Brigitte Dananché's research while affiliated with Université Paris-Saclay and other places

Abstract Introduction The problem of transcoding is recurrent when researchers wish to link occupational data from cohorts to Job-Exposure Matrices (JEMs) which were not set up in the same classifications. The Occupational Asthma-specific JEM (OAsJEM) is a JEM developed for assessing exposure to agents known at risk for asthma for jobs coded with ISCO88 occupation classification. To apply the OAsJEM in the CONSTANCES cohort, in which jobs and industries were coded with French PCS2003 and NAF2008 classifications respectively, we developed a crosswalk to convert jobs from PCS2003 into ISCO88 classification. Methods This work was carried out by 2 skilled coders and 1 novice coder who have worked independently by using different tools and transcoding strategies defined a priori. Consensus meetings were organized with skilled coders to define the final crosswalk. This work was elaborated in 2 steps: (i) for 38 ISCO88 codes classified as potentially exposed to cleaning and disinfection products by the OAsJEM, and (ii) for all jobs from the ISCO88 classification. A comparison between the 3 initial coder’s crosswalk proposals and the final crosswalk was made for the 38 ISCO codes in step (i). Results The final crosswalk provided 998 matches between the 482 4-digit PCS2003 codes, 308 4-digit ISCO88 codes, and 31 3-digit ISCO88 codes. Information regarding the NAF2008 industry classification was also used in some cases to improve the final crosswalk. For the selected 38 ISCO88 codes, the final crosswalk provided 110 combinations, but the number of proposed ISCO88–PCS2003 couples by each of the 3 coders varied greatly from 68 to 153. In addition, an important variability between the 3 coders were observed among the number of common combinations between the initial coder’s proposals and the final crosswalk (from 47% to 78%). Discussion We have developed a crosswalk specifically for an application of the OAsJEM in population-based surveys using the PCS2003 occupation classification. The development of this crosswalk is of great interest for the use of OAsJEM on the data of the CONSTANCES cohort and on any other survey with occupational data coded according to the French classifications. This OAsJEM crosswalk could be used by other teams to evaluate occupational exposures known to be at risk of asthma from occupational calendars coded with French classifications.

Objectives: Etiological factors of testicular germ cell tumors (TGCT) remain largely unknown, but a causal role of occupational exposures to solvents has been suggested. Previous studies analyzing these exposures reported discordant results, potentially related to exposure assessment methods. The aim of this study was to investigate the role of occupational exposure to solvents on the risk of developing TGCT among young men. Methods: This study examined occupational exposures to solvents and TGCT risk based on the lifetime work histories of 454 cases and 670 controls, aged 18-45 years, of the French national TESTIS case-control study. Solvent exposure was estimated using: (i) exposure assignment by job-exposure matrix (JEM) and (ii) JEM combined with self-reported exposure data from specific questionnaires (SQ) and expert assessment (EA). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. Results: Both approaches (JEM and JEM+SQ+EA) showed a consistent association between TGCT and trichloroethylene exposure (exposed versus not exposed; JEM=OR 1.80 [95% confidence interval (CI) 1.12-2.90] and JEM+SQ+EA= OR 2.59 (95% CI 1.42-4.72). Both approaches also observed positive associations with ketone esters and fuels & petroleum-based solvents. Conclusion: The results suggest that some organic solvents might be involved in the pathogenesis of TGCT among occupationally exposed men. The combined use of JEM+SQ+EA seemed to limit misclassification by considering individual exposure variability and is, therefore, an appealing approach to assess occupational exposures in epidemiological studies.

Objectives The impact of chronic occupational exposures to irritants on asthma remains discussed. We studied the associations between occupational exposures and asthma, with specific interest for chronic exposure to irritants, including disinfectants and cleaning products (DCPs) and solvents. Methods Cross-sectional analyses included 115 540 adults (55% women, mean age 43 years, 10% current asthma) working at inclusion in the French population-based CONSTANCES cohort (2012–2020). Current asthma was defined by ever asthma with symptoms, medication or asthma attacks (past 12 months), and the asthma symptom score by the sum of 5 respiratory symptoms (past 12 months). Both lifetime and current occupational exposures were assessed by the Occupational Asthma-specific Job-Exposure Matrix. Associations were evaluated by gender using logistic and binomial negative regressions adjusted for age, smoking status and body mass index. Results In women, associations were observed between current asthma and lifetime exposure to irritants (OR 1.05, 95% CI 1.00 to 1.11), DCPs (1.06, 95% CI 1.00 to 1.12) and solvents (1.06, 95% CI 0.98 to 1.14). In men, only lifetime exposure to DCPs (1.10, 95% CI 1.01 to 1.20) was associated with current asthma. Lifetime exposure to irritants was associated with higher asthma symptom score both in women (mean score ratio: 1.08, 95% CI 1.05 to 1.11) and men (1.11, 95% CI 1.07 to 1.15), especially for DCPs (women: 1.09, 95% CI 1.06 to 1.13, men: 1.21, 95% CI 1.15 to 1.27) and solvents (women 1.14, 95% CI 1.10 to 1.19, men: 1.10, 95% CI 1.05 to 1.15). For current exposures, no consistent associations were observed with current asthma and asthma symptom score. Conclusions Lifetime occupational exposures to irritants were associated with current asthma and higher asthma symptom score. These exposures should be carefully considered in asthma management.

Background Testicular germ cell tumors (TGCT) are the most frequent cancer in young men in developed countries. Parental occupational exposures during early-life periods are suspected to increase TGCT risk. The objective was to estimate the association between parental occupations at birth and adult TGCT. Methods A case–control study was conducted, including 454 TGCT cases aged 18–45 from 20 French university hospitals, matched to 670 controls based on region and year of birth. Data collected from participants included parental jobs at birth coded according to the International Standard Classification of Occupation—1968 and the French nomenclature of activities—1999. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors. Results Paternal jobs at birth as service workers (OR = 1.98, CI 1.18–3.30), protective service workers (OR = 2.40, CI 1.20–4.81), transport equipment operators (OR = 1.96, CI 1.14–3.37), specialized farmers (OR = 2.66, CI 1.03–6.90), and maternal jobs as secondary education teachers (OR = 2.27, CI 1.09–4.76) or in secondary education (OR = 2.35, CI 1.13–4.88) were significantly associated with adult TGCT. The risk of seminoma was increased for the above-mentioned paternal jobs and that of non-seminomas for public administration and defence; compulsory social security (OR = 1.99, CI 1.09–3.65); general, economic, and social administration (OR = 3.21, CI 1.23–8.39) for fathers; and secondary education teacher (OR = 4.67, CI 1.87–11.67) and secondary education (OR = 3.50, CI 1.36–9.01) for mothers. Conclusion Some paternal jobs, such as service workers, transport equipment operators, or specialized farmers, and maternal jobs in secondary education seem to be associated with an increased risk of TGCT with specific features depending on the histological type. These data allow hypotheses to be put forward for further studies as to the involvement of occupational exposures in the risk of developing TGCT, such as exposure to pesticides, solvents, or heavy metals.

Objectives: The etiology of testicular germ cell tumors (TGCT) is suspected to be related to prenatal environmental risk factors. Some solvents have potential endocrine disrupting or carcinogenic properties and may disrupt male genital development in utero. The aim of this study was to examine the association between parental occupational exposure to solvents and TGCT risk among their offspring. Methods: A French nationwide case-control study, TESTIS included 454 TGCT cases and 670 controls frequency-matched on region and 5-year age strata. Participants were interviewed via telephone and provided information on parental occupations at birth. Job-exposure matrices (JEM) developed in the French Matgéné program were used to assign exposure to five petroleum-based solvents, five solvents or groups of oxygenated solvents, and five chlorinated solvents. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors. Results: Occupational exposure to at least one solvent during the year of their son's birth was 41% among fathers and 21% among mothers. Paternal exposure to at least one solvent showed OR 0.89 (95% CI 0.68-1.15). Exposure to perchloroethylene (OR 1.41, 95% CI 0.55-3.61), methylene chloride (OR 1.13, 95% CI 0.54-2.34) and diesel/kerosene/fuel oil (OR 1.17, 95% CI 0.80-1.73) disclosed OR >1 but with low precision. Our results suggest a possible modest increase in non-seminoma risk for sons whose fathers were highly exposed to trichloroethylene (OR 1.44, 95% CI 0.79-2.63). Maternal exposure to at least one solvent showed OR 0.90 (95% CI 0.65-1.24). When stratifying by birth year, men born in the 1970s experienced an increased TGCT risk following maternal exposure to fuels and petroleum-based solvents (OR 2.74, 95% CI 1.11-6.76). Conclusion: Overall, no solid association was found between parental occupational exposure to solvents and TGCT risk. The association found with maternal occupational exposure to fuels and petroleum solvents among older men needs further investigation.

Objective Testicular germ cell tumours (TGCT) are the most common cancer in men of working age and its incidence has increased notably over the past 40 years. Several occupations have been identified as potentially associated with TGCT risk. The aim of this study was to further explore the relationship between occupations, industries and TGCT risk in men aged 18–45 years. Methods The TESTIS study is a multicenter case–control study conducted between January 2015 and April 2018 in 20 of 23 university hospital centers in metropolitan France. A total of 454 TGCT cases and 670 controls were included. Full job histories were collected. Occupations were coded according to the International Standard Classification of Occupation 1968 version (ISCO-1968) and industry according to the 1999 version of Nomenclature d’Activités Française (NAF-1999). For each job held, ORs and 95% CIs were estimated using conditional logistic regression. Results A positive association was observed between TGCT and occupation as agricultural, animal husbandry worker (ISCO: 6–2; OR 1.71; 95% CI (1.02 to 2.82)), as well as salesman (ISCO: 4–51; OR 1.84; 95% CI (1.20 to 2.82)). An increased risk was further observed among electrical fitters and related, electrical and electronics workers employed for 2 years or more (ISCO: 8–5; OR ≥2 years 1.83; 95% CI (1.01 to 3.32)). Analyses by industry supported these findings. Conclusions Our findings suggest that agricultural, electrical and electronics workers, and salesmen workers experience an increased risk of TGCT. Further research is needed to identify the agents or chemicals in these high-risk occupations which are relevant in the TGCT development. Trial registration number NCT02109926 .

Introduction Testicular cancer is the most common cancer in young men. The causes are largely unknown, although prenatal occupational and environmental exposures have been suggested. We investigated associations between paternal occupational exposure to heavy metals and welding fumes at birth and the risk of testicular germ cell tumors (TGCT) in their sons. Material and Methods Four hundred and fifty-four cases and 670 controls were included from TESTIS a French nationwide case-control study on TGCT. The INTEROCC job exposure matrix was used to assign occupational exposures (cadmium, chromium, iron, nickel, lead, and welding fumes) to the fathers’ jobs at birth, which we assumed as a proxy for exposure before and at conception. Odds ratios (ORs) for the risk of TGCT in adulthood were estimated using conditional logistic regression models for frequency-matched sets. Three complementary analytical approaches were used: 1) single-agent analysis, 2) analysis by group of exposures and 3) a principal component analysis (PCA). Results The proportion of paternal exposure to different heavy metals and welding fumes ranged from 0.7% (cadmium) to 11.8% (lead). The correlation between heavy metals and welding fumes was found to be between moderate (Spearman rho = 0.62) and high (0.99). No significant associations were observed between paternal occupational exposure to heavy metals and welding fumes at birth and the development of TGCT in their sons, irrespective of the analytical approach used. Based on the PCA, three principal components explained 93.5% of the cumulative variance and confirmed the finding of no associations. Analyses by TGCT subtype (seminoma and non-seminoma) did not alter these findings. Conclusions This study did not find any evidence of an association between paternal occupational exposure to heavy metals and welding fumes and TGCT risk in their sons.

Objectifs En épidémiologie des risques professionnels, l’évaluation des expositions est une étape cruciale qui conditionne la capacité d’une étude à mettre en évidence des associations entre une exposition et une maladie. Afin d’évaluer si l’exposition professionnelle aux solvants des parents pendant la grossesse et au cours de l’année de naissance du fils est associée au risque de tumeurs germinales du testicule (TGT) chez l’adulte, 3 matrices emplois–expositions (MEE) (solvants oxygénés, chlorés et pétroliers) du programme français Matgéné ont été appliquées. Méthodes Les participants de l’étude nationale cas-témoins TESTIS (454 cas, 670 témoins) ont fourni des informations sur les emplois occupés et les tâches réalisées par leurs parents au moment de leur naissance qui ont ensuite été codées par un hygiéniste industriel selon les nomenclatures CITP68 pour la profession (code à 5 chiffres) et NAF93 pour la branche d’activité (code à 4 chiffres). Lorsque les informations obtenues étaient insuffisantes, un code agrégé a été attribué. La MEE fournit de manière exhaustive une évaluation de l’exposition (probabilité et niveau d’exposition) au solvant considéré en fonction de la période, pour chacun des couples CITP/NAF complets (codés au plus fin). Une approche méthodologique a été développée afin d’attribuer les indices d’exposition pour chacun des couples CITP/NAF associé aux tâches, quel que soit leur niveau d’agrégation, permettant de pallier le manque d’information obtenu pour certains emplois. Résultats Les MEE ont été croisées avec 1124 emplois. Sur la totalité des tâches déclarées pour les pères, les codes étaient complets pour 86,6 % des CITP et 74,7 % des NAF. Les mères avaient respectivement 92,9 % et 70,9 % de codes CITP et NAF complets. L’évaluation de l’exposition a été possible pour la totalité des tâches avec codes complets ou agrégés. Seules 80 tâches n’ont pas été évaluées puisqu’aucun code n’a pu leur être attribué. Au final, 41 % des emplois des pères ont été évalués exposés à au moins un solvant l’année de la naissance du fils contre 21 % des mères. Conclusions Les données renseignées par les participants sur les emplois des parents ont permis de transcrire ces informations en codes CITP et NAF. L’exhaustivité des MEE a ensuite rendu possible l’évaluation de l’exposition professionnelle. Ainsi, l’application des MEE a permis l’étude de l’association entre l’exposition professionnelle parentale aux solvants et le risque de TGT.