8291693 Occupational exposure to succinate dehydrogenase-inhibiting fungicides and risk of kidney cancer among farmers in the French AGRICAN cohort

<h3>Objectives</h3> Few occupational exposures are definitely associated with kidney cancer. Because of its role in blood detoxication, the study of chemical exposure is of particular interest for this cancer. In the agricultural workplace, chemical risk is represented in particular by pesticides, yet studies of the links between kidney cancer and pesticides are rare. Succinate dehydrogenase-inhibiting (SDHI) fungicides exert their action by interfering with cellular respiration, and succinate dehydrogenase deficiency has been identified in some rare cases of kidney cancer. The aim of our study is to investigate the associations between exposure to SDHI fungicides and the risk of kidney cancer. <h3>Material and Methods</h3> Pesticide use and the type of crops concerned were assessed using questionnaire data from the AGRICAN cohort, a large prospective French cohort including ~180,000 people, ~135,000 of them were farmers, set up between 2005 and 2007. The questionnaire also provided data on potential confounding factors: smoking, BMI, hypertension. Data from the PESTIMAT crop-exposure matrix were used to determine which pesticide active ingredients may have been used, depending on the year and crop. Exposure scores were established, considering the probability, frequency, intensity of use and duration for each active ingredient. Kidney cancer cases were identified via cancer registries. Cox models with attained age as the time scale were used and subjects followed up to December 31st 2017. <h3>Results</h3> The analyses are currently in progress. We identified 654 renal cancer cases overall, and 14 active substances from the SDHI family likely to have been used in France. Of these, 5 were introduced before the 2000s (carboxin, oxycarboxin, mepronil, fenfuram, flutolanil). Analyses are being conducted separately for men and women, as pesticide exposure patterns and circumstances differ according to gender. <h3>Discussion</h3> Ten SDHI are still authorized: our results will be discussed with regard to their implications for further research and occupational health policies.