Petit Pascal, Chamot Sylvain, Al-Salameh Abdallah, Cancé Christophe, Desailloud Rachel, Bonneterre Vincent
CHU Grenoble Alpes, Centre Régional de Pathologies Professionnelles et Environnementales, 38000, Grenoble, France; Univ. Grenoble Alpes, AGEIS, 38000, Grenoble, France.
Regional Center for Occupational and Environmental Diseases of Hauts-de-France, Amiens University Hospital, 1 rond point du Pr Christian Cabrol, 80000, Amiens, France; Péritox (UMR_I 01), UPJV/INERIS, University of Picardy Jules Verne, Chemin du Thil, 80025, Amiens, France.
Environ Res. 2024 May 15;249:118458. doi: 10.1016/j.envres.2024.118458. Epub 2024 Feb 15.
BACKGROUND: Epidemiological data regarding thyroid diseases are lacking, in particular for occupationally exposed populations. OBJECTIVES: To compare the risk of hypothyroidism and hyperthyroidism between farming activities within the complete population of French farm managers (FMs). METHODS: Digital health data from retrospective administrative databases, including insurance claims and electronic health/medical records, was employed. This cohort data spanned the entirety of French farm managers (FMs) who had undertaken work at least once from 2002 to 2016. Survival analysis with the time to initial medication reimbursement as timescale was used to examine the association (hazard ratio, HR) between 26 specific farming activities and both treated hypothyroidism and hyperthyroidism. A distinct model was developed for each farming activity, comparing FMs who had never engaged in the specific farming activity between 2002 and 2016 with those who had. All analyses were adjusted for potential confounders (e.g., age), and sensitivity analyses were conducted. RESULTS: Among 1088561 FMs (mean age 46.6 [SD 14.1]; 31% females), there were 31834 hypothyroidism cases (75% females) and 620 hyperthyroidism cases (67% females), respectively. The highest risks were observed for cattle activities for both hyperthyroidism (HR ranging from 1.75 to 2.42) and hypothyroidism (HR ranging from 1.41 to 1.44). For hypothyroidism, higher risks were also observed for several animal farming activities (pig, poultry, and rabbit), as well as fruit arboriculture (HR = 1.22 [1.14-1.31]). The lowest risks were observed for activities involving horses. Sex differences in the risk of hypothyroidism were observed for eight activities, with the risk being higher for males (HR = 1.09 [1.01-1.20]) than females in viticulture (HR = 0.97 [0.93-1.00]). The risk of hyperthyroidism was two times higher for male dairy farmers than females. DISCUSSION: Our findings offer a comprehensive overview of thyroid disease risks within the FM community. Thyroid ailments might not stem from a single cause but likely arise from the combined effects of various causal agents and triggering factors (agricultural exposome). Further investigation into distinct farming activities-especially those involving cattle-is essential to pinpoint potential risk factors that could enhance thyroid disease monitoring in agriculture.
背景：关于甲状腺疾病的流行病学数据匮乏，尤其是职业暴露人群的数据。 目的：比较法国农场管理者（FM）全体人群中从事农业活动者患甲状腺功能减退症和甲状腺功能亢进症的风险。 方法：使用了来自回顾性行政数据库的数字健康数据，包括保险理赔和电子健康/医疗记录。该队列数据涵盖了2002年至2016年至少工作过一次的所有法国农场管理者（FM）。以首次药物报销时间为时间尺度进行生存分析，以检验26种特定农业活动与治疗的甲状腺功能减退症和甲状腺功能亢进症之间的关联（风险比，HR）。针对每种农业活动建立了一个独特的模型，将2002年至2016年从未从事过特定农业活动的FM与从事过该活动的FM进行比较。所有分析均对潜在混杂因素（如年龄）进行了调整，并进行了敏感性分析。 结果：在1088561名FM中（平均年龄46.6岁[标准差14.1]；31%为女性），分别有31834例甲状腺功能减退症病例（75%为女性）和620例甲状腺功能亢进症病例（67%为女性）。甲状腺功能亢进症（HR范围为1.75至2.42）和甲状腺功能减退症（HR范围为1.41至1.44）的最高风险均出现在养牛活动中。对于甲状腺功能减退症，在几种畜牧业活动（养猪、家禽和养兔）以及果树栽培中也观察到较高风险（HR =
Environ Sci Pollut Res Int. 2025-3
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