Baud, France
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Le Bouquin S.,University Europeenne Of Bretagne Anses | Huneau-Salaun A.,University Europeenne Of Bretagne Anses | Huonnic D.,University Europeenne Of Bretagne Anses | Balaine L.,University Europeenne Of Bretagne Anses | And 2 more authors.
Poultry Science | Year: 2013

Agricultural workers, and pig and poultry farmers in particular, are exposed to airborne contaminants including organic dusts, gases, fungi, bacteria, and endotoxins that can have adverse effects on their respiratory health. To date, data comparing the aerial dust concentrations in the different hen-housing systems used by commercial poultry farmers are scarce. An epidemiological study was conducted in commercial housing facilities for laying hens, half of which were housed in a cage system without litter and the remaining half on an on-floor system with litter. The aims were to measure and compare the ambient dust concentrations in the different housing systems and identify any factors in building design and hen management that could influence the dust burden. An average concentration of respirable ambient dusts (≤4 μm) of 0.37 mg/m3 (95% CI [0.31-0.42]) was measured in the on-floor system, and this value was higher than average values in the cage system {0.13 mg/m3 (95% CI [0.11-0.14]) P = 0.01}. The highest dust concentration was observed in aviaries (1.19 mg/m3 [0.80-1.59]). The type of housing and the presence of litter therefore had a preponderant effect on air quality. Dust concentrations in caged buildings were influenced by cage design and rearing practices, whereas litter management, the age of hens, and temperature control were determining factors for dust levels in on-floor houses. This study underlines the need for information and preventive measures to reduce the exposure of poultry workers to bioaerosols, particularly in alternative systems where high levels of ambient dust were observed. © 2013 Poultry Science Association Inc.


Caillaud D.,Service de Pneumologie | Toloba Y.,Service de Pneumologie | Raobison R.,Service de Pneumologie | Besancenot J.-P.,Reseau National de Surveillance Aerobiologique RNSA | And 3 more authors.
Revue des Maladies Respiratoires | Year: 2014

The aim of this review is to describe the health impact of exposure to pollen based on recently published epidemiological studies. The methodology chapter, describes a review of the literature and outlines important elements of these studies: measurement of exposure to pollens, study types used, study populations and the health indicators related to pollen exposure. In this review, two types of studies have been used to assess the epidemiological evidence of short-term links between pollen exposure and hay fever or asthma. Ecological time-series studies use daily indicators of asthma exacerbations (emergency room admissions or hospitalizations), consultations for rhinitis or conjunctivitis, or anti-allergic drug consumption within general population. Panel studies relate measurements of pollen grain concentrations to nasal, ocular and bronchial symptom severity in a group of subjects sensitized to a specific pollen, monitored during the pollen season. In both cases, the studies show a relationship on a day-to-day basis between health indicators and daily rates of atmospheric pollen collected by a pollen trap. These studies take into account confounding factors, such as air pollution, weather factors and sometimes exposure to outdoor molds. Unlike earlier studies, more and more studies focus on the shape of the dose-response relationship and the lag between pollen exposure and symptoms. Only rarely, individual susceptibility factors, the clinical phenomenon of priming and polysensitization are reported. Thus, ecological time-series studies and panel studies assess respectively the impact of pollen exposure in the general population and in groups of sensitized patients. Using appropriate statistical tools, these studies provide insight into the shape of the dose-response relationship, with a potential threshold below which symptoms are absent, then a linear relationship for nasal, ocular and bronchial symptoms and a plateau where the symptoms do not increase despite the continued increase in pollen. © 2013 SPLF.


Caillaud D.M.,University of Auvergne | Martin S.,SEPIA Sante | Segala C.,SEPIA Sante | Vidal P.,Direction Regionale Service Medical Auvergne | And 5 more authors.
Allergy: European Journal of Allergy and Clinical Immunology | Year: 2015

Background Few time-series studies, and none lasting longer than 4 years, have investigated the etiology of treated seasonal allergic rhinoconjunctivitis (SAR) on the basis of anti-allergic medication prescriptions. The aim of this article was to study the short-term relationship between pollen exposure and drug-treated SAR over 10 years in an urban area in central France. Methods A SAR case was defined as the association between an oral antihistamine and a local anti-allergic drug on the same prescription. The relationship between daily changes in pollen concentrations and daily changes in the number of treated SAR cases was analysed using generalized additive models, taking into account confounding factors such as air pollution, weather and days of the week. Results Between 2003 and 2012, the total yearly number of treated SAR cases rose from 7265 to 11 315. The relative risk of treated SAR associated with an interquartile increase in pollen concentration increased significantly for Fraxinus, Betula, Carpinus, Platanus, Poaceae and Urticaceae for the whole pollen season, and for Urticaceae in the first semester. Conclusions The prevalence of treated SAR cases rose by about 55% in 10 years. The study not only confirmed the highly allergenic role of Fraxinus, Betula and Poaceae pollens but also showed a relatively unknown association between treated SAR and Carpinus and Platanus pollens, despite their pollen counts being <1% of overall pollen concentration. It also showed robust correlations with Urticaceae pollens, especially during the first semester, suggesting a potential allergenic role of Parietaria pollination in this non-Mediterranean area. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.


Guillam M.-T.,SEPIA Sante | Thomas N.,SEPIA Sante | Nedellec V.,Vincent Nedellec Consultants | Derbez M.,French Scientific and Technical Center for Building | And 3 more authors.
Human and Ecological Risk Assessment | Year: 2010

The objective of this study was to determine the time spent by children (0- 18 years old) in indoor places of leisure and also day-care centers. The sampling scheme was stratified by geographic region and size of town. This study was performed from September 2005 to March 2006. Families were asked to complete a diary by phone on their children's activities during the last week of school and the last week of a vacation period. The time spent in each place was then extrapolated for the winter period. We then evaluated the overall attendance and time (means and quartiles) spent by all of the children, and by those of children attending places. Information was collected on 2780 children. Gymnasiums were frequented the most (52.3% during the winter period) and were the places in which children spend the greatest amount of time (average: 19 min/day). Other places frequented the most included bars/restaurants (46.5%; average: 9 min/day), cinemas/theaters (42.2%; average: 10 min/day), and indoor pools (25.4%; average: 12 min/day). Our results should help in the prioritization of specific projects investigating exposure in children during indoor leisure activities and the evaluation of the risks associated with air pollutants in these places. © Taylor & Francis Group, LLC.


Deguen S.,EHESP School of Public Health | Segala C.,Sepia Sante | Pedrono G.,Sepia Sante | Mesbah M.,University Pierre and Marie Curie
Risk Analysis | Year: 2012

Despite improvements in air quality in developed countries, air pollution remains a major public health issue. To fully assess the health impact, we must consider that air pollution exposure has both physical and psychological effects; this latter dimension, less documented, is more difficult to measure and subjective indicators constitute an appropriate alternative. In this context, this work presents the methodological development of a new scale to measure the perception of air quality, useful as an exposure or risk appraisal metric in public health contexts. On the basis of the responses from 2,522 subjects in eight French cities, psychometric methods are used to construct the scale from 22 items that assess risk perception (anxiety about health and quality of life) and the extent to which air pollution is a nuisance (sensorial perception and symptoms). The scale is robust, reproducible, and discriminates between subpopulations more susceptible to poor air pollution perception. The individual risk factors of poor air pollution perception are coherent with those findings in the risk perception literature. Perception of air pollution by the general public is a key issue in the development of comprehensive risk assessment studies as well as in air pollution risk management and policy. This study offers a useful new tool to measure such efforts and to help set priorities for air quality improvements in combination with air quality measurements. © 2012 Society for Risk Analysis.


De Giudici P.,Sepia Sante | Guillam M.-T.,Sepia Sante | Segala C.,Sepia Sante | Keck G.,Record Reseau Cooperatif de Recherche sur les Dechets et lEnvironnement
Environnement, Risques et Sante | Year: 2013

Some waste management activities can expose both workers and the neighboring general population to microbial risks. Numerous studies have assessed these risks for composting facilities and for sewage sludge applications. Many pathogenic agents (or their components) often found in compost are known to cause adverse health effects, mainly respiratory (e.g., actinomycetes, Aspergillus fumigatus, and endotoxins). These assessments have focused almost exclusively on the risks associated with bioaerosols. Most studies show background-level bioaerosol concentrations more than 200 meters away from composting facilities. Although some data link health effects to bioaerosol concentrations, only those for endotoxins clearly define thresholds for these effects. They nonetheless show worrisome risk levels for the most heavily exposed workers. The risk levels for neighboring populations, on the other hand, remain poorly characterized. Studies have also examined various scenarios of exposure to untreated sewage sludge applied to soil, sludge containing a number of well-identified pathogens that are primarily responsible for digestive disorders. These scenarios include the inhalation of sludge aerosols and the ingestion of cultivated plants or soil dust. Spatial and temporal variability make it difficult to determine germ concentrations in sludge. Transfers from sludge to soil are well documented for a number of microorganisms (unlike transfers to water or vegetation). Dose-response models for ingestion of many pathogens present in sewage sludge are available, and risk assessments could be conducted. Nonetheless, uncertainties at various stages of these evaluations weaken the results of some of the studies. Overall, uncertainties in the assessment of microbiological risks in these sectors must be reduced, and further knowledge about transfers from waste to exposure media must be acquired.


De Giudici P.,Sepia sante | Guillam M.-T.,Sepia sante | Segala C.,Sepia sante
Environnement, Risques et Sante | Year: 2013

Health risks associated with microbiological agents may be present in many areas of general life and in the workplace. Microbiological risk assessment (MRA) has been defined, by analogy with chemical risk assessment, as a succession of four steps (identification of hazards, the characterization of each, exposure estimation and risk characterization). However, the specific characteristics of biological agents (infectious or not) make the implementation of these assessments complex and difficult. The mechanisms of the adverse health effects observed after entry and multiplication in the host (in infections) vary widely (immune reactions neutralizing infectious agents, responses to toxins, allergies). At the individual level, clinical effects also vary in their symptoms and gravity. The matrix from which these agents arise significantly influences the route of exposure (the oral route has been studied most), the agent's survival and multiplication, the likelihood of transfer, etc. Basically, each exposure to an infectious agent, that is, each individual event, is considered independent from those that may have preceded or followed it. Standardized methods, based mainly on culture procedures developed long ago, are still used to identify and quantify the agents, and they present limitations, especially in terms of determining duration and specificity. Risk characterization generally does not extend beyond infection and most often uses non-threshold models. Risks are quantified as appropriate by exponential or Beta-Poisson dose response models. Once the model is validated, the quantification of the risk of infection for a given pathogen must take into account the uncertainty related to incomplete knowledge of the situation. The properties of Monte Carlo simulations (bundle of risks, scatter, etc.) are often used to describe the risks. Unlike for chemical risks, there is no consensual criterion (quantitative threshold) for deciding on the need for action. MRA requires some improvements: methods of quantifying agents, transfers between compartments, etc. Moreover, its use remains limited mainly to oral routes and to dose-response models established for infection rather than disease.


PubMed | EHESP School of Public Health, Association pour la Surveillance de la Qualite de lAir en Alsace ASPA, SEPIA Sante and University of Strasbourg
Type: Journal Article | Journal: PloS one | Year: 2014

Exposure to traffic is an established risk factor for the triggering of myocardial infarction (MI). Particulate matter, mainly emitted by diesel vehicles, appears to be the most important stressor. However, the possible influence of benzene from gasoline-fueled cars has not been explored so far.We conducted a case-crossover study from 2,134 MI cases recorded by the local Coronary Heart Disease Registry (2000-2007) in the Strasbourg Metropolitan Area (France). Available individual data were age, gender, previous history of ischemic heart disease and address of residence at the time of the event. Nitrogen dioxide, particles of median aerodynamic diameter <10 m (PM10), ozone, carbon monoxide and benzene air concentrations were modeled on an hourly basis at the census block level over the study period using the deterministic ADMS-Urban air dispersion model. Model input data were emissions inventories, background pollution measurements, and meteorological data. We have found a positive, statistically significant association between concentrations of benzene and the onset of MI: per cent increase in risk for a 1 g/m3 increase in benzene concentration in the previous 0, 0-1 and 1 day was 10.4 (95% confidence interval 3-18.2), 10.7 (2.7-19.2) and 7.2 (0.3-14.5), respectively. The associations between the other pollutants and outcome were much lower and in accordance with the literature.We have observed that benzene in ambient air is strongly associated with the triggering of MI. This novel finding needs confirmation. If so, this would mean that not only diesel vehicles, the main particulate matter emitters, but also gasoline-fueled cars--main benzene emitters-, should be taken into account for public health action.


PubMed | SEPIA Sante
Type: Journal Article | Journal: Annals of agricultural and environmental medicine : AAEM | Year: 2013

The airborne contaminant exposure levels experienced by poultry farmers have raised concerns about the possible health hazards associated with them. Thus, a longitudinal project was instituted in France to monitor these exposures in poultry workers and to evaluate the long-term effect on health.Sixty-three workers in two different poultry housing systems were included (33 from floor-based systems and 30 from cage-based systems). Personal dust concentrations (over 2 days) and activity patterns (over 14 days) were collected and then modeled to obtain average long-term estimates. Health data were collected by questionnaire.The mean daily time spent in the cage system was more than 2 hours longer than in the floor system. Two main common tasks accounted for ~70% of this time. Dust concentrations were higher in the floor system than in the cage system. The concentrations for the 14 days of known activity patterns estimated using the statistical model agreed well with the measured values. Several chronic respiratory symptoms were significantly associated with the high levels of long-term exposure estimated by the model. The highest risk was for chronic bronchitis symptoms (>4-fold higher for exposures of 0.1 mg/m(3) of respirable dust).The presented modeling strategy can be used to estimate the long-term average personal exposure to respirable dust, and to study the association between dust exposure and chronic respiratory symptoms. This population of workers will be followed-up in subsequent examinations (3 years later) to determine whether the predictive model is valid, and whether long-term dust exposure is related to the incidence of respiratory symptoms and changes in pulmonary functions.


Caillaud D.,Service de Pneumologie | Martin S.,Sepia Sante | Segala C.,Sepia Sante | Clot B.,Federal Office of Meteorology and Climatology MeteoSwiss | Thibaudon M.,Sepia Sante
International Archives of Allergy and Immunology | Year: 2014

Background: Most panel studies focusing on rhinitis and conjunctivitis symptoms and birch pollen have been performed on a linear basis and have not included air pollution and meteorological variables as potential confounders. The objective of this panel study was to assess the relationship between symptoms of seasonal allergic rhinoconjunctivitis and daily airborne birch pollen concentrations, checking with adequate statistical tools the shapes of concentration-response curves and controlling for confounders. Methods: The severity of rhinitis, conjunctivitis, and bronchial symptoms was recorded daily in March and April 2010 (3,311 person-days) in 61 seasonal allergic rhinoconjunctivitis patients sensitized to birch. Data were analyzed with generalized additive and generalized estimating equation models to quantify the effects of birch pollens. Results: The relationship between birch pollen and the percentage of patients with nasal, ocular and bronchial symptoms was linear until birch daily average concentrations of, respectively, 110, 70, and 70 grains/m3; it reached a plateau thereafter. For an increase of 10 grains/m3, the OR (95% CI) for nasal, ocular, and bronchial symptoms were, respectively, 1.07 (1.03-1.12), 1.17 (1.08-1.27), and 1.12 (1.03-1.21). At the beginning of the season, no nasal or ocular symptoms were observed below a threshold of 30 grains/m3. Conclusions: Adequate modeling regression shows that the clinical response to natural exposure to birch pollen in sensitized patients varies during Betula pollen season, with a threshold at the beginning of the season, while over the whole season the relationship is linear for nasal, ocular, and bronchial symptoms up to a saturation point, followed by a plateau. © 2013 S. Karger AG, Basel.

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