Stakeholder participation in site assessment and management : a real case of Vincennes, France

International audienceStakeholders' participation is increasingly considered as a plain part of the assessment and the management of a contaminated site. It is also acknowledged to be a difficult and sometimes risky challenge. Beside virtual experiments on "test groups", there is very little feedback on real cases of extensive stakeholders' participation on contaminated sites in Europe. No guideline or support document exist in Europe to help to organize Stakeholders' participation. We present here the real case of a Southern area of the town of Vincennes near Paris: following a high number of cancers among children in a school in the vicinity of a former industrial site and a hospital incinerator, the Health Ministry set up an independent Scientific Committee in charge of designing the epidemiological and risk assessment studies, of reviewing theirs results and of issuing recommendations. The Prefect directed a Participation Committee gathering all stakeholders in the aim of sharing all information available on the site, of discussing the results of the studies and the conclusions of the Scientific Committee and collecting opinions and expectations of each stakeholder in order to prepare decisions. Numerous studies were conducted. The Scientific Committee reviewed more than 30 protocols and reports. This experience is discussed here with regard to major questions on stakeholders' participation in site assessment and management, such as the communication between experts and non-experts and between experts of different fields (health scientists vs. environmental engineers), the impact of the media, the psychological impacts, the "crisis vs. non-crisis" aspects of participation. The discussion integrates other experience gathered on stakeholders' involvement It leads to the identification of some ingredients for an efficient stakeholders' participation, event if the specificity of each case, and the importance of spontaneity, reactivity, is recognized

The Relation Between Temperature, Ozone, and Mortality in Nine French Cities During the Heat Wave of 2003

BACKGROUND: During August 2003, record high temperatures were observed across Europe, and France was the country most affected. During this period, elevated ozone concentrations were measured all over the country. Questions were raised concerning the contribution of O(3) to the health impact of the summer 2003 heat wave. METHODS: We used a time-series design to analyze short-term effects of temperature and O(3) pollution on mortality. Counts of deaths were regressed on temperatures and O(3) levels, controlling for possible confounders: long-term trends, season, influenza outbreaks, day of the week, and bank holiday effects. For comparison with previous results of the nine cities, we calculated pooled excess risk using a random effect approach and an empirical Bayes approach. FINDINGS: For the nine cities, the excess risk of death is significant (1.01%; 95% confidence interval, 0.58–1.44) for an increase of 10 μg/m(3) in O(3) level. For the 3–17 August 2003 period, the excess risk of deaths linked to O(3) and temperatures together ranged from 10.6% in Le Havre to 174.7% in Paris. When we compared the relative contributions of O(3) and temperature to this joint excess risk, the contribution of O(3) varied according to the city, ranging from 2.5% in Bordeaux to 85.3% in Toulouse. INTERPRETATION: We observed heterogeneity among the nine cities not only for the joint effect of O(3) and temperatures, but also for the relative contribution of each factor. These results confirmed that in urban areas O(3) levels have a non-negligible impact in terms of public health

Real-Time Assessment of Health-Care Requirements During the Zika Virus Epidemic in Martinique.

The spread of Zika virus in the Americas has been associated with a surge in Guillain-Barré syndrome (GBS) cases. Given the severity of GBS, territories affected by Zika virus need to plan health-care resources to manage GBS patients. To inform such planning in Martinique, we analyzed Zika virus surveillance and GBS data from Martinique in real time with a modeling framework that captured dynamics of the Zika virus epidemic, the risk of GBS in Zika virus-infected persons, and the clinical management of GBS cases. We compared our estimates with those from the 2013-2014 Zika virus epidemic in French Polynesia. We were able to predict just a few weeks into the epidemic that, due to lower transmission potential and lower probability of developing GBS following infection in Martinique, the total number of GBS cases in Martinique would be substantially lower than suggested by simple extrapolations from French Polynesia. We correctly predicted that 8 intensive-care beds and 7 ventilators would be sufficient to treat GBS cases. This study showcased the contribution of modeling to inform local health-care planning during an outbreak. Timely studies that estimate the proportion of infected persons that seek care are needed to improve the predictive power of such approaches

Post-Epidemic Chikungunya Disease on Reunion Island: Course of Rheumatic Manifestations and Associated Factors over a 15-Month Period

Although the acute manifestations of Chikungunya virus (CHIKV) illness are well-documented, few data exist about the long-term rheumatic outcomes of CHIKV-infected patients. We undertook between June and September 2006 a retrospective cohort study aimed at assessing the course of late rheumatic manifestations and investigating potential risk factors associated with the persistence of these rheumatic manifestations over 15 months. 147 participants (>16 yrs) with laboratory-confirmed CHIKV disease diagnosed between March 1 and June 30, 2005, were identified through a surveillance database and interviewed by telephone. At the 15-month-period evaluation after diagnosis, 84 of 147 participants (57%) self-reported rheumatic symptoms. Of these 84 patients, 53 (63%) reported permanent trouble while 31 (37%) had recurrent symptoms. Age ≥45 years (OR = 3.9, 95% CI 1.7–9.7), severe initial joint pain (OR = 4.8, 95% CI 1.9–12.1), and presence of underlying osteoarthritis comorbidity (OR = 2.9, 95% CI 1.1–7.4) were predictors of nonrecovery. Our findings suggest that long-term CHIKV rheumatic manifestations seem to be a frequent underlying post-epidemic condition. Three independent risk factors that may aid in early recognition of patients with the highest risk of presenting prolonged CHIKV illness were identified. Such findings may be particularly useful in the development of future prevention and care strategies for this emerging virus infection

Surveillance du saturnisme infantile en France : bilan des activit s de depistage, resultats des donnees disponibles en mars 1997

SIGLEAvailable at La Documentation francaise (FR) Number :97-4-0289 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc

Émergence du chikungunya dans les Départements Français d’Amérique : résultats de la surveillance épidémiologique mise en œuvre en avril 2014

National audienc

Rev Epidemiol Sante Publique

International audienceThe COVID-19 pandemic and its extensive media coverage had the consequence of "putting epidemiology in the spotlight." However, even though responding to epidemics is a core missions of epidemiologists involved in public health, many felt that their profession was inadequately positioned among public health actors and that their scientific knowledge and skills were underutilized during the response to the pandemic.In this context, the Association for the Development of Field Epidemiology (Epiter) and the Association of French-speaking Epidemiologists (Adelf) conducted a survey in late 2020 and 2021, following the first wave of the epidemic, among epidemiologists belonging to both associations. This survey aimed to describe their roles and the activities they had undertaken during the pandemic response. .

Seroprevalence of Asian Lineage Chikungunya Virus Infection on Saint Martin Island, 7 Months After the 2013 Emergence

International audienc