Occupational pesticide exposure, cancer and chronic neurological disorders: A systematic review of epidemiological studies in greenspace workers.

CONTEXT: The greenspace sector includes a broad range of occupations: gardeners, landscapers, municipal workers, maintenance operators of public facilities, golf-course employees and other sports facilities, horticulturists, plant and tree nursery workers etc. The health impact of occupational pesticide exposure has mainly been studied among farmers. Other professionals such as greenspace workers are also extremely exposed, presenting specific exposure features (practices, types of pesticide used). The aim of this review was to summarize epidemiological literature that examine the relationship between pesticide exposure and the risk of cancer and long-term health effects in greenspace workers. METHOD: Six main groups of greenspace workers were identified and examined through a systematic literature review based on PubMed and Scopus. The studies were then grouped according to their design, health outcomes and the type of population studied. RESULTS: Forty-four articles were selected among the 1679 identified. Fifteen studies were conducted exclusively among greenspace workers, while ten also studied these workers with other pesticide applicators. Six were cohorts from the general population in which greenspace workers were identified. Elevated risks were found in several studies for leukaemia, soft-tissue sarcoma, multiple myeloma, non-Hodgkin lymphoma and Parkinson's disease. DISCUSSION: The majority of studies used rough parameters for defining exposure such as job titles which could lead to the misclassification of exposure, with the risk of false or positive negative conclusions. Health outcomes were mainly collected through registries or death certificates, and information regarding potential confounders was often missing. CONCLUSION: The review identified only 15 studies conducted exclusively among greenspace workers. Elevated risk was found for several sites of cancer and Parkinson's diseases. Further epidemiological research is needed, conducted specifically on these workers, to better characterize this population, its exposure to pesticides and the related health effects.

[The decrease in asthma-related mortality in France]. / Diminution de la mortalité par asthme en France.

INTRODUCTION: Asthma-related morbidity, mortality and socio- economic cost represent significant public health problems. Despite efficient therapies, in 1999 asthma still killed around 2000 people in France. METHODS: This study investigated the changes in asthma-related mortality in metropolitan France between 1980 and 2005 and examined its regional disparities. Annual age- and gender-specific mortality rates for asthma were calculated, as well as age-standardized rates. The change in asthma-related mortality was estimated by the annual average rate of change fitted using a log-linear regression model. Lastly, regional disparities were mapped. RESULTS: After having levelled off between 1990 and 1995, asthma- related mortality significantly decreased. From 2000 onwards the drop was more rapid in men than in women. The observed decrease was significant only in people aged more than 35 years. Moreover, regional disparities could be seen. CONCLUSIONS: The decline of asthma-related mortality that started in 1986 continued until 2005. Potential explanations could be better patient care due to consensus, including the use of inhaled corticosteroids and therapeutic education, and improvement in the recording of deaths.

The decrease in asthma-related mortality in France.

BACKGROUND: Asthma-related morbidity, mortality and socioeconomic cost represent significant public health problems. Despite efficient therapies, in 1999 asthma still killed around 2000 people in France. METHODS: This study investigated the changes in asthma-related mortality in metropolitan France between 1980 and 2005 and examined its regional disparities. Annual age- and gender-specific mortality rates for asthma were calculated, as well as age-standardized rates. The change in asthma-related mortality was estimated by the annual average rate of change fitted using a log-linear regression model. Lastly, regional disparities were mapped. RESULTS: After having levelled off between 1990 and 1995, asthma-related mortality significantly decreased. From 2000 onwards the drop was more rapid in men than in women. The observed decrease was significant only in people over 35. In 2005, there were 1129 deaths due to asthma. Moreover, regional disparities could be seen. CONCLUSIONS: The decline of asthma-related mortality that started in 1986 continued until 2005. Possible explanations could be better patient care, including the use of inhaled corticosteroids and therapeutic education, and improvement in the recording of deaths.