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Association des activités professionnelles et de l’exposition aux métaux avec deux maladies neurodégénératives à partir du Système National des Données de Santé

Abstract : Few French studies have examined the role of chemical exposures other than pesticides in neurodegenerative diseases. There are still uncertainties regarding the role of environmental or occupational exposure to metals in Parkinson’s disease (PD) and the excess risk of motor neuron disease (MND) among military personnel who can be exposed to lead and other products. We have examined these questions in France through nationwide incidence studies within national health insurance databases (Système National des Données de Santé, SNDS). We observed an increased PD incidence (2010-2014) in areas characterized by high proportions of workers in agriculture, metallurgy and textile sectors; occupational exposure to pesticides, metals, or solvents respectively may contribute to these associations. Furthermore, we observed a 16% increased incidence of MND (2010-2016) among men aged 50 years and older covered by the national military social security fund (Caisse nationale militaire de sécurité sociale) compared to men from the general population. This excess risk is possibly explained by smoking and occupational factors. Finally, we used biomonitoring data from mosses obtained in rural regions to investigate the role of atmospheric deposition of metals (copper, iron, mercury, manganese, lead, zinc) in PD. Its incidence (2010-2015) was 4% higher in areas where overall metal concentrations in mosses were the highest. There was a statistically significant positive association for copper and mercury. Using different indicators to assess exposure to metals, our work highlights the complexity of studies on the etiologic role of chemicals whose exposure determinants are both environmental and occupational.
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Tim Vlaar. Association des activités professionnelles et de l’exposition aux métaux avec deux maladies neurodégénératives à partir du Système National des Données de Santé. Santé publique et épidémiologie. Université Paris Saclay (COmUE), 2019. Français. ⟨NNT : 2019SACLS529⟩. ⟨tel-02436740⟩

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