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Objectives In 2003, a cluster of renal cell carcinoma (RCC) cases was reported among men working at a French chemical plant using a proprietary process to produce vitamin A. The 10 index cases yielded a standardised incidence ratio of 13.1 for 1994–2002. Nine of these 10 cases were diagnosed by a plant-specific abdominal ultrasonography screening programme that targeted exposure to an intermediate chemical, 4-chloro-1,1-dimethoxy-3-methyl-2-butene, commonly named ‘chloracetal C5’, suspected as the cause by some experts. Epidemiological investigations sought to examine the relations between occupational exposures and RCC. Methods A retrospective cohort mortality study and a nested case–control study were conducted. The cohort study included all workers who had been employed at the plant for at least 6 months between 1960 and 2003. The case–control study included an extensive search within the region for other kidney cancer cases among the cohort members. Industrial hygienists assessed occupational exposure. Results From 1968 to 2006, no significant excess mortality was observed for all causes of death or for all cancers. We found excess mortality for kidney cancer only among women. The nested case–control study showed a dose–response relation for cumulative exposure to chloracetal C5: the OR rose from 2.5 in the low-exposure category to 10.5 in the high-exposure group. Adjustment for screening attenuated this relation. Conclusions The results of the case–control study were consistent with the positive results of in vivo genotoxic tests and suggest that chloracetal C5 can have a causal role in RCC.

Occupational studies show a high risk of lung cancer related to arsenic exposure by inhalation; however, only a few studies, and with conflicting results, previously examined a potential link between arsenic exposure at work and skin cancer. The aim of this study is to assess airborne arsenic exposures at the workplace and to quantify associations with nonmelanoma skin cancer (NMSC). The study sample consists of 618 incident cases of NMSC and 527 hospital-based controls aged 30-79 years from Hungary, Romania and Slovakia. Exposures were evaluated by local experts using occupational histories. Information on host factors and other exposures was collected and used to adjust the associations of interest using multivariable logistic regression. The lifetime prevalence of exposure to work-related arsenic is 23.9% for cases and 15.5% for controls. No significant association between arsenic exposure in the workplace and NMSC was detected, although an increased adjusted odd ratio was observed for participants with higher cumulative lifetime workplace exposure to arsenic in dust and fumes compared to referents [odds ratios (OR) = 1.94, 95% confidence interval (CI) = 0.76-4.95]. There is evidence for modification of the workplace arsenic-NMSC association by work-related sunlight exposure in women, with a markedly increased adjusted OR in the presence of workplace sunlight exposure (OR = 10.22, 95% CI = 2.48-42.07). Workplace coexposure to arsenic and sunlight may thus pose an increased risk of NMSC.

Asbestos is considered a confirmed carcinogen for ovarian cancer. The IARC classification was based on data from cohorts of exposed women and mechanistic data. However, no data are available in ovarian cancer populations. The objective of the present descriptive study was to assess direct and indirect occupational and environmental rates of asbestos fibre exposure in women with ovarian cancer, and quantify exposure. Postal requests to take part in the study were addressed to patients managed for ovarian cancer in several departments of the Lyon University Hospital Centre and Leon Berard Cancer Centre between January 2010 and December 2012. Personal and occupational data were collected by telephone on a standardised questionnaire. Direct occupational exposure, indirect exposure via occupational exposure of family members, and environmental exposure were assessed by an industrial hygienist. 162 patients were included (participation rate 50%), with a mean age of 58 years. The industrial hygienist who assessed the asbestos exposure based on occupational data and questionnaire items related to asbestos exposure estimated that 29 women (18%) may have had direct exposure during their working life, and that 3.7% may have been indirectly exposed via occupational exposure of family members; 2 patients were thought to have had environmental exposure. Occupational exposure levels were probably fairly low: 14.2% of patients (n = 23) had exposure exceeding environmental norms but below 30% of the occupational exposure limit (100 f/l); 3.2% (n = 5) had exposure at 30–75%, and 0.7% (n = 1) had exposure approximating or exceeding the occupational exposure limit. The prevalence of occupational asbestos exposure in the present population was significantly higher than for women of the same age in the French general population, estimated at 4% in 2007 by the French institute for public health surveillance. The IARC classification and the present findings should encourage increased attention to asbestos exposure in ovarian cancer patients.

Resume Objectif Plusieurs etudes epidemiologiques rapportent une augmentation de la morbidite ou de la mortalite par cancer du col uterin parmi les salariees ayant ete exposees au trichloroethylene (TCE). Ce solvant chlore classe cancerogene probable par le Centre international de recherche sur le cancer (CIRC, groupe 2A) reste utilise dans l’industrie du decolletage, tres presente en Haute-Savoie. Une etude exploratoire retrospective a ete realisee a partir de donnees medicales et professionnelles recueillies au cours d’une annee par un medecin du travail suspectant un agregat de cancers. L’objectif etait de realiser une premiere estimation du risque et d’evaluer la pertinence d’une etude epidemiologique specifique. Materiels et methodes Les donnees recueillies comprenaient, d’une part, les antecedents d’exposition professionnelle au TCE et, d’autre part, les antecedents de traitement par conisation (revelant l’existence d’une pathologie cancereuse du col uterin). Le risque de pathologie du col uterin associe a l’exposition au TCE a ete estime par le calcul d’odd-ratios (OR) et le test du Chi2. Le niveau socioeconomique a ete pris en compte dans l’analyse. L’exposition a ete reevaluee pour toutes les patientes rapportant un antecedent de conisation pour estimer le biais de mesure (enregistrement concomitant de la pathologie et de l’exposition). Resultats Parmi les 777 femmes vues en visite medicale du travail au cours de l’annee consideree, 18 cas de conisations ont ete rapportes. Pour 11 d’entre elles, une exposition au TCE a ete retenue par le medecin du travail. Le risque de pathologie du col de l’uterus associe a l’exposition au TCE est de 4,55 (1,88–11,00). Il reste eleve apres ajustement sur le niveau social faible de certaines categories socioprofessionnelles, OR = 3,95 (1,36–11,49). Apres reevaluation des expositions au TCE, une augmentation du risque persiste meme si l’OR brut n’est plus statistiquement significatif, OR = 1,84 (0,71–4,75). Discussion Les donnees de la litterature, ainsi que les resultats de cette etude exploratoire permettent de faire suspecter une augmentation du risque de pathologie cancereuse du col uterin parmi les salariees exposees au TCE. Cependant, aucune des etudes epidemiologiques deja publiees n’a etudie specifiquement cette association et les facteurs de risque connus n’ont jamais ete pris en compte (human papilloma virus, par exemple). Une etude specifique paraissant justifiee et realisable, elle a ete mise en place et est en cours de realisation.

Background Several studies have investigated the association between trichloroethylene (TCE) exposure and renal cell cancer (RCC) but findings were inconsistent. The analysis of a case control study has shown an increased risk of RCC among subjects exposed to high cumulative exposure. The aim of this complementary analysis is to assess the relevance of current exposure limits regarding a potential carcinogenic effect of TCE on kidney. Methods Eighty-six cases and 316 controls matched for age and gender were included in the study. Successive jobs and working circumstances were described using a detailed occupational questionnaire. An average level of exposure to TCE was attributed to each job-period in turn. The main occupational exposures described in the literature as increasing the risk of RCC were assessed as well as non-occupational factors. A conditional logistic regression was performed to test the association between TCE and RCC risk. Three exposure levels were studied (average exposure during the eight-hour shift): 35 ppm, 50 ppm and 75 ppm. Potential confounding factors identified were taken into account at the threshold limit of 10% ( p = 0.10) (body mass index [BMI], tobacco smoking, occupational exposures to cutting fluids and to other oils). Results Adjusted for tobacco smoking and BMI, the odd-ratios associated with exposure to TCE were respectively 1.62 [0.77–3.42], 2.80 [1.12–7.03] and 2.92 [0.85–10.09] at the thresholds of 35 ppm, 50 ppm and 75 ppm. Among subjects exposed to cutting fluids and TCE over 50 ppm, the OR adjusted for BMI, tobacco smoking and exposure to other oils was 2.70 [1.02–7.17]. Conclusion Results from the present study as well as those provided in the international literature suggest that current French occupational exposure limits for TCE are too high regarding a possible risk of RCC.

Aims: To study the associations between occupational exposures and the risk of lung cancer in New Caledonia. Methods: All cases diagnosed between January 1993 and December 1995 (228 lung cancers) and 305 population controls were included. Detailed information on lifetime job history, smoking, and other potential risk factors was collected by interview. Occupational exposures were assessed from the questionnaires by an industrial hygienist, without knowledge of case-control status. Results: No significant association was found with exposures related to nickel mining and refining, the main industrial activity in the territory. Among men, an excess risk of lung cancer was found for bus and truck drivers. Increased risks were also observed in men with the highest level of cumulative exposure to cleaning products and inorganic fertilisers. Exposure to field dust was associated with lung cancer risk in both sexes, and risk increased with cumulative exposure level. In some areas tremolite asbestos derived from local outcroppings was used as a whitewash. The association between exposure to field dust and lung cancer was limited to men and women exposed to this whitewash—that is, living in areas where the soil may contain tremolite. Conclusion: This study shows several associations between occupational exposures and lung cancer. The findings suggest that exposure to tremolite fibres from cultivated fields may increase the risk of lung cancer in New Caledonia.

Objectif En 2009, le Centre international de recherche sur le cancer a classe l’amiante comme cancerogene certain pour l’ovaire. Cependant, la part des cancers de l’ovaire qui pourrait etre liee a une exposition professionnelle ou environnementale a l’amiante est imprecise. L’objectif de cette etude descriptive etait d’evaluer la frequence de l’exposition directe ou indirecte aux fibres d’amiante chez les femmes presentant un cancer de l’ovaire et de quantifier cette exposition. Methode L’etude a ete proposee par courrier de facon systematique aux patientes prises en charge pour un cancer de l’ovaire, les donnees medicales et professionnelles ont ete recueillies par telephone selon un questionnaire standardise. Les expositions ont ete evaluees par un hygieniste industriel. Les expositions indirectes a l’amiante ont ete evaluees a partir de questions sur les emplois occupes par des proches. Une analyse a ete faite visant a rechercher un lien entre l’exposition a l’amiante et le type histologique de tumeur. Resultats Au total, 162 patientes ont participe. Elles avaient en moyenne 58 ans, avaient occupe 2,4 emplois differents (duree mediane d’activite professionnelle 29 annees). Dix-huit pour cent des patientes ont ete exposees professionnellement a l’amiante, avec une duree mediane d’exposition estimee a 14 annees. Nous avons estime que 3,7 % des patientes avaient pu etre exposees indirectement a l’amiante. De plus, l’exposition aux fibres d’amiante semblait etre plus particulierement associee aux tumeurs epitheliales sereuses. Discussion/conclusion Alors qu’il n’existe actuellement pas de donnee dans la litterature sur une eventuelle association entre l’exposition a l’amiante et le type histologique de tumeur ovarienne, cette etude apporte de nouvelles hypotheses.

BACKGROUND: Studies suggest that ambient sunlight plays an important role in the pathogenesis of non-melanoma skin cancers (NMSC). However, there is ongoing controversy regarding the relevance of occupational exposure to natural and artificial ultraviolet radiation (UV) radiation. OBJECTIVES: We investigated potential associations between natural and artificial UV radiation exposure at work with NMSC in a case-control study conducted in Hungary, Romania, and Slovakia. METHODS: Occupational exposures were classified by expert assessment for 527 controls and 618 NMSC cases (515 basal cell carcinoma, BCC). Covariate information was collected via interview and multiple logistic regression models were used to assess associations between UV exposure and NMSC. RESULTS: Lifetime prevalence of occupational exposure in the participants was 13% for natural UV radiation and 7% for artificial UV radiation. Significant negative associations between occupational exposure to natural UV radiation and NMSC were detected for all who had ever been exposed (odds ratio (OR) 0.47, 95% confidence interval (CI) 0.27-0.80); similar results were detected using a semi-quantitative metric of cumulative exposure. The effects were modified by skin complexion, with significantly decreased risks of BCC among participants with light skin complexion. No associations were observed in relation to occupational artificial UV radiation exposure. CONCLUSIONS: The protective effect of occupational exposure to natural UV radiation was unexpected, but limited to light-skinned people, suggesting adequate sun-protection behaviors. Further investigations focusing on variations in the individual genetic susceptibility and potential interactions with environmental and other relevant factors are planned.

Objectives: Trichloroethylene (TCE) is suspected of association with elevated risk of cervical cancer. A case–control study was performed in a geographical area in which occupational TCE exposure is high. The study objective was to analyze the correlation between occupational TCE exposure and cervical cancer (including precancerous conditions). Methods: Case and control subjects were recruited by gynecologists. General and occupational data were collected by telephonic interviews. An industrial hygienist assessed occupational TCE exposure on a task-exposure matrix. Analysis focused on occupational TCE exposure at various levels and on cumulative dose. Multivariate analysis was performed to take account of the various risk factors. Results: In total, 67 case and 67 age-matched control subjects were included. Mean age was 36 years in both groups. Five of the possible general risk factors correlated significantly with cervical dysplasia or cancer: number of partners, history of genital or anal wart, interval between first period and first sexual relation, parity, and body mass index, the last three showing inverse correlation. Elevated risk was found in women who had had jobs as manual workers according to the PCS French classification (professions and socioprofessional categories), and production and related workers according to ISCO classification (International Standard Classification of Occupations), with odds ratios (ORs), adjusted on general and medical risk factors, of 7.68 [95% confidence interval (CI): 1.39–42.54] and 7.48 (1.30–43.24), respectively, among skilled service sector workers; the adjusted OR was close to significance, at 4.67 (95% CI: 0.92–23.67). No occupational sectors were significantly associated with elevated risk. In all, 17 (25.4%) case and 15 (22.4%) control subjects were exposed to TCE: raw OR = 1.17 (95% CI: 0.54–2.52), adjusted OR = 1.51 (95% CI: 0.42–5.41). There was no significant correlation between cumulative dose and exposure time. Conclusions: The study found no significantly increased risk of cervical dysplasia or cancer associated with occupational TCE exposure.

Objectives: We describe the elaboration and sensitivity analyses of a quantitative job-exposure matrix (SYN-JEM) for respirable crystalline silica (RCS). The aim was to gain insight into the robustness of the SYN-JEM RCS estimates based on critical decisions taken in the elaboration process. Methods: SYN-JEM for RCS exposure consists of three axes (job, region, and year) based on estimates derived from a previously developed statistical model. To elaborate SYN-JEM, several decisions were taken: i.e. the application of (i) a single time trend; (ii) region-specific adjustments in RCS exposure; and (iii) a prior job-specific exposure level (by the semi-quantitative DOM-JEM), with an override of 0 mg/m3 for jobs a priori defined as non-exposed. Furthermore, we assumed that exposure levels reached a ceiling in 1960 and remained constant prior to this date. We applied SYN-JEM to the occupational histories of subjects from a large international pooled community-based case–control study. Cumulative exposure levels derived with SYN-JEM were compared with those from alternative models, described by Pearson correlation (Rp) and differences in unit of exposure (mg/m3-year). Alternative models concerned changes in application of job- and region-specific estimates and exposure ceiling, and omitting the a priori exposure ranking. Results: Cumulative exposure levels for the study subjects ranged from 0.01 to 60 mg/m3-years, with a median of 1.76 mg/m3-years. Exposure levels derived from SYN-JEM and alternative models were overall highly correlated (Rp > 0.90), although somewhat lower when omitting the region estimate (Rp = 0.80) or not taking into account the assigned semi-quantitative exposure level (Rp = 0.65). Modification of the time trend (i.e. exposure ceiling at 1950 or 1970, or assuming a decline before 1960) caused the largest changes in absolute exposure levels (26–33% difference), but without changing the relative ranking (Rp = 0.99). Conclusions: Exposure estimates derived from SYN-JEM appeared to be plausible compared with (historical) levels described in the literature. Decisions taken in the development of SYN-JEM did not critically change the cumulative exposure levels. The influence of region-specific estimates needs to be explored in future risk analyses.

Night work involving disruption of circadian rhythm was suggested as a possible cause of breast cancer. We examined the role of night work in a large population-based case-control study carried out in France between 2005 and 2008. Lifetime occupational history including work schedules of each night work period was elicited in 1,232 cases of breast cancer and 1,317 population controls. Thirteen percent of the cases and 11% of the controls had ever worked on night shifts (OR = 1.27 [95% confidence interval = 0.99–1.64]). Odds ratios were 1.35 [1.01–1.80] in women who worked on overnight shifts, 1.40 [1.01–1.92] in women who had worked at night for 4.5 or more years, and 1.43 [1.01–2.03] in those who worked less than three nights per week on average. The odds ratio was 1.95 [1.13–3.35] in women employed in night work for >4 years before their first full-term pregnancy, a period where mammary gland cells are incompletely differentiated and possibly more susceptible to circadian disruption effects. Our results support the hypothesis that night work plays a role in breast cancer, particularly in women who started working at night before first full-term pregnancy.

We describe an empirical model for exposure to respirable crystalline silica (RCS) to create a quantitative job-exposure matrix (JEM) for community-based studies. Personal measurements of exposure to RCS from Europe and Canada were obtained for exposure modelling. A mixed-effects model was elaborated, with region/country and job titles as random effect terms. The fixed effect terms included year of measurement, measurement strategy (representative or worst-case), sampling duration (minutes) and a priori exposure intensity rating for each job from an independently developed JEM (none, low, high). 23,640 personal RCS exposure measurements, covering a time period from 1976 to 2009, were available for modelling. The model indicated an overall downward time trend in RCS exposure levels of -6% per year. Exposure levels were higher in the UK and Canada, and lower in Northern Europe and Germany. Worst-case sampling was associated with higher reported exposure levels and an increase in sampling duration was associated with lower reported exposure levels. Highest predicted RCS exposure levels in the reference year (1998) were for chimney bricklayers (geometric mean 0.11 mg m(-3)), monument carvers and other stone cutters and carvers (0.10 mg m(-3)). The resulting model enables us to predict time-, job-, and region/country-specific exposure levels of RCS. These predictions will be used in the SYNERGY study, an ongoing pooled multinational community-based case-control study on lung cancer.

Objectives Matgene is a program to develop job-exposure matrices (JEMs) adapted to the general population in France for the period since 1950. The aim is to create retrospective exposure assessment tools for estimating the prevalence of occupational exposure to various agents that can then be correlated to health-related parameters. Methods JEMs were drawn up by a team of six industrial hygienists who based their assessments on available occupational measurement, economic and statistical data, and several thousand job descriptions from epidemiological studies performed in France since 1984. Each JEM is specific to one agent, assessing exposure for a set of homogeneous combinations (occupation × activity × period) according to two occupational classifications (ISCO 1968 and PCS 1994) and one economic activities classification (NAF 2000). The cells of the JEM carry an estimate of the probability and level of exposure. Level is estimated by the duration and intensity of exposure-linked tasks or by description of the tasks when exposure measurement data are lacking for the agent in question. The JEMs were applied to a representative sample of the French population in 2007, and prevalence for each exposure was estimated in various population groups. All documents and data are available on a dedicated website. Results By the end of 2010, 18 JEMs have been developed and eight are under development, concerning a variety of chemical agents: organic and mineral dust, mineral fibers, and solvents. By implementation in the French population, exposure prevalences were calculated at different dates and for complete careers, and attributable risk fractions were estimated for certain pathologies. Some of these results were validated by comparison with those of other programs. Discussion Initial Matgene JEMs results are in agreement with the French and international literature, thus validating the methodology. Exposure estimates precision, however, vary between agents and according to the amount of exposure measurement data available. These JEMs are important epidemiological tools, and improving their quality will require investment in occupational health data harvesting, especially in the case of low-level exposures.

International audience; OBJECTIVES: The aim of the study was to determine whether self-reported occupational exposure to cleaning/disinfecting agents in hospital workers is accurate, in comparison to expert assessment, taken to be the gold standard. METHODS: In the Epidemiological Study of the Genetics and Environment of Asthma (EGEA), participants were interviewed on occupation with a specific questionnaire for hospital workers regarding tasks and cleaning/disinfecting agents. Two estimates of exposure were available: self-report and expert assessment. The expert assessment involved a standardised procedure to estimate intensity, frequency and probability of exposure for each job. The present analysis focused on eight exposures: formaldehyde, glutaraldehyde, bleach/chlorine, alcohol, quaternary ammonium components, ammonia, sprays and latex gloves. Agreement and differences between self-reported and expert estimates were studied by kappa and phi coefficients and McNemar tests, respectively. RESULTS: In the survey of 1571 adults, 176 ever hospital workers (327 occupations) with both self-reported and expert exposure assessments were studied. An underestimation of self-reported exposure was observed especially for formaldehyde (26.5% vs 32.7%, p=0.01), ammonia (7.4% vs 18.8%, p

Background It has been suggested that certain occupational exposures may play a role in breast cancer etiology. The recognition of high-risk occupations may give clues about potential mammary carcinogens in the work place. Methods We conducted a population-based case–control study in France including 1,230 breast cancer cases and 1,315 population controls with detailed information on lifetime work history. Odds ratios for women ever employed in an occupation or industry were adjusted for well-established risk factors for breast cancer. Results Adjusted odds ratios were marginally increased in some white-collar occupations, as well as in textile workers (2.4; 95% CI [0.9–6.0]), rubber and plastics product makers (1.8; 95% CI [0.9–3.5]), and in women employed for more than 10 years as nurses (1.4; 95% CI [0.9–2.1]) and as tailors/dressmakers (1.5; 95% CI [0.9–2.6]). The incidence of breast cancer was increased among women employed in the manufacture of chemicals, of non-metallic mineral products, and decreased among women in agriculture. Conclusions These findings suggest a possible role of occupational exposures in breast cancer, including night-shift work, solvents and endocrine disrupting chemicals and require further studies with detailed assessment of occupational exposures. Am. J. Ind. Med. 54:499–509, 2011. © 2011 Wiley-Liss, Inc.

Purpose: To study the association between occupational exposure to metals including chromium, cadmium, nickel, and arsenic compounds, within a population-based study design, while adjusting for confounding factors. Methods: A population-based lung cancer case-control study in Central/Eastern Europe and UK was conducted in 1998-2003, including 2,853 cases and 3,104 controls. Exposure to 70 occupational agents was assessed by local expert-teams for all subjects. Odds ratios (OR) for exposure to dust and fumes/mist of chromium, nickel, cadmium, arsenic, as well as inorganic pigment dust and inorganic acid mist, were adjusting for smoking, age, center, sex, and exposure to other occupational agents including the metals under study. Results: Exposure to arsenic (prevalence = 1.4%) was associated with an increased lung cancer risk ((OR) 1.65, 95% confidence interval (95% CI):1.05-2.58). For chromium dust (prevalence = 4.8%, OR: 1.25, 95% CI: 0.95-1.65), a linear upward trend for duration and cumulative exposure was observed. A weak association was observed for exposure to cadmium fumes (prevalence = 1.8%, OR: 1.19, 95% CI: 0.77-1.82), which was strongest for the highest category of cumulative exposure (OR: 2.04, 95% CI: 1.07-3.90). No increased risk was observed for inorganic acid mist, inorganic pigment dust, or nickel, after adjustment for other metals. An independent effect of nickel cannot be excluded, due to its collinearity with chromium exposure. Conclusions: Occupational exposure to metals is an important risk factor for lung cancer. Although the strongest risk was observed for arsenic, exposure to chromium dust was most important in terms of attributable risk due to its high prevalence. © 2011 Springer Science+Business Media B.V.

Introduction Le cancer broncho-pulmonaire (CBP) est la premiere cause de cancer professionnel. L’etude ICARE, etude cas-temoins en population generale ayant inclus tous les cas de CBP incidents, primitifs, histologiquement confirmes a pour objectif ici d’investiguer la relation entre activite professionnelle de soudage et risque de CBP. Methode Un questionnaire specifique « fumees de soudage » a permis d’obtenir une probabilite d’exposition et des donnees techniques professionnelles. Les analyses ont porte sur la population masculine et les regressions logistiques ont ete ajustees sur l’âge, le departement, le nombre total d’emplois occupes, un index de consommation tabagique et un index d’exposition cumulee a l’amiante obtenu a partir d’une matrice emploi-exposition specifique. Resultats Apres ajustement, le risque de CBP associe au metier de soudeur (code BIT 8.72) atteint 1,7 [1,1–2,5]. Il augmente plus la duree d’exposition augmente ( 10 ans : 2 [1–3,9]) et lorsque le delai par rapport a cette premiere activite depasse 35 ans. Un type precis de soudage n’a pas pu etre isole. Le risque atteint 2 [1,1–3,4] quand les pieces a souder sont recouvertes de peinture ou de graisse. Si le nettoyage s’effectue avec du trichloroethylene, il passe a 5,6 [1,3–23,6]. Conclusion Des moyens mecaniques plutot que chimiques devraient etre privilegies pour nettoyer les surfaces avant de les souder. En cas d’impossibilite, des moyens de prevention pour cette activite doivent etre renforces. Cette etude contribue a l’argumentaire de causalite entre CBP et exposition aux fumees de soudage en cas de demande de reconnaissance en maladie professionnelle.

Several studies have investigated the association between trichloroethylene (TCE) exposure and renal cell cancer (RCC) but findings were inconsistent. The analysis of a case control study has shown an increased risk of RCC among subjects exposed to high cumulative exposure. The aim of this complementary analysis is to assess the relevance of current exposure limits regarding a potential carcinogenic effect of TCE on kidney.Eighty-six cases and 316 controls matched for age and gender were included in the study. Successive jobs and working circumstances were described using a detailed occupational questionnaire. An average level of exposure to TCE was attributed to each job-period in turn. The main occupational exposures described in the literature as increasing the risk of RCC were assessed as well as non-occupational factors. A conditional logistic regression was performed to test the association between TCE and RCC risk. Three exposure levels were studied (average exposure during the eight-hour shift): 35ppm, 50ppm and 75ppm. Potential confounding factors identified were taken into account at the threshold limit of 10% (p=0.10) (body mass index [BMI], tobacco smoking, occupational exposures to cutting fluids and to other oils).Adjusted for tobacco smoking and BMI, the odd-ratios associated with exposure to TCE were respectively 1.62 [0.77-3.42], 2.80 [1.12-7.03] and 2.92 [0.85-10.09] at the thresholds of 35ppm, 50ppm and 75ppm. Among subjects exposed to cutting fluids and TCE over 50ppm, the OR adjusted for BMI, tobacco smoking and exposure to other oils was 2.70 [1.02-7.17].Results from the present study as well as those provided in the international literature suggest that current French occupational exposure limits for TCE are too high regarding a possible risk of RCC.

A hospital based case-control study was carried out in Lyon with the aim of assessing the association between haematologic malignancies and occupational exposures to 320 compounds. Job histories were obtained by questionnaire for 118 cases (52 non Hodgkin lymphomas, 48 acute myeloid leukemia, 18 others leukaemias), and 118 controls with diseases other than cancer from the same general hospital; controls were matched for sex, age and nationality. Systematic coding of exposures based on a blind analysis of job histories, was done by a team of experts in chemistry and occupational health. Mantel-Haenszel analysis was performed. Significantly elevated odds-ratio were observed for non Hodgkin lymphomas and exposure to mineral oils (14.86; 2.76-80.0), excavation dusts (3.91; 0.94-15.95), alkali compounds (2.90; 1.09-7.68), inks (2.47; 1.09-5.17). For inks, a dose-response relation was observed. Elevated odds-ratios appeared for acute myeloid leukaemias and arsenic compounds (3.02; 0.90-10.13) and lead compounds (3.70; 1.09-13.44). When regarding industrial activities, two of them are more frequently found: food industries (14 cases/5 controls), public works (12 cases/0 control). When regarding jobs, winding (6 cases/0 control), glass workers (8 cases/1 control) and warehousemen (10 cases and 4 controls) are more often seen among cases.

Objectives Occupational exposure assessment is one of the major challenges for retrospective community-based epidemiological studies. Having access to workplaces where study subjects spent their working days is basically impossible. Within the SYNERGY project we set out to test the feasibility of using existing measurement databases and measurement data from research institutes to estimate quantitatively occupational exposure to five major lung carcinogens. Methods Exposure data collection started September 2007 and finished August 2010. Existing exposure databases were identified and research institutes were approached in order to identify pertinent exposure measurement data. Individual air measurements data were entered following a standardized protocol. Results ExpoSYN database currently includes almost 370 000 personal and stationary air measurements from 21 mainly European countries. Measurements are distributed as follows: respirable crystalline silica (44%), asbestos (20%), chromium (16%), nickel (14%), and polycyclic aromatic hydrocarbons (7%). Measurement data cover a time period from 1951 until present, but great majority of measurements were collected after 1975. Quality of data differed considerably between data sources and we noted that information on sampling purpose and strategy was not always available in an informative way. In addition, other exposure concentration affecting variables like sampling and analytical methods were closely linked to country of origin of measurements, and therefore hampering adequate adjustment. Conclusions We have created a unique occupational exposure database covering a time period of more than 50 years. This database is being used to develop a country-, job-, and time-period-specific quantitative job exposure matrix (SYNJEM). SYNJEM will enable data-driven quantitative exposure assessment in the SYNERGY project.

Objectives: Matgeneis a program to develop job-exposure matrices (JEMs) adapted to the general population in France for the period since 1950. The aim is to create retrospective ex- posure assessment tools for estimating the prevalence of occupational exposure to various agents that can then be correlated to health-related parameters. Methods: JEMs were drawn up by a team of six industrial hygienists who based their assess- ments on available occupational measurement, economic and statistical data, and several thou- sand job descriptions from epidemiological studies performed in France since 1984. Each JEM is specific to one agent, assessing exposure for a set of homogeneous combinations (occupation 3 activity 3 period) according to two occupational classifications (ISCO 1968 and PCS 1994) and one economic activities classification (NAF 2000). The cells of the JEM carry an estimate of the probability and level of exposure. Level is estimated by the duration and intensity of expo- sure-linked tasks or by description of the tasks when exposure measurement data are lacking for the agent in question. The JEMs were applied to a representative sample of the French population in 2007, and prevalence for each exposure was estimated in various population groups. All docu- ments and data are available on a dedicated website. Results: By the end of 2010, 18 JEMs have been developed and eight are under development, concerning a variety of chemical agents: organic and mineral dust, mineral fibers, and sol- vents. By implementation in the French population, exposure prevalences were calculated at different dates and for complete careers, and attributable risk fractions were estimated for certain pathologies. Some of these results were validated by comparison with those of other programs. Discussion: Initial MatgeneJEMs results are in agreement with the French and interna- tional literature, thus validating the methodology. Exposure estimates precision, however, vary between agents and according to the amount of exposure measurement data available. These JEMs are important epidemiological tools, and improving their quality will require invest- ment in occupational health data harvesting, especially in the case of low-level exposures.

Background We investigated the association between exposure to trichloroethylene (TCE) and mutations in the von Hippel-Lindau (VHL) gene and the subsequent risk for renal cell carcinoma (RCC). Methods Cases were recruited from a case-control study previously carried out in France that suggested an association between exposures to high levels of TCE and increased risk of RCC. From 87 cases of RCC recruited for the epidemiological study, 69 were included in the present study. All samples were evaluated by a pathologist in order to identify the histological subtype and then be able to focus on clear cell RCC. The majority of the tumour samples were fixed either in formalin or Bouin's solutions. The majority of the tumours were of the clear cell RCC subtype (48 including 2 cystic RCC). Mutation screening of the 3 VHL coding exons was carried out. A descriptive analysis was performed to compare exposed and non exposed cases of clear cell RCC in terms of prevalence of mutations in both groups. Results In the 48 cases of RCC, four VHL mutations were detected: within exon 1 (c.332G>A, p.Ser111Asn), at the exon 2 splice site (c.463+1G>C and c.463+2T>C) and within exon 3 (c.506T>C, p.Leu169Pro). No difference was observed regarding the frequency of mutations in exposed versus unexposed groups: among the clear cell RCC, 25 had been exposed to TCE and 23 had no history of occupational exposure to TCE. Two patients with a mutation were identified in each group. Conclusion This study does not confirm the association between the number and type of VHL gene mutations and exposure to TCE previously described.