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Poole JA, Zamora-Sifuentes JL, De Las Vecillas L, Quirce S. Respiratory Diseases Associated With Organic Dust Exposure. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024:S2213-2198(24)00196-X. [PMID: 38423290 DOI: 10.1016/j.jaip.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/13/2024] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
Organic dusts are complex bioaerosol mixtures comprised of dust and par ticulate matter of organic origin. These include components from bacteria, fungi, pollen, and viruses to fragments of animals and plants commonplace to several environmental/occupational settings encompassing agriculture/farming, grain processing, waste/recycling, textile, cotton, woodworking, bird breeding, and more. Organic dust exposures are linked to development of chronic bronchitis, chronic obstructive pulmonary disease, asthma, asthma-like syndrome, byssinosis, hypersensitivity pneumonitis, and idiopathic pulmonary fibrosis. Risk factors of disease development include cumulative dust exposure, smoking, atopy, timing/duration, and nutritional factors. The immunopathogenesis predominantly involves Toll-like receptor signaling cascade, T-helper 1/T-helper 17 lymphocyte responses, neutrophil influx, and potentiation of manifestations associated with allergy. The true prevalence of airway disease directly attributed to organic dust, especially in a workplace setting, remains challenging. Diagnostic confirmation can be difficult and complicated by hesitancy from workers to seek medical care, driven by fears of potential labor-related consequence. Clinical respiratory and systemic presentations coupled with allergy testing, lung function patterns of obstructive versus restrictive disease, and radiological characteristics are typically utilized to delineate these various organic dust-associated respiratory diseases. Prevention, risk reduction, and management primarily focus on reducing exposure to the offending dust, managing symptoms, and preventing disease progression.
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Affiliation(s)
- Jill A Poole
- Division of Allergy & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Neb.
| | - Jose L Zamora-Sifuentes
- Division of Allergy & Immunology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Neb
| | | | - Santiago Quirce
- Department of Allergy, La Paz University of Hospital, IdiPAZ, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
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O' Brien C, Kingston L, Plant BJ, Coffey A. Lung Health in Farming: A Scoping Review. J Agromedicine 2023; 28:335-345. [PMID: 36773027 DOI: 10.1080/1059924x.2023.2178573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Lung disease is now recognized as an associated occupational hazard among farming and agricultural communities, however limited research surrounds lung health knowledge within our farming population. It is clear from this limited lack of knowledge that farming practices, perceptions and ideas relating to lung health are yet to be uncovered. This scoping review was conducted to identify what is known about lung health within farming and agricultural communities globally and to map the available evidence relating to lung health and lung health decline within this population. The objectives of this review were (1) focus on available lung health research from a global perspective specific to farming and agriculture relating to occupational lung exposures and (2) consolidate current knowledge, clearly identifying gaps within the literature. METHODS This systematic scoping review of the literature is guided by the Joanna Briggs Institute Methodology framework. There were 22 studies eligible for inclusion within the scoping review, providing an up-to-date review of research conducted on lung health and lung disease in farming occupations. RESULTS Results were grouped into three categories emerging from included studies: (1) focused on the prevalence of respiratory symptoms/disease within farming and agricultural occupations, (2) measurements of dust and particulate matter and correlating these with respiratory conditions, (3) common respiratory conditions linked to a decline in lung health among farming and agricultural occupations. Results identified no study focused on or referred to lung health, lung health knowledge or lung health awareness as an outcome, with all studies focusing on respiratory symptoms, development of lung disease and the common occupational hazards this population are exposed to. CONCLUSION This scoping review demonstrates the lack of literature to specifically map available evidence relating to lung health and farming occupations. Many respiratory symptoms and conditions can arise directly and indirectly from agricultural environments, however many of these cases could be prevented by lung health knowledge within the farming population. The results of this scoping review will be used to inform knowledge, awareness, education, health promotion and future research within this population.
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Affiliation(s)
- Ciara O' Brien
- Department of Nursing and Health Care Sciences, Munster Technological University, Kerry, Ireland.,Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Liz Kingston
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Barry J Plant
- Department of Medicine, University College Cork, Cork, Ireland
| | - Alice Coffey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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Jouneau S, Chapron A, Ropars C, Marette S, Robert AM, Gouyet T, Belleguic C, Rochefort-Morel C, Guillot S, Mailloux C, Desrues B, Viel JF. Prevalence and risk factors of asthma in dairy farmers: Ancillary analysis of AIRBAg. ENVIRONMENTAL RESEARCH 2022; 214:114145. [PMID: 35998695 DOI: 10.1016/j.envres.2022.114145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 07/07/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Prolonged occupational agricultural exposure is associated with an increase in asthma diagnosis. This study aimed to identify the prevalence and risk factors for asthma in dairy farmers. METHODS AIRBAg was a cross-sectional study including 1203 representative dairy farmers. They completed a self-administered questionnaire and underwent a health respiratory check-up. Referral to a pulmonologist was made for any participant with wheezing, dyspnoea, chronic bronchitis, a chronic cough or a FEV1/FEV6 ratio<80%. They underwent further examinations such as spirometry with a reversibility test. Controls (non-asthmatic dairy farmers and non-farm employees) were matched to each asthma case for sex and age (±5 years). The odds ratios (OR) between asthma and different risk factors were estimated using conditional multivariate logistic regression models. RESULTS Active asthma was diagnosed in 107 (8.9%) farmers. Compared with control dairy farmers, there was a positive association with family history of allergy (OR = 8.68; 95% CI [4.26-17.69]), personal history of eczema (OR = 3.39; 95% CI [1.61-7.13]), hay manipulation (OR = 5.36, 95% CI [1.59-18.01]), and a negative association with farm area (OR = 0.92; 95% CI [0.85-0.99]) and handling treated seeds (OR = 0.47; 95% CI [0.23-0.95]). Compared with control non-farm employees, there was a positive association between asthma and family history of allergy (OR = 95.82, 95% CI [12.55-731.47]). CONCLUSIONS The prevalence of active asthma in dairy farmers was somewhat higher than the rate observed in the general population but may be controlled by reducing exposure to airborne organic contaminants through occupational adaptions on farms.
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Affiliation(s)
- Stéphane Jouneau
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France; Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France
| | - Anthony Chapron
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France; Univ Rennes, CHU Rennes, Department of General Practice, F-35000, Rennes, France; INSERM, CIC-1414, Primary Care Research Team, F-35000, Rennes, France.
| | - Cécile Ropars
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France
| | - Solenne Marette
- Univ Rennes, CHU Rennes, Department of Occupational Pathology, University Hospital, F-35033, Rennes, France
| | - Ange-Marie Robert
- Univ Rennes, CHU Rennes, Department of Clinical Research, F-35033, Rennes, France
| | - Thomas Gouyet
- Univ Rennes, CHU Rennes, Department of Occupational Pathology, University Hospital, F-35033, Rennes, France
| | - Chantal Belleguic
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France
| | | | - Stéphanie Guillot
- Univ Rennes, CHU Rennes, Department of Pulmonary Function Tests, F-35033, Rennes, France
| | - Carole Mailloux
- Mutualité Sociale Agricole des Portes de Bretagne, F-35170, Bruz, France
| | - Benoît Desrues
- Univ Rennes, CHU Rennes, Department of Respiratory Medicine, F-35033, Rennes, France; INSERM, U1242-COSS, CLCC Eugène Marquis, Rennes 1 University, F-35000, Rennes, France
| | - Jean-François Viel
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France; Univ Rennes, CHU Rennes, Department of Epidemiology and Public Health, F-35033, Rennes, France
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Petit P, Bosson-Rieutort D, Maugard C, Gondard E, Ozenfant D, Joubert N, François O, Bonneterre V. The TRACTOR Project: TRACking and MoniToring Occupational Risks in Agriculture Using French Insurance Health Data (MSA). Ann Work Expo Health 2021; 66:402-411. [PMID: 34562080 DOI: 10.1093/annweh/wxab083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES A vast data mining project called 'TRACking and moniToring Occupational Risks in agriculture' (TRACTOR) was initiated in 2017 to investigate work-related health events among the entire French agricultural workforce. The goal of this work is to present the TRACTOR project, the challenges faced during its implementation, to discuss its strengths and limitations and to address its potential impact for health surveillance. METHODS Three routinely collected administrative health databases from the National Health Insurance Fund for Agricultural Workers and Farmers (MSA) were made available for the TRACTOR project. Data management was required to properly clean and prepare the data before linking together all available databases. RESULTS After removing few missing and aberrant data (4.6% values), all available databases were fully linked together. The TRACTOR project is an exhaustive database of agricultural workforce (active and retired) from 2002 to 2016, with around 10.5 million individuals including seasonal workers and farm managers. From 2012 to 2016, a total of 6 906 290 individuals were recorded. Half of these individuals were active and 46% had at least one health event (e.g. declared chronic disease, reimbursed drug prescription) during this 5-year period. CONCLUSIONS The assembled MSA databases available in the TRACTOR project are regularly updated and represent a promising and unprecedent dataset for data mining analysis dedicated to the early identification of current and emerging work-related illnesses and hypothesis generation. As a result, this project could help building a prospective integrated health surveillance system for the benefit of agricultural workers.
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Affiliation(s)
- Pascal Petit
- Univ. Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC, Grenoble, France
| | - Delphine Bosson-Rieutort
- School of Public Health, Department of Management, Evaluation and Health Policy, University of Montreal, Montreal, Canada.,Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
| | - Charlotte Maugard
- Univ. Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC, Grenoble, France
| | - Elise Gondard
- Univ. Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC, Grenoble, France
| | | | | | - Olivier François
- Univ. Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC, Grenoble, France
| | - Vincent Bonneterre
- Univ. Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC, Grenoble, France
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Kitjakrancharoensin P, Yasan K, Hongyantarachai K, Ratanachokthorani K, Thammasarn J, Kuwuttiwai D, Ekanaprach T, Jittakarm R, Nuntapravechpun R, Hotarapavanon S, Kulrattanarak S, Tongkaew S, Deemeechai S, Mungthin M, Rangsin R, Wongsrichanalai V, Sakboonyarat B. Prevalence and Risk Factors of Chronic Obstructive Pulmonary Disease Among Agriculturists in a Rural Community, Central Thailand. Int J Chron Obstruct Pulmon Dis 2020; 15:2189-2198. [PMID: 32982211 PMCID: PMC7501975 DOI: 10.2147/copd.s262050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 08/31/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose The present study aimed to determine the prevalence and risk factors of chronic obstructive pulmonary disease (COPD) among agriculturists in a remote rural community in central Thailand. Methods A cross-sectional study was conducted in January 2020. Face-to-face interviews were conducted using standardized questionnaires to determine demographic characteristics and risk behaviors. COPD was defined by the spirometric criterion for airflow limitation constituting a postbronchodilator fixed ratio of FEV1/FVC <0.70 following the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines 2019. Multivariable logistic regression analysis was used to determine the risk factors for COPD, and the magnitude of association was presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI). Results A total of 546 agriculturists were enrolled in the study. The overall prevalence of COPD was 5.5% (95% CI: 3.6–7.4). The prevalence of COPD among males was 8.0% (95% CI: 4.7–11.3), and 3.2% (95% CI: 1.1–5.2) among females. The risk factors of COPD included age ≥60 years old (AOR 2.7, 95% CI: 1.1–7.0), higher intensity of smoking (AOR 1.1, 95% CI: 1.0–1.1), swine farm worker (AOR 4.1, 95% CI: 1.7–10.3), cattle farm worker (AOR 3.3, 95% CI: 1.4–8.2) and home cooking (AOR 2.7, 95% CI: 0.8–9.7). Conclusion Our data emphasized that COPD was one of the significant health problems among agriculturists in a rural community. Agricultural jobs such as animal farmers and behavioral factors such as smoking were associated with COPD. Effective public health interventions, especially, modifying risk behaviors, should be promoted in remote rural areas to prevent the disease and reduce its morbidity and mortality.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Mathirut Mungthin
- Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
| | | | - Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
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Soumagne T, Degano B, Guillien A, Annesi-Maesano I, Andujar P, Hue S, Adotevi O, Jouneau S, Botebol M, Laplante JJ, Roche N, Dalphin JC. Characterization of chronic obstructive pulmonary disease in dairy farmers. ENVIRONMENTAL RESEARCH 2020; 188:109847. [PMID: 32846639 DOI: 10.1016/j.envres.2020.109847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/19/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although farming is often considered a risk factor for COPD, data regarding the burden and characteristics of COPD in dairy farmers are sparse and conflicting. OBJECTIVES To characterize COPD in dairy farmers. METHODS 4788 subjects entered two parallel COPD screening programs, one in agricultural workers and one in general practice from 2011 to 2015. Subjects with COPD were invited to participate in the characterization phase of the study. Those who accepted were included in two subgroups: dairy farmers with COPD (DF-COPD) (n = 101) and non-farmers with COPD (NF-COPD) (n = 85). Patients with COPD were frequency-matched with subjects with normal spirometry for age, sex and tobacco smoking (pack-years and status) (DF-controls n = 98, NF-controls n = 89). All subjects from these four groups underwent lung function and exercise testing, questionnaires and blood analysis. RESULTS The frequency of COPD in dairy farmers was 8.0% using the GOLD criterion and 6.2% using the lower limit of normal criterion and was similar in non-farming subjects (7.3% and 5.2%, respectively) although dairy farmers had lower tobacco consumption (screening phase). DF-COPD had better pulmonary function, exercise capacity and quality of life, fewer symptoms and comorbidities than NF-COPD, and higher levels of some Th2 biomarkers (MCP-2, periostin) (characterization phase). In farmers, COPD was not related to occupational exposure factors, supporting the role of host factors. CONCLUSION COPD secondary to organic dust exposure (dairy farming) appears less severe and associated with fewer comorbidities than COPD secondary to tobacco smoking.
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Affiliation(s)
- Thibaud Soumagne
- Service de Pneumologie, Oncologie Thoracique et Allergologie Respiratoire, CHRU de Besançon, France.
| | - Bruno Degano
- Service Hospitalier Universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, France; Université Grenoble Alpes, Grenoble, France
| | - Alicia Guillien
- Equipe d'Epidémiologie Environnementale, Institute for Advanced Biosciences, Centre de Recherche UGA, INSERM U1209, CNRS UMR 5309, Grenoble, France
| | | | - Pascal Andujar
- Centre Hospitalier Intercommunal de Créteil, Service de Pathologie Professionnelle et de l'Environnement, Créteil, France; INSERM, Unité U955 and Université Paris-Est Créteil, Créteil, France
| | - Sophie Hue
- INSERM, Unité U955 and Université Paris-Est Créteil, Créteil, France; Immunologie-Biologie, Hôpital Henri-Mondor, AP-HP, Paris, France
| | - Olivier Adotevi
- INSERM, EFS BFC, UMR1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Université de Bourgogne Franche-Comté, Besançon, France
| | - Stéphane Jouneau
- Department of Respiratory Medicine, Rennes University Hospital, Rennes, France; UMR1085, IRSET, Rennes 1 University, Rennes, France
| | - Martial Botebol
- Fédération des Maisons de Santé Comtoises (FéMaSaC), Beure, France
| | | | - Nicolas Roche
- Service de Pneumologie, Hôpital Cochin, AP-HP, Centre Université de Paris, Institut Cochin (UMR1016), Paris, France
| | - Jean-Charles Dalphin
- Service de Pneumologie, Oncologie Thoracique et Allergologie Respiratoire, CHRU de Besançon, France; UMR CNRS Chrono Environnement, Université de Franche-Comté, Besançon, France
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Jan S, Metten MA, Chapron A, Marette S, Robert AM, Guillot S, Mailloux C, Jouneau S, Viel JF. Use of the COPD Assessment Test (CAT) to screen for COPD in dairy farmers: AIRBAg study. CLINICAL RESPIRATORY JOURNAL 2020; 14:813-821. [PMID: 32386451 DOI: 10.1111/crj.13201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 03/13/2020] [Accepted: 04/24/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES People at risk of chronic obstructive pulmonary disease (COPD) can benefit from appropriate medical management before severe symptoms appear. This study assesses the value of the COPD Assessment Test (CAT) questionnaire for screening dairy farmers, who tend to be slow or reluctant to seek health care. METHODS During the time period 2012-2017, 2089 randomly selected dairy farmers in Brittany (France) were invited to complete self-administered questionnaires (including the CAT) and to undergo an occupational health check-up using an electronic mini-spirometer and conventional spirometry. Those showing symptoms suggestive of COPD and/or a ratio FEV1 /FEV6 < 80% were sent to a pulmonologist for a further check-up, including spirometry with a reversibility test. Multivariate logistic models based on CAT scores and socio-demographic or work-related factors were developed to predict COPD. RESULTS The 1231 farmers who underwent the occupational health check-up included 1203 who met the inclusion/exclusion criteria. Pulmonologist identified 16 (1.3%) cases of COPD. A multivariate logistic regression model (covariates: CAT sum score, on-farm time, BMI, smoking status, free-stall mulching) provided an area under the receiver-operating characteristic curve (AUC) of 0.87 (95% CI: 0.75-0.98). Using a cut-off of 0.007 gave a sensitivity of 93.8% and a specificity of 62.4%. Another model that included CAT breathlessness and the same covariates performed marginally better (AUC = 0.88, 95% CI: 0.77-0.98). CONCLUSION Our predictive models can both benefit dairy farmers by providing early diagnosis and management of their COPD and avoid unnecessary, costly spirometry during the screening process.
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Affiliation(s)
- Simon Jan
- Department of Epidemiology and Public Health, University Hospital, Rennes, France
| | - Marie-Astrid Metten
- Department of Epidemiology and Public Health, University Hospital, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | - Anthony Chapron
- Department of General Practice, Rennes 1 University, Rennes, France.,INSERM, CIC-1414, Primary Care Research Team, Rennes, France
| | - Solenne Marette
- Department of Occupational Medicine, University Hospital, Rennes, France
| | - Ange-Marie Robert
- Department of Clinical Research, University Hospital, Rennes, France
| | - Stéphanie Guillot
- Department of Pulmonary Function Tests, University Hospital, Rennes, France
| | - Carole Mailloux
- Mutualité Sociale Agricole des Portes de Bretagne, Bruz, France
| | - Stéphane Jouneau
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France.,Department of Respiratory Medicine, University Hospital, Rennes, France
| | - Jean-François Viel
- Department of Epidemiology and Public Health, University Hospital, Rennes, France.,Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
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