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Integration of the exposome in health risk assessment: the example of chemical mixtures
No full textInternational audienceBACKGROUND AND AIM: The exposome encompasses all environmental factors encountered over the life-course to explain their role in the development of health effects, in complement of the genome. Since the emergence of the concept in 2005, the scientific community has made a lot of efforts to produce new knowledge, data, methods and tools to assess the exposome and its impact on human health. However, the exposome has not yet been widely implemented by health and safety agencies and today, one of the key challenges is to include exposome-inspired approaches in health risk assessment. METHOD: After presenting the main recommendations to integrate the exposome in the risk assessment process, we will focus on chemical mixtures to practically show how the exposome can support risk assessment methodologies. RESULTS: Several applications of the different exposure and health data derived from studies in the French population will be presented: dietary exposure to chemical mixtures in children and women, exposure to pesticide mixtures from multiple sources of the general population and from occupational activity for agricultural workers, analysis of chemical mixtures from human biomonitoring data. CONCLUSIONS: The integration of approaches and knowledge relating to the exposome will enable environmental epidemiology and risk assessment to cross a decisive threshold, taking into account the contributions of citizen and participatory science wherever possible and useful. Developing the eco-exposome will also help for a better integration of human, animals and environmental health
Analyzing the 7C psychological antecedents of vaccine acceptance throughout the COVID-19 pandemic among healthcare sector workers in France: A repeated cross-sectional study (CappVac-Cov)
No full textInternational audienceBackground: Across various stages of the COVID-19 pandemic and related vaccine recommendations in France, we assessed the association of the 7C-psychological antecedents with vaccine uptake/intention for booster vaccination among healthcare-sector workers (HCSWs). We also assessed whether 7C-antecedent profiles changed over time.Methodology: The Research Group for the Prevention of Occupational Infections in Healthcare Workers (GERES) conducted three repeated web-surveys which were disseminated by email chain-referral among HCSWs throughout France. The questionnaires waves took place: July-November 2021, February-March 2022 and January-March 2023 (P2, P3 and P4). We also reanalysed data from a prior similar study conducted late 2020-early 2021 (Moirangthem et al. (2022)) (P1). To evaluate the association of 7C-items with vaccine uptake-intention for future vaccination, we estimated adjusted prevalence ratios (aPR) using robust variance Poisson regression. We report the 7C-item population attributable loss in vaccine intention.Results: The four surveys (P1-P4) encompassed 5234, 339, 351 and 437 participants. At earlier stages of the vaccine campaign, the principal antecedents of vaccine intention were favorable perception of vaccination benefit-risk-balance (BRB) (vs. unfavorable, aPR: 2.32), reactance to employer encouragement for vaccination (motivates vs. dissuades-me, aPR:2.23), vaccine confidence (vs. not-being-confident, aPR: 1.71) and social conformism towards vaccination (favorable vs. skeptical opinion in private environment, aPR: 1.33). Under a vaccine mandate for HCSWs, only perceiving vaccination as a collective action was associated with current vaccine status (agree vs. disagree, aPR: 2.19). At later stages of the epidemic, hypothetical booster vaccine intentions were strongly associated with BRB perception (favorable vs. unfavorable, aPR: 2.07) and perceiving vaccination as a collective action (agree vs. disagree, aPR: 1.69). Fearing a severe side effect from vaccination decreased population vaccine intention by 26.2 %.Conclusion: Our results suggest that both 7C-antecedents and their association with vaccine behaviour can change over time, and underscore the importance of assuring confidence in vaccine safety
AI and new digital technologies have transformed Alcohol and Other Drug Industries lobbying
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Sustainable wastewater reuse for agriculture
No full textInternational audienceEffective management of water resources is crucial for global food security and sustainable development. In this Review, we explore the potential benefits and challenges associated with treated wastewater (TW) reuse for irrigation. Currently, 400 km(3) yr(-1) of wastewater is generated globally, but <20% is treated, and of that TW, only 2-15% is reused for irrigation depending on region. The main limitation of TW for irrigation is the inability of current treatment technologies to completely remove all micropollutants and contaminants of emerging concern, some of which have unknown impacts on crops, environment and health. However, advanced water treatment and reuse schemes, supported by water quality monitoring and regulations, can provide a stable water supply for agricultural production, as demonstrated in regions such as the USA and Israel. Such schemes could potentially serve a net energy source, as the embedded energy in wastewater exceeds treatment needs by 9 to 10 times. Agriculturally useful nutrients such as nitrogen, phosphorus and potassium could be also recovered and reused. TW reuse for irrigation could act as a major contributor to a circular economy and sustainable development, but the first steps will be funding and implementation of advanced and sustainable treatment technologies and social acceptance
DRIVEN Une étude de cohorte rétrospective évaluant l'efficacité en vie réelle du vaccin grippal haute dose comparé au dose standard en France en 2021/2022 : robustesse des résultats via 2 méthodes d'ajustement
No full textInternational audience- Introduction : En France, la campagne de vaccination contre la grippe 2021/22 a vu l'introduction du vaccin grippal haute dose (HD) recommandé et pris en charge à partir de 65 ans. Dans une étude randomisée contrôlée, HD a démontré une Efficacité Vaccinale relative (EVr) supérieure de 24,2% (9,7% à 36,5%) vs le vaccin à dose standard (DS) pour la prévention des grippes confirmées. L'étude DRIVEN étudie l'EVr en vie réelle de HD sur la prévention des hospitalisations associées à la grippe. - Matériels et méthodes : Une cohorte rétrospective d'individus de 65 ans et plus non-institutionnalisés pour lesquels un vaccin grippal a été remboursé pendant la saison 2021/22 a été construite à partir des données de l'assurance-maladie. Les individus ont été suivis depuis la dispensation du vaccin (date index DI) jusqu'au 30 juin 2022, l'admission en EHPAD ou le décès. Les antécédents médicaux ont été identifiés à partir des données médicales disponibles jusqu'à 5 ans avant la DI. Les hospitalisations pour grippe et autres causes entre 14 jours après la date index et la fin du suivi ont été considérées. L'analyse principale a été conduite sur une population appariée sur le score de propension avec un ratio 1 HD:4 SD et une contrainte exacte sur âge, sexe, semaine de vaccination et région. La pondération inverse (ou IPTW), technique alternative a été utilisée pour apprécier la robustesse des résultats. Les ratios de taux d'incidence (IRR) ont été estimés par des modèles de régression de Poisson conditionnels. - Résultats : Au total, 431 643 individus ont reçu un vaccin HD et 7 401 210 un vaccin DS. Dans l'analyse principale, 94% des vaccinés HD ont pu être appariés à 4 vaccinés DS et la vaccination HD était associée à une diminution de 23,3% (8.4%; 35.8%) des hospitalisations pour grippe comparé aux vaccinés DS. La méthode IPTW a estimé la rVE à 22,2% (8%; 36%) pour la prévention des hospitalisations pour grippe. - Conclusion : Dans un contexte de forte circulation de SARS-CoV2 et une probable priorisation du vaccin HD vers les individus les plus fragiles, les taux d'hospitalisations pour grippe étaient significativement inférieurs chez les vaccinés HD comparativement aux vaccinés DS. Les résultats étaient robustes aux différentes méthodes statistiques et en accord avec la littérature
Compensation et vulnérabilité des ressources dans les stratégies de façonnage du travail. Le contexte du travail en 12 heures
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Lived experiences of stigma and altered self-perceptions among young people who are addicted to ENDS: a qualitative study from Aotearoa New Zealand
No full textInternational audienceIntroduction: Rising use of electronic nicotine delivery system (ENDS) among young people, especially those who have never smoked, has received considerable attention from the health community. However, fewer studies have examined the mental health impacts of ENDS use. We addressed this gap by exploring the stigma, altered self-perceptions and negative affect experienced by adolescents who assessed themselves as addicted to using ENDS. Methods: We interviewed 20 adolescents aged 16–18 who lived in Aotearoa New Zealand and assessed themselves as moderately or highly addicted to ENDS use. Using in-depth, semistructured qualitative interviews, we explored participants’ experiences of addiction and its effects on their well-being. We interpreted the data using an inductive reflexive thematic analysis approach. Results: We identified four key themes. First, addiction to ENDS use adversely affected participants’ physical and mental health. Second, addiction greatly diminished the pleasurable effects ENDS use first provided and participants who initially enjoyed using ENDS now felt unable to stop. Third, participants felt judged, stigmatised and belittled by others who did not understand their struggle with addiction. Fourth, they experienced several negative emotions, including self-blame, regret, disappointment and embarrassment that diminished how they saw themselves. Conclusions: We extend earlier studies by probing the mental health burden ENDS use imposes on young people, offer new insights into how they experience addiction and outline potential policy responses. Measures reducing young people’s access to ENDS are urgently needed alongside empathetic, youth-oriented cessation support
The COVID-19 Pandemic as a Public Health Teacher—the Lessons We Must Learn
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Current epidemiological and experimental evidence relating the chemical exposome to Alzheimer’s disease
No full textInternational audienceThis critical overview aims to provide one of the most comprehensive synthesis of epidemiological and experimental evidence relating the chemical exposome to Alzheimer’s Disease (AD). We have focused on chemical pollutants that mostly result from anthropic activities and involved in toxicology pathways, including pesticides, organic solvents, metals, combustion air pollutants, dioxins, flame retardants, fluorosurfactants, plastic components and food/cosmetic additives. In total, we have reviewed over 120 epidemiological studies examining the link between chemical exposures and the risk of AD or cognitive impairment in older adults, along with more than 250 experimental studies assessing the impact of chemical exposures on neurodegeneration‐related pathways. The predominant emphasis in epidemiological research has been on pesticides, metals, solvents and combustion air pollutants. The most consistently observed associations with AD/cognitive impairment involve occupational exposure to pesticides and exposure to fine particulate matter. Less is known about the impact of lower levels of pesticide exposure in the general population, with emerging evidence supported by a few studies. Conversely, in the general population, there is growing evidence of the role of air pollution, especially increased exposure to fine particulate matters, in AD. Regarding metals and solvents, associations with AD have been suggested in several case‐control or cross‐sectional studies but the overall weight of evidence remains low. In experimental studies, pesticides and metals have also been the most extensively investigated and predominantly implicated in the disruption of neurotransmission, oxidative stress and mitochondrial dysfunction; some pesticides might also specifically target amyloid‐β aggregation. Finally, our comprehensive literature review highlights a gap in knowledge concerning the influence of many chemical exposures on AD, especially the most recent pesticide families as well as synthetic additive chemicals considered as ubiquitous. Yet, some of these chemicals have been incriminated in neurodevelopmental defects, and there exists suggestive, albeit still limited, evidence of their involvement in neurodegeneration‐related pathways, such as neurotransmission disruption, supporting the need for further research efforts