Parental occupational exposure to pesticides at birth and risk of adult testicular germ cell tumours in offspring: a French nationwide case-control study

Adèle Paul; Aurélie Danjou; Astrid Coste; Hans Kromhout; Marie Lefevre; Johan Spinosi; Brigitte Dananché; Ann Olsson; Céline Lamouroux; Margot Guth; Rémi Béranger; Olivia Pérol; Helen Boyle; Christel Hersant; Vanessa Loup-Cabaniols; Segolene Veau; Jeanne Perrin; Joachim Schüz; Barbara Charbotel; Béatrice Fervers

doi:10.1136/oemed-2024-109893

Parental occupational exposure to pesticides at birth and risk of adult testicular germ cell tumours in offspring: a French nationwide case-control study

Adèle Paul^*
, Aurélie Danjou
, Astrid Coste
, Hans Kromhout
, Marie Lefevre
, Johan Spinosi
, Brigitte Dananché
, Ann Olsson
, Céline Lamouroux
, Margot Guth
, Rémi Béranger
, Olivia Pérol
, Helen Boyle
, Christel Hersant
, Vanessa Loup-Cabaniols
, Segolene Veau
, Jeanne Perrin
, Joachim Schüz
, Barbara Charbotel
, Béatrice Fervers^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective To assess the association between parental occupational pesticide exposures at birth and adult testicular germ cell tumour (TGCT) by histological subtype and the agreement between two pesticide job-exposure matrices (JEM).

Methods TGCT cases (n=454) and matched controls (n=670) aged 18–45 years were recruited from 20 French university hospitals into the TESTIS national case-control study. Paternal and maternal jobs at birth were obtained from interviews of participants and their mothers/relatives and coded into official nomenclatures (International Standard Classification of Occupations, French nomenclature of activity-1999). Two complementary JEMs, ALOHA+ and FRIJEM, assessed occupational exposure to all pesticides, herbicides, insecticides, fungicides with ALOHA+ for each parent by linking job titles to JEM-derived probability and intensity estimates (no/low/high). Cohen’s Kappa coefficient (κ) assessed their agreement. ORs and 95% CIs comparing exposure and levels of exposure with no exposure were estimated using conditional logistic regression adjusted for literature-based covariates statistically associated with TGCT and stratified by histological subtypes.

Results Agreement between ALOHA+and FRIJEM was moderate to substantial (κ 0.52–0.80). A statistically non-significant higher TGCT risk was observed for high paternal occupational pesticide exposure with ALOHA+ (OR 1.95, CI 0.98 to 3.84) and FRIJEM (OR 1.70, CI 0.88 to 3.28). With ALOHA+, statistically significant positive associations were seen for high paternal occupational exposure to herbicides (overall: OR 4.23, CI 1.75 to 10.22; seminomas: OR 4.78, CI 1.79 to 12.77; non-seminomas: OR 3.53, CI 1.21 to 10.3) and fungicides (overall: OR 2.09, CI 1.05 to 4.18; seminomas: OR 2.31, CI 1.02 to 5.23). No statistically significant associations were observed for other levels of paternal exposure or pesticide groups nor for maternal exposure.

Conclusion Only high paternal occupational exposure to pesticides at birth, especially herbicides and fungicides, was positively associated with TGCT.

Original language	English
Pages (from-to)	195-203
Number of pages	9
Journal	Occupational and Environmental Medicine
Volume	83
Issue number	4
Early online date	22 Jun 2026
DOIs	https://doi.org/10.1136/oemed-2024-109893
Publication status	Published - 22 Jul 2026

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/.

Funding

The project was supported by funding from the Institut National du Cancer (French National Cancer Institute, INCa, N°2013- 721 143) and the Institut National de la Santé et de la Recherche Médicale (Inserm, N°ENV201306/CLB). TESTISPro project was supported by funding from the Fondation de France (00099896). MG was supported by a doctoral grant from Université Claude Bernard Lyon 1 (grant number: not applicable). Funders were not involved in the study design, in the collection, analysis and interpretation of the data, in the writing of the report or in the decision to submit the paper for publication. We gratefully acknowledge the participants and their mothers for providing data, and medical practitioners for providing pathology reports. We are grateful to the medical teams of participating CECOS from the Fédération Française des CECOS, ART centres and maternity clinics that were involved in recruiting the study participants and their mothers. We acknowledge the Direction de la Recherche Clinique from the Toulouse University hospital for their contribution to the coordination of the investigation centres. We thank the IPSOS Company for conducting telephone interviews.

Funders	Funder number
Alpaca Research Foundation
Université Claude Bernard Lyon 1
Fédération Française des CECOS
Université de Toulouse
Institut National Du Cancer	2013- 721 143
Institut national de la santé et de la recherche médicale	ENV201306/CLB
Fondation de France	00099896

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Medical Oncology
Occupational Health
Pesticides
Urogenital System

Access to Document

10.1136/oemed-2024-109893Licence: CC BY-NC

195.fullFinal published version, 535 KBLicence: CC BY-NC

Cite this

Paul, A., Danjou, A., Coste, A., Kromhout, H., Lefevre, M., Spinosi, J., Dananché, B., Olsson, A., Lamouroux, C., Guth, M., Béranger, R., Pérol, O., Boyle, H., Hersant, C., Loup-Cabaniols, V., Veau, S., Perrin, J., Schüz, J., Charbotel, B., & Fervers, B. (2026). Parental occupational exposure to pesticides at birth and risk of adult testicular germ cell tumours in offspring: a French nationwide case-control study. Occupational and Environmental Medicine, 83(4), 195-203. https://doi.org/10.1136/oemed-2024-109893

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title = "Parental occupational exposure to pesticides at birth and risk of adult testicular germ cell tumours in offspring: a French nationwide case-control study",

abstract = "Objective To assess the association between parental occupational pesticide exposures at birth and adult testicular germ cell tumour (TGCT) by histological subtype and the agreement between two pesticide job-exposure matrices (JEM). Methods TGCT cases (n=454) and matched controls (n=670) aged 18{\textendash}45 years were recruited from 20 French university hospitals into the TESTIS national case-control study. Paternal and maternal jobs at birth were obtained from interviews of participants and their mothers/relatives and coded into official nomenclatures (International Standard Classification of Occupations, French nomenclature of activity-1999). Two complementary JEMs, ALOHA+ and FRIJEM, assessed occupational exposure to all pesticides, herbicides, insecticides, fungicides with ALOHA+ for each parent by linking job titles to JEM-derived probability and intensity estimates (no/low/high). Cohen{\textquoteright}s Kappa coefficient (κ) assessed their agreement. ORs and 95\% CIs comparing exposure and levels of exposure with no exposure were estimated using conditional logistic regression adjusted for literature-based covariates statistically associated with TGCT and stratified by histological subtypes. Results Agreement between ALOHA+and FRIJEM was moderate to substantial (κ 0.52{\textendash}0.80). A statistically non-significant higher TGCT risk was observed for high paternal occupational pesticide exposure with ALOHA+ (OR 1.95, CI 0.98 to 3.84) and FRIJEM (OR 1.70, CI 0.88 to 3.28). With ALOHA+, statistically significant positive associations were seen for high paternal occupational exposure to herbicides (overall: OR 4.23, CI 1.75 to 10.22; seminomas: OR 4.78, CI 1.79 to 12.77; non-seminomas: OR 3.53, CI 1.21 to 10.3) and fungicides (overall: OR 2.09, CI 1.05 to 4.18; seminomas: OR 2.31, CI 1.02 to 5.23). No statistically significant associations were observed for other levels of paternal exposure or pesticide groups nor for maternal exposure. Conclusion Only high paternal occupational exposure to pesticides at birth, especially herbicides and fungicides, was positively associated with TGCT.",

keywords = "Medical Oncology, Occupational Health, Pesticides, Urogenital System",

author = "Ad{\`e}le Paul and Aur{\'e}lie Danjou and Astrid Coste and Hans Kromhout and Marie Lefevre and Johan Spinosi and Brigitte Dananch{\'e} and Ann Olsson and C{\'e}line Lamouroux and Margot Guth and R{\'e}mi B{\'e}ranger and Olivia P{\'e}rol and Helen Boyle and Christel Hersant and Vanessa Loup-Cabaniols and Segolene Veau and Jeanne Perrin and Joachim Sch{\"u}z and Barbara Charbotel and B{\'e}atrice Fervers",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/.",

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doi = "10.1136/oemed-2024-109893",

language = "English",

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journal = "Occupational and Environmental Medicine",

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Paul, A, Danjou, A, Coste, A, Kromhout, H, Lefevre, M, Spinosi, J, Dananché, B, Olsson, A, Lamouroux, C, Guth, M, Béranger, R, Pérol, O, Boyle, H, Hersant, C, Loup-Cabaniols, V, Veau, S, Perrin, J, Schüz, J, Charbotel, B & Fervers, B 2026, 'Parental occupational exposure to pesticides at birth and risk of adult testicular germ cell tumours in offspring: a French nationwide case-control study', Occupational and Environmental Medicine, vol. 83, no. 4, pp. 195-203. https://doi.org/10.1136/oemed-2024-109893

Parental occupational exposure to pesticides at birth and risk of adult testicular germ cell tumours in offspring: a French nationwide case-control study. / Paul, Adèle; Danjou, Aurélie; Coste, Astrid et al.
In: Occupational and Environmental Medicine, Vol. 83, No. 4, 22.07.2026, p. 195-203.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Parental occupational exposure to pesticides at birth and risk of adult testicular germ cell tumours in offspring: a French nationwide case-control study

AU - Paul, Adèle

AU - Danjou, Aurélie

AU - Coste, Astrid

AU - Kromhout, Hans

AU - Lefevre, Marie

AU - Spinosi, Johan

AU - Dananché, Brigitte

AU - Olsson, Ann

AU - Lamouroux, Céline

AU - Guth, Margot

AU - Béranger, Rémi

AU - Pérol, Olivia

AU - Boyle, Helen

AU - Hersant, Christel

AU - Loup-Cabaniols, Vanessa

AU - Veau, Segolene

AU - Perrin, Jeanne

AU - Schüz, Joachim

AU - Charbotel, Barbara

AU - Fervers, Béatrice

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/.

PY - 2026/7/22

Y1 - 2026/7/22

N2 - Objective To assess the association between parental occupational pesticide exposures at birth and adult testicular germ cell tumour (TGCT) by histological subtype and the agreement between two pesticide job-exposure matrices (JEM). Methods TGCT cases (n=454) and matched controls (n=670) aged 18–45 years were recruited from 20 French university hospitals into the TESTIS national case-control study. Paternal and maternal jobs at birth were obtained from interviews of participants and their mothers/relatives and coded into official nomenclatures (International Standard Classification of Occupations, French nomenclature of activity-1999). Two complementary JEMs, ALOHA+ and FRIJEM, assessed occupational exposure to all pesticides, herbicides, insecticides, fungicides with ALOHA+ for each parent by linking job titles to JEM-derived probability and intensity estimates (no/low/high). Cohen’s Kappa coefficient (κ) assessed their agreement. ORs and 95% CIs comparing exposure and levels of exposure with no exposure were estimated using conditional logistic regression adjusted for literature-based covariates statistically associated with TGCT and stratified by histological subtypes. Results Agreement between ALOHA+and FRIJEM was moderate to substantial (κ 0.52–0.80). A statistically non-significant higher TGCT risk was observed for high paternal occupational pesticide exposure with ALOHA+ (OR 1.95, CI 0.98 to 3.84) and FRIJEM (OR 1.70, CI 0.88 to 3.28). With ALOHA+, statistically significant positive associations were seen for high paternal occupational exposure to herbicides (overall: OR 4.23, CI 1.75 to 10.22; seminomas: OR 4.78, CI 1.79 to 12.77; non-seminomas: OR 3.53, CI 1.21 to 10.3) and fungicides (overall: OR 2.09, CI 1.05 to 4.18; seminomas: OR 2.31, CI 1.02 to 5.23). No statistically significant associations were observed for other levels of paternal exposure or pesticide groups nor for maternal exposure. Conclusion Only high paternal occupational exposure to pesticides at birth, especially herbicides and fungicides, was positively associated with TGCT.

AB - Objective To assess the association between parental occupational pesticide exposures at birth and adult testicular germ cell tumour (TGCT) by histological subtype and the agreement between two pesticide job-exposure matrices (JEM). Methods TGCT cases (n=454) and matched controls (n=670) aged 18–45 years were recruited from 20 French university hospitals into the TESTIS national case-control study. Paternal and maternal jobs at birth were obtained from interviews of participants and their mothers/relatives and coded into official nomenclatures (International Standard Classification of Occupations, French nomenclature of activity-1999). Two complementary JEMs, ALOHA+ and FRIJEM, assessed occupational exposure to all pesticides, herbicides, insecticides, fungicides with ALOHA+ for each parent by linking job titles to JEM-derived probability and intensity estimates (no/low/high). Cohen’s Kappa coefficient (κ) assessed their agreement. ORs and 95% CIs comparing exposure and levels of exposure with no exposure were estimated using conditional logistic regression adjusted for literature-based covariates statistically associated with TGCT and stratified by histological subtypes. Results Agreement between ALOHA+and FRIJEM was moderate to substantial (κ 0.52–0.80). A statistically non-significant higher TGCT risk was observed for high paternal occupational pesticide exposure with ALOHA+ (OR 1.95, CI 0.98 to 3.84) and FRIJEM (OR 1.70, CI 0.88 to 3.28). With ALOHA+, statistically significant positive associations were seen for high paternal occupational exposure to herbicides (overall: OR 4.23, CI 1.75 to 10.22; seminomas: OR 4.78, CI 1.79 to 12.77; non-seminomas: OR 3.53, CI 1.21 to 10.3) and fungicides (overall: OR 2.09, CI 1.05 to 4.18; seminomas: OR 2.31, CI 1.02 to 5.23). No statistically significant associations were observed for other levels of paternal exposure or pesticide groups nor for maternal exposure. Conclusion Only high paternal occupational exposure to pesticides at birth, especially herbicides and fungicides, was positively associated with TGCT.

KW - Medical Oncology

KW - Occupational Health

KW - Pesticides

KW - Urogenital System

UR - https://www.scopus.com/pages/publications/105042495282

U2 - 10.1136/oemed-2024-109893

DO - 10.1136/oemed-2024-109893

M3 - Article

SN - 1351-0711

VL - 83

SP - 195

EP - 203

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

IS - 4

ER -

Parental occupational exposure to pesticides at birth and risk of adult testicular germ cell tumours in offspring: a French nationwide case-control study

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

Access to Document

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