Giovanni Veronesi , Emanuele Maria Giusti , Francesco Gianfagna , Giancarlo Cesana , Guido Grassi , Marco Mario Ferrario

Abstract

Objective: To investigate the extent of the healthy-worker effect (HWE) on all-cause and cardiovascular disease (CVD) mortality, comparing population-based (PBC) and worker-based (WBC) cohorts. Material and Methods: N=4700 men aged 30 to 59 at baseline were recruited from 1986 to 1994 in two PBCs (MONICA Brianza and PAMELA; n=2423) and in one WBC (SEMM; n=2277). We actively ascertained vital status (attrition rate: 5%) and retrieved death certificates (CVD mortality: ICD-9 codes 390-459 as main cause of death). HWE was estimated as the hazard ratio (HR) for a dummy indicator of WBC vs. PBC (reference) in age-adjusted Cox models. The HR was first computed in the full sample and then progressively restricted to ever-employed participants, workers, and salaried workers. Finally, stratified analyses were conducted by occupational class, dividing white/gold-collar and blue-collar salaried workers. Results: In 23 years of median follow-up, we observed 670 all-cause and 161 CVD deaths. Crude all-cause and CVD-mortality rates (/1000 person-years) were 4.97 and 0.96 in WBC, and 8.39 and 2.24 in PBC, respectively. Age-adjusted HRs (95%CI) were 0.83 (0.70-0.97) for all-cause and 0.62 (0.44-0.88) for CVD mortality. When the analyses were restricted to employed salaried workers, HRs reduced to 0.98 (0.82-1.19) for all-cause and to 0.83 (0.55-1.24) for CVD mortality. In stratified analyses, blue-collar workers showed a potential HWE for CVD mortality only (HR: 0.63; 0.34-1.16). Conclusion: When employment information is available, PBC can complement WBC in evaluating the relationship between occupational exposures and all-cause mortality.

Mathilde, Bureau ; Hélène, Budzinski ; Pierre, Lebailly ; Isabelle, Baldi

Abstract

Objective: The greenspace sector includes a broad range of branches (gardens, public facilities, communication network, flowers/ornamental plant production, etc.). Workers are exposed to many occupational hazards including pesticides. However, very few expology studies have been conducted and knowledge on their exposure is scarce. The EVISA project (funded by the National Research Agency) intends to better document pesticide exposure in this sector. One objective is to characterize exposure levels in real work conditions and to identify the determinants of exposure. Material & Methods: Field studies have been conducted to measure the levels of contamination during treatment and reentry tasks. Dermal contamination was assessed using cotton patches place onto the skin and cotton gloves; and respiratory contamination was measured with portative pumps. Detailed information on the tasks were collected to identify the determinants of exposure. Results: From 2022 to 2024, a total of 90 observations have been conducted: i) 30 during treatment tasks on ornamental plant nurseries and industrial facilities using various types of equipment (knapsack/handgun sprayers, mounted atomizer, etc.); ii) 50 in flowers and plant nurseries during reentry tasks such as flower harvesting, preparation of bouquets, stapling and training, manual weeding, etc.; and iii) 10 in golf courses during treatment. Contaminations from 18 fungicides, 8 insecticides and 4 herbicides have been investigated. Analyses of dosimeters are ongoing and will be linked with the detailed characteristics collected on workers, tasks, work conditions, equipment and practices. Conclusion: This large-scale project is the first to our knowledge to document pesticide exposure among greenspace workers in various situations. The data generated will help to i) build better metrics usable in epidemiological studies; ii) propose prevention measured tailored to these workers and iii) improve models used for estimating operator exposure in the pesticide registration process.