Joëlle Févotte

Claude Bernard University Lyon 1, Villeurbanne, Rhône-Alpes, France

Are you Joëlle Févotte?

Claim your profile

Publications (68)196.46 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Few occupational studies have addressed head and neck cancer, and these studies have been predominantly conducted in men. Accordingly, our objective was to investigate the association between head and neck cancer and occupation in women.MethodsICARE, a French population-based case–control study, included 296 squamous cell carcinomas of the head and neck in women and 775 controls. Lifelong occupational history was collected. Odds ratios (ORs) and 95% confidence intervals (CI), adjusted for smoking, alcohol drinking and education level, were estimated for occupations and industries.ResultsAn elevated OR was observed for working proprietors working for 10 years or more (OR = 3.83, 95% CI: 1.12–13.0) with a significant trend with duration of employment (P = 0.047). Elevated but non-significant ORs were observed for street vendors (OR = 3.76, 95% CI: 0.99–14.3, P for trend = 0.13), bakers (OR = 4.19, 95% CI: 0.63–27.9, P for trend = 0.06), and welders and flame cutters (OR = 2.18, 95% CI: 0.33–14.4, P for trend = 0.05).Conclusions This exploratory study suggests a role of occupational exposures in the development of HN cancer in women. Further investigations of exposures to specific agents are needed. Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 10/2014; · 1.59 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We aimed to investigate the role of occupational exposure to chlorinated solvents in the aetiology of lung cancer.
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A17.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To describe the performance of a lifelong task-based questionnaire (TBQ) in estimating exposures compared with other approaches in the context of a case-control study. A sample of 93 subjects was randomly selected from a lung cancer case-control study corresponding to 497 jobs. For each job, exposure assessments for asbestos and polycyclic aromatic hydrocarbons (PAHs) were obtained by expertise (TBQ expertise) and by algorithm using the TBQ (TBQ algorithm) as well as by expert appraisals based on all available occupational data (REFERENCE expertise) considered to be the gold standard. Additionally, a Job Exposure Matrix (JEM)-based evaluation for asbestos was also obtained. On the 497 jobs, the various evaluations were contrasted using Cohen's κ coefficient of agreement. Additionally, on the total case-control population, the asbestos dose-response relationship based on the TBQ algorithm was compared with the JEM-based assessment. Regarding asbestos, the TBQ-exposure estimates agreed well with the REFERENCE estimate (TBQ expertise: level-weighted κ (lwk)=0.68; TBQ algorithm: lwk=0.61) but less so with the JEM estimate (TBQ expertise: lwk=0.31; TBQ algorithm: lwk=0.26). Regarding PAHs, the agreements between REFERENCE expertise and TBQ were less good (TBQ expertise: lwk=0.43; TBQ algorithm: lwk=0.36). In the case-control study analysis, the dose-response relationship between lung cancer and cumulative asbestos based on the JEM is less steep than with the TBQ-algorithm exposure assessment and statistically non-significant. Asbestos-exposure estimates based on the TBQ were consistent with the REFERENCE expertise and yielded a steeper dose-response relationship than the JEM. For PAHs, results were less clear.
    Occupational and environmental medicine 09/2013; · 3.23 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the associations between occupations and head and neck (HN) cancer risk in men. ICARE is a French population-based case-control study on HN cancer. Analyses included 1833 cases and 2747 controls. Complete occupational history was collected. Odds ratios (ORs) were estimated for occupations and industries ever held and according to duration of employment. Elevated ORs, increasing with duration of employment, were observed for several occupations, including cleaners (OR = 1.7; 95% confidence interval [CI], 1.0 to 2.8), launderers (OR = 6.8; CI, 1.3 to 34.4), firefighters (OR = 3.9; CI, 1.4 to 11.2), several agricultural occupations, welders (OR = 1.9; CI, 1.3 to 2.8), structural metal preparers and erectors (OR = 2.1; CI, 1.2 to 3.7), rubber workers (OR = 2.0; CI, 1.0 to 3.9), several construction occupations, and material-handling equipment operators (OR = 1.8; CI, 1.1 to 2.9). Analyses by industry corroborated these findings. These results confirmed the role of occupational exposures in HN cancer.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 08/2013; · 1.88 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In 2003, a cluster of renal cell carcinoma (RCC) cases was reported among men working at a French chemical plant using a proprietary process to produce vitamin A. The 10 index cases yielded a standardised incidence ratio of 13.1 for 1994-2002. Nine of these 10 cases were diagnosed by a plant-specific abdominal ultrasonography screening programme that targeted exposure to an intermediate chemical, 4-chloro-1,1-dimethoxy-3-methyl-2-butene, commonly named 'chloracetal C5', suspected as the cause by some experts. Epidemiological investigations sought to examine the relations between occupational exposures and RCC. A retrospective cohort mortality study and a nested case-control study were conducted. The cohort study included all workers who had been employed at the plant for at least 6 months between 1960 and 2003. The case-control study included an extensive search within the region for other kidney cancer cases among the cohort members. Industrial hygienists assessed occupational exposure. From 1968 to 2006, no significant excess mortality was observed for all causes of death or for all cancers. We found excess mortality for kidney cancer only among women. The nested case-control study showed a dose-response relation for cumulative exposure to chloracetal C5: the OR rose from 2.5 in the low-exposure category to 10.5 in the high-exposure group. Adjustment for screening attenuated this relation. The results of the case-control study were consistent with the positive results of in vivo genotoxic tests and suggest that chloracetal C5 can have a causal role in RCC.
    Occupational and environmental medicine 08/2013; · 3.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the potential association between occupational exposure to chlorinated and petroleum solvents and mycosis fungoides (MF). A questionnaire on lifetime job history was administered to 100 patients diagnosed with MF and 2846 controls. Odds ratios (ORs) were calculated as the measure of the association between exposure to each specific solvent and MF. In the total sample and in men, cases and controls did not differ in relation to exposure to any of the solvents studied. In women, an association with MF was seen for the highest level of estimated exposure to perchloroethylene (OR = 11.38; 95% confidence interval: 1.04 to 124.85) and for exposure less than the median to kerosene/fuel/gasoil (OR = 8.53; 95% confidence interval: 1.11 to 65.62). These results do not provide conclusive evidence that exposure to solvents may increase risk of MF because they were not found in men.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 07/2013; · 1.88 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the risk of lung cancer associated with exposure to mineral wools (MWs), while taking into account smoking, asbestos, and crystalline silica exposures. The analyses were restricted to men (1350 cases and 1912 controls). Lifelong occupational history was collected. MWs and asbestos exposures were assessed, using task-exposure matrices and silica exposure, a job-exposure matrix. We observed consistent not-significant increased risks of lung cancer of the same order of magnitude among workers exposed to high levels of MWs (odds ratio, 1.4; 95% confidence interval: 0.9 to 2.2; for highest quartile of the Cumulative Exposure Index). These results do not allow to draw firm conclusion about a carcinogenic effect of MWs on the lung, but they cannot exclude it. Given the high number of potentially exposed workers, it will be necessary to replicate them in a future further removed from the asbestos ban.
    Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine 06/2013; · 1.88 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Occupational studies show a high risk of lung cancer related to arsenic exposure by inhalation; however, only a few studies, and with conflicting results, previously examined a potential link between arsenic exposure at work and skin cancer. The aim of this study is to assess airborne arsenic exposures at the workplace and to quantify associations with non-melanoma skin cancer (NMSC). The study sample consists of 618 incident cases of NMSC and 527 hospital-based controls aged 30-79 years from Hungary, Romania, and Slovakia. Exposures were evaluated by local experts using occupational histories. Information on host factors and other exposures was collected and employed to adjust the associations of interest using multivariable logistic regression. The lifetime prevalence of exposure to work-related arsenic is 23.9% for cases and 15.5% for controls. We do not detect a significant association between arsenic exposure in the workplace and NMSC, although an increased adjusted odd ratio is observed for participants with higher cumulative lifetime workplace exposure to arsenic in dust and fumes compared to referents (OR 1.94, 95% CI 0.76-4.95). There is evidence for modification of the workplace arsenic-NMSC association by work-related sunlight exposure in women, with a markedly increased adjusted odds ratio in the presence of workplace sunlight exposure (OR 10.22, 95% CI 2.48-42.07). Workplace co-exposure to arsenic and sunlight may thus pose an increased risk of NMSC. © 2013 Wiley Periodicals, Inc.
    International Journal of Cancer 04/2013; · 6.20 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: RATIONALE: Occupational co-exposure to asbestos and other fibers or particles could modify the carcinogenicity of asbestos with regard to pleural mesothelioma. OBJECTIVES: To estimate associations between pleural mesothelioma and occupational mineral wool and silica exposure and to study the impact of occupational co-exposure on the risk of pleural mesothelioma. METHODS: 1,199 male cases and 2,379 controls were included in a French pooled case-control study. Complete job histories were collected and occupational exposure to asbestos, mineral wool (MW), and silica were assessed by three French job exposure matrices. Unconditional logistic regression models adjusted for age, birth date, and occupational asbestos exposure were used to estimate odds ratios (OR) and 95% confidence intervals. MEASUREMENTS AND MAIN RESULTS: A significant association between mesothelioma and MW exposure was observed after adjustment for occupational asbestos exposure. OR for subjects exposed to less than 0.01 f/ml-y was 1.6 (95% CI: 1.2-2.1) and increased to 2.5 (95% CI: 1.8-3.4) for subjects exposed to more than 0.32 f/ml-y. All ORs for silica exposure were around the null. Co-exposure to either asbestos and MW or asbestos and silica seemed to increase the risk of pleural mesothelioma. ORs were 17.6 (95% CI: 11.8-26.2) and 9.8 (95% CI: 4.2-23.2) for subjects exposed to both asbestos and MW and for subjects exposed to both asbestos and silica, respectively, compared to 4.3 (95% CI: 1.9-9.8) for occupational asbestos exposure alone. CONCLUSION: Our results are in favour of an increased risk of pleural mesothelioma for subjects exposed to both asbestos and MW or asbestos and silica.
    American Journal of Respiratory and Critical Care Medicine 03/2013; · 11.04 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Studies suggest that ambient sunlight plays an important role in the pathogenesis of non-melanoma skin cancers (NMSC). However, there is ongoing controversy regarding the relevance of occupational exposure to natural and artificial ultraviolet radiation (UV) radiation. We investigated potential associations between natural and artificial UV radiation exposure at work with NMSC in a case-control study conducted in Hungary, Romania, and Slovakia. Occupational exposures were classified by expert assessment for 527 controls and 618 NMSC cases (515 basal cell carcinoma, BCC). Covariate information was collected via interview and multiple logistic regression models were used to assess associations between UV exposure and NMSC. Lifetime prevalence of occupational exposure in the participants was 13% for natural UV radiation and 7% for artificial UV radiation. Significant negative associations between occupational exposure to natural UV radiation and NMSC were detected for all who had ever been exposed (odds ratio (OR) 0.47, 95% confidence interval (CI) 0.27-0.80); similar results were detected using a semi-quantitative metric of cumulative exposure. The effects were modified by skin complexion, with significantly decreased risks of BCC among participants with light skin complexion. No associations were observed in relation to occupational artificial UV radiation exposure. The protective effect of occupational exposure to natural UV radiation was unexpected, but limited to light-skinned people, suggesting adequate sun-protection behaviors. Further investigations focusing on variations in the individual genetic susceptibility and potential interactions with environmental and other relevant factors are planned.
    PLoS ONE 01/2013; 8(4):e62359. · 3.53 Impact Factor
  • Archives des Maladies Professionnelles et de l Environnement 11/2012; 73(5):723–724. · 0.09 Impact Factor
  • Archives des Maladies Professionnelles et de l Environnement 11/2012; 73(5):716. · 0.09 Impact Factor
  • Archives des Maladies Professionnelles et de l Environnement 11/2012; 73(5):713. · 0.09 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES: Trichloroethylene (TCE) is suspected of association with elevated risk of cervical cancer. A case-control study was performed in a geographical area in which occupational TCE exposure is high. The study objective was to analyze the correlation between occupational TCE exposure and cervical cancer (including precancerous conditions). METHODS: Case and control subjects were recruited by gynecologists. General and occupational data were collected by telephonic interviews. An industrial hygienist assessed occupational TCE exposure on a task-exposure matrix. Analysis focused on occupational TCE exposure at various levels and on cumulative dose. Multivariate analysis was performed to take account of the various risk factors. RESULTS: In total, 67 case and 67 age-matched control subjects were included. Mean age was 36 years in both groups. Five of the possible general risk factors correlated significantly with cervical dysplasia or cancer: number of partners, history of genital or anal wart, interval between first period and first sexual relation, parity, and body mass index, the last three showing inverse correlation. Elevated risk was found in women who had had jobs as manual workers according to the PCS French classification (professions and socioprofessional categories), and production and related workers according to ISCO classification (International Standard Classification of Occupations), with odds ratios (ORs), adjusted on general and medical risk factors, of 7.68 [95% confidence interval (CI): 1.39-42.54] and 7.48 (1.30-43.24), respectively, among skilled service sector workers; the adjusted OR was close to significance, at 4.67 (95% CI: 0.92-23.67). No occupational sectors were significantly associated with elevated risk. In all, 17 (25.4%) case and 15 (22.4%) control subjects were exposed to TCE: raw OR = 1.17 (95% CI: 0.54-2.52), adjusted OR = 1.51 (95% CI: 0.42-5.41). There was no significant correlation between cumulative dose and exposure time. CONCLUSIONS: The study found no significantly increased risk of cervical dysplasia or cancer associated with occupational TCE exposure.
    Annals of Occupational Hygiene 10/2012; · 2.07 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVES: We describe the elaboration and sensitivity analyses of a quantitative job-exposure matrix (SYN-JEM) for respirable crystalline silica (RCS). The aim was to gain insight into the robustness of the SYN-JEM RCS estimates based on critical decisions taken in the elaboration process. METHODS: SYN-JEM for RCS exposure consists of three axes (job, region, and year) based on estimates derived from a previously developed statistical model. To elaborate SYN-JEM, several decisions were taken: i.e. the application of (i) a single time trend; (ii) region-specific adjustments in RCS exposure; and (iii) a prior job-specific exposure level (by the semi-quantitative DOM-JEM), with an override of 0 mg/m (3) for jobs a priori defined as non-exposed. Furthermore, we assumed that exposure levels reached a ceiling in 1960 and remained constant prior to this date. We applied SYN-JEM to the occupational histories of subjects from a large international pooled community-based case-control study. Cumulative exposure levels derived with SYN-JEM were compared with those from alternative models, described by Pearson correlation ( (Rp) ) and differences in unit of exposure (mg/m (3) -year). Alternative models concerned changes in application of job- and region-specific estimates and exposure ceiling, and omitting the a priori exposure ranking. RESULTS: Cumulative exposure levels for the study subjects ranged from 0.01 to 60 mg/m (3) -years, with a median of 1.76 mg/m (3) -years. Exposure levels derived from SYN-JEM and alternative models were overall highly correlated (R (p) > 0.90), although somewhat lower when omitting the region estimate ( (Rp) = 0.80) or not taking into account the assigned semi-quantitative exposure level (R (p) = 0.65). Modification of the time trend (i.e. exposure ceiling at 1950 or 1970, or assuming a decline before 1960) caused the largest changes in absolute exposure levels (26-33% difference), but without changing the relative ranking ( (Rp) = 0.99). CONCLUSIONS: Exposure estimates derived from SYN-JEM appeared to be plausible compared with (historical) levels described in the literature. Decisions taken in the development of SYN-JEM did not critically change the cumulative exposure levels. The influence of region-specific estimates needs to be explored in future risk analyses.
    Annals of Occupational Hygiene 07/2012; · 2.07 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Night work involving disruption of circadian rhythm was suggested as a possible cause of breast cancer. We examined the role of night work in a large population-based case-control study carried out in France between 2005 and 2008. Lifetime occupational history including work schedules of each night work period was elicited in 1,232 cases of breast cancer and 1,317 population controls. Thirteen percent of the cases and 11% of the controls had ever worked on night shifts (OR = 1.27 [95% confidence interval = 0.99-1.64]). Odds ratios were 1.35 [1.01-1.80] in women who worked on overnight shifts, 1.40 [1.01-1.92] in women who had worked at night for 4.5 or more years, and 1.43 [1.01-2.03] in those who worked less than three nights per week on average. The odds ratio was 1.95 [1.13-3.35] in women employed in night work for >4 years before their first full-term pregnancy, a period where mammary gland cells are incompletely differentiated and possibly more susceptible to circadian disruption effects. Our results support the hypothesis that night work plays a role in breast cancer, particularly in women who started working at night before first full-term pregnancy.
    International Journal of Cancer 06/2012; · 6.20 Impact Factor
  • Archives des Maladies Professionnelles et de l Environnement 06/2012; 73(3):416-418. · 0.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to compute attributable fractions (AF) to occupational factors in an area in North-Eastern France with high lung cancer rates and a past of mining and steel industry. A population-based case-control study among males aged 40-79 was conducted, including confirmed primary lung cancer cases from all hospitals of the study region. Controls were stratified by broad age-classes, district and socioeconomic classes. Detailed occupational and personal risk factors were obtained in face-to-face interviews. Cumulative occupational exposure indices were obtained from the questionnaires. Attributable fractions were computed from multiple unconditional logistic regression models. A total of 246 cases and 531 controls were included. The odds ratios (ORs) adjusted on cumulative smoking and family history of lung cancer increased significantly with the cumulative exposure indices to asbestos, polycyclic aromatic hydrocarbons and crystalline silica, and with exposure to diesel motor exhaust. The AF for occupational factors exceeded 50%, the most important contributor being crystalline silica and asbestos. These AFs are higher than most published figures. This can be because of the highly industrialised area or methods for exposure assessments. Occupational factors are important risk factors and should not be forgotten when defining high-risk lung cancer populations.
    British Journal of Cancer 03/2012; 106(7):1346-52. · 5.08 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Occupation as a welder has been associated with a 25%-40% increase in lung cancer risk. This study aims to elucidate to what extent confounding by smoking and asbestos drives this association and to evaluate the role of welding-related exposures such as chromium. The study included 2,197 male incident lung cancer cases and 2,295 controls from Romania, Hungary, Poland, Russia, Slovakia, the Czech Republic, and the United Kingdom from 1998 to 2001. Information on risk factors was collected through face-to-face interviews. Experts assessed exposure to 70 agents, and risk estimates were adjusted for smoking and occupational exposures. Occupation as a welder/flame cutter (prevalence controls: 3.7%) was associated with an odds ratio of 1.36 (95% confidence interval (CI): 1.00, 1.86) after adjustment for smoking and occupational exposures including asbestos. An odds ratio of 1.18 (95% CI: 1.01, 1.38) was found for welding fumes (prevalence controls: 22.8%), increasing to 1.38 for more than 25 exposure years (95% CI: 1.09, 1.75). A duration-response association was also observed for mild steel welding without chromium exposure. In this population, occupational exposure to welding fumes accounted for approximately 4% of lung cancer cases, to which both stainless and mild steel welding contributed equally. Given that welding remains a common task for many workers, exposure to welding fumes represents an important risk factor for lung cancer.
    American journal of epidemiology 02/2012; 175(7):706-14. · 4.98 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: SYNERGY is a large pooled analysis of case-control studies on the joint effects of occupational carcinogens and smoking in the development of lung cancer. A quantitative job-exposure matrix (JEM) will be developed to assign exposures to five major lung carcinogens [asbestos, chromium, nickel, polycyclic aromatic hydrocarbons (PAH), and respirable crystalline silica (RCS)]. We assembled an exposure database, called ExpoSYN, to enable such a quantitative exposure assessment. Existing exposure databases were identified and European and Canadian research institutes were approached to identify pertinent exposure measurement data. Results of individual air measurements were entered anonymized according to a standardized protocol. The ExpoSYN database currently includes 356 551 measurements from 19 countries. In total, 140 666 personal and 215 885 stationary data points were available. Measurements were distributed over the five agents as follows: RCS (42%), asbestos (20%), chromium (16%), nickel (15%), and PAH (7%). The measurement data cover the time period from 1951 to present. However, only a small portion of measurements (1.4%) were performed prior to 1975. The major contributing countries for personal measurements were Germany (32%), UK (22%), France (14%), and Norway and Canada (both 11%). ExpoSYN is a unique occupational exposure database with measurements from 18 European countries and Canada covering a time period of >50 years. This database will be used to develop a country-, job-, and time period-specific quantitative JEM. This JEM will enable data-driven quantitative exposure assessment in a multinational pooled analysis of community-based lung cancer case-control studies.
    Annals of Occupational Hygiene 01/2012; 56(1):70-9. · 2.07 Impact Factor

Publication Stats

698 Citations
196.46 Total Impact Points


  • 2001–2014
    • Claude Bernard University Lyon 1
      • Unité mixte de recherche epidémiologique et de surveillance transport travail environnement
      Villeurbanne, Rhône-Alpes, France
  • 2012
    • Massey University
      • Centre for Public Health Research
      Palmerston North, Manawatu-Wanganui, New Zealand
  • 2011–2012
    • Institut de veille sanitaire
      • Department of Occupational Health
      Charenton, Île-de-France, France
    • University of Lyon
      Lyons, Rhône-Alpes, France
    • French Institute of Health and Medical Research
      • Centre de Recherche en Épidémiologie et Santé des Populations CESP U1018
      Paris, Ile-de-France, France
  • 2003–2011
    • International Agency for Research on Cancer
      Lyons, Rhône-Alpes, France
  • 2010
    • Universität Bremen
      • Bremen Institute for Prevention Research and Social Medicine (BIPS)
      Bremen, Bremen, Germany
  • 2007
    • University of Liverpool
      Liverpool, England, United Kingdom
    • Centrum Onkologii-Instytutu
      Warszawa, Masovian Voivodeship, Poland
  • 2004
    • Université René Descartes - Paris 5
      Lutetia Parisorum, Île-de-France, France
  • 2000
    • Institut Universitaire de France
      Lutetia Parisorum, Île-de-France, France