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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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Michel M, Arvis Souaré M, Dindorf C, Danguy V, Chevreul K. Health check-ups for the French under-consuming agricultural population: A pilot evaluation of the Instants santé MSA program. Rev Epidemiol Sante Publique 2023; 71:101420. [PMID: 36610246 DOI: 10.1016/j.respe.2022.101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 11/17/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The social protection scheme in charge of farmers and agricultural employees (MSA) in France has developed a two-step health promotion program with a nurse appointment followed by a consultation with a doctor of the participant's choosing to reach its under-consuming beneficiaries and enroll them back into a care pathway. Our objective was to carry out a pilot evaluation of this program. METHODS The evaluation was carried out on the population invited during the second semester of 2017 using data from the program's service providers (date of invitation, of nurse appointment…), regional MSA bodies (consultation voucher), and reimbursement data (other care consumption). Participation rates were calculated overall and by participant characteristics. Medical needs were identified during the nurse appointment and new care pathways were assessed using reimbursement data. Multivariable regression models identified factors associated with participation. RESULTS 2366 beneficiaries were included in the analysis. 1559 (65.89%) were men and mean age was 52.41 (standard deviation = 14.86). 409 (17.29%) attended the nurse appointment. There was a significant increase in participation with age, in farmers vs. employees (odds ratio = 1.905, 95% confidence interval = 1.393-2.604), and in people living in the most disadvantaged areas (odds ratio = 1.579, 95% confidence interval=1.079-2.312). Participation to the consultation following the nurse appointment was high (62.35%-73.11%). 87.53% of participants had at least one medical need, and new care pathways were more frequent among those who had attended the nurse appointment (55.50% vs. 34.80%, p < 0.0001). CONCLUSIONS This pilot evaluation shows promising results which need to be confirmed with a national evaluation of the program and longer-term evidence.
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Affiliation(s)
- Morgane Michel
- Université Paris Cité, ECEVE, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, 75004 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France; INSERM, ECEVE UMR 1123, 75010 Paris, France.
| | - Mariam Arvis Souaré
- Direction du contrôle médical et de l'offre de soins, Caisse centrale de la Mutualité Sociale Agricole, 93000 Bobigny, France
| | - Christel Dindorf
- Université Paris Cité, ECEVE, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, 75004 Paris, France; INSERM, ECEVE UMR 1123, 75010 Paris, France
| | - Véronique Danguy
- Département Études et évaluation en santé, Caisse centrale de la Mutualité Sociale Agricole, 93000 Bobigny, France
| | - Karine Chevreul
- Université Paris Cité, ECEVE, 75010 Paris, France; Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, 75004 Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, 75019 Paris, France; INSERM, ECEVE UMR 1123, 75010 Paris, France
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Haruyama K, Yokomichi H, Yamagata Z. Farm working experience could reduce late-life dependency duration among Japanese older adults: The Yamanashi Healthy-Active Life Expectancy cohort study based on the STROBE guidelines. Medicine (Baltimore) 2020; 99:e22248. [PMID: 32957372 PMCID: PMC7505340 DOI: 10.1097/md.0000000000022248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
With the advance of medical care, the duration of dependency on nursing care in later life has increased worldwide. There is a question of whether farm work could extend or shorten the dependency duration. We investigated the association between farm work experience and the duration of dependency on nursing support or care in late life.We randomly selected 600 adults aged ≥65 years, who were independent and not hospitalized, as part of the Yamanashi Healthy-Active Life Expectancy cohort and followed them for 13 years. We defined the duration of dependency as the time from reception of long-term care insurance benefits to death, and we adjusted for multiple covariates.We analyzed data from 225 adults (139 men and 86 women) who died during the follow-up period. Ninety four had received long-term care benefits. Mean age was 79.6 years (standard deviation [SD]: 6.3) in individuals with farm work experience and 80.1 years (SD: 7.2) in individuals without farm work experience. The estimated duration of dependency on long-term care was 1.3 years (standard error [SE]: 0.4) in individuals with farm work experience vs 2.1 years (SE: 0.5) in individuals without farm work experience (P = .01). The estimated duration of dependency in individuals with farm work experience and without farm work experience was 0.4 years (SE: 0.5) vs 1.3 years (SE: 0.6) in men respectively (P = .03) and 1.6 years (SE: 0.9) vs 2.4 years (SE: 0.9) in women, respectively (P = .16). The sensitivity analysis yielded an estimated duration of 1.2 years (SE: 0.5) in those with farm work experience and 2.3 years (SE: 0.5) in those without farm work experience (P = .004).Individuals with farm work experience required less long-term care prior to death, suggesting that agricultural and physical activities promote health. Policymakers focusing on preventing the need for nursing care in older populations could consider promoting farming or gardening.
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Affiliation(s)
- Kayo Haruyama
- Department of Occupational Therapy, Iryo Sosei University, 5-5-1 Chuodai Iino, Iwaki City, Fukushima
| | - Hiroshi Yokomichi
- Department of Health Sciences, Graduate School of Medicine, University of Yamanashi, Shimokato, Chuo City, Yamanashi, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, Graduate School of Medicine, University of Yamanashi, Shimokato, Chuo City, Yamanashi, Japan
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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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Maesano CN, Caillaud D, Youssouf H, Banerjee S, Prud'Homme J, Audi C, Horo K, Toloba Y, Ramousse O, Annesi-Maesano I. Indoor exposure to particulate matter and volatile organic compounds in dwellings and workplaces and respiratory health in French farmers. Multidiscip Respir Med 2019; 14:33. [PMID: 31592111 PMCID: PMC6774217 DOI: 10.1186/s40248-019-0194-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/14/2019] [Indexed: 01/31/2023] Open
Abstract
Introduction Few investigations have related objective assessments of indoor air pollutants to respiratory health in farmers, in spite of the many rural environmental hazards to which they are exposed. Chemical air pollution has been particularly neglected. Objective We investigated the relationships of indoor exposure to particulate matter (PM) and volatile organic compounds (VOCs) to respiratory health in farmers. Methods Nineteen VOCs (5 families) and PM (from ultrafine to total suspended particles (TSP)) were objectively assessed in dwellings and workplaces in 109 French farmers during a week. To take into account multiple exposures, scores of exposure were computed for total VOCs and VOCs families. Individuals filled a standardized questionnaire and underwent spirometry with bronchodilation test. Results On average, VOCs concentrations were higher in dwellings than in workplaces. The reverse was observed for PM. When considering the mean concentrations of air pollutants for the whole farm (dwellings + workplaces), asthma (9.3%) was positively associated with elevated exposure to benzene (adjusted odds-ratio (ORa) = 6.64, 95%CI: 1.56–28.27), trichloroethylene (4.80, 1.00–23.30) and halogenated hydrocarbons score (2.9, 95% 1.3–6.8). Early airway obstruction (FEF25–75 < 80%, with normal FEV1 and FVC and FEV/FVC ≥ 70%) (29.8%) was related to elevated exposure to 2-butoxyetylacetate (11.49, 1.55–85.37) and glycol ethers score (2.0; 1.0–4.1) in the whole farm and to PM2.5 (ORa = 5.26, 95% CI: 1.09–25.28) in the granary/stable. The risk of Chronic Obstructive Pulmonary Diseases (FEV/FVC < 70%) (COPD) (4.26%) was found to be larger with elevated exposure to aldehydes (OR = 3.95, 1.09–14.26). Conclusion Indoor chemical air pollution is detrimental to farmers’ respiratory health. More epidemiological investigations with detailed exposure assessments and clinical measures of respiratory effects are needed in rural settings to corroborate these findings.
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Affiliation(s)
- Cara Nichole Maesano
- 1Epidemiology of Allergic and Respiratory diseases department (EPAR), Institut Pierre Louis d'Épidémiologie et de Santé Publique, INSERM, Sorbonne Université, Medical School St Antoine, 27 rue Chaligny, 75571 Paris CEDEX 12, France
| | - Denis Caillaud
- 2Service de Pneumologie, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Hassani Youssouf
- 1Epidemiology of Allergic and Respiratory diseases department (EPAR), Institut Pierre Louis d'Épidémiologie et de Santé Publique, INSERM, Sorbonne Université, Medical School St Antoine, 27 rue Chaligny, 75571 Paris CEDEX 12, France
| | - Soutrik Banerjee
- 1Epidemiology of Allergic and Respiratory diseases department (EPAR), Institut Pierre Louis d'Épidémiologie et de Santé Publique, INSERM, Sorbonne Université, Medical School St Antoine, 27 rue Chaligny, 75571 Paris CEDEX 12, France
| | - Julie Prud'Homme
- 1Epidemiology of Allergic and Respiratory diseases department (EPAR), Institut Pierre Louis d'Épidémiologie et de Santé Publique, INSERM, Sorbonne Université, Medical School St Antoine, 27 rue Chaligny, 75571 Paris CEDEX 12, France
| | - Christelle Audi
- 1Epidemiology of Allergic and Respiratory diseases department (EPAR), Institut Pierre Louis d'Épidémiologie et de Santé Publique, INSERM, Sorbonne Université, Medical School St Antoine, 27 rue Chaligny, 75571 Paris CEDEX 12, France
| | - Kigninlman Horo
- 3Intensive Care Unit and Respiratory Diseases Department, CHU, Cocody, Abidjan, Côte d'Ivoire
| | - Yacouba Toloba
- Service de pneumologie, CHU du Point-G, Bamako, E1631 Mali
| | | | - Isabella Annesi-Maesano
- 1Epidemiology of Allergic and Respiratory diseases department (EPAR), Institut Pierre Louis d'Épidémiologie et de Santé Publique, INSERM, Sorbonne Université, Medical School St Antoine, 27 rue Chaligny, 75571 Paris CEDEX 12, France
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Barrera C, Rocchi S, Degano B, Soumagne T, Laurent L, Bellanger AP, Laplante JJ, Millon L, Dalphin JC, Reboux G. Microbial exposure to dairy farmers' dwellings and COPD occurrence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2019; 29:387-399. [PMID: 30461300 DOI: 10.1080/09603123.2018.1545900] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/05/2018] [Indexed: 06/09/2023]
Abstract
Dairy farming is a risk factor for chronic obstructive pulmonary disease (COPD). The aim was to determine predictive markers either in blood samples or in dwelling dust samples by comparing COPD and healthy controls with or without farming activity. Dust was collected and analyzed by real-time quantitative PCR. ELISA and DELFIA® were performed to assay the level of specific IgG and IgE of 10 targeted microorganisms. The dwelling exposure of farmers was higher than in the non-farmers (Especially Eurotium amstelodami and Lichtheimia corymbifera). The IgG response against Wallemia sebi and Saccharopolyspora rectivirgula was more often higher in the farmers than the non-farmers. However, exposure and sensitization to the microorganisms tested cannot explain the occurrence of COPD in the dairy farmers' population. COPD development is probably caused by multiple factors associated with exposure over a period of several years.
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Affiliation(s)
- Coralie Barrera
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Steffi Rocchi
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Bruno Degano
- c Department of Functional Explorations , University Hospital , Besançon , France
| | - Thibaud Soumagne
- d Department of Pneumology , University Hospital , Besançon , France
| | - Lucie Laurent
- c Department of Functional Explorations , University Hospital , Besançon , France
| | - Anne-Pauline Bellanger
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Jean-Jacques Laplante
- e Department of Occupational Diseases , Social and Agricultural Mutual (MSA) of Franche-Comté , Besançon , France
| | - Laurence Millon
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
| | - Jean-Charles Dalphin
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- d Department of Pneumology , University Hospital , Besançon , France
| | - Gabriel Reboux
- a UMR/CNRS 6249 Chrono-Environnement, UFR Sciences médicales et pharmaceutiques , University of Bourgogne Franche-Comté , Besançon , France
- b Department of Parasitology-Mycology , University Hospital , Besançon , France
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Jouneau S, Marette S, Robert AM, Gouyet T, Guillot S, Chapron A, Mailloux C, Desrues B, Viel JF. Prevalence and risk factors of chronic obstructive pulmonary disease in dairy farmers: AIRBAg study. ENVIRONMENTAL RESEARCH 2019; 169:1-6. [PMID: 30399467 DOI: 10.1016/j.envres.2018.10.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/27/2018] [Accepted: 10/25/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The AIRBAg study was designed to assess the prevalence of chronic obstructive pulmonary disease (COPD) in dairy farmers and to define its associated risk factors. METHODS Between March 2012 and February 2017 randomly selected dairy farmers in the French region of Brittany were asked to complete a self-administered questionnaire and undergo an occupational health check-up with electronic mini-spirometry and standard spirometry. Those having one or more of the following features: chronic cough, chronic bronchitis, wheezing, dyspnea and/or a ratio FEV1/FEV6 < 80% were then referred to a pulmonologist for further check-up including spirometry with a reversibility test. Each COPD case was matched with three controls (dairy farmers and non-farm employees), for sex and age ( ± 5 years). Conditional multivariate logistic regression models were used to estimate the odds ratios between COPD occurrence and various risk factors. RESULTS The 1203 farmers examined included 525 (43.6%) who were "at risk of bronchial obstruction" and 432 (35.9%) of these saw the pulmonologist. This screening identified 16 (1.3%) cases of COPD, including eight non-smokers and five with an FEV1 < 80% of predicted values. Their average age was 54.6 ( ± 7.7) years and 10 of them were men. None complained of illness before the study. Multivariate analyses revealed no significant occupational risk factors for COPD. CONCLUSIONS This unexpected result may be because Breton dairy farms began to modernize early (1950s), giving rise to conditions with much lower exposure to airborne contaminants.
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Affiliation(s)
- Stéphane Jouneau
- Department of Respiratory Medicine, University Hospital, 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
| | - Solenne Marette
- Department of Occupational Pathology, University Hospital, F-35033 Rennes, France
| | - Ange-Marie Robert
- Department of Clinical Research, University Hospital, F-35033 Rennes, France
| | - Thomas Gouyet
- Department of Occupational Pathology, University Hospital, F-35033 Rennes, France
| | - Stéphanie Guillot
- Department of Pulmonary Function Tests, University Hospital, F-35033 Rennes, France
| | - Anthony Chapron
- Department of General Practice, Rennes 1 University, F-35000 Rennes, France; INSERM, CIC-1414, Primary Care Research Team, F-35000 Rennes, France
| | - Carole Mailloux
- Mutualité Sociale Agricole des Portes de Bretagne, F-35170 Bruz, France
| | - Benoît Desrues
- Department of Respiratory Medicine, University Hospital, 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; Department of Epidemiology and Public Health, University Hospital, F-35033 Rennes, France.
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Mortality by cause of death and risk behaviors in farmers versus non-farmers: the importance of avoiding the healthy worker effect. Int Arch Occup Environ Health 2019; 92:599-608. [DOI: 10.1007/s00420-018-1396-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 12/13/2018] [Indexed: 12/13/2022]
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Case-Finding for Persistent Airway Obstruction in Farmers: A Questionnaire With Optimal Diagnosis Criteria. Am J Prev Med 2017; 53:837-844. [PMID: 28818418 DOI: 10.1016/j.amepre.2017.06.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 06/05/2017] [Accepted: 06/29/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Appropriate identification of subjects who are candidates for spirometry through case-finding questionnaires may help solve the problem of chronic obstructive pulmonary disease misdiagnosis. The performance of case-finding questionnaires depends at least partially on the characteristics of the population used for their development. The use of an accurate threshold for the forced expiratory volume in 1 second / forced vital capacity ratio to define persistent airway obstruction is also vital in ascertaining chronic obstructive pulmonary disease. METHODS Using a population examined between October 2012 and May 2013 that included a large subset of agricultural workers both exposed and unexposed to tobacco smoking, the authors aimed to select a combination of items that would identify persons most likely to have persistent airway obstruction defined as forced expiratory volume in 1 second / forced vital capacity less than the lower limit of normal according to the Global Lung Initiative-2012 equations. Two thirds of the population (n=3,397) were randomly selected to develop a questionnaire, and one third (n=1,698) was reserved for questionnaire validation. Statistical analysis was performed in 2016. RESULTS The selected items were sex, dyspnea, BMI, tobacco smoking habits, age, history of respiratory diseases, and history of occupation at risk. The C-index of the model was 0.84 (95% CI=0.80, 0.88) for the development population and 0.76 (95% CI=0.66, 0.86) for the validation population. Using the selected items in combination, the sensitivity and specificity in identifying persistent airway obstruction were 76% and 77%, respectively, in the development population (and 68% and 73%, respectively, in the validation population) for a threshold value of 2.50%. CONCLUSIONS This seven-item questionnaire is the first developed from a population comprising a large subset of agricultural workers and using the Global Lung Initiative-2012 equations.
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