Environmental health risks perceptions: results from cross-sectional surveys in Southeastern France

International audienceBackground: Arsenic is a toxic metalloid element frequently found in the environment. Chronic arsenic exposure is a critical public health issue in many countries since the identification of arsenic and its compounds as human carcinogens by the World Health Organization. After absorption, inorganic arsenic (iAs) is mainly methylated into monomethylated and dimethylated compounds (MMA, DMA), which are then excreted through the kidney together with unmethylated iAs. Whether the methylation process is to detoxify or potentiate arsenic toxicity, however, remains an ongoing debate. The purpose of this systematic review was to conduct a comprehensive meta-analysis to estimate the association between arsenic exposure and urothelial cancer. Methods: 10 observational studies met the inclusion criteria and were included in the systematic review. IAs%, MMA% and DMA% were extracted from each paper. Weighted Mean Differences with 95% confidence intervals were defined according to Cases minus Controls. Pooled risk estimates from individual studies were assessed using random effects models. Meta-regression analysis was performed to estimate the extent of urothelial cancer risk as a function of iAs%, MMA% and DMA%. Results: Results showed as patients with urothelial cancer presented higher level of urinary iAs% (WMD 2.70, 95%CI 0.64-4.76), MMA% (WMD 2.81, 95%CI 1.43-4.20) and DMA% (WMD-3.44, 95%CI-6.57-0.30). Conclusions: These findings suggest that higher level of iAs% and MMA% and lower level of DMA% were associated with an increased risk of urothelial cancer. Additional population based studies are needed to understand the role of arsenic in cancer development. Understanding the meaning of arsenic metabolism could improve the risk assessment of arsenic toxicity and provide a potential tool for disease prediction and prevention. Key messages: Higher level of iAs%, MMA% and DMA% were associated with an increased risk of urothelial cancer. Understanding the meaning of arsenic metabolism could improve the risk assessment of arsenic toxicity. Background: Heatwaves can lead to increased mortality. Portugal has a Heat-Health Warning System (HHWS) in place (ÍCARO system). Researchers at the Instituto Ricardo Jorge send a daily report with heat-related mortality forecasts to key stakeholders (e.g. Heat-Health Action Plans (HHAP) staff). HHAP practitioners issue warnings and implement measures to prevent heatwaves-related mortality. ICARO is amongst the recommended data sources to assess risk and issue warnings but its use and understanding is unknown. Therefore, we aimed to assess ÍCARO's use and understanding by key HHAP practitioners. Methods: We conducted semi-structured interviews with national and regional HHAP practitioners. Interviews were recorded, transcribed, and analysed using thematic content analysis. Intercoder reliability was applied to a sample of segments from 5 of 6 interviews. Results: We conducted 6 interviews with 9 professionals (mean time 52 minutes). We identified 4 categories: Report's content and presentation, Report's reception and communication, ÍCARO and risk assessment, Other issues. Practitioners use ÍCARO and perceived it as very relevant tool. However, they mentioned several questions on its interpretation. Practitioners also felt their questions were not fully answered, given researchers' use of statistical terms. Finally, practitioners referred the need to assess risk at the local level, information not currently provided. We also identified the need for improved communication and report's clarity. Conclusions: Our study stresses the need for an integrated collaboration between experts within HHWS and HHAP. Despite ICARO's understanding being challenging, practitioners consider it a relevant tool. Researchers should use less statistical language and clarify ÍCARO interpretation. Practitioners' needs should be considered when developing or revising tools. We are currently implementing some of these recommendations in an attempt to close the gap between researchers and practitioners

Avis relatif aux masques dans le cadre de la lutte contre la propagation du virus SARS-CoV-2 en rapport avec l'émergence du variant Omicron (HCSP, Avis et Rapports)

International audienceAvis relatif aux masques dans le cadre de la lutte contre la propagation du virus SARS-CoV-2 en rapport avec l'émergence du variant Omicron (HCSP, Avis et Rapports)Ch. Chidiac, J.-F. Gehanno, B. Pozzetto, N. Vernazza, S. Aho-Glele, D. Lepelletier, J.-M. Brignon, E. Gehin, P. Hartemann, Y. Lévi, F. Marano, J.-L. Roubaty, F. Squinazi, A. Billette de Villemeur, A. Berger-Carbonne, É. Gaffet, B. Moltrecht, G. Salvat, S. Van Der Werf, F. Eker, A. Pariente-Khayat, S. Urban-BoudjelabEditeur : Haut Conseil de la Santé PubliqueDate du document : 23 Décembre 2021Date de mise en ligne : 2 Février 2022 (33 pages)https://www.hcsp.fr/Explore.cgi/AvisRapportsDomaine?clefr=1147Le HCSP examine dans cet avis les stratégies d’indications du port des appareils de protection respiratoire (APR) de type FFP2 en population générale ou à risque, dans le cadre de la lutte contre la propagation du virus SARS-CoV-2 dans le contexte d’émergence du variant Omicron.Il précise, dans un complément au DGS le 7 janvier 2022, actualisé le 15 janvier 2022, que le port correct des APR de type FFP2.Le HCSP rappelle que :-L’efficacité et la performance de protection (filtration) des masques, quels qu’ils soient, sont étroitement dépendantes de la constance du port, de l’ajustement au visage et de la qualité du port couvrant impérativement le nez, la bouche et le menton ;--Le masque ne peut à lui seul réduire le risque de transmission ; il constitue une mesure parmi l’ensemble des mesures de protection à respecter (vaccination, hygiène des mains, ventilation des locaux, distanciation sociale, etc.).Le HCSP souligne les fortes incertitudes et manques de données scientifiques sur plusieurs aspects importants de l’analyse du rapport bénéfices/risques en faveur d’un élargissement du port d’APR de type FFP2 en population générale.Le HCSP définit 4 scenarii possibles relatifs aux indications du port d’APR de type FFP2 en population générale.Dans un complément au DGS le 7 janvier 2022, actualisé le 15 janvier 2022, il précise que le port correct des APR de type FFP2 en population générale peut trouver des indications chez les personnes à risque de formes graves de Covid-19 et en échec de vaccination par immunosuppression, et en capacité de le supporter, sur consultation médicale. Cette recommandation doit s’accompagner de formations spécifiques sur les caractéristiques, les performances et le port correct d’APR FFP2 notamment l’adaptation à la taille et à la morphologie du visage pour les personnes concernées.Le HCSP précise également, à cette occasion, ses recommandations concernant le milieu scolaire et universitaire.Ce document est complémenté par :Appareils de protection respiratoire de type FFP2 en population générale dans le cadre de la lutte contre la propagation du virus SARS-CoV-2 en rapport avec l'émergence du variant Omicron (complément) du 7 janvier 2022Lire aussi dans les avis et rapports :Coronavirus SARS-CoV-2 : Rationalisation de l’utilisation des masques respiratoires pour les professionnels de santé en période épidémique du 10 mars 2020Covid-19 : actualisation de la liste des facteurs de risque de forme grave du 29 octobre 2020Masques dans le cadre de la lutte contre la propagation du virus SARS-CoV-2 du 29 octobre 2020Covid-19 : avis sur le protocole sanitaire renforcé proposé pour les commerces du 22 novembre 2020Covid-19 : Risque de transmission du SARS-CoV-2 par aérosols en milieux de soins du 10 septembre 2020Covid-19 : contrôle de la diffusion des nouveaux variants du virus du 14 janvier 2021Covid-19 : stratégie pour la définition de mesures permettant la réouverture des établissements recevant du public du 18 avril 2021Stratégie à adopter pour le stock de l’État en masques et équipements de protection individuelle du 6 août 2021Appareils de protection respiratoire de type FFP2 par les professionnels de santé dans le cadre de la lutte contre la propagation du virus SARS-CoV-2 en rapport avec l'émergence du variant Omicron (complément) du 7 janvier 2022Lire aussi :Masques de protection respiratoire et risques biologiques : foire aux question

FFP2 respiratory protective devices in the general population to fight against the spread of the SARS-CoV-2 virus in relation to the emergence of the Omicron variant (HCSP, Avis et Rapports)

International audienceFFP2 respiratory protective devices in the general population to fight against the spread of the SARS-CoV-2 virus in relation to the emergence of the Omicron variantIn this statement, the French High Council for Public Health or HCSP examines the strategies for indicating the use of FFP2-type respirator protective devices (RPE) in the general population or in populations at risk, as part of the fight against the spread of the SARS-CoV-2 virus in the context of the emergence of the Omicron variant.It specifies, in a supplement sent to the Directorate-General for Health (DGS) on 7 January 2022, (updated on 15 January 2022), that the correct wearing of FFP2-type respirators is essential.The HCSP takes into account that :The effectiveness and protective performance (filtration) of masks, whatever they may be, are closely dependent on the constancy of wear, the fit to the face and the quality of wear covering the nose, mouth and chin imperatively;The mask alone cannot completely stop the risk of transmission; it is one of the protective measures to be respected (vaccination, hand hygiene, ventilation of premises, social distancing, etc.).The HCSP stresses the high level of uncertainty and lack of scientific data on several important aspects of the analysis of the benefit/risk ratio in favour of extending the use of FFP2-type respirators in the general population.The HCSP defines 4 possible scenarios relating to the indications for wearing FFP2-type respirators in the general population.In a supplement sent to the DGS on 7 January 2022, (updated on 15 January 2022), it specifies that the correct wearing of FFP2 type respirators in the general population may be indicated for people at risk of severe forms of Covid-19 and who have failed immunosuppression vaccination, and who are able to tolerate it, on medical advice. This recommendation must be accompanied by specific training on the characteristics, performance and correct wearing of FFP2-type respirators, in particular the adaptation to the size and morphology of the face of the persons concerned.The HCSP also specifies, on this occasion, its recommendations concerning the school and university environment.Lire en français :Appareils de protection respiratoire de type FFP2 en population générale dans le cadre de la lutte contre la propagation du virus SARS-CoV-2 en rapport avec l'émergence du variant Omicron du 23 décembre 202