Abstract
This work is part of a global project aiming to use medico-administrative big data from the whole French agricultural population (~3 millions), collected through their mandatory health insurance system (Mutualité Sociale Agricole), to highlight associations between chronic diseases and agricultural activities. At the request of the French Agency for Food, Environmental and Occupational Health & Safety (ANSES), our objective was to estimate which pesticides were probably used by each agricultural worker, in order to include this information in our analyses and search for association with diseases. We selected five databases to achieve this objective: the Graphical Land Parcel Registration (RPG), the French Agricultural Census, “Cultivation Practice” surveys from the Agriculture ministry, the MATPHYTO crop-exposure matrix and the Compilation of Phytosanitary Indexes from the French Public Health Agency. A geographical grid was designed to use geographical location while maintaining worker anonymity, dividing France into square tracts of variable surface each containing a minimum of 1500 agricultural workers. We developed an automated algorithm to predict each individual potential exposure by crossing her/his occupational activity, the geographical grid and the RPG to deduce cultivation practices and use it as a gateway to estimate pesticides use. This approach allowed drawing, from administrative data, a list of substances potentially used by each agricultural worker throughout France. Results of the algorithm are illustrated at collective level (descriptive statistics for the whole population), as well as at individual level (some workers taken as examples). The generalization of this method in other national contexts is discussed. By linking this information with the health insurance databases, this approach could contribute to the agricultural workers health surveillance.
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Acknowledgements
We thank the Mutualité Sociale Agricole (MSA) for their support, especially Nadia Joubert (current head of MSA statistical department), Alain Pelc (former head of MSA statistical department), the Medical prestation data department supervised by Damien Ozenfant, as well as privileged contact, Marc Parmentier, Patrick Le Bourhis and Valérie Vincent (Contributors data), Nicolas Sabin (Long Term Diseases Data), Nicolas Viarouge and Sébastien Odiot (occupational accidents and diseases data), Thierry Grech (Retirees data), as well as Prof William Dab (former chair of MSA scientific committee), Prof Anne Laure Crémieux (former MSA national physician) and Prof Jean Marc Soulat (current MSA national physician) for their interest and support for this work. We thank the French Agency for Food, Environmental and Occupational Health & Safety ANSES, for the grant which allowed this project to be conducted, and especially Mathilde Merlo, Alexandra Papadopoulos, Fabrizio Botta, and Jean Luc Volatier for their technical and scientific support. We thank the French Public Health Agency, Santé Publique France, especially Johan Spinosi and Laura Chaperon (agronomists) and Mounia El Yamani (head of the occupational exposure assessment Unit) to have made their crop-exposure matrix available for this work, and for their technical support on agricultural practices. Finally, we thank Alison Foote (Grenoble Alpes University Hospital) for editing the manuscript.
Funding
This project was funded and supported by ANSES (grant agreement 2016-CRD-03_PPV16) via the tax on sales of plant protection products. The proceeds of this tax are assigned to ANSES to finance the establishment of the system for monitoring the adverse effects of plant protection products, called ‘phytopharmacovigilance’ (PPV), established by the French Act on the Future of Agriculture of 13 October 2014.
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VB and DBR designed the project and acquired the necessary funding and collaborations. AP and DBR performed data management, data analysis and algorithm development. CC provided expertise in GIS and performed the geographical grid. JS provided crop exposures matrices and technical support on cultural practices. DO provided MSA data and technical support on medico-administrative aspects. VB, DBR, AP and CM contributed to the data interpretation. AP, CM, DBR and VB wrote the manuscript. All authors discussed the results and commented on the manuscript.
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Achard, P., Maugard, C., Cancé, C. et al. Medico-administrative data combined with agricultural practices data to retrospectively estimate pesticide use by agricultural workers. J Expo Sci Environ Epidemiol 30, 743–755 (2020). https://doi.org/10.1038/s41370-019-0166-x
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DOI: https://doi.org/10.1038/s41370-019-0166-x


