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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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Abstract
The mental health of the farming community across industrialised nations has long been a major concern. Using an adapted procedure for a systematic literature review of observational epidemiological studies reporting prevalence (informed by the Joanna Briggs Institute method), this paper reviews peer-reviewed literature that explicitly compares farmer and non-farmer mental health (n = 48). In doing so, it provides a central and accessible evidence base for researchers and practitioners, and simultaneously reveals a stark lack of consensus; specifically, 54.0% of measures deployed to assess farmer mental health determined it to be the same as or even better than non-farming populations. This ambiguity sits in sharp contrast to the unequivocally worrisome farmer suicide statistics. Informed by the literature, the paper discusses potential reasons for this mismatch, including (i) farmers' progression through a different "pathway" to suicide that is not always preceded by mental illness, and (ii) a failure of current methods to accurately gauge the mental health status of farmers. The paper concludes by recommending more research into farmers' "pathway" to suicide, and highlights the need for a dedicated and multi-disciplinary programme of methods research that will afford a more culturally appropriate and effective means of understanding mental health in the farming community.
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Affiliation(s)
- Hannah Chiswell
- Francis Close Hall, Countryside and Community Research Institute, University of Gloucestershire, Cheltenham, UK
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Kham-Ai P, Heaton K, Li P. Association Between COPD Symptoms and Psychological Distress Among Farmers. Workplace Health Saf 2023; 71:89-95. [PMID: 35997067 DOI: 10.1177/21650799221113057] [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: 02/03/2023]
Abstract
BACKGROUND Farmers have an increased risk of developing chronic obstructive pulmonary disease (COPD) and psychological distress. The potential role of psychological distress in worsening COPD symptoms has been reported among the general population, but no studies have examined this relationship among farmers with COPD, which is the purpose of this study. METHODS This study used the data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS). Farmers reporting both psychological distress and COPD symptoms were included in this study (n = 239). Both unadjusted and adjusted logistic regressions were used to explore the association among psychological distress, age, health status, smoking, and COPD symptoms, with crude and adjusted odds ratio (OR) and 95% CIs reported. FINDINGS The unadjusted analysis suggested that COPD symptoms were significantly associated with psychological distress among farmers (OR = 2.05 [1.18, 3.58]). While adjusted models showed the significant association between COPD symptoms and psychological distress among farmers after controlling for smoking, age, and health status (adjusted OR = 2.08 [1.10, 4.01]). CONCLUSION/IMPLICATIONS FOR PRACTICE These results suggest that psychological distress is associated with an increased risk of COPD symptoms in farmers, which is consistent with observations from studies in non-farmers. Occupational health professionals need to provide screen for COPD among farmers as well as psychological distress screening and mental health promotion among farmers with COPD.
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Affiliation(s)
| | | | - Peng Li
- The University of Alabama at Birmingham
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Fang X, Qiao Z, Yu X, Tian R, Liu K, Han W. Effect of Singing on Symptoms in Stable COPD: A Systematic Review and Meta-Analysis. Int J Chron Obstruct Pulmon Dis 2022; 17:2893-2904. [PMID: 36407671 PMCID: PMC9673938 DOI: 10.2147/copd.s382037] [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: 07/14/2022] [Accepted: 10/31/2022] [Indexed: 11/15/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a chronic lung disease which feature is progressive airflow obstruction. Singing is a popular and convenient activity that requires people to manage their lung volumes and airflow actively. Despite the well-known benefits of singing to healthy people, the specific effect still remains unclear. Objective To investigate the mental and psychological benefits of singing in patients with stable COPD. Search Methods We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA) on randomized controlled trials (RCTs) including singing exercise as the main intervention in stable COPD. We searched 8 electronic databases, including Web of Science, PubMed, Embase, Cochrane Library, Clinical Trials.gov, and the Physical Therapy Evidence Database (PEDro), CNKI, and Wanfang Database from inception until May 2022. The searching languages was English or Chinese. Data extraction using standardized templates was performed by two independent reviewers. The quality of the studies was assessed using the PEDro scale. Data synthesis was performed with Revman 5.4. The pooled effect sizes are reported by MD and 95% CI. Results Five RCTs involving 333 patients with stable COPD were included in this meta-analysis. Singing was regarded as the main intervention in the experimental group. Meta-analysis revealed that singing improves quality of life on Short Form 36 physical component summary (SF-36 PCS) (MD = 12.63, 95% CI: 5.52 to 19.73, P < 0.01) and respiratory muscle in maximal expiratory pressure (PEmax) (MD = 14.30, 95% CI: 0.87 to 27.73, P = 0.04) in patients with COPD. However, it has limited effects on Short Form 36 mental component summary (SF-36 MCS), lung function, exercise capability, and adverse mental state. Conclusion Based on results of the meta-analysis, singing could be used to improve quality of life (SF-36 PCS) and respiratory muscles (PEmax) in patients with COPD.
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Affiliation(s)
- Xuejie Fang
- School of Clinical Medicine, Weifang Medical University, Weifang, People's Republic of China
| | - Zhengtong Qiao
- School of Rehabilitation Medicine, Binzhou Medical University, Yantai, People's Republic of China
| | - Xinjuan Yu
- Department of Respiratory and Critical Medicine, Respiratory Disease Key Laboratory of Qingdao, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), Qingdao, People's Republic of China.,Clinical Research Center, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), Qingdao, People's Republic of China
| | - Rujin Tian
- Department of Rehabilitation Medicine, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), Qingdao, People's Republic of China
| | - Kai Liu
- Department of Rehabilitation Medicine, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), Qingdao, People's Republic of China
| | - Wei Han
- Department of Respiratory and Critical Medicine, Respiratory Disease Key Laboratory of Qingdao, University of Health and Rehabilitation Sciences Qingdao Hospital (Qingdao Municipal Hospital), Qingdao, People's Republic of China
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Sharma S, Shore XW, Mohite S, Myers O, Kesler D, Vlahovich K, Sood A. Association between Spirometric Parameters and Depressive Symptoms in New Mexico Uranium Workers. SOUTHWEST JOURNAL OF PULMONARY AND CRITICAL CARE 2021; 22:58-68. [PMID: 33664988 DOI: 10.13175/swjpcc015-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Uranium workers are at risk of developing lung disease, characterized by low forced expiratory volume in one second (FEV1) and/or forced vital capacity (FVC). Previous studies have found an association between decreased lung function and depressive symptoms in patients with pulmonary pathologies, but this association has not been well examined in occupational cohorts, especially uranium workers. Methods This cross-sectional study evaluated the association between spirometric measures and depressive symptoms in a sample of elderly former uranium workers screened by the New Mexico Radiation Exposure Screening & Education Program (NM-RESEP). Race- and ethnicity-specific reference equations were used to determine predicted spirometric indices (predictor variable). At least one depressive symptom [depressed mood and/or anhedonia, as determined by a modified Patient Health Questionnaire-2 (PHQ-2)], was the outcome variables. Chi-square tests and multivariable logistic regression models were used for statistical analyses. Results At least one depressive symptom was self-reported by 7.6% of uranium workers. Depressed mood was reported over twice as much as anhedonia (7.2% versus 3.3%). Abnormal FVC was associated with at least one depressive symptom after adjustment for covariates. There was no significant interaction between race/ethnicity and spirometric indices on depressive symptoms. Conclusions Although depressive symptoms are uncommonly reported in uranium workers, they are an important comorbidity due to their overall clinical impact. Abnormal FVC was associated with depressive symptoms. Race/ethnicity was not found to be an effect modifier for the association between abnormal FVC and depressive symptoms. To better understand the mechanism underlying this association and determine if a causal relationship exists between spirometric indices and depressive symptoms in occupational populations at risk for developing lung disease, larger longitudinal studies are required. We recommend screening for depressive symptoms for current and former uranium workers as part of routine health surveillance of this occupational cohort. Such screening may help overcome workers' reluctance to self-report and seek treatment for depression and may avoid negative consequences to health and safety from missed diagnoses.
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Affiliation(s)
- Shiva Sharma
- Preventive Medicine Section, Department of Internal Medicine, University of New Mexico School of Medicine
| | - Xin W Shore
- Department of Family and Community Medicine, University of New Mexico School of Medicine
| | - Satyajit Mohite
- Department of Behavioral Health, Psychiatry & Psychology, Mayo Clinic Health System
| | - Orrin Myers
- Department of Family and Community Medicine, University of New Mexico School of Medicine
| | - Denece Kesler
- Preventive Medicine Section, Department of Internal Medicine, University of New Mexico School of Medicine
| | - Kevin Vlahovich
- Preventive Medicine Section, Department of Internal Medicine, University of New Mexico School of Medicine
| | - Akshay Sood
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of New Mexico School of Medicine
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Yao HM, Xiao RS, Cao PL, Wang XL, Zuo W, Zhang W. Risk factors for depression in patients with chronic obstructive pulmonary disease. World J Psychiatry 2020; 10:59-70. [PMID: 32399399 PMCID: PMC7203084 DOI: 10.5498/wjp.v10.i4.59] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/26/2020] [Accepted: 03/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The prevalence of depression in patients with chronic obstructive pulmonary disease (COPD) ranges from 10% to 42%, but the diagnosis of depression in patients with COPD is often unrecognized and untreated. Unrecognized depression has major implications for compliance with medical treatment, prolonged lengths of stay, increased frequency of hospital admissions, and increased consultations with primary care physicians. Many studies have attempted to identify risk factors for progression, prognosis and response to therapy in patients with depression. However, few studies have examined the risk factors for depression in patients with COPD, and some results remain controversial.
AIM To identify the potential risk factors to define patients with COPD who are at “high risk” of depression.
METHODS The clinical data of 293 patients with COPD were reviewed from January 2017 to December 2018. The correlations between demographics, clinical characteristics and depression were analyzed. The risk factors for depression in patients with COPD were identified by multivariate logistic regression analysis. The cutoff value, sensitivity and specificity of the independent correlation factors were calculated with a receiver operating characteristic curve.
RESULTS Of the 293 patients included, 65 (22.18%) individuals were identified to have depression. Significant differences were detected between patients with and without depression in terms of body mass index (BMI), forced expiratory volume in 1 s (FEV1), and COPD assessment test (CAT) score (all P < 0.05). Low BMI, low FEV1, and high CAT were independent risk factors for depression in patients with COPD and the cutoff values of BMI, FEV1, and CAT scores were 21.373 kg/m2, 0.855 L and 12.5, respectively.
CONCLUSION Low BMI, low FEV1, and high CAT score were identified as independent risk factors for depression in patients with COPD.
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Affiliation(s)
- Hui-Ming Yao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Ren-Sen Xiao
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Ping-Liang Cao
- Second Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Xiao-Lei Wang
- Second Department of Cardiovascular Medicine, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Wei Zuo
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Wei Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
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Jones-Bitton A, Best C, MacTavish J, Fleming S, Hoy S. Stress, anxiety, depression, and resilience in Canadian farmers. Soc Psychiatry Psychiatr Epidemiol 2020; 55:229-236. [PMID: 31197397 DOI: 10.1007/s00127-019-01738-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/03/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To estimate the prevalence of stress, anxiety, depression, and resilience amongst Canadian farmers. METHODS An online cross-sectional survey using validated psychometric scales [Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale] conducted with farmers in Canada between September 2015 and February 2016. RESULTS 1132 farmers participated in the study. The average PSS score was 18.9. Approximately 57% and 33% of participants were classified as possible and probable cases for anxiety, respectively; the respective proportions for depression were 34% and 15%. The average resilience score was 71.1. Scores for stress, anxiety, and depression were higher, and resilience lower, than reported normative data. Females scored less favorably on all mental health outcomes studied, highlighting important gender disparities. CONCLUSIONS These results highlight a significant public health concern amongst farmers, and illustrate a critical need for research and interventions related to farmer mental health. These findings are important for policymakers, physicians, and public and mental health service providers, and can help to inform decision-making, policy recommendations, resource allocation, and development and delivery of training programs for farmers.
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Affiliation(s)
- Andria Jones-Bitton
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
| | - Colleen Best
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada
| | | | - Stephen Fleming
- Department of Psychology, York University, Faculty of Health, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Sandra Hoy
- School of Social Work, Laurentian University, 935 Ramsey Lake Road, Sudbury, ON, P3E 2C6, Canada
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Daghagh Yazd S, Wheeler SA, Zuo A. Key Risk Factors Affecting Farmers' Mental Health: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4849. [PMID: 31810320 PMCID: PMC6926562 DOI: 10.3390/ijerph16234849] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023]
Abstract
Recently, concern has increased globally over farmers' mental health issues. We present a systematic review of the outcomes, locations, study designs, and methods of current studies on farmers' mental health. In particular, this review aims to fill an important gap in understanding of the potential key risk factors affecting farmers' mental health around the world. 167 articles on farmer mental health were included in a final systematic review using a standardized electronic literature search strategy and PRISMA guidelines. The four most-cited influences on farmers' mental health in the reviewed literature respectively were pesticide exposure, financial difficulties, climate variabilities/drought, and poor physical health/past injuries. The majority of studies were from developed countries, most specifically from the United States, Australia, and the United Kingdom. Comparative studies on the mental health of farmers and other occupational workers showed mixed results, with a larger portion identifying that psychological health disturbances were more common in farmers and farm-workers. Knowledge of farmer psychological disorder risk factors and its impacts are essential for reducing the burden of mental illness. Further research will be required on climate change impacts, developing country farmers' mental health, and information on how to reduce help-seeking barriers amongst farmers.
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Affiliation(s)
| | - Sarah Ann Wheeler
- Centre for Global Food and Resources, Faculty of Professions, University of Adelaide, Adelaide, SA 5000, Australia; (S.D.Y.); (A.Z.)
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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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