The AGRIculture and CANcer (AGRICAN) cohort study: enrollment and causes of death for the 2005-2009 period.

OBJECTIVE: To elaborate and describe a large prospective agricultural cohort including males and females in France with various agricultural activities and to study causes of death. METHODS: To date, few large prospective cohorts have been conducted among agricultural population. AGRIculture and CANcer cohort is a large prospective cohort of subjects in agriculture studying cancer among active and retired males and females, farm owners and workers, living in eleven areas of France with a population-based cancer registry. RESULTS: Enrollment was conducted from 2005 to 2007 with a postal questionnaire. In January 2008, 180,060 individuals (54 % males, 54 % farm owners, 50 % retired) were enrolled. Mortality was studied until December 2009 (605,956 person-years with standardized mortality ratio (SMR) by comparison with the general population of the areas. Over this period, 11,450 deaths 6,741 in men and 4,709 in women were observed, including 3,405 cancer-related deaths. SMRs were significantly reduced for global mortality (SMR = 0.68, 95 % CI 0.67-0.70 in males and SMR = 0.71, 95 % CI 0.69-0.73 in females) and for death by cancer (SMR = 0.67, 95 % CI 0.65, 0.70 in males and SMR = 0.76, 95 % C: 0.71, 0.80 in females). These results were mainly explained by less frequent smoking-related causes of death (lung cancer, cardiovascular diseases). Nonsignificant excesses of death were observed only for rheumatoid arthritis and arthrosis, suicides (in females), death for event of undetermined intent (in males) and breast cancer in male agricultural workers. CONCLUSIONS: These first results are the first ones obtained in France based on a large prospective agricultural cohort showing that farmers would be in healthier condition than the general population.

Biomechanical and psychosocial work exposures and musculoskeletal symptoms among vineyard workers.

OBJECTIVES: This study explored the associations between biomechanical and psychosocial work factors and musculoskeletal symptoms in vineyard workers. METHODS: This cross-sectional study was based on a random sample of 2,824 male and 1,123 female vineyard workers in France. Data were collected using a self-administered questionnaire. Neck/shoulder, back and upper and lower extremity symptoms were evaluated using the Nordic questionnaire. Biomechanical exposures included 15 tasks related to vineyard activities. Psychosocial work factors included effort-reward imbalance and overcommitment, measured using the effort-reward imbalance model, and low job control and insufficient material means. Statistical analysis was performed using logistic regression analysis, and the results were adjusted for age, body mass index, educational level, work status and years in vineyard. RESULTS: Pruning-related factors increased the risk of upper extremity pain for both genders, of back pain for men and of neck/shoulder and lower extremity pain for women. Driving increased the risk of neck/shoulder and back pain among men. Psychosocial work factors, which were insufficient material means, overcommitment (both genders), effort-reward imbalance (men) and low job control (women), were associated with musculoskeletal symptoms, back and upper extremity pain for both genders and neck/shoulder and lower extremity pain for men. CONCLUSIONS: These results underlined that both biomechanical and psychosocial work factors may play a role in musculoskeletal pain among vineyard workers. Prevention policies focusing on both biomechanical and psychosocial work exposures may be useful to prevent musculoskeletal symptoms.

[Harassment of personnel in contact with the public: from experiencing aggressive behaviour to preventing it]. / Agression du personnel en contact avec le public: de l'agression vécue à la prévention.

The Agricultural Social Mutual Insurance System (MSA) has been mobilised to support a corporate approach in the perspective to decrease mortal acts of violence or aggression. The plan brought together the skills of all the companies' actors (management, hygiene committees, safety and working conditions committee, occupational health and safety at work, and salaried workers). The MSA occupational health departments carried out a situational inventory (through a survey of salaried workers exposed to the risk of aggression). An intervention methodology was addressed to the occupational medical practitioners (PECVAT Protocol). A corporate framework agreement has specified the plan that was developed by company and the actors concerned. Finally, an evaluation enabled them to define the level at which this prevention intervention should be implemented.

[1966-2006: from occupational medicine to occupational health in agriculture]. / 1966-2006: de la médecine du travail a la santé au travail en agriculture.

Occupational medicine in agriculture was established in 1966 in a different and specific way as compared to occupational medicine in the commerce and industry social security scheme. The long preliminary debates resulted in the establishment of an occupational medicine for all farm employees and voluntary operators. This mission was entrusted to the Mutualité sociale agricole (MSA), a French welfare agency, which directly hires specifically trained occupational physicians. In parallel, preventive medicine examinations have been implemented for those insured by the MSA. The order adopted on May 11th, 1982, a reference regulation regarding occupational medicine in agriculture, was amended by the reform adopted in 2004. Occupational health in agriculture is now codified in the rural law.