Utilisation de Codes-Barres pour évaluer les expositions aux produits de nettoyage - COBANET: Utilisation de Codes-Barres pour évaluer les expositions professionnelles ou domestiques aux produits de nettoyage et de désinfection – Étude de faisabilité

National audienceLes produits d’entretien contiennent de nombreuses substances irritantes ou sensibilisantes qui peuvent provoquer de l’asthme selon des mécanismes encore peu connus. Bien que des associations aient été mises en évidence entre l’utilisation régulière de ces produits et l’apparition de l’asthme, les agents chimiques en cause n’ont pas été clairement identifiés. Pour améliorer l’évaluation des expositions en minimisant les effets de biais, la piste proposée dans le projet COBANET serait d’évaluer l’utilisation des produits de nettoyage et de désinfection en France à partir de leurs codes‐barres

L'asthme chez les personnels hospitaliers et de ménage

Plus de 400 substances ont été identifiées comme pouvant intervenir dans l’asthme professionnel. Parmi les métiers exposés figurent ceux liés au nettoyage, notamment en milieu hospitalier, milieu dans lequel l’exposition professionnelle aux désinfectants ou aux produits de nettoyage est d’autant plus élevée que ces substances permettent de prévenir la survenue d’infections nosocomiales

Cleaning and asthma characteristics in women.

International audienceWe aimed to assess the associations between occupational exposure to cleaning products, a gender-related exposure, and asthma characteristics, considering clinical, immunological and inflammatory aspects. Analyses were conducted in 391 women (73 with adult-onset asthma) from the follow-up of the Epidemiological Study on the Genetics and Environment of Asthma (EGEA). Occupational exposure to cleaning/disinfecting products was estimated using the asthma-specific job-exposure-matrix (44 women exposed). Occupational exposures were associated with more symptomatic asthma (odds ratio (95% CI): 2.8(1.2-6.4)) and severe asthma (5.1(1.7-15.3)). An association was suggested for poorly controlled asthma (2.2(0.9-5.5)). Associations were observed for asthma without positive skin prick test (3.0(1.1-8.3)), with a low IgE level (2.8(1.2-6.2)), and with a low eosinophil count (3.2(1.5-7.1)). Results strengthen the evidence of a deleterious role of cleaning products in asthma and are consistent with the hypothesis of non-allergic mechanisms in relation to workplace cleaning exposures

EGEA Collection: A Biobank Devoted to Asthma and Asthma-related Phenotypes

The Epidemiological study on the Genetics and Environment of Asthma (EGEA) is a 20-year cohort including cases with asthma (n = 388), their first degree relatives (n = 1244) and population-based controls (n = 415) recruited in the early 90’s from five French cities. Participants were extensively characterized regarding environment and respiratory health, and a specific effort was made to trace and bank biological samples (ISO 9001 certification since 2006). Access to data and samples is opened to researchers wishing to develop new scientific collaborative programs. The survey has already led to more than a hundred papers with almost one third in collaboration with national and international teams.</p

Ability of ecological deprivation indices to measure social inequalities in a French cohort

Background: Despite the increasing interest in place effect to explain health inequalities, there is currently no consensus on which kind of area-based socioeconomic measures researchers should use to assess neighborhood socioeconomic position (SEP). The study aimed to evaluate the reliability of different area-based deprivation indices (DIs) in capturing socioeconomic residential conditions of French elderly women cohort. Methods: We assessed area-based SEP using 3 DIs: Townsend Index, French European Deprivation Index (FEDI) and French Deprivation index (FDep), among women from E3N (Etude épidémiologique auprès des femmes de la Mutuelle Générale de l’Education Nationale). DIs were derived from the 2009 French census at IRIS level (smallest geographical units in France). Educational level was used to evaluate individual-SEP. To evaluate external validity of the 3 DIs, associations between two well-established socially patterned outcomes among French elderly women (smoking and overweight) and SEP, were compared. Odd ratios were computed with generalized estimating equations to control for clustering effects from participants within the same IRIS. Results: The analysis was performed among 63,888 women (aged 64, 47% ever smokers and 30% overweight). Substantial agreement was observed between the two French DIs (Kappa coefficient = 0.61) and between Townsend and FEDI (0.74) and fair agreement between Townsend and FDep (0.21). As expected among French elderly women, those with lower educational level were significantly less prone to be ever smoker (Low vs. High; OR [95% CI] = 0.43 [0.40–0.46]) and more prone to being overweight (1.89 [1.77–2.01]) than women higher educated. FDep showed expected associations at area-level for both smoking (most deprived vs. least deprived quintile; 0.77 [0.73–0.81]) and overweight (1.52 [1.44–1.62]). For FEDI opposite associations with smoking (1.13 [1.07–1.19]) and expected association with overweight (1.20 [1.13–1.28]) were observed. Townsend showed opposite associations to those expected for both smoking and overweight (1.51 [1.43–1.59]; 0.93 [0.88–0.99], respectively). Conclusion: FDep seemed reliable to capture socioeconomic residential conditions of the E3N women, more educated in average than general French population. Results varied strongly according to the DI with unexpected results for some of them, which suggested the importance to test external validity before studying social disparities in health in specific populations

Occupational airborne exposure in relation to Chronic Obstructive Pulmonary Disease (COPD) and lung function in individuals without childhood wheezing illness: A 50-year cohort study

Background Evidence from longitudinal population-based studies relating occupational exposure to the full range of different forms of airborne pollutants and lung function and airway obstruction is limited. Objective To relate self-reported COPD and lung function impairment to occupational exposure to different forms of airborne chemical pollutants in individuals who did not have childhood wheeze. Methods A prospective cohort study was randomly selected in 1964 at age 10–15 years and followed up in 1989, 1995, 2001 and 2014 (aged 58–64) by spirometry and respiratory questionnaire. Occupational histories were recorded in 2014 and occupational exposures assigned using an airborne chemical job exposure matrix. The risk of COPD and lung function impairment was analyzed in subjects, who did not have childhood wheeze, using logistic and linear regression and linear mixed effects models. Results 237 subjects without childhood wheeze (mean age 60.6 years, 47% male) were analyzed. There was no association between any respiratory outcomes and exposure to gases, fibers, mists or mineral dusts and no consistent associations with exposure to fumes. Reduced FEV1 was associated with longer duration (years) of exposure to any of the six main pollutant forms - vapors, gases, dusts, fumes, fibers and mists (VGDFFiM) with evidence of a dose-response relationship (p-trend=0.004). Exposure to biological dusts was associated with self-reported COPD and FEV1<Lower Limit of Normal (LLN) (adjusted odds ratio [95%CI] 4.59 [1.15,18.32] and 3.54 [1.21,10.35] respectively), and reduced FEF25–75% (adjusted regression coefficients [95% CIs] −9.11 [−17.38, −0.84] respectively). Exposure to vapors was associated with self-reported COPD and FEV1<LLN (adjOR 6.46 [1.18,35.37] and 4.82 [1.32,17.63]). Longitudinal analysis demonstrated reduced FEV1 and FEF25–75% associated with exposure to biological dusts or vapors. Conclusions People with no history of childhood wheezing who have been occupationally exposed to biological dusts or vapors or had longer duration of lifetime exposure to any VGDFFiM are at a higher risk of reduced lung function at age 58–64 years. Occupational exposure to biological dusts or vapors also increased the risk of self-reported COPD

Recognition of Antimicrobial Peptides by a Bacterial Sensor Kinase

SummaryPhoQ is a membrane bound sensor kinase important for the pathogenesis of a number of Gram-negative bacterial species. PhoQ and its cognate response regulator PhoP constitute a signal-transduction cascade that controls inducible resistance to host antimicrobial peptides. We show that enzymatic activity of Salmonella typhimurium PhoQ is directly activated by antimicrobial peptides. A highly acidic surface of the PhoQ sensor domain participates in both divalent-cation and antimicrobial-peptide binding as a first step in signal transduction across the bacterial membrane. Identification of PhoQ signaling mutants, binding studies with the PhoQ sensor domain, and structural analysis of this domain can be incorporated into a model in which antimicrobial peptides displace divalent cations from PhoQ metal binding sites to initiate signal transduction. Our findings reveal a molecular mechanism by which bacteria sense small innate immune molecules to initiate a transcriptional program that promotes bacterial virulence

Asthma caused by occupational exposures is common – A systematic analysis of estimates of the population-attributable fraction

<p>Abstract</p> <p>Background</p> <p>The aim of this paper is to highlight emerging data on occupational attributable risk in asthma. Despite well documented outbreaks of disease and the recognition of numerous specific causal agents, occupational exposures previously had been relegated a fairly minor role relative to other causes of adult onset asthma. In recent years there has been a growing recognition of the potential importance of asthma induced by work-related exposures</p> <p>Methods</p> <p>We searched Pub Med from June 1999 through December 2007. We identified six longitudinal general population-based studies; three case-control studies and eight cross-sectional analyses from seven general population-based samples. For an integrated analysis we added ten estimates prior to 1999 included in a previous review.</p> <p>Results</p> <p>The longitudinal studies indicate that 16.3% of all adult-onset asthma is caused by occupational exposures. In an overall synthesis of all included studies the overall median PAR value was 17.6%.</p> <p>Conclusion</p> <p>Clinicians should consider the occupational history when evaluating patients in working age who have asthma. At a societal level, these findings underscore the need for further preventive action to reduce the occupational exposures to asthma-causing agents.</p

Occup Environ Med

OBJECTIVES: Asthma has significant occupational consequences. The objective of our study was to investigate the links between asthma and the career path, taking into account gender and age at asthma onset. METHODS: Using cross-sectional data collected at inclusion in the French CONSTANCES cohort in 2013-2014, we studied the links between each career path indicator (number of job periods, total duration of employment, numbers of part-time jobs and work interruptions due to unemployment or health issues, employment status at inclusion) on the one hand, and current asthma and asthma symptom score in the last 12 months on the other hand, as reported by the participants. Multivariate analyses were performed separately for men and women using logistic and negative binomial regression models adjusted for age, smoking status, body mass index and educational level. RESULTS: When the asthma symptom score was used, significant associations were observed with all of the career path indicators studied: a high symptom score was associated with a shorter total duration of employment as well as a greater number of job periods, part-time jobs and work interruptions due to unemployment or health issues. These associations were of similar magnitude in men and women. When current asthma was used, the associations were more pronounced in women for some career path indicators. CONCLUSION: The career path of asthmatic adults is more often unfavourable than that of those without asthma. Efforts should be made to support people with asthma in the workplace, in order to maintain employment and facilitate the return to work.La cohorte CONSTANCES - Infrastructure épidémiologique ouverte pour la recherche et la surveillanc