The effects of annoyance due to aircraft noise on psychological distress: Results of the DEBATS study in France

European Congress of Epidemiology 2018, LYON, FRANCE, 04-/07/2018 - 06/07/2018Background : Many studies have evidenced adverse effects of exposure to aircraft noise on health, such as annoyance, sleep disturbance, cardiovascular diseases or altered cognitive performance. Mental health has been less investigated. In France, about 18% of the population suffer from mental disorders. The effects of noise annoyance on psychological distress have rarely been evaluated, and no study exists in France. We investigated associations between annoyance due to aircraft noise and psychological distress for people living near airports in France. Methods : The DEBATS longitudinal study included 1,244 residents around three French airports: Paris-Charles-de-Gaulle, Toulouse-Blagnac, and Lyon-Saint-Exupéry. Information about psychological distress was assessed by a face-to-face questionnaire, including a single question about the feeling of depression, and the 12-version of the General Health Questionnaire (GHQ-12). Annoyance due to aircraft noise was assessed with the following question 'Thinking about the last 12 months, when you are at home, how much does aircraft noise annoy you?' The five-point verbal scale proposed by the International Commission on the Biological Effects of Noise was used: extremely, very, moderately, slightly or not at all. Associations with psychological distress were investigated using logistic regressions including relevant confounders such as gender, age, country of birth, occupational activity, marital status, alcohol consumption, smoking, sleep duration, number of stressful life events, education, income, and antidepressant use. Results : About 13% of the participants reported depression and 22% were considered to have psychological distress according to the GHQ-12. Significant associations were found between annoyance due to aircraft noise and the feeling of depression, and between annoyance due to aircraft noise and psychological distress evaluated with the GHQ-12. The Odds Ratio (OR) for the feeling of depression ranged from 0.89 (95% CI 0.50-1.59) to 2.61 (95% CI 1.09-6.23). The OR for the GHQ-12 ranged from 1.49 (95% CI 0.94-2.39) to 3.64 (95% CI 1.70-7.78). For the both outcomes, OR reached the maximum estimate for people reporting to be extremely annoyed compared to those who are not at all annoyed. Discussion : The present study found significant associations between annoyance due to aircraft noise and psychological distress assessed both with a single question about the feeling of depression and with the GHQ-12, with gradual ORs according to the different categories of noise annoyance. This result is in line with the findings of a cross-sectional study performed in Minneapolis. However the direction of the association can be questioned. Extremely annoyed people might be more at risk to have psychological disorders, and it is also possible that people with psychological disorders might be more at risk to be annoyed

L'accompagnement vers l'emploi. Acteurs, pratiques, dynamiques

Rapport de rechercheNational audienceEn Mars 2006, la DARES lançait un appel à projet intitulé « l'accompagnement vers l'emploi et l'accompagnement dans l'emploi ». Les objectifs de cet appel à projet étaient, d'une part, de mieux cerner les spécificités de l'accompagnement en mettant en lumière les principaux types d'accompagnement au regard des pratiques professionnelles et des modes de coordination et, d'autre part, de recenser les facteurs potentiels, mais aussi effectifs de réussite des différentes formes d'accompagnement.notre projet de recherche affichait deux objectifs principaux. Le premier visait à saisir de manière fine les pratiques d'accompagnement et à proposer sur cette base une typologie des pratiques locales rencontrées. En ce sens, le projet consistait à se focaliser sur les pratiques des acteurs, sur leurs outils et méthodes en cherchant à mettre en évidence les différences selon les intermédiaires, selon les publics concernés, ou selon les marchés du travail locaux ou les segments de marchés. Il s'agissait également de saisir la manière dont les partenariats locaux interagissent avec les pratiques d'accompagnement, ainsi que les logiques et critères dans les procédures de répartition des publics entre les acteurs de l'accompagnement. Le second objectif du projet de recherche affichait l'ambition de mettre en évidence des pratiques innovantes construites dans le cadre de processus d'accompagnement

The protein level of isoenergetic formulae does not modulate postprandial insulin secretion in piglets and has no consequences on later glucose tolerance

Early postnatal nutrition is involved in metabolic programming, an excess of protein being suspected to enhance early growth and the propensity to later develop insulin resistance and type 2 diabetes mellitus. The aim of the present study was to test the hypothesis that excessive protein intake during the suckling period would overstimulate the endocrine pancreas in the short term and alter durably its maturation, contributing to the later disruption of glucose homeostasis. Normal-birth-weight and low-birth-weight piglets were fed isoenergetic formulae providing an adequate-protein (AP, equivalent to sow milk) or a high-protein (HP, +48%) supply between 7 and 28d of age and were fed a standard diet until 70d of age. During the formula-feeding period, the HP formula did not modify postprandial insulin secretion but transiently increased fasting insulin and the homeostasis model assessment-insulin resistance index (HOMA-IR, P<0·05). Fasting insulin and HOMA-IR were restored to AP piglets' values 1month after weaning. The structure of the endocrine pancreas was not affected by the protein content of the formula. The weight at birth had no major effect on the studied parameters. We concluded that a high-protein supply during the suckling period does not interfere with insulin secretion and endocrine pancreas maturation in the short term. It has no consequences either on glucose tolerance 1month after weaning. The present study demonstrated that up-regulation of postprandial insulin secretion is not involved in higher growth observed in piglets fed a HP formul

Noise in urban areas: How does the definition of "neighborhood" impact exposure assessment?

International audienceEnvironmental epidemiological studies commonly quantify subjects' noise exposure level in their neighborhood. How this neighborhood is defined can vary across studies, leading to different approaches whose impacts on exposure levels remain unclear. This article examines the impact of the neighborhood's definition on environmental noise exposure estimates. L Aeq,24h exposures in the vicinity of 10,825 residential buildings were estimated using a high-definition noise map, built on a middle-sized French city. Various definitions of neighborhood (address point, façade, buffers, and official zoning) were used to produce different exposure estimates. Influence of urban environmental factors was analyzed using multilevel modeling. The results showed a significant increase of the exposure estimates (+3.9 dB) and a significant decrease of the variability, when the sample size of the considered neighborhood increased (P<0.01). The difference between the estimates from the 50-m-radius buffers and the 400-m-radius buffers ranged across buildings between –9.4 and +22.3 dB. This variation was influenced by urban environmental characteristics (P<0.01). Furthermore, the same approach was conducted individually considering assessments of exposure to road traffic noise railway noise and two atmospheric pollutants (NO2 and PM 10). The results highlight the need in further exposure and/or epidemiological studies to carefully consider neighborhood definition and environmental composition

Smoking, genetic polymorphisms of glutathione S-transferases and biological indices of inflammation and cellular adhesion in the STANISLAS study

A recent clinical study has focused on: 1- the interaction between genetic variants of glutathione S-transferases M1 and T1 (GSTM1 and GSTT1) and smoking on the risk of cardiovascular diseases, 2- the potential capacity of GSTM1 and T1 genotypes in modifying the effect of smoking on inflammation and endothelial function. In this study, we investigated whether carriage of these 2 polymorphisms altered the smoking impact on biological indices of inflammation and cellular adhesion. White blood cell count (WBC), albumin, C-reactive protein (CRP), interleukine-6 (IL-6), tumor necrosis factor-alpha (TNF-a), L-selectin, E-selectin, P-selectin and intracellular adhesion molecule-1 (ICAM-1) were measured in 189 non-smokers and 76 smokers (aged 20-55 years) genotyped for the GSTM1 and T1 polymorphisms. Accounting for age and sex, smokers lacking GSTM1 had a higher WBC count, CRP and ICAM-1 levels as compared to the other groups; interaction term between smoking and genotype being significant (p=0.05). Conversely, non-smokers lacking GSTM1 had a higher levels of TNF-a; the test for interaction being significant (p=0.05). No significant interaction was found between smoking and GSTT1 genotypes, considering the 9 biological indices. However, significantly lower levels of IL-6 were noticed for non-smokers with GSTT1-0 null allele (p=0.05). Our study confirms previous results showing that GSTM1 polymorphism could modulate the interrelationships between smoking and biological markers of inflammation and endothelial function

NADPH oxidase activity is associated with cardiac osteopontin and pro-collagen type I expression in uremia.

International audienceCardiovascular disease is a frequent complication inducing mortality in chronic kidney disease (CKD) patients, which can be determined by both traditional risk factors and non-traditional risk factors such as malnutrition and oxidative stress. This study aimed to investigate the role of oxidative stress in uremia-induced cardiopathy in an experimental CKD model. CKD was induced in Sprague-Dawley rats by a 4-week diet supplemented in adenine, calcium and phosphorous and depleted in proteins. CKD was associated with a 3-fold increase in superoxide anion production from the NADPH oxidase in the left ventricle, but the maximal activity of mitochondrial respiratory chain complexes was not different. Although manganese mitochondrial SOD activity decreased, total SOD activity was not affected and catalase or GPx activities were increased, strengthening the major role of NADPH oxidase in superoxide anion output. Superoxide anion output was associated with enhanced expression of osteopontin (×7.7) and accumulation of pro-collagen type I (×3.7). To conclude, the increased activity of NADPH oxidase during CKD is associated with protein modifications which could activate a pathway leading to cardiac remodelling

Les effets de l'exposition au bruit des avions sur la qualité subjective du sommeil des riverains des aéroports français

22ème Journée Scientifique de l'EDISS, VILLEURBANNE, FRANCE, 12-/10/2017 - 12/10/2017Transport: major source of exposure to environmental nuisances for the population. Airplane noise exposure to airport neighborhoods resulting in public health problems and sleep disturbancesTransports : source majeure d'exposition à des nuisances environnementales pour la population. Exposition au bruit des avions aux voisinages des aéroports engendrant des problèmes de santé publique et des perturbations du sommei

Immunosuppressive therapy after solid-organ transplantation: does the INTERMED identify patients at risk of poor adherence?

Lack of adherence to medication is a trigger of graft rejection in solid-organ transplant (SOT) recipients. This exploratory study aimed to assess whether a biopsychosocial evaluation using the INTERMED instrument before transplantation could identify SOT recipients at risk of suboptimal post-transplantation adherence to immunosuppressant drugs. We hypothesized that complex patients (INTERMED&gt;20) might have lower medication adherence than noncomplex patients (INTERMED≤20). Each patient eligible for transplantation at the University Hospital of Lausanne, Switzerland, has to undergo a pre-transplantation psychiatric evaluation. In this context the patient was asked to participate in our study. The INTERMED was completed pre-transplantation, and adherence to immunosuppressive medication was monitored post-transplantation by electronic monitors for 12 months. The main outcome measure was the implementation and persistence to two calcineurin inhibitors, cyclosporine and tacrolimus, according to the dichotomized INTERMED score (&gt;20 or ≤20). Among the 50 SOT recipients who completed the INTERMED, 32 entered the study. The complex (N=11) and noncomplex patients (N=21) were similar in terms of age, sex and transplanted organ. Implementation was 94.2% in noncomplex patients versus 87.8% in complex patients (non-significant p-value). Five patients were lost to follow-up: one was non-persistent, and four refused electronic monitoring. Of the four patients who refused monitoring, two were complex and withdrew early, and two were noncomplex and withdrew later in the study. Patients identified as complex pre-transplant by the INTERMED tended to deviate from their immunosuppressant regimen, but the findings were not statistically significant. Larger studies are needed to evaluate this association further, as well as the appropriateness of using a nonspecific biopsychosocial instrument such as INTERMED in highly morbid patients who have complex social and psychological characteristics

A cellular model to study drug-induced liver injury in nonalcoholic fatty liver disease: application to acetaminophen

International audienceObesity and nonalcoholic fatty liver disease (NAFLD) can increase susceptibility to hepatotoxicity induced by some xenobiotics including drugs, but the involved mechanisms are poorly understood. For acetaminophen (APAP), a role of hepatic cytochrome P450 2E1 (CYP2E1) is suspected since the activity of this enzyme is consistently enhanced during NAFLD. The first aim of our study was to set up a cellular model of NAFLD characterized not only by triglyceride accumulation but also by higher CYP2E1 activity. To this end, human HepaRG cells were incubated for one week with stearic acid or oleic acid, in the presence of different concentrations of insulin. Although cellular triglycerides and the expression of lipid-responsive genes were similar with both fatty acids, CYP2E1 activity was significantly increased only by stearic acid. CYP2E1 activity was reduced by insulin and this effect was reproduced in cultured primary human hepatocytes. Next, APAP cytotoxicity was assessed in HepaRG cells with or without lipid accretion and CYP2E1 induction. Experiments with a large range of APAP concentrations showed that the loss of ATP and glutathione was almost always greater in the presence of stearic acid. In cells pretreated with the CYP2E1 inhibitor chlormethiazole, recovery of ATP was significantly higher in the presence of stearate with low (2.5 mM) or high (20 mM) concentrations of APAP. Levels of APAP-glucuronide were significantly enhanced by insulin. Hence, HepaRG cells can be used as a valuable model of NAFLD to unveil important metabolic and hormonal factors which can increase susceptibility to drug-induced hepatotoxicit