Projet PAISARC+ : pollution atmosphérique, inégalités sociales, asthme, risque cardiaque. Influence du contexte de vie

International audienceLe projet PAISARC+ (« pollution atmosphérique, inégalités sociales, asthme, risque cardiaque : influence du contexte de vie ») s’inscrit dans une perspective qui vise à étudier le rôle des expositions environnementales dans les inégalités sociales de santé. L’objectif de ce projet est d’évaluer l’intérêt d’une nouvelle approche mesurant, par le biais d’une typologie et d’une nouvelle unité, les effets du contexte de vie sur le risque d’exacerbation de l’asthme, d’une part, et la survenue d’infarctus, d’autre part, induits par la pollution atmosphérique sur la Communauté urbaine de Strasbourg (CUS). Les données recueillies par cette dernière sont traitées spatialement à une échelle fine puis regroupées en quatre domaines (socio-économique ; ressources publiques ; environnement physique ; environnement psychosocial). La mise en place d’une analyse factorielle multiple suivie de l’application d’une classification ascendante hiérarchique (CAH) a permis de construire une typologie. Les résultats indiquent que cette approche, en proposant de caractériser le contexte de vie via la typologie et une nouvelle unité d’étude, permet de tenir compte de diverses dimensions de la « défaveur » susceptibles d’influencer l’état de santé

Association Between Air Pollution Perception and Pollutants Concentrations-First Results of the SEQAP Study

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Influence of Socioeconomic Deprivation on the Relation Between Air Pollution and β-Agonist Sales for Asthma

International audienceBackground: Air pollution triggers asthma attacks hours to days after exposure. It remains unclear whether socioeconomic deprivation modulates these effects. Investigation of these interactions requires adequate statistical power, obtainable by using either a sufficient number of observations or very sensitive indicators of asthma attacks. Using a small-area temporal ecologic approach, we studied the short-term relations between ambient air pollution and sales of short-acting beta-agonist (SABA) drugs, a frequent and specific treatment for control of asthma attacks in children and young adults, and then tested the influence of deprivation on these relations.Methods: The study took place in Strasbourg, France in 2004. Health insurance funds provided data on 15,121 SABA sales for patients aged 0 to 39 years. Deprivation was estimated by small geographic areas using an index constructed from census data. Daily average ambient concentrations of particulate matter (particles with an aerodynamic diameter < 10 microm [PM(10)]), nitrogen dioxide (NO(2)), and ozone (O(3)) were modeled on a small-area level. Adjusted case-crossover models were used for statistical analysis.Results: Increased of 10 microg/m(3) in ambient PM(10), NO(2), and O(3) concentrations were associated, respectively, with increases of 7.5% (95% confidence interval [CI], 4 to 11.2%), 8.4% (95% CI, 5 to 11.9%), and 1% (95% CI, - 0.3 to 2.2%) in SABA sales. Deprivation had no influence on these relations.Conclusion: The associations observed are consistent with those reported by studies focusing on SABA use. Similar studies in other settings should confirm whether the lack of interaction with deprivation is due to specific local conditions

681 Epidemiology of traumatic brain injuries based on hospital reports in metropolitan france: which ICD10 codes should be selected?

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Estimating the short-term health impacts of air pollution in populations of divergent socioeconomic deprivation levels: A methodological challenge

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Air pollution, asthma attacks, and socioeconomic deprivation: a small-area case-crossover study.

International audienceWith few exceptions, studies of short-term health effects of air pollution use pollutant concentrations that are averaged citywide as exposure indicators. They are thus prone to exposure misclassification and consequently to bias. Measurement of the relations between air pollution and health, generally and in specific populations, could be improved by employing more geographically precise exposure estimates. The authors investigated short-term relations between ambient air pollution estimated in small geographic areas (French census blocks) and asthma attacks in Strasbourg, France, in 2000-2005--in the general population and in populations with contrasting levels of socioeconomic deprivation. Emergency health-care networks provided data on 4,683 telephone calls made for asthma attacks. Deprivation was estimated using a block-level index constructed from census data. Hourly concentrations of particulate matter less than 10 microm in aerodynamic diameter (PM(10)), sulfur dioxide, nitrogen dioxide, and ozone were modeled by block with ADMS-Urban software. Adjusted case-crossover analyses showed that asthma calls were positively but not significantly associated with PM(10) (for a 10-microg x m(-3) increase, odds ratio (OR) = 1.035, 95% confidence interval (CI): 0.997, 1.075), sulfur dioxide (OR = 1.056, 95% CI: 0.979, 1.139), and nitrogen dioxide (OR = 1.025, 95% CI: 0.990, 1.062). No association was observed for ozone (OR = 0.998, 95% CI: 0.965, 1.032). Socioeconomic deprivation had no significant influence on these relations