all districts. These district-level estimations are valid if the ratio does not vary greatly across the districts or if variations remain moderate compared with variations in incidence rates., Methods: Validation was performed in the districts covered by cancer registries over the period 2000-2005. The district variability of the ALD/I ratio was studied, adjusted for age (mixed-effects Poisson model), and compared with the district variability in incidence rate. The epidemiological context is also considered in addition to statistical analyses., Results: District-level estimation using the ALD/I ratio was considered valid for eight cancer sites out of the 24 studied (lip-oral cavity-pharynx, oesophagus, stomach, colon-rectum, lung, breast, ovary and testis) and incidence maps were provided for these cancer sites., Conclusion: Estimating cancer incidence at a sub-national level remains a difficult task without a national registry and there are few studies on this topic. Our validation approach may be applied in other countries, using health insurance or hospital discharge data as correlate of incidence., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Introduction: Active employees in the construction industry are particularly exposed to occupational cement eczema (OCE) which affects the hands in 80 to 90% of cases. The importance of OCE in France and the impact of the application of decree n(o). 2005-577 on 26 May 2005 were estimated from data collected by the Occupational risks division of the French national health insurance fund for salaried workers (CNAMTS). This decree prohibits the placing on the market and use of cement (and preparations containing it) with a chromium VI content above 0.0002% in order to reduce its hazardousness., Methods: All cases of OCE reported to and recognized by the CNAMTS between 1 January 2004 and 31 December 2008 among construction workers were selected. The following parameters were noted in each case: age, gender, industrial sector concerned, local French National health insurance agency, causal agent and the number of working days lost. The incidence per 100,000 salaried workers could be determined from the total number of salaried workers followed up by occupational medicine as well as those working in the construction industry., Results: For the five years studied, 3698 cases of occupational eczema (OE) were reported in construction workers and this was 17.1% of the total number of cases of OE for all salaried employees (n=12.689). Cement was the causal agent most frequently involved in the construction sector (57.8%, 2139/3698). The annual incidence of OCE decreased from 37.8 to 21.1 new cases per 100,000 employees in the construction industry per year between 2004 and 2008. The total number of days lost from work due to OCE decreased by 39% during the study period., Conclusion: This descriptive study highlights the importance and socio-economic impact of OCE in the construction industry. Application of decree n(o). 2005-577 on 26 May 2005 may explain a reduction in OCE., (Copyright © 2012. Published by Elsevier Masson SAS.)

Background: Employees active in the cleaning and maintenance industry (CMI) are particularly exposed to occupational eczema (OE), which affects the hands in 80 to 90% of cases. This risk of OCE in France was evaluated using data collected by the Occupational Risks Division of the French National Health Insurance Fund for Salaried Workers (CNAMTS)., Patients and Methods: All cases of OE among CMI employees declared to and recognized by the CNAMTS between 1st January 2004 and 31st December 2007 were selected. The following parameters were noted in each case: age, gender, trade in question, National Health Insurance Office of residence, causal agent and number of days of sick leave. The incidence per 100,000 employees could be determined from the total number of employees followed up by occupational medicine and the numbers working in the CMI., Results: For the 4 years studied, 769 cases of OE were reported in CMI workers representing 2.6% of the salaried employee population. The annual incidence of OE was 43.5 per 100,000 employees. There was a marked female predominance (75.7%). OE led to loss of 32,714 workdays., Conclusion: This is the first study conducted in France about OE among NIS employees. It highlights the socioeconomic impact of OE. The difficulties of interpretation show the limits of recognition of occupational disease. Analysis of cases of OE in France and monitoring require the development of a specific database to clarify risk situations and identify priority regional and national preventive actions., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Background: Limited epidemiological data are available in France for occupational contact dermatitis (OCD), a non- infectious inflammatory skin condition arising from direct skin contact with substances used in the workplace., Objective: To estimate the occurrence of, and number of workdays lost to, OCD in France., Methods: Descriptive study of all OCD declared by salaried workers and recognised as occupational disease in France over a 4-year period., Results: 10,582 OCD cases were reported, representing 9.6% of all occupational diseases recognised. The estimated annual incidence of OCD recognised was 15.72/100,000 salaried workers (i.e. 146.87/100,000 employees for all occupational diseases). OCD cases were mainly in the construction and public works industries with 3,057 (36.7%) salaried workers affected. In the services sector, OCD predominantly affected employees aged less than 30 years (41%), particularly hairdressers (69%). OCD accounted for the loss of 395,069 working days., Conclusion: OCD represents a significant public health problem in France, particularly for construction workers and hairdressers., (Copyright © 2013 S. Karger AG, Basel.)

Objective: The inhalation of radon, a well-established human carcinogen, is the principal-and omnipresent-source of radioactivity exposure for the general population of most countries. Scientists have thus sought to assess the lung cancer risk associated with indoor radon. Our aim here is to assess this risk in France, using all available epidemiologic results and performing an uncertainty analysis., Methods: We examined the exposure-response relations derived from cohorts of miners and from joint analyses of residential case-control studies and considered the interaction between radon and tobacco. The exposure data come from measurement campaigns conducted since the beginning of the 1980s by the Institute for Radiation Protection and Nuclear Safety and the Directorate-General of Health in France. We quantified the uncertainties associated with risk coefficients and exposures and calculated their impact on risk estimates., Results: The estimated number of lung cancer deaths attributable to indoor radon exposure ranges from 543 [90% uncertainty interval (UI) , 75-1,097] to 3,108 (90% UI, 2,996-3,221) , depending on the model considered. This calculation suggests that from 2.2% (90% UI, 0.3-4.4) to 12.4% (90% UI, 11.9-12.8) of these deaths in France may be attributable to indoor radon., Discussion: In this original work we used different exposure-response relations from several epidemiologic studies and found that regardless of the relation chosen, the number of lung cancer deaths attributable to indoor radon appears relatively stable. Smokers can reduce their risk not only by reducing their indoor radon concentration but also by giving up smoking.

This study was undertaken to evaluate the ecological association between terrestrial and cosmic gamma radiation, indoor radon, and acute leukemia incidence among children under 15 y of age. From 1990 to 2001, 5,330 cases of acute leukemia were registered by the French National Registry of Childhood Leukemia and Lymphoma. Exposure to terrestrial gamma radiation was based on measurements, using thermoluminescent dosimeters, at about 1,000 sites covering all the "Départements." In addition, 8,737 indoor terrestrial gamma dose rate measurements covering 62% of the "Départements" and 13,240 indoor radon concentration measurements covering all the "Départements" were made during a national campaign. Cosmic ray doses were estimated in each of the 36,363 "Communes" of France. There was no evidence of an ecological association between terrestrial gamma dose (range: 0.22-0.90 mSv y) or total gamma dose (range: 0.49-1.28 mSv y) and childhood acute leukemia incidence, for acute myeloid leukemia (AML) or for acute lymphoblastic leukemia (ALL), in univariate or multivariate regression analyses including indoor radon. A significant positive association between indoor radon (range: 22-262 Bq m) and AML incidence among children was observed and remained significant in multivariate regression analyses including either terrestrial gamma dose [SIR per 100 Bq m = 1.29 (1.09-1.53)] or total gamma dose [SIR per 100 Bq m = 1.29 (1.09-1.53)]. The study showed no ecological association between terrestrial gamma radiation and childhood leukemia for the range of variation in gamma dose rates observed in France. The moderate ecological association between childhood AML incidence and indoor radon does not appear to be confounded by terrestrial gamma dose.

The objective of this study was to evaluate the ecological association between indoor radon concentration and acute leukaemia incidence among children under 15 years of age in the 348 geographical units (zones d'emploi, ZE) of France between 1990 and 1998. During that period, 4015 cases were registered by the French National Registry of Childhood Leukaemia and Lymphoma. Exposure assessment was based on a campaign of 13 240 measurements covering the whole country. The arithmetic mean radon concentration was 85 Bq/m (range, 15-387 Bq/m) and the geometric mean, 59 Bq/m (range: 13-228 Bq/m). A positive ecological association, on the borderline of statistical significance (P=0.053), was observed between indoor radon concentration and childhood leukaemia incidence. The association was highly significant for acute myeloid leukaemia (AML) (P=0.004) but not for acute lymphocytic leukaemia (ALL) (P=0.49). The standardized incidence ratio (SIR) increased by 7, 3 and 24% for all acute leukaemia, ALL and AML, respectively, when radon concentration increased by 100 Bq/m. In conclusion, the present ecological study supports the hypothesis of a moderate association between indoor radon concentration and childhood acute myeloid leukaemia. It is consistent with most previous ecological studies. Since the association is moderate, this result does not appear inconsistent with the five published case-control studies, most of which found no significant association.

In France, natural sources account for most of the population exposure to ionising radiation. This exposure varies widely with area. Radon and gamma-ray exposure data come from national measurement campaigns; cosmic doses were calculated from city altitude. These data were corrected for season of measurement, housing characteristics and population density to study their relationship with health indicators. The crude average of indoor radon concentrations was 89 Bq m(-3), and the average corrected for season and housing characteristics was 83 Bq m(-3) (range over districts: 19-297). Weighting by district population density yielded a national average of 63 Bq m(-3). Gamma-ray dose rates averaged 55 nSv h(-1) (23-96) indoors and 46 nSv h(-1) (25-85) outdoors; corrections did not change the means. Corrected cosmic annual doses averaged 0.28 mSv (0.27-0.38). These corrections estimated the radiation exposure of the French population more accurately and represented its distribution well, thereby allowing its study as a cofactor in ecological studies.

Indoor radon concentrations are subject to seasonal variation with a maximum in winter and a minimum in summer. Procedures to correct for seasonal variation are necessary in order to get an unbiased estimate of the annual average radon concentration from data based on short-period radon measurements. To obtain correction factors, we apply the model developed by Pinel et al to the French database of indoor radon measurements (measurements performed as part of the indoor radon case-control study and of the national radon measurement campaign). For 6-month measurements, the correction factors vary from 0.87 to 1.17 and agree with those previously published. These results might be applicable when assessing indoor radon concentrations with regard to recommended action levels.