Scientific publications portal of EHESP researchers
Not a member yet
5609 research outputs found
Sort by
SVOCs, VOCs and microbiological contamination in sports facilities, what are people exposed to?
No full textInternational audienceThe indoor air quality of sports facilities was studied in France for different types of sports rooms (fitness, dojos,motor skills, physical activity). A total of 53 VOCs, 44 SVOCs and 7 microbiological parameters were assessed inair or settled dust. In air, levels of VOCs and SVOCs concentrations in air were like those found in schools andhomes, and SARS-CoV-2 was not identified. High concentrations of total bacteria were observed in two sportfacilities with values exceeding the indoor air guideline of European directive and the World Health Organization.In indoor dust, SVOCs ranged from <0.05 μg/g to 274 μg/g, and five SVOCs showed median concentrationshigher than in homes, daycare centers, or schools: 2-ethylhexyl diphenyl phosphate (EHDPP), triphenyl phosphate(TPP), benzophenone, 4-tert-butylphenol (4tBP), and 4-tert-octylphenol (4tOP). Considering the toxicity ofthe compounds quantified, a risk assessment seems necessary for the health of athletes and children in gyms, butexposure parameters for sports activities (dust ingestion, inhalation rates, and skin contact) are not available atthis time
La nouvelle norme AFNOR « XP X43-300 » : une démarche combinant des motifs d'intervention, une enquête préalable et des stratégies de mesurage des bioaérosols pour des actions en prévention dans les environnements de travail
No full textInternational audienceThe AFNOR X43C/GE 1 ?Biological Agents' expert group has just finalised the drafting of standard XP X43-300, which describes a strategy for analysing biological risks in the workplace. The standard describes an analysis process undertaken for specific occupational health reasons, listed in the document, which must result in the preparation and implementation of a prevention action plan. The process described in standard XP X43-300 begins with a preliminary investigation, which may be sufficient to propose an action plan. It also provides for the preliminary investigation to be supplemented by measurements if necessary. The standard details the bioaerosol measurement strategies that can be used. The presentation reviews the XP X43-300 standard, which is the first document of its kind for bioaerosols and will be published in 2026 as an experimental standard.Le groupe d'experts AFNOR X43C/GE 1 « Agents Biologiques » vient de finaliser la rédaction de la norme XP X43-300 décrivant une stratégie d'analyse des risques biologiques en environnement de travail. La norme décrit une démarche d'analyse engagée pour des problématiques en de santé au travail précis, listés dans le document, et qui doit aboutir à la préparation et à la mise en ?uvre d'un plan d'action de prévention. La démarche décrite dans la norme XP X43-300 débute par une enquête préalable qui peut suffire à proposer un plan d'action. Elle prévoit aussi de compléter l'enquête préalable par le biais de mesurages si nécessaire. La norme détaille les stratégies de mesurage des bioaérosols qui peuvent être employées. La présentation passe en revue la norme XP X43-300 qui est le premier document du genre pour les bioaérosols et qui sera publiée en 2026 sous le statut de norme expérimentale
Réguler sans contraindre : l’État et les médecins face aux déserts médicaux
No full textInternational audienceDès les années 2000, la démographie des médecins généralistes commence à inquiéter les pouvoirs publics, la population et la profession médicale elle-même. Pour lutter contre les déserts médicaux, les politiques privilégient des mesures incitatives, refusant de toucher à la liberté d'installation et d'organisation des médecins.La plus emblématique d'entre elles est la création des maisons de santé pluriprofessionnelles (MSP), en 2007, qui rassemblent des professionnels médicaux et paramédicaux. Ceux-ci s’engagent auprès de l’assurance maladie et de l’administration sanitaire à appliquer de nouvelles règles en matière d’accès aux soins et de coordination, mais aussi à développer des activités de santé publique. Adoubées par l’État, les MSP sont considérées comme attractives par les jeunes médecins généralistes qui, sans y être contraints, acceptent désormais d’exercer sous contrat.À travers une étude menée à l’échelle nationale et dans six MSP, Anne Moyal montre que, si les médecins généralistes ont réussi à s’approprier ce modèle et à préserver jusqu’à présent leur autonomie, les maisons de santé contribuent à un encadrement progressif de leur activité. Cette enquête révèle ainsi les profondes transformations de la médecine générale en France
Maternal anthropometric measurements in pregnancy and child neurocognitive and behavioral development at 1 and 6 years of age – a cohort study in Benin, Sub-Saharan Africa
No full textInternational audienceBackgroundMaternal malnutrition, especially obesity, is hypothesized to impact offspring neurodevelopment, but less is known in sub-Saharan Africa where undernutrition is highly prevalent.ObjectiveThis study aimed to investigate the association between maternal nutritional status during pregnancy and neurocognitive and behavioral development in children at age one and six years, in a mother-child cohort from Benin.MethodsThis prospective cohort study included surviving singletons born to pregnant women in Allada, Benin. Cognitive and motor functions of 747 and 574 children were assessed at one and six years of age, respectively, in addition to behavioral difficulties and attention deficit and hyperactivity disorders. Statistical analysis using multiple linear regression models tested main associations, potential mediating factors were additionally adjusted for.Results17%, 72.5%, 7.7% and 2.5% of women were estimated to be underweight, normal weight, overweight and obese before pregnancy, respectively. Women who were underweight had a higher median weight gain [240 (170 – 300)] over the course of pregnancy, compared to normal BMI women [210 (160 – 260)], and overweight/obese women [150 (110 – 240)]. After exclusion of obese women, pre-pregnancy BMI was significantly associated with a higher motor scores (0.26, 95%CI 0.002-0.53) and cognitive scores (0.37, 95%CI 0.02-0.72) after adjustment for confounding factors. There was no association between gestational weight gain and offspring neurodevelopment at one and six years of age. There was no association between maternal BMI and gestational weight gain and behavior and attention deficit and hyperactivity disorders at six years of age.ConclusionsOur study suggests that poor maternal nutritional status before pregnancy may impair short- and long-term neurocognition in children in the Beninese context. Undernutrition in childhood has great impact and efforts to adequate prevention for both child and maternal undernutrition should be enforced in low- and middle-income countries
Self-employment, health, and health care: When the going gets tough, the tough get going?
No full textInternational audienceThis study provides a life-course analysis of the relationship between self-employment, health, and health care use among individuals aged 50 and older in Europe. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE), we apply first-difference and dynamic panel data models that go beyond standard approaches in mitigating endogeneity concerns. Our findings show that the self-employed enjoy better health at younger ages, consistent with a selection effect. In addition, they experience a steeper decline in physical health over time. We also document two distinct phases of health care use: during working life, the self-employed are more likely to be hospitalised, suggesting delayed care until acute needs arise; after retirement, the number of medical visits increases, consistent with a lower opportunity cost of care
Mapping Stakeholder Alignment for Deprescribing Policy in France: Insights from a Policy Delphi Approach
No full textBackground : With growing efforts aimed at optimizing health care services by reducing “low value care”, medical deprescribing represents a critical policy challenge at the intersection of clinical quality, fiscal sustainability, and environmental stewardship. Despite growing evidence of its benefits, France lacks a comprehensive national framework for systematic medication review and deprescribing implementation. Objective: To identify areas of consensus and divergence among key French stakeholders using an adapted Policy Delphi approach to inform national deprescribing policy development. Methods: An exploratory survey was conducted among stakeholders across five groups (healthcare professionals, patients, academia, policymakers, and the pharmaceutical industry). Consensus levels were assessed using graded Likert scales and analysed across policy domains, including knowledge and training, collaboration, resources, policy support, and sustainability opportunities. Results: High consensus emerged around knowledge gaps, the need for interprofessional collaboration, and clinical benefits of deprescribing. Moderate consensus existed regarding resource constraints and environmental sustainability. Divergence was observed between professionals/academia and policymakers/industry regarding financial incentives and regulatory readiness. A policy Delphi heatmap revealed specific alignment patterns that could serve as policy entry points. Conclusions: Multi-stakeholder consensus mapping provides an innovative governance tool for identifying actionable policy opportunities and contributes to recent tools aimed at reducing low-value care. High-consensus domains, including training, patient safety, and sustainability, offer immediate entry points for coalition-building. On the contrary, areas of divergence require structured dialogue and iterative policy learning among France’s fragmented governance structures to translate stakeholder alignment into systematic deprescribing implementation
Sterile insect technique for suppression of endemic Aedes albopictus in urban Reunion Island: a pilot trial of technical feasibility and entomological impact
No full textInternational audienceBackground. The sterile insect technique (SIT) has progressed from theory to a validated vector control strategy for Aedes-borne diseases, including dengue and chikungunya. We assessed the feasibility and effectiveness of SIT for suppressing Aedes albopictus in small-scale urban environments on Reunion Island.Methods. From July 2021 to September 2022, over 10 million Ae. albopictus males sterilised as pupae with 40 Gy X-rays were released at a 20-hectare pilot site. Weekly releases ranged from 60,000 to 275,000 males (3000–13,750 per hectare). Outcomes were monitored using ovitrap surveillance and periodic adult sampling during a 6-month baseline and a 13-month intervention.Results. Sterile-to-wild male ratios ranged from 6:1 to 18:1. Compared with the control site, the treated site showed a 33.5% reduction in egg abundance and a 61.5% reduction in egg viability (range 40.0–81.9). Reductions in egg fertility were temporally aligned with a 60.4% decline in female abundance relative to baseline.Conclusion. This study demonstrates that SIT was technically and logistically feasible and achieved measurable suppression of Ae. albopictus. Despite scale and operational constraints, the intervention achieved significant reductions in egg fertility and female abundance, providing strong proof of concept for SIT-based mosquito control on Reunion Island
Wearing face masks to protect oneself and/or others: counter-intuitive results from a simple epidemic model accounting for selfish and altruistic human behavior
No full textInternational audienceWe study a simple SIS epidemic model accounting for human behavior. Individuals can decide at each instant of time whether or not they wear a face mask. Mask wearing decreases susceptibility to and/or transmission of the pathogen. We consider a situation in which individuals are unaware of their health status (infected or not), but they can perceive the prevalence of infection at the population level. This assumption fits situations in which most infected individuals are asymptomatic. Individual decision dynamics depends both on prevalence, as a proxy for the risk of being infected or infecting others, and on the fraction of the population complying to mask-wearing, which people can observe in their everyday life. Specifically, human behavior is assumed to be driven by imitation dynamics. When the epidemic does not naturally die out, the model has three types of endemic equilibria: no-compliance, partial-compliance, and full-compliance. Only one of these equilibria can be stable at a time. We assume that the efficacy of mask-wearing is positively correlated to its cost at the individual level. Increasing mask efficacy and therefore its individual cost can make the system switch from full-compliance to partial-compliance. This way, increasing mask efficacy may increase the prevalence of infection at equilibrium. In other words, prevalence is minimized for intermediate mask efficacy and cost. This is because, when mask-wearing is too effective and therefore costly, part of the population free-rides on the effort of others and drops mask, resulting in increased prevalence. Altogether, our results show that the interplay between epidemiology and human behavior may lead to counter-intuitive but nevertheless intelligible outcomes, which should be anticipated when designing public health policies
La santé, un enjeu incontournable des prochaines élections municipales
No full texthttps://theconversation.comAlors que l’échelon des collectivités locales est particulièrement pertinent en matière de santé, les freins qui s’opposent à une réelle « territorialisation » de la santé sont nombreux. Fruit des échanges entre Laurent Chambaud, médecin de santé publique et inspecteur général des affaires sociales, qui a dirigé l’École des hautes études en santé publique (EHESP) de 2013 à 2022 et Gilbert Hangard, adjoint au maire d’Albi délégué à la santé et président de l’association Élus Santé Publique et Territoires (ESPT), ce texte fait le point sur la situation, à la veille des élections municipales 2026