For Marine*, it started in July 2016. At the time, this agricultural worker spent her nights criss-crossing the vineyards of the Hérault farms, spraying a mixture of pesticides intended to protect them from disease. “I had a feeling of great fatigue, but I thought it was only temporary. Then one morning, when I got home, I felt unwell,” she says. Worried, the tractor driver went to her attending physician, who prescribed a blood test: “As soon as the results arrived, I was sent to the hematology emergency room in Montpellier”. There, Marine learns that she has myeloproliferative syndrome, a tumoral disease of the bone marrow. “Blood cancer,” she explains.
Faced with the urgency of the situation, Marine immediately begins oral chemotherapy. “I spent several weeks in the fog, not understanding anything about what was happening to me. I was a real robot”, she recalls. Over the months, the agricultural worker seeks to understand the reasons for her illness. “I am someone who wants to understand what it does. During my fifteen years in the vineyards, I had often read the instructions on the back of the bottles of pesticides we used. But I was not sure then that my illness comes from there,” she says. During a consultation with a doctor from the agricultural social mutuality (MSA), the social protection scheme for the sector, everything becomes clear: “She advised me immediately to start compiling a file for a declaration of occupational disease” . We are then at the beginning of the year 2017. Marine does not yet know that in addition to her illness, she is entering a long tunnel of administrative procedures. “It took more than four years for my cancer to be recognized as an occupational disease,” she explains. Four years in a maze of letters, endless phone calls and administrative paperwork.
A growing recognition
Helped in her approach by the Phyto-Victimes association, which specializes in helping professional victims of pesticides, Marine does not yet see the outcome. In July 2022, six years after the declaration of her symptoms, she still does not receive the compensation due to her. “I am blocked: physically, I am too weak to exercise my professional activity. Morally, I am undermined”. Undermined by her state of health, and by the shifty gaze of her former colleagues and bosses. “When they look at me! Because no one wants to be held responsible for my condition,” she says, annoyed. Marine’s case, notable for the length of its proceedings, is far from unique. Recognizing an occupational disease linked to pesticides in the agricultural world is an obstacle course.
However, the situation has improved. Thanks to the progress of research, more and more pathologies have been recognized as occupational diseases related to exposure to pesticides in recent years. In 2012, this was the case for Parkinson’s disease, for example. In 2015, non-Hodgkin’s lymphoma. In 2019, multiple myeloma. Recently, in April, a table of occupational diseases relating to prostate cancer was also published in the Official Journal.
law of silence
Advances that farmers are often unaware of. One of the first obstacles to recognition comes from the lack of information in the agricultural world. Because the declaration of an occupational disease is not made automatically when a diagnosis is made: it is up to the person concerned to make a request to his MSA. It is therefore essential, first of all, that the farmer make the connection between his symptoms and his professional activity. “Even if progress has been made in raising awareness among farmers, admitting that one’s disease comes from one’s professional practice requires a personal journey. However, when the disease occurs, many do not necessarily realize its origin, remarks Michel Besnard, member of the Western Pesticide Victim Support Collective. They have suspicions, but are often misinformed.”
According to the associations and patients interviewed, doctors do not have the reflex to make the link between pathology and professional practice each time. Gilles, a former farmer in Loire-Atlantique, can attest to this. “A few months after the start of my retirement, in 2015, I was told that I had lymphoma, he recalls. No one told me about an occupational disease”. At the beginning of 2017, his hematologist prescribed him chemotherapy. “There again, nothing. For my part, I was in denial. I refused to see that my years as an employee and then a farmer could play a role in my illness”. It was only several months later, thanks to a chance meeting with a friend, a retired doctor, that Gilles made the connection. “None of my practitioners had done it so far,” he says.
Lack of information
A lack of information which necessarily limits patients in their file preparation: many are simply not aware of the steps to be taken. “Awareness of this subject only represents a few hours in the training of today’s general practitioner, regrets Antoine Lambert, president of Phyto-Victimes. This is part of the work which requires regular information during career, which is not always done”. Problem, when the declaration of an occupational disease begins with the observation of a doctor, whether treating, specialist, office or hospital. In the case of an agricultural employee, the latter must be accompanied by a salary certificate sent by the employer.
Once the procedures have been launched, the patients embark on long-term actions. “When a case passes without difficulty, there is generally a year between the time a person contacts the association to lodge their complaint and the one where she gets her pension”, says Michel Besnard. In theory, however, the law imposes relatively short deadlines on the MSA: once the file has been received, it must respond within three months, otherwise the latter is automatically requalified as occupational disease During this period, the organization carries out its investigation with the employer, the doctor and the labor inspector concerned.
A complex reconstruction
If a patient has a condition recognized in a chart, the task is usually easier. “The process was relatively quick: I started my file in February 2022 and a few months later, it was good,” confirms Dominique, a former agricultural worker with prostate cancer. However, he waited a long time before launching his case. “My cancer was diagnosed in 2007. But as this disease was not strictly listed in the table until now, I preferred not to take any steps. I was afraid that it would be too complex”.
Associations such as Phyto-Victimes or the Collective to support victims of pesticides in the West try to facilitate the process for patients. As in a police investigation, they urge applicants to methodically reconstruct their professional and medical background. Among the essential documents, there is obviously the list of products used by farmers during their career. But it is often complicated to be exhaustive in its count. “Farmworkers often do not know or remember the exact products used, because they did not buy them,” notes Claire Bourasseau, manager at the Phyto-victim association. Among operators too, this reconstruction work is complex.
Discouraged
Noël, a farmer in Morbihan, experienced this. In November 2014, the operator woke up one morning with “lumps” in his neck. After a visit to his doctor, the ax falls. “I had tumors all over my body,” he says. At the age of 47, he began chemotherapy then, two years later, the constitution of his occupational disease file. “I had to find the list of phytosanitary products that I had used and show them to the MSA,” he continues. But Noël knows that his file is incomplete anyway. In his family, we are farmers from father to son, he started working very early on the family farm. “My father himself died of cancer, and from the age of 12, I was in contact with the products when I took over, he says. But that period n was not taken into account in my file, on the pretext, in particular, that my mother had not declared my work at the time”.
His occupational disease has nevertheless ended up being recognized. But not as he would like: the MSA only recognized the operator with a “permanent partial disability” (IPP) rate of 35%. However, when the latter is less than 50%, the compensation paid decreases: “So I only have a pension of 250 euros per month, which is not enough to remunerate the employee whom I took on exploitation to replace me”. At 54, today, Christmas is bitter: “It took me three years to have my occupational disease recognized, and when I see the amount of it, I am a little discouraged”.
This long fight is no exception. When a pathology is not listed in a table – such as certain neurodegenerative diseases or certain cancers – the files are sent to a regional committee for the recognition of occupational diseases (CRRMP). It is then necessary to wait a year before obtaining a first response. If the CRRMP refuses, the farmer can start legal proceedings. Difficult, then, to control the recognition times. Patients sometimes do not have time to see the process come to an end. Of the 71 people assisted by the Western Pesticide Victims Support Collective whose disease was recognized, ten died before the end of the procedure.
*Name has been changed.