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1. Occupational Asbestos Exposure and Incidence of Colon and Rectal Cancers in French Men: The Asbestos-Related Diseases Cohort (ARDCo-Nut)

Author

Christophe Paris, Pilar Galan, Fabrice Herin, Pascal Wild, Patrick Brochard, Serge Hercberg, Gaëlle Coureau, Aude Lacourt, Soizick Chamming's, Jean-Claude Pairon, Isabelle Thaon, Bénédicte Clin, Pascal Andujar, Amandine Luc, Antoine Gislard, Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Cancers et préventions, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU), Service de Santé au Travail et Pathologie Professionnellel [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), Service de santé au travail et pathologie professionnelle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Aliments Bioprocédés Toxicologie Environnements (ABTE), Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle (CRESS - U1153), Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Paris 13 (UP13)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Direction Scientifique (DS), Institut national de recherche et de sécurité (Vandoeuvre lès Nancy) (INRS ( Vandoeuvre lès Nancy)), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service des Maladies Professionnelles et Environnementales, Université Fédérale Toulouse Midi-Pyrénées-Centre hospitalier universitaire de Toulouse - CHU Toulouse, Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'investigation clinique et d'épidémiologie clinique 7 (CIC-EC7), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut Bergonié - CRLCC Bordeaux-Institut National de la Santé et de la Recherche Médicale (INSERM)-Cancéropôle du Grand Sud-Ouest, Registre Général des Cancers de la Gironde, Université Bordeaux Segalen - Bordeaux 2-Institut Bergonié - CRLCC Bordeaux-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED), Service de Médecine du Travail et de Pathologies Professionnelles, CHU Bordeaux [Bordeaux]-Hôpital Pellegrin, Institut Interuniversitaire de Médecine du Travail de Paris Ile de France (IIMTPIF), CHI Créteil-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), Epidémiologie et anlyses en santé publique: risques, maladies chroniques et handicaps, Université Paul Sabatier - Toulouse 3 (UPS) - Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Toulouse - Centre hospitalier universitaire de Toulouse - CHU Toulouse, Normandie Université (NU) - Normandie Université (NU) - Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Santé au Travail et Pathologie Professionnelle, CHU Caen, Université de Bordeaux (UB) - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - Institut National de la Santé et de la Recherche Médicale (INSERM) - Université de Bordeaux (UB) - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED) - Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier de Nancy (CHU Nancy), Université Bordeaux Segalen - Bordeaux 2 - CHU Bordeaux [Bordeaux] - Institut Bergonié - CRLCC Bordeaux - Institut National de la Santé et de la Recherche Médicale (INSERM) - Cancéropôle du Grand Sud-Ouest, Université Bordeaux Segalen - Bordeaux 2 - Institut Bergonié - CRLCC Bordeaux - Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED), CHU Bordeaux [Bordeaux] - Hôpital Pellegrin, CHI Créteil - Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de médecin du travail et de pathologie professionnelle du CHU de Rouen, CHU de Rouen, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), Institut National de la Recherche Agronomique (INRA) - Université Paris Diderot - Paris 7 (UPD7) - Université Paris Descartes - Paris 5 (UPD5) - Université Paris 13 - Institut National de la Santé et de la Recherche Médicale (INSERM) - Institut National de la Recherche Agronomique (INRA) - Université Paris Diderot - Paris 7 (UPD7) - Université Paris Descartes - Paris 5 (UPD5) - Université Paris 13 - Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA) - Université Paris Diderot - Paris 7 (UPD7) - Université Paris Descartes - Paris 5 (UPD5) - Université Paris 13 - Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12) - Institut National de la Santé et de la Recherche Médicale (INSERM) - IFR10

Subjects
Oncology, Adult, Male, medicine.medical_specialty, Pathology, Colorectal cancer, Health, Toxicology and Mutagenesis, Air Pollutants, Occupational, medicine.disease_cause, Asbestos, 03 medical and health sciences, 0302 clinical medicine, Air pollutants, Internal medicine, Occupational Exposure, medicine, [SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health, Humans, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Asbestos-related diseases, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, business.industry, Rectal Neoplasms, Incidence (epidemiology), Incidence, Research, Public Health, Environmental and Occupational Health, Middle Aged, medicine.disease, 3. Good health, Occupational Diseases, 030220 oncology & carcinogenesis, [SDV.TOX]Life Sciences [q-bio]/Toxicology, Cohort, Colonic Neoplasms, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business
Abstract

Background: The relationships between asbestos exposure and colorectal cancer remain controversial. Objectives: We examined the association between asbestos exposure and colorectal cancer incidence. Methods: Volunteer retired workers previously exposed to asbestos were invited to participate in the French ARDCo screening program between 2003 and 2005. Additional data on risk factors for colorectal cancer were collected from the ARDCo-Nut subsample of 3,769 participants in 2011. Cases of colon and rectal cancer were ascertained each year through 2014 based on eligibility for free medical care following a cancer diagnosis. Survival regression based on the Cox model was used to estimate the relative risk of colon and rectal cancer separately, in relation to the time since first exposure (TSFE) and cumulative exposure index (CEI) to asbestos, and with adjustment for smoking in the overall cohort and for smoking, and certain risk factors for these cancers in the ARDCo-Nut subsample. Results: Mean follow-up was 10.2 years among 14,515 men, including 181 colon cancer and 62 rectal cancer cases (41 and 17, respectively, in the ARDCo-Nut subsample). In the overall cohort, after adjusting for smoking, colon cancer was significantly associated with cumulative exposure (HR = 1.14; 95% CI: 1.04, 1.26 for a 1-unit increase in ln-CEI) and ≥ 20–40 years since first exposure (HR = 4.67; 95% CI: 1.92, 11.46 vs. 0–20 years TSFE), and inversely associated with 60 years TSFE (HR = 0.26; 95% CI: 0.10, 0.70). Although rectal cancer was also associated with TSFE 20–40 years (HR = 4.57; 95% CI: 1.14, 18.27), it was not associated with ln-CEI, but these findings must be interpreted cautiously due to the small number of cases. Conclusions: Our findings provide support for an association between occupational exposure to asbestos and colon cancer incidence in men. Citation: Paris C, Thaon I, Hérin F, Clin B, Lacourt A, Luc A, Coureau G, Brochard P, Chamming’s S, Gislard A, Galan P, Hercberg S, Wild P, Pairon JC, Andujar P. 2017. Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the Asbestos-Related Diseases Cohort (ARDCo-Nut). Environ Health Perspect 125:409–415; http://dx.doi.org/10.1289/EHP153

Published
2017

2. [The French mesothelioma network from 1998 to 2013]

Author

Galateau-Sallé, Françoise, Gilg Soit Ilg, Anabelle, Le Stang, Nolwenn, Brochard, Patrick, Pairon, Jean-Claude, Astoul, Philippe, Frenay, Catherine, Blaizot, Gaëtane, Chamming'S, Soizick, Ducamp, Stéphane, Rousvoal, Thomas, De Quillacq, Anne, Abonnet, Véronique, Abdalsamad, Issam, Begueret, Hugues, Brambilla, Elisabeth, Capron, Frédérique, Copin, Marie-Christine, Danel, C., De Lajartre, Anne-Yvonne, Foulet-Rogé, Armelle, Garbe, Louise, Groussard, Odile, Giusiano, S., Hofman, Véronique, Lantuejoul, Sylvie, Piquenot, Jean-Michel, Rouquette, Isabelle, Sagan, Christine, Thivolet-Bejui, Françoise, Vignaud, Jean-Michel, Scherpereel, A., Jaurand, Marie-Claude, Jean, D., Hainaut, Pierre, Chérié-Challine, Laurence, Goldberg, Marcel, Luce, Danièle, Imbernon, Ellen, Centre national référent cancers rares - mésothéliomes malins pleuraux et tumeurs péritonéales rares ( MESOPATH ), CHU Caen-Hôpital côte de nacre, Registre MESONATCHU, Département santé travail ( DST-InVS ), Institut de Veille Sanitaire, Institut de Santé Publique, d'Epidémiologie et de Développement ( ISPED ), Université Bordeaux Segalen - Bordeaux 2, Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Institut Interuniversitaire de Médecine du Travail de Paris Ile de France ( IIMTPIF ), CHI Créteil-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Oncologie thoracique, maladies de la plèvre et pneumologie interventionnelle, Assistance Publique - Hôpitaux de Marseille ( APHM ) -CHU Marseille- Hôpital Nord [CHU - APHM], Biomolécules et inflammation pulmonaire, Institut Pasteur de Lille, Réseau International des Instituts Pasteur ( RIIP ) -Réseau International des Instituts Pasteur ( RIIP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lille, Droit et Santé, Service de pneumologie et oncologie thoracique, Hôpital Calmette-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Genomique Fonctionnelle des Tumeurs Solides, Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Descartes - Paris 5 ( UPD5 ) -IFR105-Université Paris Diderot - Paris 7 ( UPD7 ), International Prevention Research Institute ( IPRI ), Registre Multicentrique à Vocation Nationale des Mésothéliomes Pleuraux (MESONAT), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Département santé travail (DST-InVS), Institut de Veille Sanitaire (INVS), Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille- Hôpital Nord [CHU - APHM], Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Hôpital Calmette-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), International Prevention Research Institute (IPRI), and Guellaen, Georges

Subjects
Pathology, Clinical, Time Factors, clinicobiological database, Pleural Neoplasms, register of cancers, medicolegal impact, therapeutic impact, expert pathological second opinion, mesothelioma, diagnostic impact, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, France, Referral and Consultation, [ SDV.BBM ] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Societies, Medical
Abstract

International audience; Mesothelioma is a rare disease less than 0.3% of cancers in France, very aggressive and resistant to the majority of conventional therapies. Asbestos exposure is nearly the only recognized cause of mesothelioma in men observed in 80% of case. In 1990, the projections based on mortality predicted a raise of incidence in mesothelioma for the next three decades. Nowadays, the diagnosis of this cancer is based on pathology, but the histological presentation frequently heterogeneous, is responsible for numerous pitfalls and major problems of early detection toward effective therapy. Facing such a diagnostic, epidemiological and medico-legal context, a national and international multidisciplinary network has been progressively set up in order to answer to epidemiological survey, translational or academic research questions. Moreover, in response to the action of the French Cancer Program (action 23.1) a network of pathologists was organized for expert pathological second opinion using a standardized procedure of certification for mesothelioma diagnosis. We describe the network organization and show the results during this last 15years period of time from 1998-2013. These results show the major impact on patient's management, and confirm the interest of this second opinion to provide accuracy of epidemiological data, quality of medico-legal acknowledgement and accuracy of clinical diagnostic for the benefit of patients. We also show the impact of these collaborative efforts for creating a high quality clinicobiological, epidemiological and therapeutic data collection for improvement of the knowledge of this dramatic disease.

Published
2014

3. Threshold regression models adapted to case-control studies. Application to lung cancer induced by occupational exposure to asbestos

Author

Antoine Chambaz, Dominique Choudat, Catherine Huber, Jean-Claude Pairon, Mark van Der Laan, Modélisation aléatoire de Paris X (MODAL'X), Université Paris Nanterre (UPN), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Service de pathologie professionnelle, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5), Mathématiques Appliquées Paris 5 (MAP5 - UMR 8145), Université Paris Descartes - Paris 5 (UPD5)-Institut National des Sciences Mathématiques et de leurs Interactions (INSMI)-Centre National de la Recherche Scientifique (CNRS), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pneumologie et Pathologie Professionnelle, CHI Créteil, Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Université Biomédicale des Saints-Pères, Division of Biostatistics [Berkeley], School of Public Health [Berkeley], University of California [Berkeley], University of California-University of California-University of California [Berkeley], University of California-University of California, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5), University of California [Berkeley] (UC Berkeley), University of California (UC)-University of California (UC)-University of California [Berkeley] (UC Berkeley), University of California (UC)-University of California (UC), Chambaz, Antoine, Modélisation aléatoire de Paris X ( MODAL'X ), Université Paris Nanterre ( UPN ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ), Mathématiques Appliquées à Paris 5 ( MAP5 - UMR 8145 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National des Sciences Mathématiques et de leurs Interactions-Centre National de la Recherche Scientifique ( CNRS ), Institut Mondor de Recherche Biomédicale ( IMRB ), Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10, and Division of Biostatistics, School of Public Health

Subjects
[STAT.TH] Statistics [stat]/Statistics Theory [stat.TH], Threshold regression model, [MATH.MATH-ST]Mathematics [math]/Statistics [math.ST], Case-control study, Cross-validation, [ MATH.MATH-ST ] Mathematics [math]/Statistics [math.ST], [STAT.TH]Statistics [stat]/Statistics Theory [stat.TH], [ STAT.TH ] Statistics [stat]/Statistics Theory [stat.TH], [MATH.MATH-ST] Mathematics [math]/Statistics [math.ST]
Abstract

International audience; We rely on a recent French matched case-control study to investigate the effect of occupational exposure to asbestos on the occurrence of lung cancer. We build a large collection of threshold regression models, data-adaptively select a better model in it by multi-fold likelihood-based cross-validation, then fit the resulting better model by maximum likelihood. A necessary preliminary step to eliminate the bias due to the case-control sampling is made possible because the conditional distribution of being a case given the matching variable and the marginal distribution of the matching variable can be computed beforehand based on two studies independent from our dataset. The implications of the fitted model in terms of expected years of life free of lung cancer lost due to the occupational exposure to asbestos are discussed.

Published
2014

4. Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects

Author

Sébastien Gendarme, Jean-Claude Pairon, Pascal Andujar, François Laurent, Patrick Brochard, Fleur Delva, Bénédicte Clin, Antoine Gislard, Christophe Paris, Isabelle Thaon, Helene Goussault, Florence Canoui-Poitrine, Christos Chouaïd, Centre Hospitalier Intercommunal de Créteil (CHIC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique (CEpiA), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Université de Caen Normandie (UNICAEN), Normandie Université (NU), Aliments Bioprocédés Toxicologie Environnements (ABTE), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), CHU Rouen, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), and Tapia, Claudia

Subjects
Cancer Research, screening, [SDV.CAN]Life Sciences [q-bio]/Cancer, lung neoplasms, asbestos, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, JEL: I - Health, Education, and Welfare/I.I1 - Health/I.I1.I18 - Government Policy • Regulation • Public Health, Oncology, [SDV.CAN] Life Sciences [q-bio]/Cancer, occupational diseases, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, cost-effectiveness, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SHS.ECO] Humanities and Social Sciences/Economics and Finance
Abstract

Background: The National Lung Screening Trial (NLST) and NELSON study opened the debate on the relevance of lung cancer (LC) screening in subjects exposed to occupational respiratory carcinogens. This analysis reported the incremental cost-effectiveness ratios (ICER) of an organized LC screening program for an asbestos-exposed population. Methods: Using Markov modelization, individuals with asbestos exposure were either monitored without intervention or annual low-dose thoracic computed-tomography (LDTCT) scan LC screening. LC incidence came from a prospective observational cohort of subjects with occupational asbestos exposure. The intervention parameters were those of the NLST study. Utilities and LC-management costs came from published reports. A sensitivity analysis evaluated different screening strategies. Results: The respective quality-adjusted life year (QALY) gain, supplementary costs and ICER [95% confidence interval] were: 0.040 [0.010–0.065] QALY, 6900 [3700–11,800] € and 170,000 [75,000–645,000] €/QALY for all asbestos-exposed subjects; and 0.144 [0.071–0.216] QALY, 13,000 [5700–26,800] € and 90,000 [35,000–276,000] €/QALY for smokers with high exposure. When screening was based on biennial LDTCT scans, the ICER was 45,000 [95% CI: 15,000–116,000] €/QALY. Conclusions: Compared to the usual ICER thresholds, biennial LDTCT scan LC screening for smokers with high occupational exposure to asbestos is acceptable and preferable to annual scans.

Published
2022

5. Pulmonary Toxicity of Silica Linked to Its Micro- or Nanometric Particle Size and Crystal Structure: A Review

Author

Vanessa Marques Da Silva, Manon Benjdir, Pierrick Montagne, Jean-Claude Pairon, Sophie Lanone, Pascal Andujar, IMRB - GEIC2O/'Genetic and Environmental Interactions in COPD, Cystic fibrosis and Other (rare) respiratory diseases' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Eyevensys S.A.S. [Paris, France] (Biopark), Centre Hospitalier Intercommunal de Créteil (CHIC), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), and Andujar, Pascal

Subjects
[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, [SDV.TOX] Life Sciences [q-bio]/Toxicology, [SDV.TOX]Life Sciences [q-bio]/Toxicology, General Chemical Engineering, [SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, General Materials Science, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Abstract

International audience; Silicon dioxide (SiO2) is a mineral compound present in the Earth’s crust in two mineral forms: crystalline and amorphous. Based on epidemiological and/or biological evidence, the pulmonary effects of crystalline silica are considered well understood, with the development of silicosis, emphysema, chronic bronchitis, or chronic obstructive pulmonary disease. The structure and capacity to trigger oxidative stress are recognized as relevant determinants in crystalline silica’s toxicity. In contrast, natural amorphous silica was long considered nontoxic, and was often used as a negative control in experimental studies. However, as manufactured amorphous silica nanoparticles (or nanosilica or SiNP) are becoming widely used in industrial applications, these paradigms must now be reconsidered at the nanoscale (

Published
2022

6. Devenir des internes de médecine du travail formes en France entre 2002 et 2004

Author

J.F. Gehanno, T. Vu, F. Conso, Dominique Choudat, Lecroq, Thierry, Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA), Service de santé au travail et pathologie professionnelle [Rouen], CHU Rouen, Normandie Université (NU), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Service de pathologie professionnelle, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5), Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Université Biomédicale des Saints-Pères, Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes ( LITIS ), Institut national des sciences appliquées Rouen Normandie ( INSA Rouen Normandie ), Normandie Université ( NU ) -Normandie Université ( NU ) -Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Université Le Havre Normandie ( ULH ), Normandie Université ( NU ), Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -CHU Rouen, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)

Subjects
03 medical and health sciences, 0302 clinical medicine, Public Health, Environmental and Occupational Health, 030212 general & internal medicine, 030210 environmental & occupational health, ComputingMilieux_MISCELLANEOUS, 3. Good health
Abstract

Resume Objectifs Depuis une decennie, le deficit en medecins du travail a incite les pouvoirs publics a multiplier les voies de formation au metier de medecin du travail. Les enseignants de medecine du travail ont observe un effet secondaire de ce dispositif sous la forme d′une reorientation de certains internes a l′issue de leur formation vers d′autres specialites. L′objectif de cette etude etait de dresser un bilan de ce dernier phenomene et d′obtenir l′avis des anciens internes sur leur formation. Methode Un questionnaire portant sur la formation recue et l′exercice professionnel actuel a ete adresse a 338 internes ayant obtenu le diplome d′etudes specialisees (DES) de medecine du travail en 2002, 2003, 2004 dans chacune des regions de France. Resultats Au total, 253 reponses ont ete obtenues (taux de reponse de 75 %). Les medecins, dans leur grande majorite, etaient satisfaits de leurs conditions d′exercice, mais 9 % des anciens internes avaient quitte la discipline a l′issue de la formation et 8 % envisageaient de le faire. Les medecins jugeaient que l′enseignement pratique (stages) et l′enseignement theorique les avaient correctement prepares a leur exercice professionnel pour respectivement 76 % et 62 % d′entre eux. Discussion Le pourcentage de medecins ayant quitte la specialite a l′issue de leur DES, ou envisageant de le faire, est similaire a celui observe dans d′autres specialites. Certains medecins expriment des incertitudes sur leur avenir professionnel, en particulier en fonction de l′evolution de la discipline secondaire a la reforme de la medecine du travail. Les medecins interroges dans cette etude apparaissent tres majoritairement satisfaits de leurs conditions d′exercice et de leur formation.

Published
2007

7. Deep Learning for the Automatic Quantification of Pleural Plaques in Asbestos-Exposed Subjects

Author

Ilyes Benlala, Baudouin Denis De Senneville, Gael Dournes, Morgane Menant, Celine Gramond, Isabelle Thaon, Bénédicte Clin, Patrick Brochard, Antoine Gislard, Pascal Andujar, Soizick Chammings, Justine Gallet, Aude Lacourt, Fleur Delva, Christophe Paris, Gilbert Ferretti, Jean-Claude Pairon, François Laurent, CHU Bordeaux [Bordeaux], Institut de Mathématiques de Bordeaux (IMB), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS), Modélisation Mathématique pour l'Oncologie (MONC), Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1 (UB)-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS)-Institut Bergonié [Bordeaux], UNICANCER-UNICANCER-Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHRU de Nancy, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU de Bordeaux Pellegrin [Bordeaux], UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Intercommunal de Créteil (CHIC), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), This research was funded by French National Health Insurance (Occupational Risk Prevention Department), French Ministry of Labour and Social Relations, French Agency for Food, Environmental and Occupational Health and Safety (ANSES grant 07-CRD-51, EST 2006/1/43, EST 2009/68)., Université Bordeaux Segalen - Bordeaux 2-Université Sciences et Technologies - Bordeaux 1-Université de Bordeaux (UB)-Institut Polytechnique de Bordeaux (Bordeaux INP)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Normandie Université (NU), Université de Bordeaux (UB), Aliments Bioprocédés Toxicologie Environnements (ABTE), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), CHU Rouen, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Hospitalier Universitaire [Grenoble] (CHU), Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail, Ministère du Travail, de l’Emploi, de la Formation Professionnelle et du Dialogue Social, and Admin, Oskar

Subjects
artificial intelligence, pleural plaques, asbestos exposure, Health, Toxicology and Mutagenesis, Public Health, Environmental and Occupational Health, Asbestos, Deep Learning, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Artificial Intelligence, Occupational Exposure, Medicine, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Retrospective Studies
Abstract

International audience; OBJECTIVE: This study aimed to develop and validate an automated artificial intelligence (AI)-driven quantification of pleural plaques in a population of retired workers previously occupationally exposed to asbestos. METHODS: CT scans of former workers previously occupationally exposed to asbestos who participated in the multicenter APEXS (Asbestos PostExposure Survey) study were collected retrospectively between 2010 and 2017 during the second and the third rounds of the survey. A hundred and forty-one participants with pleural plaques identified by expert radiologists at the 2nd and the 3rd CT screenings were included. Maximum Intensity Projection (MIP) with 5 mm thickness was used to reduce the number of CT slices for manual delineation. A Deep Learning AI algorithm using 2D-convolutional neural networks was trained with 8280 images from 138 CT scans of 69 participants for the semantic labeling of Pleural Plaques (PP). In all, 2160 CT images from 36 CT scans of 18 participants were used for AI testing versus ground-truth labels (GT). The clinical validity of the method was evaluated longitudinally in 54 participants with pleural plaques. RESULTS: The concordance correlation coefficient (CCC) between AI-driven and GT was almost perfect (>0.98) for the volume extent of both PP and calcified PP. The 2D pixel similarity overlap of AI versus GT was good (DICE = 0.63) for PP, whether they were calcified or not, and very good (DICE = 0.82) for calcified PP. A longitudinal comparison of the volumetric extent of PP showed a significant increase in PP volumes (p < 0.001) between the 2nd and the 3rd CT screenings with an average delay of 5 years. CONCLUSIONS: AI allows a fully automated volumetric quantification of pleural plaques showing volumetric progression of PP over a five-year period. The reproducible PP volume evaluation may enable further investigations for the comprehension of the unclear relationships between pleural plaques and both respiratory function and occurrence of thoracic malignancy.

Published
2022
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8. Pleural plaques and risk of lung cancer in workers formerly occupationally exposed to asbestos: extension of follow-up

Author

Justine Gallet, François Laurent, Christophe Paris, Bénédicte Clin, Antoine Gislard, Isabelle Thaon, Soizick Chammings, Celine Gramond, Guy Ogier, Gilbert Ferretti, Pascal Andujar, Patrick Brochard, Fleur Delva, Jean-Claude Pairon, Aude Lacourt, Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Rouen, Normandie Université (NU), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Lorraine (UL), CHI Créteil, Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), Caisse primaire d'assurance maladie (CPAM), Centre Hospitalier Universitaire [Grenoble] (CHU), Université Grenoble Alpes (UGA), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), French Ministry of Labour and Social Relations, French National Health Insurance (Occupational Risk Prevention Department), French Agency for Food, Environmental and Occupational Health Safety [07-CRD-51, EST 2006/1/43, EST 2009/68], Jonchère, Laurent, Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
[SDV] Life Sciences [q-bio], CT scan, screening, [SDV]Life Sciences [q-bio], occupational health, Public Health, Environmental and Occupational Health, Lung cancer, asbestos, pleural plaques, respiratory system
Abstract

BackgroundOccupational asbestos exposure is associated with pleural plaques (PP), a benign disease often seen as a marker of past exposure to asbestos and lung cancer. The association between these two diseases has not been formally proved, the aim of this study was to evaluate this association in the asbestos-related disease cohort (ARDCO) cohort.MethodsARDCO is a French multicentric cohort including workers formerly occupationally exposed to asbestos from 2003 to 2005. CT scan was performed to diagnose PP with double reading and lung cancer (incidence and mortality) was followed through health insurance data and death certificates. Cox models were used to estimate the association between PP and lung cancer adjusting for occupational asbestos exposure (represented by cumulative exposure index, time since first exposure and time since last exposure) and smoking status.ResultsA total of 176 cases (of 5050 subjects) and 88 deaths (of 4938 subjects) of lung cancer were recorded. Smoking status was identified as an effect modifier. Lung cancer incidence and mortality were significantly associated with PP only in non-smokers, respectively, HR=3.13 (95% CI 1.04 to 9.35) and HR=16.83 (95% CI 1.87 to 151.24) after adjustment for age, occupational asbestos exposure and smoking status.ConclusionsARDCO study was the first to study this association considering equal asbestos exposure, and more specifically, our study is the first to test smoking as an effect modifier, so comparison with scientific literature is difficult. Our results seem to consolidate the hypothesis that PP may be an independent risk factor for lung cancer but they must be interpreted with caution.

Published
2022

9. Association between occupational exposure and Dupuytren’s contracture using a job-exposure matrix and self-reported exposure in the CONSTANCES cohort

Author

Marc Fadel, Alexis Descatha, Laure Ngabirano, Bradley A. Evanoff, Yves Roquelaure, Annette Leclerc, Ann Marie Dale, Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), 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), Washington University in Saint Louis (WUSTL), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), École des Hautes Études en Santé Publique [EHESP] (EHESP), EHESP-Irset (EHESP-Irset), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Caisse nationale d’assurance maladie (CNAM), MSD, AstraZeneca and Lundbeck, ANR-11-INBS-0002,CONSTANCES,La cohorte CONSTANCES - Infrastructure épidémiologique ouverte pour la recherche et la surveillance(2011), 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), Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Adult, Male, medicine.medical_specialty, Lifting, [SDV]Life Sciences [q-bio], Population, Job-exposure matrix, Logistic regression, Vibration, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Occupational Exposure, Surveys and Questionnaires, Epidemiology, Humans, Medicine, Prospective Studies, occupational, 030212 general & internal medicine, Dupuytren's contracture, education, Prospective cohort study, Aged, education.field_of_study, business.industry, Confounding, Public Health, Environmental and Occupational Health, job-exposure matrix, Middle Aged, dupuytren’s contracture, medicine.disease, 030210 environmental & occupational health, Biomechanical Phenomena, Dupuytren Contracture, Cohort, Physical therapy, Female, epidemiology, Ergonomics, France, business
Abstract

BackgroundAlthough several studies highlighted an association between occupational exposure and Dupuytren’s contracture (DC), they were often limited by the highly selected population. We aimed to study this association using a job-exposure matrix (JEM) and self-reported exposure in a large cohort.MethodsFrom CONSTANCES, a French population-based prospective cohort, we retrieved sex, age, social position, alcohol/tobacco intake and diabetes. Lifetime exposures were assessed by two different methods: with the biomechanical JEM ‘JEM Constances’, we assessed exposure to vibration and/or forearm rotation for participants whose work history was available, and from a self-administered questionnaire, we retrieved self-reported exposure to arduous work and/or carrying heavy loads. Surgery for DC was collected from the French Health Administrative database from 2009 to 2016. Multivariate logistic regression models adjusted for confounders were built to assess association between surgery for DC and occupational exposures.ResultsWork history was retrieved for 23 795 subjects among whom 98 underwent surgery for DC. Adjusted OR (aOR) was 2.08 (1.03–4.2) for being ever exposed to vibration and/or forearm rotation for subjects ConclusionsManual work is associated with surgery for DC among younger subjects. Monitoring exposed workers is important to prevent future functional limitations.

Published
2019

10. Interstitial Lung Abnormalities Detected by CT in Asbestos-Exposed Subjects Are More Likely Associated to Age

Author

Aude Lacourt, Bénédicte Clin, Gilbert Ferretti, A. Gislard, Pascal Andujar, Ilyes Benlala, Gaël Dournes, François Laurent, Fleur Delva, Céline Gramond, Jean-Claude Pairon, Isabelle Thaon, Christophe Paris, Patrick Brochard, Justine Gallet, Soizick Chamming's, CHU Bordeaux [Bordeaux], Centre de recherche Cardio-Thoracique de Bordeaux [Bordeaux] (CRCTB), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Aliments Bioprocédés Toxicologie Environnements (ABTE), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHU Rouen, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Henri Mondor, Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), French National Health Insurance (Occupational Risk Prevention Department), French Ministry of Labour and Social Relations, French Agency for Food, Environmental and Occupational Health and Safety (ANSES) [07-CRD-51, EST 2006/1/43, EST 2009/68], Chard-Hutchinson, Xavier, CHU Henri Mondor [Créteil], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
[SDV.MHEP.AHA] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], medicine.medical_specialty, asbestosis, Asbestosis, Population, Cumulative Exposure, medicine.disease_cause, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Article, Asbestos, Pulmonary function testing, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, [SDV.MHEP.AHA]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], [SDV.EE.SANT] Life Sciences [q-bio]/Ecology, environment/Health, Medicine, 030212 general & internal medicine, education, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, education.field_of_study, Lung, business.industry, General Medicine, respiratory system, medicine.disease, asbestos-exposition, 3. Good health, medicine.anatomical_structure, 030228 respiratory system, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, HRCT, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Population study, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract

Objective: the aim of this study was to evaluate the association between interstitial lung abnormalities, asbestos exposure and age in a population of retired workers previously occupationally exposed to asbestos. Methods: previously occupationally exposed former workers to asbestos eligible for a survey conducted between 2003 and 2005 in four regions of France, underwent chest CT examinations and pulmonary function testing. Industrial hygienists evaluated asbestos exposure and calculated for each subject a cumulative exposure index (CEI) to asbestos. Smoking status information was also collected in this second round of screening. Expert radiologists performed blinded independent double reading of chest CT-scans and classified interstitial lung abnormalities into: no abnormality, minor interstitial findings, interstitial findings inconsistent with UIP, possible or definite UIP. In addition, emphysema was assessed visually (none, minor: emphysema &lt, 25%, moderate: between 25 and 50% and severe: &gt, 50% of the lung). Logistic regression models adjusted for age and smoking were used to assess the relationship between interstitial lung abnormalities and occupational asbestos exposure. Results: the study population consisted of 2157 male subjects. Interstitial lung abnormalities were present in 365 (16.7%) and emphysema in 444 (20.4%). Significant positive association was found between definite or possible UIP pattern and age (OR adjusted =1.08 (95% CI: 1.02–1.13)). No association was found between interstitial abnormalities and CEI or the level of asbestos exposure. Conclusion: presence of interstitial abnormalities at HRCT was associated to aging but not to cumulative exposure index in this cohort of former workers previously occupationally exposed to asbestos.

Published
2021

11. Liens entre cancer de l’œsophage et exposition professionnelle à l’amiante : étude au sein de la cohorte ARDCo

Author

Soizick Chamming's, Patrick Brochard, Isabelle Thaon, Mathilde Boulanger, Aude Lacourt, Jean-Claude Pairon, Bénédicte Clin, Amandine Luc, Christophe Paris, Guy Ogier, Antoine Gislard, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Centre de consultations de pathologies professionnelles [CHRU Nancy] (CCPP), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), and Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF)

Subjects
030506 rehabilitation, 03 medical and health sciences, 0302 clinical medicine, Public Health, Environmental and Occupational Health, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, 0305 other medical science, 030210 environmental & occupational health, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, ComputingMilieux_MISCELLANEOUS, 3. Good health
Abstract

Contexte L’association eventuelle entre l’exposition professionnelle a l’amiante et le cancer de l’œsophage demeure actuellement controversee, comme en temoigne l’evaluation du Centre international de recherche sur le cancer (CIRC) realisee en 2012. La question du lien eventuel entre ce cancer et l’exposition a l’amiante est cependant tres importante, tant en matiere de surveillance medicale des sujets exposes, qu’en matiere de reparation medico-legale des patients presentant ce type de pathologie. Objectif L’objectif de notre etude est d’analyser l’incidence et la mortalite par cancer de l’œsophage dans une cohorte de sujets ayant ete exposes professionnellement a l’amiante (cohorte ARDCo : « Asbestos-Related Diseases Cohort »). Methode Un suivi sur 10 ans de 14 515 hommes inclus dans le programme ARDCo entre octobre 2003 et decembre 2005 a ete realise. L’exposition a l’amiante a ete analysee par des hygienistes industriels a partir des donnees issues d’un questionnaire standardise adresse aux sujets eligibles. Les variables utilisees pour caracteriser cette exposition a l’amiante ont associe : la duree d’exposition a l’amiante, un indice d’exposition cumulee a l’amiante (IEC) et la latence (delai entre le debut de l’exposition et l’apparition des premiers symptomes de la maladie). Une analyse statistique des associations entre les variables d’exposition a l’amiante et, d’une part, l’incidence du cancer de l’œsophage et, d’autre part, la mortalite par cancer de l’œsophage, a ete realisee a l’aide d’un modele de Cox, avec ajustement sur le statut tabagique, la latence et l’IEC (exprime en Ln (IEC + 1)). Resultats Nous avons mis en evidence une relation dose-effet significative entre l’IEC a l’amiante et le cancer de l’œsophage, a la fois en incidence et en mortalite. Conclusion Cette vaste etude est en faveur d’une relation entre l’exposition a l’amiante et le cancer de l’œsophage.

Published
2018

12. Cancer of the esophagus and asbestos exposure

Author

Mathilde Boulanger, Christophe Paris, Guy Ogier, Bénédicte Clin, Jean-Claude Pairon, Amandine Luc, Isabelle Thaon, Soizick Chamming's, Patrick Brochard, Antoine Gislard, Aude Lacourt, Bodescot, Myriam, Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Santé au Travail et Pathologie Professionnellel [CHU Caen], Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Interactions Gènes-Risques environnementaux et Effets sur la Santé (INGRES), Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Cancer environnement (EPICENE ), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France (IIMTPIF), Service de santé au travail et pathologie professionnelle [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Aliments Bioprocédés Toxicologie Environnements (ABTE), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de santé au travail et pathologie professionnelle [Rouen], Agence Régionale de la Santé (ARS), Centre Hospitalier Intercommunal de Créteil (CHIC), Molecular virology and immunology – Physiopathology and therapeutic of chronic viral hepatitis (Team 18) (Inserm U955), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, This work was supported by the French National Health Insurance (Occupational Risk Prevention Department), the French Ministry of Labor and Social Relations, the French Agency for Food, Environmental, and Occupational Health & Safety (ANSES grant 07-CRD-51 and EST 2006/1/43 and EST 2009/68)., CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, and Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)

Subjects
Male, medicine.medical_specialty, Esophageal Neoplasms, Cumulative Exposure, [SDV.CAN]Life Sciences [q-bio]/Cancer, medicine.disease_cause, Asbestos, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Humans, Medicine, cancer, 030212 general & internal medicine, Aged, esophagus, business.industry, Proportional hazards model, Incidence (epidemiology), Hazard ratio, Public Health, Environmental and Occupational Health, Cancer, occupational exposure, Middle Aged, medicine.disease, asbestos, mortality, Confidence interval, 3. Good health, Occupational Diseases, [SDV.TOX] Life Sciences [q-bio]/Toxicology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, 030220 oncology & carcinogenesis, [SDV.TOX]Life Sciences [q-bio]/Toxicology, Cohort, Carcinogens, incidence, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Follow-Up Studies
Abstract

International audience; BACKGROUND:Our study aimed at analyzing incidence and mortality from esophageal cancer within a cohort of workers with previous occupational asbestos exposure (ARDCo Program).METHODS:A 10-year follow-up study was conducted in the 14 515 male subjects included in this program between October 2003 and December 2005. Follow-up began when exposure stopped. Asbestos exposure was analyzed by industrial hygienists using data from a standardized questionnaire. The Cox model was used, with age as the time axis variable adjusted for smoking, time since first exposure (TSFE) and cumulative exposure index (CEI) of exposure to asbestos.RESULTS:We reported a significant dose-response relationship between CEI of exposure to asbestos and esophageal cancer, in both incidence (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.00-1.58), and mortality (HR 1.40, [95%CI 1.12-1.75]).CONCLUSIONS:This large-scale study suggests the existence of a relationship between asbestos exposure and cancer of the esophagus.

Published
2017

13. Choice of rating method for assessing occupational asbestos exposure: study for compensation purposes in France.: Method for occupational exposure assessment

Author

Celine, Gramond, Patrick, Rolland, Aude, Lacourt, Stephane, Ducamp, Soizick, Chamming's, Yvon, Creau, Michel, Hery, Jacques, Laureillard, Brahim, Mohammed-Brahim, Ewa, Orlowski, Christophe, Paris, Jean-Claude, Pairon, Marcel, Goldberg, Patrick, Brochard, S, Chamming's, Epidémiologie et Biostatistique [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Université Bordeaux Segalen - Bordeaux 2, Département santé travail (DST-InVS), Institut de Veille Sanitaire (INVS), Institut Interuniversitaire de Médecine du Travail de Paris Ile de France, Laboratoire de chimie, Caisse Régionale d'Assurance Maladie Normandie, Institut national de recherche et de sécurité (Vandoeuvre lès Nancy) (INRS ( Vandoeuvre lès Nancy)), Caisse Régionale d'Assurance Maladie Ile de France, Association de Médecine et de Santé au travail, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de médecine du travail (LSTE), CHU Bordeaux [Bordeaux], The PNSM is supported by the National Institute for Public Health Surveillance (InVS), the Ministries of Labour and Health, and the Foundation for Medical Research (one-time grant)., Members of the PNSM Study Group are listed in the acknowledgment section, Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10

Subjects
Male, Mesothelioma, Cumulative Exposure, MESH: Risk Assessment, medicine.disease_cause, MESH: Occupational Exposure, 0302 clinical medicine, Cohen's kappa, Surveys and Questionnaires, Medicine, 030212 general & internal medicine, MESH: Compensation and Redress, MESH: Case-Control Studies, 030210 environmental & occupational health, rating method, Occupational Diseases, MESH: Reproducibility of Results, Compensation and Redress, MESH: Asbestos, Female, France, Occupational exposure, MESH: Occupational Diseases, Validation study, MESH: Probability, Risk Assessment, Asbestos, 03 medical and health sciences, kappa coefficient, Environmental health, Humans, Occupations, Probability, MESH: Occupations, MESH: Humans, MESH: Mesothelioma, business.industry, MESH: Questionnaires, experts, Public Health, Environmental and Occupational Health, Reproducibility of Results, occupational exposure, asbestos, MESH: Male, MESH: France, Case-Control Studies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Kappa
Abstract

Background In the course of setting up the National Mesothelioma Surveillance Program (PNSM), established in France in 1998, the question arose as to the most suitable method of assessing occupational exposure. The aim of this study was to define the most suitable rating method for assessing occupational asbestos exposure in order to assess medico-social care. Method The study included 100 subjects—50 cases of mesothelioma and 50 controls—randomly selected and representing 457 jobs held. Job asbestos exposure was assessed by a six-expert panel using two methods: “by job” rating, where all the jobs in were assessed regardless of the subjects; and “by subject” rating, where all the jobs of a subject were assessed at the same time. Consensus was obtained and subjects' exposure was calculated for each rating. Then, two internal experts assessed job asbestos exposure with the “by subject” rating. Kappa coefficients were used to measure agreement between the ratings. Results Agreement between “by job” and “by subject” ratings was very good for subject probability of exposure (kappa = 0.84) and cumulative exposure index (kappa = 0.80). Agreement between the six-expert panel and the two internal experts was good for subject exposure (kappa for probability = 0.71; kappa for cumulative exposure index= 0.68). Conclusion This study shows that the two rating systems have good or very good agreement. These results validate the routine use in the PNSM of the “by subject” rating, with the advantage of being convenient and quick to provide feedback on occupational asbestos exposure to mesothelioma cases for compensation. Am. J. Ind. Med. 55:440–449, 2012. © 2012 Wiley Periodicals, Inc.

Published
2012

14. Occupational asthma and occupational rhinitis: the united airways disease model revisited

Author

Brice Loddé, Vincent Bonneterre, Jacques Ameille, Pascal Andujar, Jean-Claude Pairon, Alexis Descatha, Gérard Lasfargues, Mickael Rinaldo, Lynda Bensefa-Colas, Robert Garnier, D. Dupas, Karine Hamelin, Service de la Santé au Travail [Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Département de Médecine du Travail, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Interuniversitaire de Médecine du Travail de Paris Ile de France, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), EPSP, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Médecine du Travail et des Risques Professionnels, Faculté de Médecine-Pôle d'information médicale, évaluation et santé publique (Pimesp)-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de la Santé au Travail [Fernand Widal], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Fernand Widal, Service Pathologies Professionnelles, Hôpital Morvan [Brest]-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Médecine du Travail et de Pathologies Professionnelles, CHU Bordeaux [Bordeaux]-Hôpital Pellegrin, Agence Française de Sécurité Sanitaire de l'Environnement et du Travail (AFSSET), AFSSET, This study was supported by a grant from the French agency for food, environmental and occupational health and safety [Anses (07 CRD 10), the members of the rnv3p : Réseau national de vigilance et de prévention des pathologies professionnelles., Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre hospitalier universitaire de Nantes (CHU Nantes)-Faculté de Médecine-Pôle d'information médicale, évaluation et santé publique (Pimesp), Université Joseph Fourier - Grenoble 1 (UJF)-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 Joseph Fourier - Grenoble 1 (UJF)-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), and Guellaen, Georges

Subjects
Adult, Male, Medical surveillance, medicine.medical_specialty, high molecular weight, Occupational disease, Disease, Air Pollutants, Occupational, Article, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, Odds Ratio, Prevalence, occupational rhinitis, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, 030212 general & internal medicine, Asthma, Occupational, Occupations, Asthma, Rhinitis, business.industry, Airways disease, Incidence (epidemiology), Incidence, Public Health, Environmental and Occupational Health, food and beverages, Odds ratio, Middle Aged, medicine.disease, low molecular weight, 3. Good health, Molecular Weight, Occupational Diseases, 030228 respiratory system, Immunology, Female, France, business, occupational asthma, Occupational asthma
Abstract

International audience; OBJECTIVES: Whereas accumulating evidence indicates close associations between rhinitis and asthma, little is known about the relationships between occupational rhinitis (OR) and occupational asthma (OA). This study analyses the prevalence of OR associated with OA, globally and according to the various causal agents, and investigates the temporal relationships between these two conditions. METHODS: Data on incident cases of OA (2008-2010) were collected through the French national occupational disease surveillance and prevention network, using a standardised form including information on occupation, causal agents, presence of OR, and respective dates of occurrence of rhinitis and asthma. RESULTS: Among the 596 reported OA cases with latency period, 555 could be attributed to identified agents: high molecular weight (HMW) agents (n=174); low molecular weight (LMW) agents (n=381). Overall, OR was associated with OA in 324 (58.4%) cases. The frequency of association was significantly higher for HMW agents than for LMW agents (72.2% vs 51.5%, p

Published
2013

15. Choice of rating method for assessing occupational asbestos exposure: study for compensation purposes in France

Author

Gramond, Céline, Rolland, Patrick, Lacourt, Aude, Ducamp, Stéphane, Chamming'S, Soizick, Creau, Yvon, Héry, Michel, Laureillard, Jacques, Mohammed-Brahim, Brahim, Orlowski, Ewa, Paris, Christophe, Pairon, Jean-Claude, Goldberg, Marcel, Brochard, Patrick, Gramond, Céline, Epidémiologie et Biostatistique [Bordeaux], Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Université Bordeaux Segalen - Bordeaux 2, Département santé travail (DST-InVS), Institut de Veille Sanitaire (INVS), Institut Interuniversitaire de Médecine du Travail de Paris Ile de France, Laboratoire de chimie, Caisse Régionale d'Assurance Maladie Normandie, Institut national de recherche et de sécurité (Vandoeuvre lès Nancy) (INRS ( Vandoeuvre lès Nancy)), Caisse Régionale d'Assurance Maladie Ile de France, Association de Médecine et de Santé au travail, Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de médecine du travail (LSTE), CHU Bordeaux [Bordeaux], The PNSM is supported by the National Institute for Public Health Surveillance (InVS), the Ministries of Labour and Health, and the Foundation for Medical Research (one-time grant)., and Members of the PNSM Study Group are listed in the acknowledgment section

Subjects
MESH: Occupational Diseases, MESH: Occupations, MESH: Humans, MESH: Mesothelioma, MESH: Probability, MESH: Questionnaires, experts, MESH: Compensation and Redress, occupational exposure, asbestos, MESH: Risk Assessment, MESH: Case-Control Studies, rating method, MESH: Male, MESH: Occupational Exposure, MESH: Reproducibility of Results, MESH: France, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, kappa coefficient, MESH: Asbestos, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female
Abstract

International audience; BACKGROUND: In the course of setting up the National Mesothelioma Surveillance Program (PNSM), established in France in 1998, the question arose as to the most suitable method of assessing occupational exposure. The aim of this study was to define the most suitable rating method for assessing occupational asbestos exposure in order to assess medico-social care. METHOD: The study included 100 subjects-50 cases of mesothelioma and 50 controls-randomly selected and representing 457 jobs held. Job asbestos exposure was assessed by a six-expert panel using two methods: "by job" rating, where all the jobs in were assessed regardless of the subjects; and "by subject" rating, where all the jobs of a subject were assessed at the same time. Consensus was obtained and subjects' exposure was calculated for each rating. Then, two internal experts assessed job asbestos exposure with the "by subject" rating. Kappa coefficients were used to measure agreement between the ratings. RESULTS: Agreement between "by job" and "by subject" ratings was very good for subject probability of exposure (kappa = 0.84) and cumulative exposure index (kappa = 0.80). Agreement between the six-expert panel and the two internal experts was good for subject exposure (kappa for probability = 0.71; kappa for cumulative exposure index= 0.68). CONCLUSION: This study shows that the two rating systems have good or very good agreement. These results validate the routine use in the PNSM of the "by subject" rating, with the advantage of being convenient and quick to provide feedback on occupational asbestos exposure to mesothelioma cases for compensation.

Published
2012

16. Intoxication au mercure

Author

Bensefa-Colas, Lynda, Andujar, Pascal, Descatha, Alexis, Département de Médecine du Travail, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut Interuniversitaire de Médecine du Travail de Paris Ile de France, Service de pneumologie et pathologie professionnelle, CHI Créteil, Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Santé publique et épidémiologie des déterminants professionnels et sociaux de la santé, 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 de Versailles Saint-Quentin-en-Yvelines (UVSQ), Unité de pathologie professionnelle, environnementale et d'insertion, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], and 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)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
methylmercure, toxicité, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, mercure
Abstract

International audience; Mercury is a widespread heavy metal with potential severe impacts on human health. Exposure conditions to mercury and profile of toxicity among humans depend on the chemical forms of the mercury: elemental or metallic mercury, inorganic or organic mercury compounds. This article aims to reviewing and synthesizing the main knowledge of the mercury toxicity and its organic compounds that clinicians should know. Acute inhalation of metallic or inorganic mercury vapours mainly induces pulmonary diseases, whereas chronic inhalation rather induces neurological or renal disorders (encephalopathy and interstitial or glomerular nephritis). Methylmercury poisonings from intoxicated food occurred among some populations resulting in neurological disorders and developmental troubles for children exposed in utero. Treatment using chelating agents is recommended in case of symptomatic acute mercury intoxication; sometimes it improves the clinical effects of chronic mercury poisoning. Although it is currently rare to encounter situations of severe intoxication, efforts remain necessary to decrease the mercury concentration in the environment and to reduce risk on human health due to low level exposure (dental amalgam, fish contamination by organic mercury compounds...). In case of occupational exposure to mercury and its compounds, some disorders could be compensated in France. Clinicians should work with toxicologists for the diagnosis and treatment of mercury intoxication.

Published
2011

17. Attributable risk in men in two French case-control studies on mesothelioma and asbestos

Author

Patrick Brochard, Louis-Rachid Salmi, Marcel Goldberg, Françoise Galateau-Sallé, Y. Iwatsubo, Stéphane Ducamp, P. Rolland, Anabelle Gilg Soit Ilg, C. Frenay, Céline Gramond, Aude Lacourt, Jean Claude Pairon, Ellen Imbernon, Nolwenn Le Stang, Philippe Astoul, Soizick Chamming's, Laboratoire Santé Travail Environnement, EA 3672, Institut de Santé Publique, d'Épidémiologie et de Développement, Université Bordeaux Segalen - Bordeaux 2, Équipe Associée en Santé Travail - Essat (InVS/DST - LSTE/EA3672), Département santé travail (DST-InVS), Institut de Veille Sanitaire (INVS), Service d'Oncologie Thoracique, Département des Maladies Respiratoires, Hôpital Sainte Marguerite, Institut Interuniversitaire de Médecine du Travail de Paris Ile de France, Registre Multicentrique à Vocation Nationale des Mésothéliomes Pleuraux (MESONAT), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Côte de Nacre [CHU Caen], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Faculté de Médecine, Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Université Bordeaux Segalen - Bordeaux 2

Subjects
Male, Mesothelioma, medicine.medical_specialty, Epidemiology, Population, Job-exposure matrix, medicine.disease_cause, Risk Assessment, Asbestos, Occupational medicine, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, 030212 general & internal medicine, education, Selection Bias, Aged, education.field_of_study, business.industry, Patient Selection, Case-control study, Men, Middle Aged, Occupational exposure, medicine.disease, 030210 environmental & occupational health, Surgery, Case-Control Studies, Attributable risk, Female, France, business
Abstract

International audience; Pleural mesothelioma is a primary tumor of the pleura that is mainly due to asbestos exposure. To study the relationship between mesothelioma and occupational asbestos exposure in France, two case-control studies (A and B) were conducted. A substantial difference in the attributable risk in the population (AR) was observed among men: 44.5% (95% CI: [32.6-56.4]) in study A and 83.2% (95% CI: [76.8-89.6]) in study B. As different exposure assessment expert methods were used, the main objective of this work was to re-estimate the AR men in two case-control studies according to a common standardized exposure assessment by using a Job Exposure Matrix (JEM) and to assess the role of subjects' selection. The initial observed AR difference was maintained: 36.3% (95% CI: [24.3-50.3]) in study A and 69.7% (95% CI: [51.7-83.2]) in study B. Further investigations highlighted the potential selection bias introduced in both studies, especially among controls. The AR could be underestimated in study A and overestimated in study B. After weighting subjects according to distribution of socio-economic status in the general population for controls and according to distribution of socio-economic status of cases registered by the French National Mesothelioma Surveillance Program, re-estimated AR values were 52.4% in study A and 70.2% in study B. These results provide additional information to describe the relationship between pleural mesothelioma and occupational asbestos exposure, but also confirm the importance of subjects' recruitment in case control studies, particularly control selection.

Published
2010

18. Niveaux, Déterminants et Variabilité des nanoparticules dans l'environnement intérieur - Projet NANOP

Author

Mandin, Corinne, Ji, Xiaolin, Le Bihan, Olivier, Ramalho, Olivier, D'ANNA, Barbara, Martinon, Laurent, Nicolas, Mélanie, Larbre, Juliette, Bard, Denis, Pairon, Jean-Claude, Institut National de l'Environnement Industriel et des Risques (INERIS), Centre Scientifique et Technique du Bâtiment (CSTB), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut de recherches sur la catalyse et l'environnement de Lyon (IRCELYON), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Etude des Particules Inhalées (LEPI), Ville de Paris, ENSP, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pneumologie et Pathologie Professionnelle, CHI Créteil, Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Université Biomédicale des Saints-Pères, Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), and Ramalho, Olivier

Subjects
[SDE] Environmental Sciences, Environnement intérieur, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDE]Environmental Sciences, Nanoparticules, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Projet NANOP
Abstract

http://www.afsset.fr/index.php?pageid=2530&parentid=631; National audience; Niveaux, Déterminants et Variabilité des nanoparticules dans l'environnement intérieur - Projet NANOP

Published
2010

19. Characterisation of particles emitted by incense burning in an experimental house

Author

Jean-Claude Pairon, Xiaolin Ji, Corinne Mandin, Olivier Ramalho, O. Le Bihan, Barbara D'Anna, Mélanie Nicolas, Denis Bard, Laurent Martinon, Institut National de l'Environnement Industriel et des Risques (INERIS), Centre Scientifique et Technique du Bâtiment (CSTB), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut de recherches sur la catalyse et l'environnement de Lyon (IRCELYON), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), Laboratoire d'Etude des Particules Inhalées (LEPI), Ville de Paris, ENSP, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pneumologie et Pathologie Professionnelle, CHI Créteil, Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Université Biomédicale des Saints-Pères, and Université de Lyon-Université de Lyon-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Incense, Environmental Engineering, Materials science, 010504 meteorology & atmospheric sciences, Analytical chemistry, Chemical composition, Specific surface area, 010501 environmental sciences, 01 natural sciences, Smoke, Ultrafine particle, Humans, Particle Size, Ceremonial Behavior, 0105 earth and related environmental sciences, Public Health, Environmental and Occupational Health, Environmental engineering, Building and Construction, Particulates, Aerosol, Ultrafine particles, 13. Climate action, Air Pollution, Indoor, [SDE]Environmental Sciences, Housing, Particle, Particle size, Dispersion (chemistry), Particulate matter
Abstract

The potential health effects of fine and ultrafine particles are of increasing concern. A better understanding of particle characteristics and dispersion behavior is needed. This study aims at characterizing spatial and temporal variations in fine and ultrafine particle dispersion after emission from a model source in an experimental house. Particles emitted by an incense stick burning for 15 min were characterized. Number concentration, specific surface area and mass were measured. Partial chemical analysis of particles was also realized. Near the burning incense stick, the maximum concentration was 25,500 particles/cm(3); the indoor PM(2.5) concentration reached 197 microg/m(3), and the specific surface area concentration was 180 microm(2)/cm(3). The estimated incense smoke density was 1.1 g/cm(3). Time of Flight Aerosol Mass Spectrometer measurements indicated that the organic fraction was predominant in the aerosol mass detected, and other minor components identified were K(+), NO(3)(-), and Cl(-). The combustion of an incense stick in the living room was associated with significant modifications of the concentrations of particles measured in the different rooms of the house. This demonstration of pollution by particle dispersion by a model source of moderate intensity may have significant implications in terms of assessment of indoor exposure to such particles. Practical Implications The particles emitted in a domestic environment by a source of moderate intensity such as burning incense disperse throughout the house, even in rooms with closed doors and in rooms as far away as the next floor. This dispersion has significant implications in terms of evaluating human indoor exposure to fine and ultrafine particles.

Published
2010

20. Exposure to nanoparticles in residential environment

Author

Ji, Xiaolin, Mandin, Corinne, Ramalho, Olivier, Le Bihan, Olivier, Martinon, Laurent, Bard, Denis, Pairon, Jean-Claude, Institut National de l'Environnement Industriel et des Risques (INERIS), Centre Scientifique et Technique du Bâtiment (CSTB), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Laboratoire d'Etude des Particules Inhalées (LEPI), Ville de Paris, ENSP, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pneumologie et Pathologie Professionnelle, CHI Créteil, Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Université Biomédicale des Saints-Pères, and Ramalho, Olivier

Subjects
[SDE] Environmental Sciences, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDE]Environmental Sciences, Residential environment, Nanoparticles, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, ComputingMilieux_MISCELLANEOUS, Exposure
Abstract

International audience

Published
2008

21. Exposition humaine aux particules ultrafines : caractérisation des sources domestiques - projet NANOP

Author

Ji, Xiaolin, Mandin, Corinne, Le Bihan, Olivier, Ramalho, Olivier, Martinon, Laurent, Bard, Denis, Pairon, Jean-Claude, Institut National de l'Environnement Industriel et des Risques (INERIS), Centre Scientifique et Technique du Bâtiment (CSTB), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Laboratoire d'Etude des Particules Inhalées (LEPI), Ville de Paris, ENSP, École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pneumologie et Pathologie Professionnelle, CHI Créteil, Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Université Biomédicale des Saints-Pères, and Ramalho, Olivier

Subjects
[SDE] Environmental Sciences, Sources domestiques, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Particules ultrafines, [SDE]Environmental Sciences, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Projet NANOP
Published
2008

22. Ethers de Glycol. Synthèse des connaissances sur les expositions de la population française générale et professionnelle

Author

Multigner, Luc, Droz, Pierre-Olivier, Dutertre, Hélène, Garnier, Robert, Labat, Laurence, Kirchner, Séverine, Steenhout, Anne, Groupe d'Etude de la Reproduction Chez l'Homme et les Mammiferes (GERHM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Service de la Santé au Travail [Fernand Widal], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Fernand Widal, Laboratoire de Toxicologie et Génopathies, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Scientifique et Technique du Bâtiment (CSTB), Afsset, Brébion, Alice, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
[SDV.TOX] Life Sciences [q-bio]/Toxicology, [SDV.TOX]Life Sciences [q-bio]/Toxicology
Published
2008

23. Measuring levels, assessing determinants and variabilities of nanoparticles concentrations in residential environment, The NANOP Project

Author

Mandin, Corinne, Ramalho, Olivier, Le Bihan, Olivier, Pairon, Jean-Claude, Martinon, Laurent, Bard, Denis, Institut National de l'Environnement Industriel et des Risques (INERIS), Centre Scientifique et Technique du Bâtiment (CSTB), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pneumologie et Pathologie Professionnelle, CHI Créteil, Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Université Biomédicale des Saints-Pères, Laboratoire d'Etude des Particules Inhalées (LEPI), Ville de Paris, ENSP, École des Hautes Études en Santé Publique [EHESP] (EHESP), and Ramalho, Olivier

Subjects
[SDE] Environmental Sciences, [SDE]Environmental Sciences
Abstract

International audience; The NANOP project aims at assessing nanoparticle levels and their spatial and temporal variation in domestic environment simulated within an experimental house (MARIA) based at the Building Technical and Scientific Center (CSTB), i.e. a fully controlled domestic environment (as regards air exchange, heating...). Possible relations between different metrics such as particle number, mass, specific surface, size distribution should be identified. Respective contributions of indoor sources to exposure, but also from outdoor air will be determined.

Published
2007

24. [Occupational chronic obstructive pulmonary disease: a poorly understood disease]

Author

Ameille, J., Dalphin, J. C., Descatha, A., Pairon, J. C., Service de la Santé au Travail [Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches], Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre National de la Recherche Scientifique ( CNRS ), Dalphin, Jean-Charles, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)

Subjects
MESH: Occupational Diseases, MESH: Pneumoconiosis, MESH : Textile Industry, MESH: Pulmonary Disease, Chronic Obstructive, MESH : Agriculture, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Mining, MESH : Mining, Pulmonary Disease, Chronic Obstructive, MESH: Metallurgy, Risk Factors, MESH: Risk Factors, Humans, MESH : France, MESH: Humans, MESH: Textile Industry, MESH : Humans, MESH : Metallurgy, Agriculture, MESH : Occupational Diseases, MESH : Pulmonary Disease, Chronic Obstructive, MESH: Mining, MESH : Risk Factors, respiratory tract diseases, Occupational Diseases, MESH: France, Textile Industry, Metallurgy, MESH : Pneumoconiosis, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, France, Pneumoconiosis, MESH: Agriculture, [ SDV.MHEP.PSR ] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Abstract

International audience; INTRODUCTION: According to several recent population-based studies 15-20% of chronic obstructive pulmonary disease (COPD) is work related. BACKGROUND: The occupational fields in which a causal relationship is established are the mining industry, construction and public works, iron and steel, textiles, grain (silo workers), dairy and pig farming. The main causative substances are silica, coal dust, cotton dust, grain dust and endotoxins. VIEWPOINT: Knowledge of the occupational causes of COPD is important for both prevention and compensation. CONCLUSIONS: The undertaking of a complete and rigorous occupational questionnaire is essential for all patients with COPD.

Published
2006

25. Natural rubber latex allergy among health care workers: a systematic review of the evidence

Author

Jacques Ameille, C Pecquet, Karine Chevrie, Jean Bousquet, Antoine Flahault, Olivier Vandenplas, Jean-Jacques Duron, Isabella Annesi-Maesano, Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 (UP11)-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, 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), Service de la Santé au Travail [Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Bousquet J, Flahault A, O Vandenplas, Ameille J, JJ Duron, C Pecquet, K Chevrie, and Annesi-Maesano je

Subjects
Allergy, Health Personnel, medicine.disease_cause, MESH: Occupational Exposure, 030207 dermatology & venereal diseases, 0302 clinical medicine, Allergen, Immunopathology, Prevalence, Immunology and Allergy, Prospective Studies, MESH: Incidence, Sensitization, MESH: Gloves, Protective, education.field_of_study, Incidence, 3. Good health, Occupational Diseases, medicine.anatomical_structure, Latex allergy, MESH: Occupational Diseases, medicine.medical_specialty, Occupational Diseases/*epidemiology/prevention & control, Immunology, Population, education, 03 medical and health sciences, MESH: Cross-Sectional Studies, Latex Hypersensitivity, MESH: Latex Hypersensitivity, Occupational Exposure, Internal medicine, medicine, Humans, MESH: Prevalence, Asthma, MESH: Humans, business.industry, Occupational Exposure/adverse effects, Odds ratio, medicine.disease, MESH: Prospective Studies, Cross-Sectional Studies, 030228 respiratory system, Latex Hypersensitivity/*epidemiology/prevention & control, MESH: Health Personnel, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Gloves, Protective
Abstract

International audience; BACKGROUND: Natural rubber latex is a recognized allergen, but a recent meta-analysis failed to find any association between latex exposure and allergy in health care workers (HCWs). OBJECTIVES: A meta-analysis was carried out under the auspices of the French National Regulatory Authority to assess the allergic risk induced by latex gloves in HCWs. METHODS: The risk of work-related exposure to latex for the development of latex allergy was assessed. Prevalence and incidence rates of latex sensitization or allergy were compared in HCWs and in the general population. Exposure-response relationships were assessed in HCWs. RESULTS: Latex allergy was found in 4.32% (range, 4.01% to 4.63%) of HCWs and in 1.37% (range, 0.43% to 2.31%) of the general population. Latex-positive skin prick test responses ranged from 2.1% to 3.7% in the general population and from 6.9% to 7.8% for the HCWs. HCWs exposed to latex showed an increased risk of hand dermatitis (odds ratio [OR], 2.46; 95% CI, 2.11-2.86), asthma or wheezing (OR, 1.55; 95% CI, 1.15-2.08), rhinoconjunctivitis (OR, 2.73; 95% CI, 1.97-3.81), and at least one generic symptom (OR, 1.27; 95% CI, 1.09-1.47). Sensitization to latex was significantly associated with asthma and rhinoconjunctivitis. By contrast, exposure to latex was not associated with a significantly increased risk of positive skin prick test responses to latex (OR, 1.47; 95% CI, 0.94-2.30). CONCLUSION: HCWs have an increased risk of sensitization and allergic symptoms to latex. CLINICAL IMPLICATIONS: Prevention of latex allergy in HCWs is needed.

Published
2006

26. [Disabled workers with motor impairments: data from an occupational health service]

Author

Schnitzler, A., D'Apolito, A. C., Roche, Nicolas, Genêt, F., Ameille, J., Azouvi, Philippe, Physiologie et physiopathologie de la motricité chez l'homme, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR70-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de la Santé au Travail [Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Service de réeducation fonctionnelle [Raymond Poincaré], Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR70-Institut National de la Santé et de la Recherche Médicale ( INSERM ), and Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches]

Subjects
Adult, Employment, Male, MESH : Male, MESH : Human Engineering, MESH: Occupational Health, Humans, MESH : Female, MESH : Middle Aged, Disabled Persons, MESH : Disabled Persons, MESH : France, MESH: Human Engineering, Occupational Health, MESH: Humans, MESH: Middle Aged, [SDV.BA.MVSA]Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health, MESH: Employment, MESH : Humans, MESH: Adult, MESH : Adult, Middle Aged, MESH: Disabled Persons, MESH : Occupational Health, MESH: Male, MESH : Employment, Motor Skills Disorders, MESH: France, MESH : Motor Skills Disorders, Female, Ergonomics, France, [ SDV.BA.MVSA ] Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health, MESH: Female, MESH: Motor Skills Disorders
Abstract

INTRODUCTION: Mediclen is an occupational health service in charge of following-up 36,736 workers (divided among 1770 companies) in 3 cities of an area near Paris. The employment rate of disabled people among the French population is not well known (rough estimate 4.4%), and few studies have reported on the situation of workers with a motor impairment. SUBJECTS AND METHOD: The recent computerization of medical records allowed us to identify 195 workers considered disabled by the French administration (i.e. 0.55% of the 36,736 workers followed up in 2002). Among these, 26 had a motor impairment. RESULTS: Twenty-one neurological disabilities were central and 5 were peripheral or neuromuscular. The workers were 44-years-old. Only two workers had a severe handicap. Companies had to adapt workstations for half of the workers, with the advice of neurologists (7 of 10 advice given) and once a physical medicine doctor. DISCUSSION-CONCLUSION: The integration of people with motor impairments into the world of work is rare and difficult. This practical experience showed the difficulties people with motor impairment face. Close collaboration of physical medicine services with occupational health services is necessary to improve the integration of this population into the world of work.

Published
2006

27. [Occupational lung cancers: how to screen?]

Author

Pairon, J.-C., Ameille, J., Dalphin, J.-C., Service de la Santé au Travail [Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Dalphin, Jean-Charles, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches], Laboratoire Chrono-environnement ( LCE ), and Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre National de la Recherche Scientifique ( CNRS )

Subjects
MESH : Mass Screening, MESH: Occupational Diseases, Lung Neoplasms, MESH: Humans, MESH: Questionnaires, MESH : Humans, MESH : Questionnaires, MESH : Occupational Diseases, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Lung Neoplasms, Occupational Diseases, MESH: France, Surveys and Questionnaires, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Humans, Mass Screening, MESH : Lung Neoplasms, France, MESH: Mass Screening, MESH : France, [ SDV.MHEP.PSR ] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2006

28. Pleural plaques and risk of lung cancer in workers formerly occupationally exposed to asbestos: extension of follow-up.

Author

Gallet J, Laurent F, Paris C, Clin B, Gislard A, Thaon I, Chammings S, Gramond C, Ogier G, Ferretti G, Andujar P, Brochard P, Delva F, Pairon JC, and Lacourt A

Abstract

Background: Occupational asbestos exposure is associated with pleural plaques (PP), a benign disease often seen as a marker of past exposure to asbestos and lung cancer. The association between these two diseases has not been formally proved, the aim of this study was to evaluate this association in the asbestos-related disease cohort (ARDCO) cohort., Methods: ARDCO is a French multicentric cohort including workers formerly occupationally exposed to asbestos from 2003 to 2005. CT scan was performed to diagnose PP with double reading and lung cancer (incidence and mortality) was followed through health insurance data and death certificates. Cox models were used to estimate the association between PP and lung cancer adjusting for occupational asbestos exposure (represented by cumulative exposure index, time since first exposure and time since last exposure) and smoking status., Results: A total of 176 cases (of 5050 subjects) and 88 deaths (of 4938 subjects) of lung cancer were recorded. Smoking status was identified as an effect modifier. Lung cancer incidence and mortality were significantly associated with PP only in non-smokers, respectively, HR=3.13 (95% CI 1.04 to 9.35) and HR=16.83 (95% CI 1.87 to 151.24) after adjustment for age, occupational asbestos exposure and smoking status., Conclusions: ARDCO study was the first to study this association considering equal asbestos exposure, and more specifically, our study is the first to test smoking as an effect modifier, so comparison with scientific literature is difficult. Our results seem to consolidate the hypothesis that PP may be an independent risk factor for lung cancer but they must be interpreted with caution., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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29. Deep Learning for the Automatic Quantification of Pleural Plaques in Asbestos-Exposed Subjects.

Author

Benlala I, De Senneville BD, Dournes G, Menant M, Gramond C, Thaon I, Clin B, Brochard P, Gislard A, Andujar P, Chammings S, Gallet J, Lacourt A, Delva F, Paris C, Ferretti G, Pairon JC, and Laurent F

Subjects
Artificial Intelligence, Humans, Retrospective Studies, Asbestos, Deep Learning, Occupational Exposure
Abstract

Objective: This study aimed to develop and validate an automated artificial intelligence (AI)-driven quantification of pleural plaques in a population of retired workers previously occupationally exposed to asbestos., Methods: CT scans of former workers previously occupationally exposed to asbestos who participated in the multicenter APEXS (Asbestos PostExposure Survey) study were collected retrospectively between 2010 and 2017 during the second and the third rounds of the survey. A hundred and forty-one participants with pleural plaques identified by expert radiologists at the 2nd and the 3rd CT screenings were included. Maximum Intensity Projection (MIP) with 5 mm thickness was used to reduce the number of CT slices for manual delineation. A Deep Learning AI algorithm using 2D-convolutional neural networks was trained with 8280 images from 138 CT scans of 69 participants for the semantic labeling of Pleural Plaques (PP). In all, 2160 CT images from 36 CT scans of 18 participants were used for AI testing versus ground-truth labels (GT). The clinical validity of the method was evaluated longitudinally in 54 participants with pleural plaques., Results: The concordance correlation coefficient (CCC) between AI-driven and GT was almost perfect (>0.98) for the volume extent of both PP and calcified PP. The 2D pixel similarity overlap of AI versus GT was good (DICE = 0.63) for PP, whether they were calcified or not, and very good (DICE = 0.82) for calcified PP. A longitudinal comparison of the volumetric extent of PP showed a significant increase in PP volumes ( p < 0.001) between the 2nd and the 3rd CT screenings with an average delay of 5 years., Conclusions: AI allows a fully automated volumetric quantification of pleural plaques showing volumetric progression of PP over a five-year period. The reproducible PP volume evaluation may enable further investigations for the comprehension of the unclear relationships between pleural plaques and both respiratory function and occurrence of thoracic malignancy.

Published
2022
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30. Interstitial Lung Abnormalities Detected by CT in Asbestos-Exposed Subjects Are More Likely Associated to Age.

Author

Laurent F, Benlala I, Dournes G, Gramond C, Thaon I, Clin B, Brochard P, Gislard A, Andujar P, Chammings S, Gallet J, Lacourt A, Delva F, Paris C, Ferretti G, and Pairon JC

Abstract

Objective: the aim of this study was to evaluate the association between interstitial lung abnormalities, asbestos exposure and age in a population of retired workers previously occupationally exposed to asbestos., Methods: previously occupationally exposed former workers to asbestos eligible for a survey conducted between 2003 and 2005 in four regions of France, underwent chest CT examinations and pulmonary function testing. Industrial hygienists evaluated asbestos exposure and calculated for each subject a cumulative exposure index (CEI) to asbestos. Smoking status information was also collected in this second round of screening. Expert radiologists performed blinded independent double reading of chest CT-scans and classified interstitial lung abnormalities into: no abnormality, minor interstitial findings, interstitial findings inconsistent with UIP, possible or definite UIP. In addition, emphysema was assessed visually (none, minor: emphysema <25%, moderate: between 25 and 50% and severe: >50% of the lung). Logistic regression models adjusted for age and smoking were used to assess the relationship between interstitial lung abnormalities and occupational asbestos exposure., Results: the study population consisted of 2157 male subjects. Interstitial lung abnormalities were present in 365 (16.7%) and emphysema in 444 (20.4%). Significant positive association was found between definite or possible UIP pattern and age (OR adjusted =1.08 (95% CI: 1.02-1.13)). No association was found between interstitial abnormalities and CEI or the level of asbestos exposure., Conclusion: presence of interstitial abnormalities at HRCT was associated to aging but not to cumulative exposure index in this cohort of former workers previously occupationally exposed to asbestos.

Published
2021
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31. Cancer of the esophagus and asbestos exposure.

Author

Clin B, Thaon I, Boulanger M, Brochard P, Chamming's S, Gislard A, Lacourt A, Luc A, Ogier G, Paris C, and Pairon JC

Subjects
Aged, Esophageal Neoplasms mortality, Follow-Up Studies, France epidemiology, Humans, Incidence, Male, Middle Aged, Occupational Diseases mortality, Occupational Exposure statistics & numerical data, Asbestos toxicity, Carcinogens toxicity, Esophageal Neoplasms epidemiology, Occupational Diseases epidemiology, Occupational Exposure adverse effects
Abstract

Background: Our study aimed at analyzing incidence and mortality from esophageal cancer within a cohort of workers with previous occupational asbestos exposure (ARDCo Program)., Methods: A 10-year follow-up study was conducted in the 14 515 male subjects included in this program between October 2003 and December 2005. Follow-up began when exposure stopped. Asbestos exposure was analyzed by industrial hygienists using data from a standardized questionnaire. The Cox model was used, with age as the time axis variable adjusted for smoking, time since first exposure (TSFE) and cumulative exposure index (CEI) of exposure to asbestos., Results: We reported a significant dose-response relationship between CEI of exposure to asbestos and esophageal cancer, in both incidence (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.00-1.58), and mortality (HR 1.40, [95%CI 1.12-1.75])., Conclusions: This large-scale study suggests the existence of a relationship between asbestos exposure and cancer of the esophagus., (© 2017 Wiley Periodicals, Inc.)

Published
2017
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32. Inter-reader agreement in HRCT detection of pleural plaques and asbestosis in participants with previous occupational exposure to asbestos.

Author

Laurent F, Paris C, Ferretti GR, Beigelman C, Montaudon M, Latrabe V, Jankowski A, Badachi Y, Clin B, Gislard A, Letourneux M, Luc A, Schorlé E, Brochard P, Ameille J, and Pairon JC

Subjects
Aged, Asbestosis diagnostic imaging, Cross-Sectional Studies, Fibrosis, Health Personnel standards, Humans, Middle Aged, Pleural Diseases diagnostic imaging, Asbestos adverse effects, Asbestosis diagnosis, Diagnostic Errors prevention & control, Occupational Exposure adverse effects, Pleura diagnostic imaging, Pleural Diseases diagnosis, Tomography, X-Ray Computed methods
Abstract

Objectives: To investigate inter-reader agreement for the detection of pleural and parenchymal abnormalities using CT in a large cross-sectional study comprising information on individual cumulative exposure to asbestos., Methods: The project was approved by the hospital ethics committee, and all patients received information on the study and gave their written informed consent. In 5511 CT scans performed in a cohort of retired workers previously exposed to asbestos and volunteering to participate in a multiregional survey programme (Asbestos Related Diseases Cohort, ARDCO), double randomised standardised readings, triple in case of disagreement, were performed by seven trained expert radiologists specialised in thoracic imaging and blind to the initial interpretation. Inter-reader agreement was evaluated by calculating the κ-weighted coefficient between pairs of expert readers and results of routine practice and final diagnosis after expert reading., Results: κ-Weighted coefficients between trained experts ranged from 0.28 to 0.52 (fair to good), 0.59 to 0.86 (good to excellent) and 0.11 to 0.66 (poor to good) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. κ-Weighted coefficients between results of routine practice and final diagnosis after expert reading were 0.13 (poor), 0.53 (moderate) and 0.11 (poor) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively., Conclusions: Interpretation of benign asbestos-related thoracic abnormalities requires standardisation of the reading and trained readers, particularly for participants asking for compensation, and with a view to the longitudinal survey of asbestos-exposed workers., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

Published
2014
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33. Compensation of pleural mesothelioma in France: data from the French National Mesothelioma Surveillance Programme.

Author

Chamming's S, Clin B, Brochard P, Astoul P, Ducamp S, Galateau-Salle F, Ilg AG, Goldberg M, Gramond C, Imbernon E, Rolland P, and Pairon JC

Subjects
Adult, Aged, Aged, 80 and over, Air Pollutants toxicity, Asbestos toxicity, Environmental Exposure adverse effects, Environmental Exposure economics, Female, France, Humans, Male, Mesothelioma etiology, Middle Aged, National Health Programs economics, National Health Programs statistics & numerical data, Occupational Diseases etiology, Pleural Neoplasms etiology, Population Surveillance, Compensation and Redress, Mesothelioma economics, Occupational Diseases economics, Pleural Neoplasms economics, Workers' Compensation statistics & numerical data
Abstract

Background: The aim of this study was to determine the rates of compensation awarded to patients presenting with pleural mesothelioma and factors linked to such compensation in France., Methods: The study population consisted of 2,407 patients presenting with pleural mesothelioma, recorded by the National Mesothelioma Surveillance Programme between January 1, 1999 and December 31, 2009. Analysis of claims for recognition as "occupational disease" (OD) and claims for compensation by the Compensation Fund for Asbestos Victims (FIVA) were analyzed., Results: Approximately 30% of subjects presenting with pleural mesothelioma, affiliated to the General National Health Insurance fund, neither sought recognition as an OD nor claimed for FIVA compensation. Gender, age at diagnosis, type of health insurance, and socio-professional category influence the likelihood of patients presenting with mesothelioma seeking compensation for this disease., Conclusions: Results show an under-compensation of pleural mesothelioma as OD and by the FIVA in France., (Copyright © 2012 Wiley Periodicals, Inc.)

Published
2013
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34. [Occupational rhinitis].

Author

Garnier R, Villa A, and Chataigner D

Subjects
Humans, Incidence, Prevalence, Risk Factors, Occupational Diseases diagnosis, Occupational Diseases epidemiology, Occupational Diseases etiology, Occupational Diseases therapy, Rhinitis diagnosis, Rhinitis epidemiology, Rhinitis etiology, Rhinitis therapy
Abstract

Introduction: Rhinitis is one of the most common occupational diseases. It is often neglected by those affected because it causes little disability. It is poorly understood by doctors who have insufficient experience of occupational diseases and their causes. However it is often the first manifestation of a respiratory disorder that may cause physical complications and socio-economic disability., Background: Numerous diverse agents are potential causes of rhinitis. The diagnosis of occupational rhinitis should be considered when sneezing, rhinorrhoea or nasal obstruction are associated with work. The causal agent can be identified by ta-king a careful history. When the mechanism of the disease is immunologic the suspected antigen can be confirmed by skin testing, specific IgE or nasal provocation. The respiratory disorder of which rhinitis is the first manifestation may progress to asthma if the exposure continues. The prevention of occupational rhinitis depends on the reduction of exposure to allergens and/or irritants. When it has developed removal of the causative agent is essential to prevent progression to asthma.

Published
2007
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35. Asbestos exposure and radiological abnormalities among maintenance and custodian workers in buildings with friable asbestos-containing materials.

Author

Matrat M, Pairon JC, Paolillo AG, Joly N, Iwatsubo Y, Orlowski E, Letourneux M, and Ameille J

Subjects
Adult, Body Mass Index, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Pleural Diseases chemically induced, Pneumoconiosis etiology, Radiography, Smoking adverse effects, Time Factors, Asbestos toxicity, Occupational Exposure adverse effects, Pleural Diseases diagnostic imaging, Pneumoconiosis diagnostic imaging
Abstract

Objectives: Few studies have been carried out to evaluate the respiratory effects of asbestos exposure of custodian and maintenance workers., Methods: By a multicentre cross-sectional study, 277 custodian and maintenance employees working in buildings with friable asbestos-containing materials and 87 unexposed subjects were studied for radiological abnormalities by use of the International Labour Office (ILO) classification of radiographs of pneumoconiosis, in relation to parameters of asbestos exposure., Results: The cumulative asbestos exposure index was generally low (fewer than 5 fibres/ml x years in 82.3% of exposed workers). On multivariate analysis, pleural thickening was significantly related to latency since onset of exposure to asbestos in exposed workers, after adjustment for age, body mass index and tobacco smoking., Conclusions: Asbestos exposure of custodian and maintenance employees in buildings with friable asbestos-containing materials might be associated with an excess of pleural thickening on chest X-rays., (Copyright 2004 Springer-Verlag)

Published
2004
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36. Reported incidence of occupational asthma in France, 1996-99: the ONAP programme.

Author

Ameille J, Pauli G, Calastreng-Crinquand A, Vervloët D, Iwatsubo Y, Popin E, Bayeux-Dunglas MC, and Kopferschmitt-Kubler MC

Subjects
Adolescent, Adult, Age Distribution, Confidence Intervals, Female, France epidemiology, Humans, Incidence, Male, Middle Aged, Occupations statistics & numerical data, Poisson Distribution, Residence Characteristics, Sex Distribution, Asthma epidemiology, Occupational Diseases epidemiology
Abstract

Aims: To estimate the general and specific incidence of occupational asthma in France in 1996-99; and to describe the distribution of cases by age, sex, suspected causal agents, and occupation., Methods: New cases of occupational asthma were collected by a national surveillance programme, based on voluntary reporting, named Observatoire National des Asthmes Professionnels (ONAP), involving a network of occupational and chest physicians. For each case, the reporting form included information on age, sex, location of workplace, occupation, suspected causal agent, and methods of diagnosis. Estimates of the working population, used to calculate incidence rates by age, sex, region, and occupation, were obtained from the Institut National de la Statistique et des Etudes Economiques (INSEE) and from the French Securite Sociale statistics., Results: In 1996-99, 2178 cases of occupational asthma were reported to the ONAP, giving a mean annual rate of 24/million. Rates in men were higher than rates in women (27/million versus 19/million). The highest rate was observed in the 15-29 years age group (30/million). The most frequently incriminated agents were flour (20.3%), isocyanates (14.1%), latex (7.2%), aldehyde (5.9%), persulphate salts (5.8%), and wood dusts (3.7%). The highest risks of occupational asthma were found in bakers and pastry makers (683/million), car painters (326/million), hairdressers (308/million), and wood workers (218/million)., Conclusion: Despite likely underreporting, the number of cases of occupational asthma reported to the ONAP was approximately twice the number of compensated cases over the same period. The relevance of the programme is confirmed by the reproducibility of the results year after year, and its consistency with other surveillance programmes. The ONAP programme is useful for the identification of targets for primary prevention.

Published
2003
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37. [Health effects of artificial mineral fibers].

Author

Pairon JC, Brochard P, and De Vuyst P

Subjects
Animals, Cricetinae, Humans, Lung Neoplasms etiology, Mesothelioma etiology, Mineral Fibers classification, Pleural Diseases etiology, Pulmonary Fibrosis etiology, Rats, Mineral Fibers adverse effects, Occupational Diseases etiology
Abstract

Data from mortality studies in cohorts of workers employed in the production of man-made mineral fibres, where levels of exposure were generally low, show an excess of mortality by lung cancer, although the role of the fibres themselves remains unclear in this excess. Standardized mortality ratio for lung cancer was lower in glass-wool production workers than in rock-slag-wool workers. Preliminary data for refractory ceramic fibres-exposed workers suggest the occurrence of benign pleural diseases and obstructive functional defects. Attention should be paid to levels of exposure to various man-made mineral fibres encountered by end-users commonly exposed to peaks of fibre concentrations higher than production workers.

Published
1998

38. [Rolled atelectasis and asbestosis. Apropos of 26 patients].

Author

Bayeux MC, Letourneux M, Brochard P, Raffaelli C, Pairon JC, Iwatsubo Y, and Ameille J

Subjects
Asbestosis diagnostic imaging, Chest Pain etiology, Cohort Studies, Cough etiology, Diagnosis, Differential, Dyspnea etiology, Female, Humans, Lung Neoplasms diagnosis, Male, Maximal Expiratory Flow Rate physiology, Maximal Midexpiratory Flow Rate physiology, Middle Aged, Occupational Exposure, Pleural Diseases diagnostic imaging, Pulmonary Atelectasis diagnostic imaging, Residual Volume physiology, Tomography, X-Ray Computed, Total Lung Capacity physiology, Vital Capacity physiology, Asbestosis complications, Pleural Diseases complications, Pulmonary Atelectasis etiology
Abstract

Round atelectasis (AE) is a benign form of respiratory problem which develops due to fixing of the visceral pleura. This lesion for which the principal cause is exposure to asbestos may pose problems of differential diagnosis with bronchopulmonary cancer. In a cohort of 286 patients suffering from benign asbestos related pleural disease the diagnosis of round atelectasis was made on computerized tomography in 26 patients (31 AE) on the following criteria: rounded opacities of less than 7 cm in diameter situated at the periphery of the lung in contact with a thickened pleura with an acute angle linking the pleura and the opacity, a reduction of lung volume on the side of the atelectasis and the presence of a "comet tail sign". These patients were investigated to specify the circumstances of the occurrence, including their symptomatology, the changes in lung function, the topography of the round atelectasis and the associated radiological signs. Intense exposure to asbestos either continuous or discontinuous was found in 19 patients; 20 patients presented with some respiratory symptoms (dyspnoea 15/26, cough 11/26 and chest pain 9/26) but the reduction in lung function was moderate (7 had restrictive ventilatory trouble, 4 obstructive problems and a mixed problem in 1). The preferred localisation for round atelectasis was in the inferior lobes in the posterior basal lateral vertebral area (26/31) which may explain their being frequently missed on the standard radiograph (only one case of round atelectasis was visible on the straight chest radiograph in our study). An understanding of the pathology and the computered tomographic characteristics are now well defined and should enable an unnecessary diagnostic thoracotomy to be avoided which besides has no justification from the functional point of view.

Published
1998

39. Consequences of occupational asthma on employment and financial status: a follow-up study.

Author

Ameille J, Pairon JC, Bayeux MC, Brochard P, Choudat D, Conso F, Devienne A, Garnier R, and Iwatsubo Y

Subjects
Adolescent, Adult, Age Factors, Asthma diagnosis, Educational Status, Female, Follow-Up Studies, France, Humans, Income, Logistic Models, Male, Middle Aged, Occupational Diseases diagnosis, Occupational Exposure, Risk Factors, Surveys and Questionnaires, Telephone, Unemployment, Workers' Compensation economics, Asthma economics, Employment, Occupational Diseases economics, Social Class
Abstract

The aim of this study was to describe changes in employment and income following a diagnosis of occupational asthma, and to determine what factors might affect these changes. Two hundred and nine patients with occupational asthma were reviewed on average 3.1 yrs after the diagnosis had been made. They were contacted by telephone or were sent a self-administered questionnaire by post. Multiple logistic regression models were constructed to determine which variables were associated with loss of employment after the diagnosis. At the time of review, 44% of patients had left their previous job and 25% were currently unemployed. Remarkably, 32% remained exposed to the offending agents in the same job. Forty six percent of the patients had suffered a reduction of income (84% of those who had left their employer versus 19% of those still employed in the same company (p < 0.001)). Claims for compensation, size of the company, level of education, and age at the time of diagnosis were significantly associated with a risk for becoming unemployed or having a new employer after the diagnosis of occupational asthma. Occupational asthma results in severe socioeconomic consequences. The French compensation system for occupational asthma should be revised, as the criteria currently used to determine compensation for this disease largely underestimate the social and occupational damages.

Published
1997
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40. Methyl iodide poisoning: report of two cases.

Author

Hermouet C, Garnier R, Efthymiou M, and Fournier P

Subjects
Abducens Nerve drug effects, Adult, Cerebellar Diseases chemically induced, Chemical Industry, Cranial Nerve Diseases chemically induced, Diagnosis, Differential, Humans, Male, Middle Aged, Multiple Sclerosis diagnosis, Occupational Exposure, Oculomotor Nerve drug effects, Recurrence, Respiratory Protective Devices, Spinal Cord Diseases chemically induced, Substance-Related Disorders etiology, Trochlear Nerve drug effects, Hydrocarbons, Iodinated poisoning, Occupational Diseases chemically induced
Abstract

Two workers were poisoned following exposure to methyl iodide with inadequate protective devices. Their cases are presented together with a review of literature. Both patients developed symptoms and signs of cerebellar lesions and damage of the third, fourth, or sixth cranial nerve pathways. Spinal cord lesions producing motor and sensory disturbances were present in one. Late psychiatric disorders were observed in both patients. Although these symptoms were very similar to those reported in the nine published cases of methyl iodide poisoning, the toxicological diagnosis was delayed in one case: as repeated overexposure produced recurrent attacks of multifocal neurological dysfunction, multiple sclerosis was initially diagnosed, although several of the features observed are unusual in this disease. The manifestations of methyl iodide poisoning are similar to those of intoxication with other monohalomethanes. All these compounds probably share the same mechanisms of action. This mechanism and its therapeutic consequences are discussed.

Published
1996
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41. Respiratory symptoms, ventilatory impairment, and bronchial reactivity in oil mist-exposed automobile workers.

Author

Ameille J, Wild P, Choudat D, Ohl G, Vaucouleur JF, Chanut JC, and Brochard P

Subjects
Adult, Chronic Disease, Cough chemically induced, Humans, Lung drug effects, Male, Middle Aged, Mineral Oil classification, Occupational Diseases chemically induced, Prevalence, Air Pollutants, Occupational adverse effects, Automobiles, Cough epidemiology, Lung physiopathology, Mineral Oil adverse effects, Occupational Diseases epidemiology
Abstract

Studies concerning the respiratory effects of oil mists are sparse and contradictory. The aim of this study was to determine the respective effects of occupational exposure to straight cutting oils and soluble mineral oils on the prevalence of respiratory symptoms, ventilatory impairment, and bronchial reactivity. The population study consisted of 308 male workers of a large French car-making plant, including 40 subjects chronically exposed to straight cutting oils (group S), 51 subjects chronically exposed to soluble mineral oils (group E), 139 subjects with chronic dual exposure to straight cutting oils and soluble mineral oils (group D), and 78 unexposed assembly workers used as a control group (group C). Worker evaluation included a standardized questionnaire, measurement of pulmonary function, and a methacholine challenge. Oil mist concentration at the work place was determined by gravimetric analysis. The arithmetic mean concentration was 2.6 +/- 1.8 mg/m3. The geometric mean concentration was 2.2 +/- 1.9 mg/m3. The prevalence of respiratory symptoms did not differ significantly among the four groups. However, the subjects exposed to straight cutting oils (group S + group D) had a significantly higher prevalence of chronic cough and/or phlegm than the others (group E + group O): 25.7% vs. 16.3% (p = 0.048). Furthermore, the prevalence of cough and/or phlegm increased significantly (p = 0.03) with increasing duration of exposure to straight cutting oils after adjustment on smoking categories. Lung function tests did not differ significantly among the four groups but we observed a significant decrease of forced expiratory volume in 1 sec (FEV1), forced expiratory flow during the middle half of forced vital capacity (FEF25-75), and maximal flow rate at 50% and 25% of exhaled forced vital capacity (V50 and V25) according to duration of exposure among smokers exposed to straight cutting oils, suggesting a synergistic effect of tobacco and insoluble oils. No effect of exposure to mineral oils on bronchial reactivity was demonstrated. It is concluded that despite low levels of pollution by oil mists, the present study has shown tenuous adverse chronic effects of straight cutting oils on respiratory symptoms and lung function. However, no adverse effect of soluble mineral oils was demonstrated. These results suggest that threshold limit values for mineral oils should be reassessed.

Published
1995
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