November 2021 additions to NERDB

November 2021 additions to NERDB

NERDB is the New and emerging risks database. This bibliographic database is an initiative of Nicole Palmen and Annet Lenderink with the support of Modernet and is currently powered by Airtable.

More information on this database on the NERDB page

On the website, we will publish regular updates on new disease-exposure combinations we added to the database. Currently, we have 320 entries. Ordered by year in which the abstract is published

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Last new entries:

Afbeelding van Jill Wellington via Pixabay

Ronsmans S, De Ridder J, Vandebroek E, Keirsbilck S, Nemery B, Hoet PHM, Vanderschueren S, Wuyts WA, Yserbyt J. Associations between occupational and environmental exposures and organ involvement in sarcoidosis: a retrospective case-case analysis. Respir Res. 2021 Aug 9;22(1):224. doi: 10.1186/s12931-021-01818-5. PMID: 34372845; PMCID: PMC8351152.

Sarcoidosis most commonly affects lungs and intrathoracic lymph nodes, but any other organ can be involved. In epidemiological studies, many occupational and environmental exposures have been linked to sarcoidosis, but their relationship with the disease phenotype has barely been studied.

The aim of the authors was to investigate how occupational and environmental exposures prior to diagnosis relate to organ involvement in patients with sarcoidosis. They retrospectively studied patients seen at a sarcoidosis clinic between 2017 and 2020. Patients were included if they had a clinical presentation consistent with sarcoidosis and histologically confirmed epithelioid granulomas, or had Löfgren syndrome. In a case-case analysis using multivariable logistic regression, we calculated odds ratios (OR) of prespecified exposure categories (based on expert ascertainment) for cases with a given organ involvement versus cases without this organ involvement.

They included 238 sarcoidosis patients. Sarcoidosis limited to pulmonary involvement was associated with exposure to inorganic dust prior to diagnosis (OR 2.11; 95% confidence interval [CI] 1.11-4.17).

Patients with liver involvement had higher odds of contact with livestock (OR 3.68; 95% CI 0.91-12.7) or having jobs with close human contact (OR 4.33; 95% CI 1.57-11.3) than patients without liver involvement. Similar associations were found for splenic involvement (livestock: OR 4.94, 95% CI 1.46-16.1; close human contact: OR 3.78; 95% CI 1.47-9.46).

Cardiac sarcoidosis was associated with exposure to reactive chemicals (OR 5.08; 95% CI 1.28-19.2) or livestock (OR 9.86; 95% CI 1.95-49.0).

Active smokers had more ocular sarcoidosis (OR 3.26; 95% CI 1.33-7.79).

The authors conclude that their study indicates that, in sarcoidosis patients, different exposures might be related to different organ involvements-hereby providing support for the hypothesis that sarcoidosis has more than one cause, each of which may promote a different disease phenotype.

Morimoto, Y., Nishida, C., Tomonaga, T., Izumi, H., Yatera, K., Sakurai, K., & Kim, Y. (2021). Lung disorders induced by respirable organic chemicalsJournal of Occupational Health63(1), e12240.

Respirable organic chemicals were originally thought to cause allergic respiratory diseases, such as bronchial asthma and hypersensitivity pneumonitis, and believed not to cause lung disorders derived from inflammatory or fibrotic processes such as pulmonary fibrosis and interstitial pneumonitis. It has recently been reported, however, that exposure to organic chemicals can cause interstitial lung diseases. In this review, we discuss the clinical features of occupational asthma and hypersensitivity pneumonitis, as well as other lung disorders, including interstitial pneumonitis, caused by humidifier disinfectants in Korea and by a cross-linked acrylic acid-based polymer (CL-PAA) in Japan.

Perrin, L., Spinosi, J., Chaperon, L., Kab, S., Moisan, F., & Ebaz, A. (2021). Pesticides expenditures by farming type and incidence of Parkinson disease in farmers: A French nationwide studyEnvironmental Research197, 111161.

Professional pesticides’ exposure is associated with PD risk, but it remains unclear whether specific
products, which strongly depend on the farming type, are specifically involved. The authors performed a nationwide ecological study to examine the association of pesticides expenditures for the main farming types with PD incidence in French farmers. They used the French National Health Insurance database to identify incident PD cases in farmers (2010–2015). We combined data on pesticides expenditures with the agricultural census to compute pesticides expenditures for nine farming types in 2000 in 3571 French cantons. The association between pesticides expenditures and PD age/sex standardized incidence was examined using multilevel Poisson regression, adjusted for smoking, neurologists’ density, and deprivation index.

As a result, 10,282 incident PD cases were identified. Cantons with the highest pesticides expenditures for vineyards without designation of origin were characterized by 16% (95% CI = 6–28%) higher PD incidence (p-trend corrected for multiple testing = 0.006). This association was significant in men and older farmers. There was no association with pesticides expenditures for other farming types, including vineyards with a designation of origin.

PD incidence increased significantly with pesticides expenditures in vineyards without designation
of origin characterized by high fungicide use
. This result suggests that agricultural practices and pesticides used in these vineyards may play a role in PD and that farmers in these farms should benefit from preventive measures aiming at reducing exposure. Our study highlights the importance of considering farming type in studies on pesticides and PD and the usefulness of pesticides expenditures for exposure assessment.

Shrestha, S., Parks, C. G., Umbach, D. M., Richards-Barber, M., Hofmann, J. N., Chen, H., … & Sandler, D. P. (2020). Pesticide use and incident Parkinson’s disease in a cohort of farmers and their spousesEnvironmental Research191, 110186.

Extensive literature suggests an association between general pesticide use and Parkinson’s disease
(PD). However, with few exceptions, little is known about associations between specific pesticides and PD. That is why the authors evaluated the use of pesticides and incident PD in 38,274 pesticide applicators and 27,836 of their spouses in the Agricultural Health Study cohort followed over 20 years. They used self-reported information on the ever-use of 50 specific pesticides as of enrollment for both applicators and spouses, and considered intensity-weighted lifetime days (IWLD) reported at enrollment and through the first 5-year follow-up among applicators. They estimated covariate-adjusted hazard ratios (HR) and 95% confidence intervals (CI) using Cox regression. We also examined heterogeneity in associations by a history of head injury and chemical-resistant glove use.

A total of 373 applicators and 118 spouses self-reported incident doctor-diagnosed PD. Ever-use of the
insecticide terbufos (HR:1.31, 95%CI:1.02–1.68) and the herbicides trifluralin (HR:1.29, 95%CI: 0.99–1.70) and
2,4,5-T (HR:1.57, 95%CI:1.21–2.04) was associated with elevated PD risk. On the other hand, diazinon (HR:0.73, 95%CI: 0.58–0.94) and 2,4,5-TP (HR:0.39, 95%CI:0.25–0.62) were associated with reduced risk.

They observed heterogeneity in ever-use associations by head injury and chemical-resistant glove use for some pesticides, with a higher risk among those who reported a history of head injury, or who did not use gloves. PD risk was also elevated for applicators in the highest category of IWLD for dichlorvos, permethrin (animal use), and benomyl.

They found evidence of increased PD risk for some pesticides. Our results also suggest higher susceptibility for pesticide-associated PD among individuals with a head injury, as well as protection without the use of
chemical-resistant gloves, although further research is needed to understand the impact of head injury. Research on current and newer pesticides, including mechanisms relevant to PD, is important given widespread pesticide use.



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