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

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

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

Associations between Nitric Oxide Synthase Genes and Exhaled NO-Related Phenotypes according to Asthma Status

International audienceBACKGROUND: The nitric oxide (NO) pathway is involved in asthma, and eosinophils participate in the regulation of the NO pool in pulmonary tissues. We investigated associations between single nucleotide polymorphisms (SNPs) of NO synthase genes (NOS) and biological NO-related phenotypes measured in two compartments (exhaled breath condensate and plasma) and blood eosinophil counts. METHODOLOGY: SNPs (N = 121) belonging to NOS1, NOS2 and NOS3 genes were genotyped in 1277 adults from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA). Association analyses were conducted on four quantitative phenotypes: the exhaled fraction of NO (Fe(NO)), plasma and exhaled breath condensate (EBC) nitrite-nitrate levels (NO2-NO3) and blood eosinophils in asthmatics and non-asthmatics separately. Genetic heterogeneity of these phenotypes between asthmatics and non-asthmatics was also investigated. PRINCIPAL FINDINGS: In non-asthmatics, after correction for multiple comparisons, we found significant associations of Fe(NO) levels with three SNPs in NOS3 and NOS2 (P ≤ 0.002), and of EBC NO2-NO3 level with NOS2 (P = 0.002). In asthmatics, a single significant association was detected between Fe(NO) levels and one SNP in NOS3 (P = 0.004). Moreover, there was significant heterogeneity of NOS3 SNP effect on Fe(NO) between asthmatics and non-asthmatics (P = 0.0002 to 0.005). No significant association was found between any SNP and NO2-NO3 plasma levels or blood eosinophil counts. CONCLUSIONS: Variants in NO synthase genes influence Fe(NO) and EBC NO2-NO3 levels in adults. These genetic determinants differ according to asthma status. Significant associations were only detected for exhaled phenotypes, highlighting the critical relevance to have access to specific phenotypes measured in relevant biological fluid

Étude de l’asthme chez les personnels hospitaliers et de ménage: Rôle des expositions professionnelles ou domestiques aux produits de nettoyage et de désinfection dans l’asthme

L’asthme professionnel représente 5 à 10 % des asthmes en France. Il est défini comme « un asthme déclenché ou aggravé par une substance inhalée sur les lieux du travail ». Plus de 400 substances ont été identifiées comme pouvant intervenir dans l’asthme professionnel, parmi lesquelles : l’ammoniac, l’eau de javel, le formaldéhyde, etc. 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. Si les données montrent une augmentation progressive des nouveaux cas d’asthme professionnel, le rôle des produits chimiques dans le déclenchement de l’asthme n’est pas encore très clair. Le projet de recherche « NETA » (2009-2013) traite de l’exposition aux produits de nettoyage et aux désinfectants en milieu hospitalier et de son lien avec l’asthme

L’exposition aux produits de nettoyage : un risque pour la santé respiratoire des nourrissons et des enfants ?: Impact des expositions environnementales aux produits de NETtoyage et de désinfection sur la santé RESPIratoire des nourrissons et très jeunes enfants en Crèches

National audienceDe nombreuses études suggèrent l’existence de liens entre l’exposition environnementale précoce et la survenue de maladies chroniques. Ainsi, l’exposition aux produits de nettoyage est considérée comme un facteur de risque émergent pour la santé respiratoire des enfants. L’originalité du projet CRESPINET réside dans le fait qu’aucune étude épidémiologique, à ce jour, n’a porté sur : 1.L’effet de l’exposition précoce aux produits de nettoyage/désinfection en crèche sur la santé respiratoire au cours des premières années de la vie / 2.L’utilisation de méthodes novatrices et complémentaires pour améliorer l’évaluation de ces expositions

Damaging effects of household cleaning products on the lungs

International audienc

Do chronic workplace irritant exposures cause asthma?

International audienceThe present review summarizes the recent literature on the relation between chronic workplace irritant exposures and asthma, focusing on exposures of low to moderate levels. We discuss results from epidemiological surveys, potential biological mechanisms, and needs for further research. These aspects are largely illustrated by studies on exposure to cleaning products. Recent results from nine population-based and workplace-based epidemiological studies, mostly cross-sectional, found an increased risk of both new-onset and work-exacerbated asthma among participants exposed to moderate level of irritants and/or cleaning products. Evidence of a causal effect of chronic workplace irritant exposure in new-onset asthma remains limited, mainly because of a lack of longitudinal studies and the difficulty to evaluate irritant exposures. However, recent epidemiological studies strengthen the evidence of an effect of chronic exposure to irritants in work-related asthma. The underlying mechanism remains unknown but may be related to oxidative stress, neurogenic inflammation and dual irritant and adjuvant effects. However, disentangling chronic irritant effects from either acute irritant-induced asthma or immunological low molecular weight agent-induced asthma is difficult for some agents. Further research is needed to improve assessment of irritant exposures and identify biomarkers