Risk for non Hodgkin’s lymphoma in the vicinity of French municipal solid waste incinerators

<p>Abstract</p> <p>Background</p> <p>Dioxin emissions from municipal solid waste incinerators are one of the major sources of dioxins and therefore are an exposure source of public concern. There is growing epidemiologic evidence of an increased risk for non-Hodgkin's lymphoma (NHL) in the vicinity of some municipal solid waste incinerators with high dioxin emission levels. The purpose of this study was to examine this association on a larger population scale.</p> <p>Methods</p> <p>The study area consisted of four French administrative departments, comprising a total of 2270 block groups. NHL cases that had been diagnosed during the period 1990–1999, and were aged 15 years and over, were considered. Each case was assigned a block group by residential address geocoding. Atmospheric Dispersion Model System software was used to estimate immissions in the surroundings of 13 incinerators which operated in the study area. Then, cumulative ground-level dioxin concentrations were calculated for each block group. Poisson multiple regression models, incorporating penalized regression splines to control for covariates and dealing with Poisson overdispersion, were used. Five confounding factors were considered: population density, urbanisation, socio-economic level, airborne traffic pollution, and industrial pollution.</p> <p>Results</p> <p>A total of 3974 NHL incident cases was observed (2147 among males, and 1827 among females) during the 1990–1999 time period. A statistically significant relationship was found at the block group level between risk for NHL and dioxin exposure, with a relative risk (RR) of 1.120 (95% confidence interval [CI] 1.002 – 1.251) for persons living in highly exposed census blocks compared to those living in slightly exposed block groups. Population density appeared positively linked both to risk for NHL and dioxin exposure. Subgroup multivariate analyses per gender yielded a significant RR for females only (RR = 1.178, 95% CI 1.013 – 1.369).</p> <p>Conclusion</p> <p>This study, in line with previous results obtained in the vicinity of the incinerator located in Besançon (France), adds further evidence to the link between NHL incidence and exposure to dioxins emitted by municipal solid waste incinerators. However, the findings of this study cannot be extrapolated to current incinerators, which emit lower amounts of pollutants.</p

Risk of cancer in the vicinity of municipal solid waste incinerators: importance of using a flexible modelling strategy

<p>Abstract</p> <p>Background</p> <p>We conducted an ecological study in four French administrative departments and highlighted an excess risk in cancer morbidity for residents around municipal solid waste incinerators. The aim of this paper is to show how important are advanced tools and statistical techniques to better assess weak associations between the risk of cancer and past environmental exposures.</p> <p>Methods</p> <p>The steps to evaluate the association between the risk of cancer and the exposure to incinerators, from the assessment of exposure to the definition of the confounding variables and the statistical analysis carried out are detailed and discussed. Dispersion modelling was used to assess exposure to sixteen incinerators. A geographical information system was developed to define an index of exposure at the IRIS level that is the geographical unit we considered.</p> <p>Population density, rural/urban status, socio-economic deprivation, exposure to air pollution from traffic and from other industries were considered as potential confounding factors and defined at the IRIS level. Generalized additive models and Bayesian hierarchical models were used to estimate the association between the risk of cancer and the index of exposure to incinerators accounting for the confounding factors.</p> <p>Results</p> <p>Modelling to assess the exposure to municipal solid waste incinerators allowed accounting for factors known to influence the exposure (meteorological data, point source characteristics, topography). The statistical models defined allowed modelling extra-Poisson variability and also non-linear relationships between the risk of cancer and the exposure to incinerators and the confounders.</p> <p>Conclusion</p> <p>In most epidemiological studies distance is still used as a proxy for exposure. This can lead to significant exposure misclassification. Additionally, in geographical correlation studies the non-linear relationships are usually not accounted for in the statistical analysis. In studies of weak associations it is important to use advanced methods to better assess dose-response relationships with disease risk.</p

Evaluation d'un projet minier (approche bayésienne et options réelles)

PARIS-MINES ParisTech (751062310) / SudocFONTAINEBLEAU-MINES ParisTech (771862302) / SudocSudocFranceF

Ecological Study on Hospitalizations for Cancer, Cardiovascular, and Respiratory Diseases in the Industrial Area of Etang-de-Berre in the South of France

The Etang-de-Berre area is a large industrialized area in the South of France, exposing 300,000 inhabitants to the plumes of its industries. The possible associated health risks are of the highest concern to the population, who asked for studies investigating their health status. A geographical ecological study based on standardized hospitalizations ratios for cancer, cardiovascular, and respiratory diseases was carried out over the 2004–2007 period. Exposure to air pollution was assessed using dispersion models coupled with a geographic information system to estimate an annual mean concentration of sulfur dioxide (SO2) for each district. Results showed an excess risk of hospitalization for myocardial infarction in women living in districts with medium or high SO2 exposure, respectively, 38% [CI 95% 4 : 83] and 54% [14 : 110] greater than women living in districts at the reference level exposure. A 26% [2 : 57] excess risk of hospitalization for myocardial infarction was also observed in men living in districts with high SO2 levels. No excess risk of hospitalization for respiratory diseases or for cancer was observed, except for acute leukemia in men only. Results illustrate the impact of industrial air pollution on the cardiovascular system and call for an improvement of the air quality in the area

Does arsenic in soil contribute to arsenic urinary concentrations in a French population living in a naturally arsenic contaminated area?

International audienceA cross sectional study using environmental and biological samples was implemented to assess the association between arsenic (As) concentrations in the environment and urinary As levels of residents living in an area where the soil is naturally As rich. As was measured in drinking water, atmospheric particulate matter, and soil and a geographic information system was used to assign environmental concentrations closest to the participants' dwellings and the sum of inorganic As and metabolites in urine samples. The only potential source of As environmental contamination was from soil with a range of 13–131 mg As/kg of dry matter. As(V) was the only species present among As extracted from the analyzed soil samples. The chemical extraction showed a poor mobility of As soil. There was no difference between child and teenager, and adult urinary As concentrations, though men had higher urinary As concentrations than women (pb0.001). Given the important differences in lifestyle between 7–18 year olds, men, and women, these groups were analyzed separately. Whilst we were unable to find a stable model for the 7–18 year old group, for the adult men group we found that seafood consumption in the 3 days prior to the investigation (p=0.02), and beer (p=0.03) and wine consumption in the 4 days before the study, were associated with As urinary levels (μg/L). In adult women, creatinine was the only variable significantly associated with As urinary concentration (μg/L). The concentrations we measured in soils were variable and although high, only moderately so and no link between As concentrations in the soil and urinary As concentrations could be found for either men or women. Some individual factors explained half of the variability of adult men urinary As levels. The unexplained part of the variability should be searched notably in As mobility in soil and uncharacterized human behavior

Spatial contrasts and temporal changes in fine-scale heat exposure and vulnerability in the Paris region

International audienceHeat is identified as a key climate risk in Europe. Vulnerability to heat can be aggravated by enhanced exposure (e.g., urban heat island), individual susceptibility (e.g., age, income), and adaptive capacity (e.g., home ownership, presence of vegetation). We investigated the spatial and temporal patterns of the environmental and social drivers of vulnerability to heat in the Paris region, France, over the 2000-2020 period, and their association with mortality (restricted to 2000-2017). Daily temperatures were modeled for the 5,265 IRIS of the Paris region for 2000-2020. Annual land use and socioeconomic data were collected for each IRIS. They were used to identify a priori five classes of heat-vulnerable areas based on a cluster analysis. The temperature-mortality relationship was investigated using a time-series approach stratified by clusters of vulnerability. The Paris region exhibited a strong urban heat island effect, with a marked shift in temperature distributions after 2015. The clustering suggested that the most heat-vulnerable IRIS in the Paris region have a high or very high exposure to temperature in a highly urbanized environment with little vegetation, but are not systematically associated with social deprivation. A similar J-shape temperature-mortality relationship was observed in the five clusters. Between 2000 and 2017, around 8,000 deaths were attributable to heat, 5,600 of which were observed in the most vulnerable clusters. Vulnerability assessments based on geographical indicators are key tools for urban planners and decision-makers. They complement the knowledge about individual risk factors but should be further evaluated through interdisciplinary collaborations

Waterborne disease outbreak detection: a simulation-based study

Waterborne disease outbreaks (WBDOs) remain a public health issue in developed countries, but to date the surveillance of WBDOs in France, mainly based on the voluntary reporting of clusters of acute gastrointestinal infections (AGIs) by general practitioners to health authorities, is characterized by low sensitivity. In this context, a detection algorithm using health insurance data and based on a space&ndash;time method was developed to improve WBDO detection. The objective of the present simulation-based study was to evaluate the performance of this algorithm for WBDO detection using health insurance data. The daily baseline counts of acute gastrointestinal infections were simulated. Two thousand simulated WBDO signals were then superimposed on the baseline data. Sensitivity (Se) and positive predictive value (PPV) were both used to evaluate the detection algorithm. Multivariate regression was also performed to identify the factors associated with WBDO detection. Almost three-quarters of the simulated WBDOs were detected (Se = 73.0%). More than 9 out of 10 detected signals corresponded to a WBDO (PPV = 90.5%). The probability of detecting a WBDO increased with the outbreak size. These results underline the value of using the detection algorithm for the implementation of a national surveillance system for WBDOs in France