Improvement of the hazard identification and assessment in application of the Seveso II directive (part II)

National audienceThe Council Directive 96/82/EC of 9 December 1996 on the control of major-accident hazards involving dangerous substances, known as Seveso II Directive, aims at the prevention of major accidents in high risk industries, and the limitation of their consequences for human beings and environment. Although rules are well established to identify maximal hazard potential, there is no recognised method for taking into account, in the assessment of risk level, safety devices and safety management systems implemented by operators. This paper deals with the second stage of a global methodology aiming at better assessing benefits gained from safety devices and safety management systems, through accident scenarios selection. The methodology presented in this paper enables risk assessors and competent authorities to identify Reference Accidents Scenarios (RAS), by taking into account the influence of some safety barriers, in accordance with the Seveso II Directive requirements. This method could help stakeholders involved in the public risk-based decision-making process to evaluate the safety level of high-risk establishments. Since the risk management decisions are based on the risk assessment [12], and since the choices and hypothesis to define the RAS are arbitrary, there is a need to reach a consensus among all the stakeholders to limit the discrepancy in the decision and improve the transparency.La Directive européenne 96/82/EC du 9 Décembre 1982 sur le contrôle des accidents majeurs impliquant des substances dangereuses, connue également sous le nom de Directive Seveso II, a pour objectif la prévention des accidents majeurs dans les sites industriels à hauts risques, et la limitation de leurs conséquences pour les populations et l'environnement. Bien que les règles soient bien établies pour l'identification du risque potentiel, il n'y a pas de méthode reconnue pour la prise en compte, dans l'évaluation du potentiel maximal de danger, des dispositifs de sécurité et des systèmes de gestion de la sécurité mis en oeuvre par les exploitants. Cet article traite de la seconde étape d'une méthodologie générale, qui vise à mieux évaluer les améliorations apportées par les dispositifs de sécurité et des systèmes de gestion de la sécurité, à travers la sélection des scénarios d'accidents. La méthode présentée dans cet article permet aux évaluateurs du risque ainsi qu'aux autorités compétentes d'identifier les Scénarios Accidentels de Référence, qui prennent en compte l'influence de certaines barrières de sécurité, en accord avec les exigences de la Directive Seveso II. Cette méthode pourrait aider les parties prenantes impliquées dans le processus décisionnel de gestion publique basé sur les risques, afin d'évaluer le niveau de sécurité des établissements à hauts risques. Comme les décisions de gestion des risques sont basées sur l'évaluation des risques, et comme les choix et les hypothèses pour définir les Scénarios Accidentels de Référence sont arbitraires, il est nécessaire d'obtenir un consensus parmi les parties prenantes, afin de limiter les divergences dans les décisions et améliorer la transparence

Randomized controlled study of fractional doses of inactivated poliovirus vaccine administered intradermally with a needle in the Philippines

SummaryObjectiveComparison of a fractional inactivated poliovirus vaccine (IPV) dose administered intradermally (ID) to a full dose administered intramuscularly (IM).MethodsHealthy Filipino infants were randomized to receive IPV as either a fractional (1/5th) dose ID by needle injection or a full dose IM at 6, 10, and 14 weeks and a booster at 15–18 months of age. Pre- and post-vaccination anti-polio 1, 2, and 3 titers were estimated. Adverse events were monitored throughout the study.ResultsFollowing primary series vaccination, anti-polio 1, 2, and 3 titers were ≥8 (1/dil) in 99–100% of participants, and the ID route was non-inferior to the IM route. Depending on the study group, antibody persistence was detected in 83–100% of participants, and the booster dose resulted in a strong anamnestic response in all groups. The incidence of adverse events in each group was similar, except for injection-site erythema (higher in the ID group).ConclusionsPrimary series and booster vaccination of a fractional IPV dose administered by the ID route was highly immunogenic and well tolerated. These data confirm the medical validity of using fractional ID doses of IPV. The programmatic feasibility of implementing affordable mass vaccination programs based on this delivery mode has yet to be established

Les enfants de moins de 15 ans face au risque d'accident de la route à Ouagadougou (Burkina Faso)

À Ouagadougou, les déplacements pendulaires entre la périphérie et le centre-ville génèrent un trafic dense. Ces mobilités représentent un risque d’accident de la route pour des usagers vulnérables que sont les enfants. Cet article a pour objectif de comprendre les déterminants géographiques (environnement urbain en particulier) des accidents de la route chez les enfants de moins de 15 ans dans leurs pratiques quotidiennes. La méthodologie mobilisée a combiné une approche quantitative avec des questionnaires auprès des élèves dans 12 écoles primaires et une approche qualitative avec des observations directes. Les résultats montrent que les garçons (31 %) sont davantage impliqués dans les accidents que les filles (25 %). Les enfants des zones loties (36 %) sont plus impliqués dans les accidents de route que ceux des zones non loties (18 %).Road accidents among children are now a major public health problem worldwide. According to a WHO report (2015), 186 300 children die on the roads worldwide, and the most at risk of death live in low- and middle-income countries (WHO 2015). The sub-Saharan African region has the highest number of road accidents among children with 32% of deaths (Li, Alonge, and Hyder 2016). They are the most vulnerable to road crash risk because of their physical and cognitive attributes still in development (Cloutier and Apparicio 2008). Ouagadougou, the capital of Burkina Faso, has experienced, and continues to experience, rapid spatial dynamics. The commuting between the periphery and the city centre is very important and generates dense traffic. These mobilities, through the different modes of transport, represent a risk of road accidents for vulnerable users such as children. Little research has been done on children’s exposure to road crash risks. The objective is to analyse the individual characteristics of children and the residential areas urban environment in relation to road accident risk among children under 15 years of age in their daily activities (play and going to and from school) in Ouagadougou. This research aims to understand their vulnerability in their daily mobility on the Ouagadougou territory. We conducted a study in 12 elementary schools in the city of Ouagadougou between April and May 2017 with students under 15 years of age in the first (CE1) and second year (CE2) of elementary classes, and in the first year (CM1) and second year (CM2) of middle classes. The surveyed schools were randomly selected by district. Authorization was requested and granted from the Ministry of National Education and Literacy regional directorate for a survey of students in these schools. Students were interviewed individually using a questionnaire. Each student randomly selected came out of the classroom in turn to answer different questions. Collected data were entered into the Sphinx data processing and analysis software. The data analysis was performed on XLSTAT 2018 software. As for the qualitative data collection method, it is based on direct observation technique including a form on the different types of facilities around schools. More than 500 children (523) were surveyed. Boys (31%) are more involved in accidents than girls (25%). State-employed fathers (41%) and not working fathers (33%) have more children involved in road accidents. At the mother level, it is students (33%) and state employees (31%) who have more children involved in accidents. Children residing in unplanned areas (36%) are more involved in road accidents than those in unplanned areas (18%). Children are more likely to be involved in an accident if they prefer to play on the street in front of the housing yard (31%) and if they prefer to play inside the housing yard (30%). Nearly 28% of children have already had a road accident and 70% of them have been injured. Facilities around schools to reduce the risk of children being involved in road accidents are non-existent. Thus, in all the schools surveyed, no speed bumps were built to reduce the speeds of motorized users, nor were there any warning signs to alert road users of the presence of a school. In addition, schools near major roads (main roads) do not have crossing guards to help children cross. It is important to reduce the risk of accidents among children by providing facilities around schools and in densely populated areas. These results reveal a high exposure of children to accident risks in subdivided areas compared to un-divided areas in Ouagadougou. Monitoring children during their street play and planning policies that take children’s road safety into account are necessary to reduce the risk

Children under 15 years old of road risk in Ouagadougou (Burkina Faso)

Road accidents among children are now a major public health problem worldwide. According to a WHO report (2015), 186 300 children die on the roads worldwide, and the most at risk of death live in low- and middle-income countries (WHO 2015). The sub-Saharan African region has the highest number of road accidents among children with 32% of deaths (Li, Alonge, and Hyder 2016). They are the most vulnerable to road crash risk because of their physical and cognitive attributes still in development ..

Gut microbiota imbalance and colorectal cancer.

International audienceThe gut microbiota acts as a real organ. The symbiotic interactions between resident micro-organisms and the digestive tract highly contribute to maintain the gut homeostasis. However, alterations to the microbiome caused by environmental changes (e.g., infection, diet and/or lifestyle) can disturb this symbiotic relationship and promote disease, such as inflammatory bowel diseases and cancer. Colorectal cancer is a complex association of tumoral cells, non-neoplastic cells and a large amount of micro-organisms, and the involvement of the microbiota in colorectal carcinogenesis is becoming increasingly clear. Indeed, many changes in the bacterial composition of the gut microbiota have been reported in colorectal cancer, suggesting a major role of dysbiosis in colorectal carcinogenesis. Some bacterial species have been identified and suspected to play a role in colorectal carcinogenesis, such as Streptococcus bovis, Helicobacter pylori, Bacteroides fragilis, Enterococcus faecalis, Clostridium septicum, Fusobacterium spp. and Escherichia coli. The potential pro-carcinogenic effects of these bacteria are now better understood. In this review, we discuss the possible links between the bacterial microbiota and colorectal carcinogenesis, focusing on dysbiosis and the potential pro-carcinogenic properties of bacteria, such as genotoxicity and other virulence factors, inflammation, host defenses modulation, bacterial-derived metabolism, oxidative stress and anti-oxidative defenses modulation. We lastly describe how bacterial microbiota modifications could represent novel prognosis markers and/or targets for innovative therapeutic strategies

Une méthode de cartographie participative des pratiques et représentations urbaines à Ouagadougou (Burkina Faso)

Cet article présente une méthode de cartographie participative réalisée auprès d’habitants de Ouagadougou (Burkina Faso) sur la base de focus groups. Ces ateliers ont été conçus pour alimenter une réflexion méthodologique sur l’accès à l’espace urbain dans la capitale burkinabè. Cette méthode, qui mêle démarches qualitative, quantitative et spatiale, a consisté à réunir des habitants de différents quartiers de la ville et à les interroger sur leurs pratiques et représentations spatiales. Les données recueillies retranscrites pendant le focus group sur un SIG, sont ensuite proposées aux habitants sous formes de cartes projetées sur l’écran, sur lesquelles ceux-ci sont invités à réagir. Ces ateliers permettent de construire une conception fine des représentations des habitants et proposent une hiérarchisation alternative des espaces

Une politique concernant les données issues d’un programme de recherches interventionnelles en santé mondiale

ArticleLa recherche interventionnelle en santé mondiale est souvent effectuée au moyen de partenariats scientifiques internationaux. Mais la réalisation de telles recherches, notamment dans les pays à faible revenu où les enjeux de pouvoir, d’argent et de relations interculturelles sont exacerbés, soulève de nombreux défis éthiques, notamment concernant la conduite responsable lors des recherches collaboratives. L’un d’eux est la conservation, l’accès, l’utilisation et la publication des données. Malgré l’existence de multiples politiques et documents phares sur l’éthique et la conduite responsable de la recherche, les chercheurs en recherche interventionnelle sont encore peu outillés pour faire face à ce défi. Dans le contexte d’un programme de recherches interventionnelles réalisées au Burkina Faso, les auteurs souhaitent partager leur expérience dans le développement d’une politique interne concernant leurs données. Après avoir évoqué le contexte global et particulier, l’article présente le processus de formulation et d’adoption de cette politique par les chercheurs d’une équipe interdisciplinaire et internationale (Allemagne, Burkina Faso, Canada, France). Les valeurs qui enchâssent cette politique interne sont la transparence, la prévention, le consensus autour du processus de production, le respect des principes internationaux, l’accès libre aux connaissances produites et la préoccupation pour leur diffusion et utilisation. La politique se présente en plusieurs parties : objet, types et statuts des chercheurs impliqués, conservation des données, accès et utilisation des données, production scientifique et paternité. Les principaux défis rencontrés par les chercheurs pour formuler cette politique sont analysés dans un souci de partage pour susciter un débat rarement abordé. La confiance, la transparence et le respect mutuel doivent être au cœur de tout partenariat scientifique en recherche interventionnelle.Interventional global health research is often carried out through international scientific partnerships. However, the conduct of such research, especially in low-income countries where issues of power, money and intercultural relations are exacerbated, raises many ethical challenges particularly related to responsible conduct in collaborative research. One of these challenges is the storage, access, use and publication of data. Despite the existence of multiple influential policies and documents on ethics and the responsible conduct of research, researchers in intervention research are still not equipped to deal with such challenges. In the context of an intervention research program conducted in Burkina Faso, the authors would like to share their experience in the development of an internal policy concerning their data. After presenting the global and the particular context, the paper presents the process of policy formulation and its adoption by the researchers of an interdisciplinary and international team (Burkina Faso, Canada, France, Germany). The values that entrench this internal policy are: transparency, prevention, consensus about the production process, respect for international principles, free access to the knowledge produced and concerns regarding its dissemination and use. The policy is presented in several parts: aim, types and status of the participating researchers, data storage, access and use of data, scientific production and authorship. The main challenges faced by researchers in formulating this policy are analyzed in a shared desire to spark a debate that is rarely addressed. Trust, transparency and mutual respect should be central to any scientific partnership in intervention research