Abstract

Surveillance of both diseases and associated exposures is a major issue of public health, in particular for identifying and preventing new threats for health. Indeed, environmental exposure – health associations remain poorly understood and sometimes not elucidated due to the lack of exploitation of data and global view of population exposures including critical periods of exposure or during exposed occupations. In the occupational health context, we used the observational database of the Occupational Health Problems (OHPs) from the RNV3P network (French National Network of Surveillance and Prevention of Occupational Diseases) to investigate the relationship structure of OHPs with occupational (multi)-exposures. And, to improve our understanding and capability of analysing occupational environment – health associations, we employed the newly developed Observational Surveillance method, based on the Occupational Exposome approach, for an optimal exploitation of the RNV3P database (of about 200 000 OHPs). The method involves structuring the data in terms of an occupational exposome, i.e., a relational network of significant occupational exposures associated with OHPs. It allows the identification of significant associations (disease related exposures and/or sectors) and the study of the spectrosome, i.e., the dynamical and structured spectrum of exposures associated to OHPs.

To illustrate, we considered the non-Hodgkin lymphoma (NHL) representing 90% of lymphomas and which the incidence was found increasing from 1970s until the end of the 20th century and starting to level off in the last few years. Causes of the increase and associated risk factors remain largely unknown. Exposures to solvents or agricultural products have been suggested, but the very widespread multi-exposure at the workplace prevents to conclude from epidemiological studies.

The spectrosome analyses of NHL from the RNV3P allowed to highlight new occupational (multi)-exposures, in addition to those already known, and to study the dynamic structure of occupational exposures and NHL relationship in specific workplace.