RESUMEN
We report the third outbreak of pneumococcal pneumonia within one year among workers in European shipyards. During January and February 2020, 37 cases of pneumonia were identified in a shipyard in Marseille, south-eastern France. Outbreak control measures were implemented, including a mass vaccination campaign with 23-valent pneumococcal polysaccharide vaccine targeting all shipyard workers. Given the high mobility of shipyard workers, coordinated responses between European public health institutes are necessary to avoid further outbreaks.
Asunto(s)
Brotes de Enfermedades/prevención & control , Exposición por Inhalación/efectos adversos , Exposición Profesional/efectos adversos , Neumonía Neumocócica/epidemiología , Streptococcus pneumoniae/aislamiento & purificación , Adulto , Anciano , Femenino , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Infecciones Neumocócicas/prevención & control , Vacunas Neumococicas/administración & dosificación , Neumonía Neumocócica/prevención & control , Salud PúblicaRESUMEN
Leaf and root essential oils of two closely related but ecologically distant Philodendron species were extracted in natural conditions in French Guiana and analysed by GC/MS to i) describe the blends of volatile organic compounds (VOCs) produced by those species and ii) analyse species and environment-based variations in extracts composition. A total of 135 VOCs were detected with a majority of aliphatic sesquiterpenes. P. fragrantissimum produced mainly ß-bisabolene (on average 29.12% of the extract) as well as α- and ß-selinene (14.52% and 17.50%, respectively) while in P. melinonii, four aliphatic sesquiterpenes could alternatively be the main component: (E)-ß-farnesene (up to 91.42% of the extract), germacrene-D (73.74%), ß-caryophyllene (51.63%) and trans-α-bergamotene (41.26%). A significant effect of species and organs on extracts composition was observed while the environment (sun exposure) only affected the relative proportions of monoterpenes and sesquiterpenes in roots of P. melinonii. These results are discussed in the light of the potential role of leaf and root terpenes in Philodendron species.
Asunto(s)
Philodendron/química , Compuestos Orgánicos Volátiles/análisis , Guyana Francesa , Monoterpenos/análisis , Monoterpenos/efectos de la radiación , Aceites Volátiles/análisis , Hojas de la Planta/química , Raíces de Plantas/química , Raíces de Plantas/efectos de la radiación , Sesquiterpenos/análisis , Sesquiterpenos/efectos de la radiación , Luz SolarRESUMEN
INTRODUCTION: Worldwide, air pollution has become a main environmental cause of premature mortality. This burden is largely due to fine particles. Recent cohort studies have confirmed the health risks associated with chronic exposure to PM2.5 for European and French populations. We assessed the mortality impact of PM2.5 in continental France using these new results. METHODS: Based on a meta-analysis of French and European cohorts, we computed a shrunken estimate of PM2.5-mortality relationship for the French population (RR 1.15 [1.05:1.25] for a 10µg/m(3) increase in PM2.5). This RR was applied to PM2.5 annual concentrations estimated at a fine spatial scale, using a classical health impacts assessment method. The health benefits associated with alternative scenarios of improving air quality were computed for 36,219 French municipalities for 2007-2008. RESULTS: 9% of the total mortality in continental France is attributable to anthropogenic PM2.5. This represents >48,000 deaths per year, and 950,000years of life lost per year, more than half occurring in urban areas larger than 100,000 inhabitants. If none of the municipalities exceeded the World Health Organization guideline value for PM2.5 (10µg/m(3)), the total mortality could be decreased by 3%, corresponding to 400,000years of life saved per year. CONCLUSION: Results were consistent with previous estimates of the long-term mortality impacts of fine particles in France. These findings show that further actions to improve air quality in France would substantially improve health.
Asunto(s)
Contaminantes Atmosféricos/toxicidad , Exposición a Riesgos Ambientales/efectos adversos , Mortalidad Prematura , Material Particulado/toxicidad , Estudios de Cohortes , Francia/epidemiología , Tamaño de la PartículaRESUMEN
INTRODUCTION: Long-term exposure to air pollution (AP) has been shown to have an impact on mortality in numerous countries, but since 2005 no data exists for France. OBJECTIVES: We analyzed the association between long-term exposure to air pollution and mortality at the individual level in a large French cohort followed from 1989 to 2013. METHODS: The study sample consisted of 20,327 adults working at the French national electricity and gas company EDF-GDF. Annual exposure to PM10, PM102.5, PM2.5, NO2, O3, SO2, and benzene was assessed for the place of residence of participants using a chemistry-transport model and taking residential history into account. Hazard ratios were estimated using a Cox proportional-hazards regression model, adjusted for selected individual and contextual risk factors. Hazard ratios were computed for an interquartile range (IQR) increase in air pollutant concentrations. RESULTS: The cohort recorded 1967 non-accidental deaths. Long-term exposures to b aseline PM2.5, PM10-25, NO2 and benzene were associated with an increase in non-accidental mortality (Hazard Ratio, HR = 1.09; 95% CI: 0.99, 1.20 per 5.9 µg/m3, PM10-25; HR=1.09; 95% CI: 1.04, 1.15 per 2.2 µg/m3, NO2: HR=1.14; 95% CI: 0.99, 1.31 per 19.3 µg/m3 and benzene: HR=1.10; 95% CI: 1.00, 1.22 per 1.7 µg/m3).The strongest association was found for PM10: HR = 1.14; 95% CI: 1.05, 1.25 per 7.8 µg/m3. PM10, PM10-25 and SO2 were associated with non-accidental mortality when using time varying exposure. No significant associations were observed between air pollution and cardiovascular and respiratory mortality. CONCLUSION: Long-term exposure to fine particles, nitrogen dioxide, sulfur dioxide and benzene is associated with an increased risk of non-accidental mortality in France. Our results strengthen existing evidence that outdoor air pollution is a significant environmental risk factor for mortality. Due to the limited sample size and the nature of our study (occupational), further investigations are needed in France with a larger representative population sample.
Asunto(s)
Contaminantes Atmosféricos/análisis , Enfermedades Cardiovasculares/mortalidad , Exposición a Riesgos Ambientales/análisis , Material Particulado/análisis , Enfermedades Respiratorias/mortalidad , Adulto , Benceno/análisis , Femenino , Estudios de Seguimiento , Francia/epidemiología , Humanos , Masculino , Modelos Teóricos , Mortalidad/tendencias , Dióxido de Nitrógeno/análisis , Ozono/análisis , Modelos de Riesgos Proporcionales , Factores de Riesgo , Dióxido de Azufre/análisis , Encuestas y CuestionariosRESUMEN
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.
Asunto(s)
Contaminantes Atmosféricos/toxicidad , Enfermedades Cardiovasculares/epidemiología , Neoplasias/epidemiología , Material Particulado/toxicidad , Enfermedades Respiratorias/epidemiología , Dióxido de Azufre/toxicidad , Adolescente , Adulto , Contaminantes Atmosféricos/análisis , Enfermedades Cardiovasculares/inducido químicamente , Femenino , Francia/epidemiología , Hospitalización , Humanos , Lactante , Masculino , Neoplasias/etiología , Material Particulado/análisis , Enfermedades Respiratorias/inducido químicamente , Medición de Riesgo , Clase Social , Factores Socioeconómicos , Dióxido de Azufre/análisisRESUMEN
We performed a literature review to investigate how epidemiological studies have been used to assess the health consequences of living in the vicinity of industries. 77 papers on the chronic effects of air pollution around major industrial areas were reviewed. Major health themes were cancers (27 studies), morbidity (25 studies), mortality (7 studies), and birth outcome (7 studies). Only 3 studies investigated mental health. While studies were available from many different countries, a majority of papers came from the United Kingdom, Italy, and Spain. Several studies were motivated by concerns from the population or by previous observations of an overincidence of cases. Geographical ecological designs were largely used for studying cancer and mortality, including statistical designs to quantify a relationship between health indicators and exposure. Morbidity was frequently investigated through cross-sectional surveys on the respiratory health of children. Few multicenter studies were performed. In a majority of papers, exposed areas were defined based on the distance to the industry and were located from <2 km to >20 km from the plants. Improving the exposure assessment would be an asset to future studies. Criteria to include industries in multicenter studies should be defined.
Asunto(s)
Contaminantes Atmosféricos/toxicidad , Exposición a Riesgos Ambientales , Métodos Epidemiológicos , Monitoreo del Ambiente , Humanos , Trastornos Mentales/inducido químicamente , Trastornos Mentales/epidemiología , Morbilidad , Neoplasias/inducido químicamente , Neoplasias/epidemiología , Enfermedades Respiratorias/inducido químicamente , Enfermedades Respiratorias/epidemiología , RiesgoRESUMEN
INTRODUCTION: Short term associations between air pollution indicators and hospitalizations for cardiovascular diseases have been suggested by epidemiological and clinical studies. The present study aims at estimating the association between particles with diameter <10 microm (PM(10)), nitrogen dioxide (NO(2)) and ozone and hospitalizations for cardiovascular diseases in eight French cities during the 1998-2003 period. METHODS: The daily number of hospitalizations in each city was extracted from the French hospital information system (PMSI) for cardiovascular diseases, cardiac diseases, ischemic heart diseases and stroke. Excess relative risks (ERRs) of hospitalization associated with a 10 microg/m(3) increase in pollutant levels were estimated in each city by fitting a Poisson regression model, controlling for well-known confounding factors and temporal trends. City-specific results were then combined by inverse variance weighting. RESULTS: Daily number of hospitalizations for cardiovascular diseases was associated with PM(10) levels (for a 10 microg/m(3) increase, ERR=0.8%, 95% CI: [0.2, 1.5]), with NO(2) (1.1%, [0.6, 1.6]) but not with ozone (0.1% [-0.2%, 0.5%]). Associations were stronger in people aged 65 years and over, and when only hospitalizations for ischemic heart diseases were considered. No association was found between strokes and air pollution levels. DISCUSSION: Our study suggests that the ambient levels of air pollutants currently experienced in the eight French cities, which are close to European air quality guidelines, are yet linked to a short term increase of hospitalizations for cardiovascular diseases. These results are consistent with epidemiological and toxicological data on the cardiovascular effects of air pollution.
Asunto(s)
Contaminación del Aire/efectos adversos , Enfermedades Cardiovasculares/epidemiología , Hospitalización/estadística & datos numéricos , Anciano , Contaminantes Atmosféricos/toxicidad , Ciudades , Exposición a Riesgos Ambientales/efectos adversos , Francia/epidemiología , Humanos , Dióxido de Nitrógeno/toxicidad , Ozono/toxicidad , Material Particulado/toxicidad , RiesgoRESUMEN
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 O3 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 O3 pollution on mortality. Counts of deaths were regressed on temperatures and O3 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 microg/m3 in O3 level. For the 3-17 August 2003 period, the excess risk of deaths linked to O3 and temperatures together ranged from 10.6% in Le Havre to 174.7% in Paris. When we compared the relative contributions of O3 and temperature to this joint excess risk, the contribution of O3 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 O3 and temperatures, but also for the relative contribution of each factor. These results confirmed that in urban areas O3 levels have a non-negligible impact in terms of public health.
Asunto(s)
Exposición a Riesgos Ambientales , Rayos Infrarrojos/efectos adversos , Mortalidad/tendencias , Ozono/toxicidad , Salud Pública/estadística & datos numéricos , Ciudades , Europa (Continente)/epidemiología , Francia/epidemiología , Trastornos de Estrés por Calor/epidemiología , Trastornos de Estrés por Calor/historia , Trastornos de Estrés por Calor/mortalidad , Historia del Siglo XXI , Humanos , Medición de Riesgo , Factores de TiempoRESUMEN
In the past few years many studies on air pollution and health based on time series have been carried out. Yet, this approach does not assess exposure to air pollution at an individual level but it is based on ambient concentrations measured by air quality monitoring networks. Questions on the estimates of exposure to pollutants have been raised, in particular the fact that background measuring stations only have been considered in the set up of pollution indicators. To assess the impact of exposure indicator characteristics on the results of time series analysis, two series (black smoke and sulfur dioxide, respectively) of exposure indicators to urban air pollution were set up taking into account a growing part of proximity measures (industrial sources) available in the studied urban area (Le Havre, France). For each pollutant, indicators distributions were almost similar, especially for black smoke. Whatever the pollutant, the most obvious heterogeneity could be observed between the 100% background indicator and the indicator including the arithmetic mean for all the stations (50% background stations and 50% proximity stations). Then the sensitivity of the associations between mortality and air pollution to these indicators was studied. These indicators did not show statistically significant differences in the estimated excess risk. Yet, confidence intervals were more statistically significant as the contribution of proximity stations was more substantial, in particular for SO2. To conclude, the use of proximity measurements did not influence dramatically on the mean estimates of the association between air pollution and mortality indicators in Le Havre. Therefore it does not seem relevant to include the data provided by the proximity stations in the urban exposure indicators within the context of the epidemiology monitoring system.
Asunto(s)
Contaminantes Atmosféricos/toxicidad , Contaminación del Aire/efectos adversos , Monitoreo del Ambiente/métodos , Humo/efectos adversos , Dióxido de Azufre/toxicidad , Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/mortalidad , Ciudades , Monitoreo Epidemiológico , Francia/epidemiología , Humanos , Mortalidad , Enfermedades Respiratorias/etiología , Enfermedades Respiratorias/mortalidad , Humo/análisis , Dióxido de Azufre/análisisRESUMEN
BACKGROUND: A heatwave occurred in France in August 2003, with an accompanying excess of all-cause mortality. This study quantifies this excess mortality and investigates a possible harvesting effect in the few weeks after the heatwave. METHODS: A time-series study using a Poisson regression model with regression splines to control for nonlinear confounders was used to analyze the correlation between heatwave variable and mortality in 9 French cities. RESULTS: After controlling for long-term and seasonal time trends and the usual effects of temperature and air pollution, we estimated that 3,096 extra deaths resulted from the heatwave. The maximum daily relative risk of mortality during the heatwave (compared with expected deaths at that time of year) ranged from 1.16 in Le Havre to 5.00 in Paris. There was little evidence of mortality displacement in the few weeks after the heatwave, with an estimated deficit of 253 deaths at the end of the period. CONCLUSIONS: The heatwave in France during August 2003 was associated with a large increase in the number of deaths. The impact estimated using a time-series design was consistent with crude previous estimates of the impact of the heatwave. This finding suggests that neither air pollution nor long-term and seasonal trends confounded previous estimates. There was no evidence to suggest that the extras deaths associated with the heatwave were simply brought forward in time.
Asunto(s)
Causas de Muerte , Clima , Calor , Francia/epidemiología , HumanosRESUMEN
OBJECTIVE: To assess the value of repeated point-prevalence surveys in measuring the trend in nosocomial infections after adjustment for case mix. SETTING: A 3,500-bed teaching facility composed of 4 acute care hospitals. METHODS: From May 1992 to June 1996, eight point-prevalence surveys of nosocomial infections were performed in the hospitals using a sampling process. The trend of adjusted nosocomial infection rates was studied for the four surveys that collected data on indwelling catheters. Adjusted rates were calculated using a logistic regression model and a direct standardization method. RESULTS: From 1992 to 1996, a total of 20,238 patients were included in the 8 point-prevalence surveys. The nosocomial infection rate decreased from 8.6% in 1992 to 5% in 1996 (P < .001). The analysis of adjusted nosocomial infection rates included 9,600 patients. Four independent risk factors were identified: length of stay greater than 12 days, hospitalization in an intensive care unit, presence of an indwelling urinary catheter, and history of a surgical procedure. After adjustment for case mix, the nosocomial infection rate still showed a downward trend (from 7.2% in 1993 to 5.1% in 1996; P = .02). CONCLUSION: Adjusted prevalence rates of nosocomial infections showed a significant downward trend during the period of this study.
Asunto(s)
Infección Hospitalaria/epidemiología , Estudios Transversales , Anciano , Infección Hospitalaria/etiología , Femenino , Francia/epidemiología , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Unidades de Cuidados Intensivos/tendencias , Tiempo de Internación , Modelos Logísticos , Masculino , Complicaciones Posoperatorias , Factores de Riesgo , Cateterismo Urinario/efectos adversosRESUMEN
Mathematical models currently used to study the relationship between the prevalence of the resistance to an antibiotic and the amount of drug may not be adequate because they do not integrate temporal and area analyses simultaneously. Furthermore, the forms of such relationship are unknown. We applied the Generalized Additive Model (GAM) to study fluoroquinolone use and the incidence of fluoroquinolone-resistance in Staphylococcus aureus in our institution over a 3-year period. Overall institution and individual hospital unitrestricted analyses were performed. Relative risk (RR) observed for increasing fluoroquinolone use with a 4-month lag from the 25th percentile to the 75th percentile was 1.27 (95% CI: 1.13-1.42). In the surgery units, RR was 1.23 (95% CI: 1.01-1.50) for fluoroquinolone use with a 2-months lag. GAM enabled us to observe for the first time a significant temporal relationship between fluoroquinolone use and the incidence of fluoroquinolone-resistant nosocomial S. aureus isolates.
Asunto(s)
Infección Hospitalaria/tratamiento farmacológico , Farmacorresistencia Bacteriana , Revisión de la Utilización de Medicamentos/estadística & datos numéricos , Fluoroquinolonas/administración & dosificación , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus aureus/efectos de los fármacos , Infección Hospitalaria/microbiología , Infección Hospitalaria/prevención & control , Fluoroquinolonas/farmacología , Francia , Unidades Hospitalarias/estadística & datos numéricos , Humanos , Incidencia , Tiempo de Internación , Modelos Lineales , Medición de Riesgo , Infecciones Estafilocócicas/prevención & control , Staphylococcus aureus/aislamiento & purificación , Factores de TiempoRESUMEN
Between 1990 and 1995, 9 French cities provided data on daily air pollution, total mortality, cardiovascular mortality, and respiratory mortality. Personnel in individual cities performed Poisson regressions, controlling for trends in seasons, calendar effects, influenza epidemics, temperature, and humidity, to assess the short-term effects of air pollution. The authors describe results obtained from the quantitative pooling of these local analyses. When no heterogeneity could be detected, a fixed-effect model was used; otherwise, a random-effect model was used. Significant and positive associations were found between total daily deaths in these cities and the 4 air pollution indicators studied: (1) Black Smoke, (2) sulfur dioxide, (3) nitrogen dioxide, and (4) ozone. A 50-microg/m3 increase in Black Smoke (24 hr), sulfur dioxide (24 hr), nitrogen dioxide (24 hr), or ozone (8 hr) was associated with increases in total mortality of 2.9% (95% confidence interval [CI]) = 1.3, 4.4), 3.6% (95% CI = 2.1, 5.2), 3.8% (95% CI = 2.0, 5.5), and 2.7% (95% CI = 1.3, 4.1), respectively. Similar results were obtained for cardiovascular mortality. Except for sulfur dioxide, positive--but not significant--associations were found with respiratory mortality. The internal consistency among the cities studied, as well as consistency with previously published results, favors a causal interpretation of these associations.