Characterizing environmental geographic inequalities using an integrated exposure assessment.

BACKGROUND: At a regional or continental scale, the characterization of environmental health inequities (EHI) expresses the idea that populations are not equal in the face of pollution. It implies an analysis be conducted in order to identify and manage the areas at risk of overexposure where an increasing risk to human health is suspected. The development of methods is a prerequisite for implementing public health activities aimed at protecting populations. METHODS: This paper presents the methodological framework developed by INERIS (French National Institute for Industrial Environment and Risks) to identify a common framework for a structured and operationalized assessment of human exposure. An integrated exposure assessment approach has been developed to integrate the multiplicity of exposure pathways from various sources, through a series of models enabling the final exposure of a population to be defined. RESULTS: Measured data from environmental networks reflecting the actual contamination of the environment are used to gauge the population's exposure. Sophisticated methods of spatial analysis are applied to include additional information and take benefit of spatial and inter-variable correlation to improve data representativeness and characterize the associated uncertainty. Integrated approaches bring together all the information available for assessing the source-to-human-dose continuum using a Geographic Information System, multimedia exposure and toxicokinetic model. DISCUSSION: One of the objectives of the integrated approach was to demonstrate the feasibility of building complex realistic exposure scenarios satisfying the needs of stakeholders and the accuracy of the modelling predictions at a fine spatial-temporal resolution. A case study is presented to provide a specific application of the proposed framework and how the results could be used to identify an overexposed population. CONCLUSION: This framework could be used for many purposes, such as mapping EHI, identifying vulnerable populations and providing determinants of exposure to manage and plan remedial actions and to assess the spatial relationships between health and the environment to identify factors that influence the variability of disease patterns.

A necessary distinction between spatial representativeness of an air quality monitoring station and the delimitation of exceedance areas.

The European legislation on ambient air quality introduces the concepts of spatial representativeness of a monitoring station and spatial extent of an exceedance zone. Spatial representativeness is an essential macro-scale siting criterion which should be evaluated before the setting-up and during the life of a monitoring point. As for the exceedance area, it has to be defined each time an environmental objective is exceeded in an assessment zone. No specific approach is prescribed to delimit such areas. A probabilistic methodology is presented, based on a preliminary kriging estimation of atmospheric concentrations at each point of the domain. It is applied to NO2 pollution on the urban scale. In the proposed approach, a point belongs to the area of representativeness of a station if its concentration differs from the station measurement by less than a given threshold. To take the estimation uncertainty into account, the standard deviation of the kriging error is used in a probabilistic framework. The choice of the criteria used to deal with overlapping areas is first tested on NO2 annual mean concentration maps of France, built by combining surface monitoring observations and outputs from the CHIMERE chemistry transport model. At the local scale, data from passive sampling surveys and high -resolution auxiliary variables are used to provide a more precise estimation of the background pollution in different French cities. The traffic-related pollution can also be accounted for in the map by additional predictors such as distance to the road, and traffic-related NOx emissions. Similarly, the proposed approach is implemented to identify the points, at a given statistical risk, where the NO2 concentration is above the annual limit value.

Building spatial composite indicators to analyze environmental health inequalities on a regional scale.

BACKGROUND: Reducing health inequalities involves the identification and characterization of social and exposure factors and the way they accumulate in a given area. The areas of accumulation then allow for prioritization of interventions. The present study aims to build spatial composite indicators based on the aggregation of environmental, social and health indicators and their inter-relationships. METHOD: Preliminary work was carried out firstly to homogenize spatial coverage, and secondly to study spatial variation of environmental (EI), socioeconomic (SI) and health (HI) indicators. The aggregation of the different indicators was performed using several methodologies for which results and decision-makers' usability were compared. RESULTS: Four methodologies were tested: 1) A simple summation of normalized HI, EI and SI indicators (IC), 2) the sum of the normalized HI, EI and SI indicators weighted by the first principal component of a Principal Component Analysis (IC PCA), 3) the sum of normalized and weighted indicators of the first principal component of Local Principal Component Analysis (IC LPCA), and 4) the sum of normalized and weighted indicators of the first principal component of a Geographically Weighted Principal Component Analysis (IC GWPCA). CONCLUSION: The GWPCA is particularly adapted to taking into account the spatial heterogeneity and the spatial autocorrelation between SI, EI and HI. This approach invalidates the basic assumptions of many standard statistical analyses. Where socioeconomic indicators present high deprivation and where they are associated with potential modifiable health determinants, decision-makers can prioritize these areas for reducing inequalities by controlling the socioeconomic and health determinants.

Relationship between Environmental Conditions and Utilisation of Community-Based Mental Health Care: A Comparative Study before and during the COVID-19 Pandemic in Italy.

(1) Background: Lower socioeconomic status increases psychiatric service use, exacerbated during the COVID-19 pandemic by environmental stressors like air pollution and limited green spaces. This study aims to assess the influence of sociodemographic and environmental factors on mental health service utilisation. (2) Methods: This retrospective study uses an administrative database focusing on community mental health services in Northeast Italy. Spatial and temporal analyses were used to address space-time dependencies. (3) Results: Findings showed that sociodemographic factors like living in rented apartments and lower education levels predicted higher mental health service use. Environmental factors, such as elevated NO2 levels and, before the pandemic, lower solar radiation and tree cover, correlated with increased service utilisation. COVID-19 reduced most of the pre-existing differences associated with these factors across census blocks with a different composition of sociodemographic and environmental factors. (4) Conclusions: These findings contribute to a better understanding of the impact of the environment on public mental health.

An iterative optimization scheme to accommodate inequality constraints in air quality geostatistical estimation of multivariate PM.

The kriging-based estimation of the different types of atmospheric particulate matter (PM) pollutions defined in the air quality regulation raises some operational problems because the (co)kriging equations are obtained by minimizing a linear combination of the estimation variances subject to unbiasedness constraints. As a consequence, the estimation process can result in total PM10 concentrations that are less than the PM2.5 concentrations which would be physically impossible. In a previous publication, it was shown that a convenient external drift modeling can reduce the number of spatial locations where the inequality constraint is not satisfied, without completely solving the problem. In this work, the formulation of the cokriging system is modified, inspired by previous works focusing on positive kriging. The introduction of additional constraints on the cokriging weights are presented, leading to a unique and optimal solution to the problem of cokriging under inequality constraints between two variables. Some computational and algorithmic details are introduced. An evaluation of the penalized cokriging is provided by using the European PM monitoring sites dataset: some maps and performance scores are given to assess the relevance of our iterative optimization scheme.

Characterization of Environmental Health Inequalities Due to Polyaromatic Hydrocarbon Exposure in France.

Reducing environmental health inequalities has become a major focus of public health efforts in France, as evidenced by the French action plans for health and the environment. To evaluate environmental inequalities, routine monitoring networks provide a valuable source of data on environmental contamination, which can be used in integrated assessments, to identify overexposed populations and prioritize actions. However, available databases generally do not meet sufficient spatial representativeness to characterize population exposure, as they are usually not assembled for this specific purpose. The aim of this study was to develop geoprocessing procedures and statistical methods to build spatial environmental variables (water, air, soil, and food pollutant concentrations) at a fine resolution, and provide appropriate input for the exposure modelling. Those methods were designed to combine in situ monitoring data with correlated auxiliary information (for example, atmospheric emissions, population, and altitude), in order to better represent the variability of the environmental compartment quality. The MODUL'ERS multimedia exposure model developed by INERIS (French Institute for industrial Environment and Risks) was then used to assess the transfer of substances from the environment to humans, through inhalation and ingestion pathway characterization. We applied the methodology to a carcinogenic Polycyclic Aromatic Hydrocarbon substance, benzo[a]pyrene(B[a]P), to map spatialized exposure indicators, at the national scale. The largest environmental contribution corresponded to the ingestion pathway. Data processing algorithms and calculation of exposure will be integrated into the French coordinated integrated environment and health platform PLAINE (PLteforme intégrée d'Analyse des INégalités Environnementales) which has been developed to map and analyze environmental health inequalities.