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Petit P, Chamot S, Al-Salameh A, Cancé C, Desailloud R, Bonneterre V. Farming activity and risk of treated thyroid disorders: Insights from the TRACTOR project, a nationwide cohort study. ENVIRONMENTAL RESEARCH 2024; 249:118458. [PMID: 38365059 DOI: 10.1016/j.envres.2024.118458] [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: 11/20/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Epidemiological data regarding thyroid diseases are lacking, in particular for occupationally exposed populations. OBJECTIVES To compare the risk of hypothyroidism and hyperthyroidism between farming activities within the complete population of French farm managers (FMs). METHODS Digital health data from retrospective administrative databases, including insurance claims and electronic health/medical records, was employed. This cohort data spanned the entirety of French farm managers (FMs) who had undertaken work at least once from 2002 to 2016. Survival analysis with the time to initial medication reimbursement as timescale was used to examine the association (hazard ratio, HR) between 26 specific farming activities and both treated hypothyroidism and hyperthyroidism. A distinct model was developed for each farming activity, comparing FMs who had never engaged in the specific farming activity between 2002 and 2016 with those who had. All analyses were adjusted for potential confounders (e.g., age), and sensitivity analyses were conducted. RESULTS Among 1088561 FMs (mean age 46.6 [SD 14.1]; 31% females), there were 31834 hypothyroidism cases (75% females) and 620 hyperthyroidism cases (67% females), respectively. The highest risks were observed for cattle activities for both hyperthyroidism (HR ranging from 1.75 to 2.42) and hypothyroidism (HR ranging from 1.41 to 1.44). For hypothyroidism, higher risks were also observed for several animal farming activities (pig, poultry, and rabbit), as well as fruit arboriculture (HR = 1.22 [1.14-1.31]). The lowest risks were observed for activities involving horses. Sex differences in the risk of hypothyroidism were observed for eight activities, with the risk being higher for males (HR = 1.09 [1.01-1.20]) than females in viticulture (HR = 0.97 [0.93-1.00]). The risk of hyperthyroidism was two times higher for male dairy farmers than females. DISCUSSION Our findings offer a comprehensive overview of thyroid disease risks within the FM community. Thyroid ailments might not stem from a single cause but likely arise from the combined effects of various causal agents and triggering factors (agricultural exposome). Further investigation into distinct farming activities-especially those involving cattle-is essential to pinpoint potential risk factors that could enhance thyroid disease monitoring in agriculture.
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Affiliation(s)
- Pascal Petit
- CHU Grenoble Alpes, Centre Régional de Pathologies Professionnelles et Environnementales, 38000, Grenoble, France; Univ. Grenoble Alpes, AGEIS, 38000, Grenoble, France.
| | - Sylvain Chamot
- Regional Center for Occupational and Environmental Diseases of Hauts-de-France, Amiens University Hospital, 1 rond point du Pr Christian Cabrol, 80000, Amiens, France; Péritox (UMR_I 01), UPJV/INERIS, University of Picardy Jules Verne, Chemin du Thil, 80025, Amiens, France
| | - Abdallah Al-Salameh
- Péritox (UMR_I 01), UPJV/INERIS, University of Picardy Jules Verne, Chemin du Thil, 80025, Amiens, France; Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, 1 rond point du Pr Christian Cabrol, 80054, Amiens, France
| | - Christophe Cancé
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, 38000, Grenoble, France
| | - Rachel Desailloud
- Péritox (UMR_I 01), UPJV/INERIS, University of Picardy Jules Verne, Chemin du Thil, 80025, Amiens, France; Department of Endocrinology, Diabetes Mellitus and Nutrition, Amiens University Hospital, 1 rond point du Pr Christian Cabrol, 80054, Amiens, France
| | - Vincent Bonneterre
- CHU Grenoble Alpes, Centre Régional de Pathologies Professionnelles et Environnementales, 38000, Grenoble, France; Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, 38000, Grenoble, France
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Petit P, Gondard E, Gandon G, Moreaud O, Sauvée M, Bonneterre V. Agricultural activities and risk of Alzheimer's disease: the TRACTOR project, a nationwide retrospective cohort study. Eur J Epidemiol 2024; 39:271-287. [PMID: 38195954 PMCID: PMC10995077 DOI: 10.1007/s10654-023-01079-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 11/02/2023] [Indexed: 01/11/2024]
Abstract
Data regarding Alzheimer's disease (AD) occurrence in farming populations is lacking. This study aimed to investigate whether, among the entire French farm manager (FM) workforce, certain agricultural activities are more strongly associated with AD than others, using nationwide data from the TRACTOR (Tracking and monitoring occupational risks in agriculture) project. Administrative health insurance data (digital electronic health/medical records and insurance claims) for the entire French agricultural workforce, over the period 2002-2016, on the entire mainland France were used to estimate the risk of AD for 26 agricultural activities with Cox proportional hazards model. For each analysis (one for each activity), the exposed group included all FMs that performed the activity of interest (e.g. crop farming), while the reference group included all FMs who did not carry out the activity of interest (e.g. FMs that never farmed crops between 2002 and 2016). There were 5067 cases among 1,036,069 FMs who worked at least one year between 2002 and 2016. Analyses showed higher risks of AD for crop farming (hazard ratio (HR) = 3.72 [3.47-3.98]), viticulture (HR = 1.29 [1.18-1.42]), and fruit arboriculture (HR = 1.36 [1.15-1.62]). By contrast, lower risks of AD were found for several animal farming types, in particular for poultry and rabbit farming (HR = 0.29 [0.20-0.44]), ovine and caprine farming (HR = 0.50 [0.41-0.61]), mixed dairy and cow farming (HR = 0.46 [0.37-0.57]), dairy farming (HR = 0.67 [0.61-0.73]), and pig farming (HR = 0.30 [0.18-0.52]). This study shed some light on the association between a wide range of agricultural activities and AD in the entire French FMs population.
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Affiliation(s)
- Pascal Petit
- CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, Univ. Grenoble Alpes, 38000, Grenoble, France.
- Centre Régional de Pathologies Professionnelles et Environnementales, CHU Grenoble Alpes, 38000, Grenoble, France.
- AGEIS, Univ. Grenoble Alpes, 38000, Grenoble, France.
| | - Elise Gondard
- CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, Univ. Grenoble Alpes, 38000, Grenoble, France
| | - Gérald Gandon
- Centre Régional de Pathologies Professionnelles et Environnementales, CHU Grenoble Alpes, 38000, Grenoble, France
| | - Olivier Moreaud
- Centre Mémoire de Ressources et de Recherche, CHU Grenoble Alpes, 38000, Grenoble, France
- Laboratoire de Psychologie et Neurocognition, UMR 5105, CNRS, LPNC, Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, 38000, Grenoble, France
| | - Mathilde Sauvée
- Centre Mémoire de Ressources et de Recherche, CHU Grenoble Alpes, 38000, Grenoble, France
- Laboratoire de Psychologie et Neurocognition, UMR 5105, CNRS, LPNC, Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, 38000, Grenoble, France
| | - Vincent Bonneterre
- CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, Univ. Grenoble Alpes, 38000, Grenoble, France
- Centre Régional de Pathologies Professionnelles et Environnementales, CHU Grenoble Alpes, 38000, Grenoble, France
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Petit P, Gandon G, Dubuc M, Vuillerme N, Bonneterre V. Agricultural activities and risk of treatment for depressive disorders among the entire French agricultural workforce: the TRACTOR project, a nationwide retrospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 31:100674. [PMID: 37408876 PMCID: PMC10318497 DOI: 10.1016/j.lanepe.2023.100674] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023]
Abstract
Background Although depression is a major issue among farming population, to date, there have been few studies on specific agricultural activities. We aimed to investigate whether, among the entire French farm manager (FM) workforce, certain agricultural activities are more strongly associated with depression than others. Methods This nationwide retrospective cohort study used data from an administrative health database available to the TRACTOR project. This database pertains to the entire French agricultural workforce (overseas workers not included). Data were analyzed from January 2021 to December 2022. All FMs that worked at least once over the period 2002-2016 were included. The outcome measure was the association between 26 agricultural activities and the risk of depression measured as hazard ratios (HRs) after adjusting for age, sex, and pre-existing medical comorbidities. The time to first depression insurance declaration, or first antidepressant prescription claim was used as the underlying timescale. For each activity, the reference/control group included all FMs that never performed the considered activity between 2002 and 2016, while the exposed group included FMs that performed the considered activity at least once from 2002 to 2016. Four sensitivity analyses were conducted to test hypotheses, and to address potential sources of bias. Findings There were 84,507 (7.76%; 28.2 cases per 1000 person-years) depression cases among 1,088,561 FMs (mean age 46.6 [SD 14.1]). Compared to other activities, dairy farming (HR = 1.37, 95% confidence interval: 1.32-1.42), cow farming (HR = 1.53 [1.47-1.59]), poultry and rabbit farming (HR = 1.37 [1.27-1.50]), and mixed farming (HR = 1.30 [1.24-1.36]) were more strongly associated with depression. Sex differences were observed, with most of the time, risks higher for females than for males. Interpretation Agricultural activities at risk of depression among the entire French agricultural workforce were identified. These findings do represent a crucial first step on the road to implement effective preventive measures against depression to determine where additional resources should be allocated to screen for depression, along with intervention. Funding MIAI@Grenoble Alpes, and Mutualité Sociale Agricole.
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Affiliation(s)
- Pascal Petit
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, 38000 Grenoble, France
- CHU Grenoble Alpes, Centre Régional de Pathologies Professionnelles et Environnementales, 38000 Grenoble, France
- Univ. Grenoble Alpes, AGEIS, 38000 Grenoble, France
| | - Gérald Gandon
- CHU Grenoble Alpes, Centre Régional de Pathologies Professionnelles et Environnementales, 38000 Grenoble, France
| | - Marc Dubuc
- CHU Grenoble Alpes, Service de psychiatrie (psychiatrie de liaison/VigilanS), 38000 Grenoble, France
| | - Nicolas Vuillerme
- Univ. Grenoble Alpes, AGEIS, 38000 Grenoble, France
- Institut Universitaire de France, Paris, France
| | - Vincent Bonneterre
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, 38000 Grenoble, France
- CHU Grenoble Alpes, Centre Régional de Pathologies Professionnelles et Environnementales, 38000 Grenoble, France
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Petit P, Gandon G, Chabardès S, Bonneterre V. Agricultural activities and risk of central nervous system tumors among French farm managers: Results from the TRACTOR project. Int J Cancer 2022; 151:1737-1749. [PMID: 35781883 PMCID: PMC9796624 DOI: 10.1002/ijc.34197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/02/2022] [Accepted: 06/21/2022] [Indexed: 01/01/2023]
Abstract
The etiology of central nervous system (CNS) tumors is complex and involves many suspected risk factors. Scientific evidence remains insufficient, in particular in the agricultural field. The goal of our study was to investigate associations between agricultural activities and CNS tumors in the entire French farm manager workforce using data from the TRACTOR project. The TRACTOR project hold a large administrative health database covering the entire French agricultural workforce, over the period 2002-2016, on the whole French metropolitan territory. Associations were estimated for 26 activities and CNS tumors using Cox proportional hazards model, with time to first CNS tumor insurance declaration as the underlying timescale, adjusting for sex, age and geographical area. There were 1017 cases among 1 036 069 farm managers, including 317 meningiomas and 479 gliomas. Associations varied with tumor types, sex and types of crop and animal farming. Analyses showed several increased risks of CNS tumors, in particular for animal farming. The main increases in risk were observed for meningioma in mixed dairy and cow farming (hazard ratio [HR] = 1.75, 95% confidence interval [CI]: 1.09-2.81) and glioma in pig farming (HR = 2.28, 95% CI: 1.37-3.80). Our study brings new insights on the association of a wide range of agricultural activities and CNS tumor and subtype-specific risks in farm managers. Although these findings need to be corroborated in further studies and should be interpreted cautiously, they could have implications for enhancing CNS tumor surveillance in agriculture.
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Affiliation(s)
- Pascal Petit
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMCGrenobleFrance
| | - Gérald Gandon
- CHU Grenoble AlpesOccupational Diseases CenterGrenobleFrance
| | - Stéphan Chabardès
- Univ. Grenoble Alpes, INSERM, U1216, CHU Grenoble Alpes, Grenoble Institut NeurosciencesGrenobleFrance
| | - Vincent Bonneterre
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMCGrenobleFrance
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