Search

Copyright of Actualités Pharmaceutiques is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Resolving health inequalities continues to be a priority in improving quality of life around the world. Their impact is of increasing concern to public health governance, which considers the issue of environmental health inequalities to be paramount. To meet this challenge, we have developed a methodology based on the development of spatial composite index in order to assess these inequalities while also providing an alternative to classic approaches that are solely based on territory weaknesses. The aggregation of the widest possible range of factors involved in environmental health provide a clear picture of a territory. This study uses different cases to understand how the change of scale influences the analysis of environmental health inequalities. Our analysis is based on a densely populated area located in a region in the north of France where the standardized mortality ratio is higher than the national average. Multidimensional composite indices were developed simultaneously from datasets collected for different administrative units, and were used to compare levels of resilience and vulnerability within the geographical area. Joint analysis of composite indices led to the identification of territorial blackspots. Indices could therefore enable stakeholders to prioritize certain administrative units, implementing specific measures according to the specificities of each administrative unit. The study discusses the consequences of the choice of a spatial unit and a geographical area in the assessment of territorial inequalities in health, particularly in terms of accessibility, availability and exhaustivity of data. The selection criteria also depend on the jurisdictional fields of action stakeholders. • Consequences of the spatial unit choice on resilience and vulnerability indices. • Comparative analysis of strengths and weaknesses related to spatial scale. • Accessibility, availability and exhaustivity in territorial inequalities assessment. • Management of environmental health issues through aggregation of multifaceted data. • Associate rather than oppose territorial issue, spatial scale and data choice. [ABSTRACT FROM AUTHOR]

The environmental health research carried out on a broad scale does not provide decision-makers with tools for managing environmental and social inequalities in health on a fine scale. The goal of the present study was to develop a method for neighborhood-level territorial diagnosis that decision-makers can use to incorporate health issues into their planning policies. The primary objective was to analyze composite spatial vulnerability and resilience indices in the Lille metropolitan area in northern France. The secondary objective was to refine these results by taking account of neighborhood-level characteristics. The study highlights the interest of transdisciplinary research and collaboration with local experts to effectively evaluate and address environmental health issue (more than 30 experts gathered and 12 thematic workshops organized). The results showed that the proposed method allows for the comparison of neighborhoods; however, certain specificities may be underestimated. The real importance of certain variables linked to specific contexts can be minimized, which can distort our understanding of the challenges these neighborhoods face. Analyzing the environmental and social inequalities in health in the metropolitan area's center vs. its belt made it possible to take better account of the characteristics of the areas studied. • Spatialized composite indices as a decision-making tool for local planning policies. • More than 30 local experts gathered and 12 thematic workshops organized. • Multidimensional methodology applicable to urban, peri-urban and rural neighborhoods. • Contrasting profiles discriminated by joint analysis of resilience and vulnerability. [ABSTRACT FROM AUTHOR]

The comet assay is a sensitive technique for the measurement of DNA damage in individual cells. Although it has been primarily applied to animal cells, its adaptation to higher plant tissues significantly extends the utility of plants for environmental genotoxicity research. The present review focuses on 101 key publications and discusses protocols and evolutionary trends specific to higher plants. General consensus validates the use of the percentage of DNA found in the tail, the alkaline version of the test and root study. The comet protocol has proved its effectiveness and its adaptability for cultivated plant models. Its transposition in wild plants thus appears as a logical evolution. However, certain aspects of the protocol can be improved, namely through the systematic use of positive controls and increasing the number of nuclei read. These optimizations will permit the increase in the performance of this test, namely when interpreting mechanistic and physiological phenomena. [ABSTRACT FROM AUTHOR]

[Display omitted] • A nationwide fine-scale spatial study of different degrees of preterm-birth in France. • Proposed a composite air pollution score for multiple exposure. • Found positive association between preterm birth and air pollution score. • The greater the degree of prematurity, the stronger the association. [ABSTRACT FROM AUTHOR]

The paper describes the development of an inductively coupled plasma mass spectrometry (ICP MS) method for multitrace element determination in dried blood spots (DBSs). The analytical conditions were optimized using Seronorm™ L-3 and L-1 Certified Reference Materials. The best results were obtained by sampling blood drops on a decontaminated PVDF filter membrane. After drying under metal-free conditions, the DBSs underwent acidic digestion and were analyzed with ICP MS. The method was then validated for As, Cd, Cu, Pb, Mo, Se and Zn. Using a matrix-matched calibration curve, the recovery levels ranged from 96% to 117%. The repeatability and reproducibility were generally below 15%. Limits of quantification ranging from 0.5 to 50 μg/L. In order to investigate the analytical procedure under real sampling conditions, the results obtained from DBSs and liquid blood aliquots (less subject to contamination) from two adult subjects were compared. [ABSTRACT FROM AUTHOR]

An investigation was undertaken to identify the most significant soil parameters that can be used to predict Cd, Pb, and Zn bioaccessibility in smelter-contaminated agricultural soils. A robust model was established from an extended database of soils by using: (i) a training set of 280 samples to select the main soil parameters, to define the best population to be taken into account for the model elaboration, and to construct multivariate regression models, and (ii) a test set of 110 samples to validate the ability of the regression models. Total carbonate, organic matter, sand, P2O5, free Fe–Mn oxide, and pseudototal Al and trace element (TE) contents appeared as the main variables governing TE bioaccessibility. The statistical modeling approach was reasonably successful, indicating that the main soil factors influencing the bioaccessibility of TEs were taken into account and the predictions could be applicable for further risk evaluation in the studied area. [Copyright &y& Elsevier]

Correlations between terricolous bryophyte- and lichen- vegetation and edaphic parameters (pH, organic matter, nitrogen, Carbon/nitrogen ratio, Cation Exchange Capacity, and Cd, Pb and Zn soil contents) of soils submitted to a gradient of metal contamination in northern France were performed using statistical analysis. Six classes can be distinguished according to the low-, intermediate- and high-trace metal levels respectively, leading to the conclusion that bryophyte- and lichen-groupings have a strong bioindicative value of the heavy metal pollution of soils. [Copyright &y& Elsevier]

Although the incidence of Crohn's disease has increased worldwide over the past 30 years, the disorder's exact causes and physiological mechanisms have yet to be determined. Given that genetic determinants alone do not explain the development of Crohn's disease, there is growing interest in "environmental" determinants. In medical science, the term "environment" refers to both the ecological and social surroundings; however, most published studies have focused on the latter. In environmental and exposure sciences, the term "environment" mostly relates to contamination of the biotope. There are many unanswered questions on how environmental hazards might contribute to the pathogenesis of Crohn's disease. Which pollutants should be considered? Which mechanisms are involved? And how should environmental contamination and exposure be evaluated? The objective was to perform a systematic review of the literature on Crohn's disease and environmental contamination. We searched the PubMed, Google Scholar, Scopus, ISI Web of Science and Prospero databases. We considered all field studies previous to April 2019 conducted on human health indicators, and evaluating exposure to all type of physical, biological and chemical contamination of the environment. The lack of clear answers to date can be ascribed to the small total number of field studies (n = 16 of 39 publications, most of which were conducted by pioneering medical scientists), methodological differences, and the small number of contaminants evaluated. This make it impossible to conduct a coherent and efficient meta-analysis. Based on individual analysis of available studies, we formulated five recommendations on improving future research: (i) follow up the currently identified leads - especially metals and endocrine disruptors; (ii) explore soil contamination; (iii) gain a better knowledge of exposure mechanisms by developing transdisciplinary studies; (iv) identify the most plausible contaminants by developing approaches based on the source-to-target distance; and (v) develop registries and cohort-based analyses. Image 1 • The first systematic review of environmental contamination and Crohn's disease. • The few field studies had differing methodologies and conflicting results. • Metals and endocrine disruptors are potential candidates. • A source-to-target-distance-based approach might highlight new candidate pollutants. • Soil contamination should always be investigated for chronic diseases. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • Spatial heterogeneity of environmental justice can be mapped at neighborhood scale. • Socio-economic, demographic and environmental determinants could be cumulated. • A matrix combined with radar charts provides a clear picture of these determinants. • A same level of vulnerability can be related to different profiles of determinants. • Composite index emphasises on the biological susceptibility to air pollution. Abstract Differential and not fair exposure to environmental risk factors across socio-demographic groups, called environmental justice (EJ), may contribute to inequalities in health and most often put disadvantaged groups at higher risk for environmental health effects. Main literature has difficulties to consider the potential exposure of populations to different levels of air pollutants. Cumulative and long-term exposures are still seldom considered. We propose a comprehensive EJ methodology to prioritize and characterize neighborhoods which takes into account the cumulative impact of health determinants. For this purpose, the use of environmental biomonitoring is an innovative approach to consider the integrated and long-term exposure to complex air pollution. Cumulative Impact Screening (CIS) methodology was used for two contrasted living areas of France. CIS is based on synthetic and composite index construction. Three scores were attributed to each neighborhood according to a cumulative calculation of key parameters: environmental score (using 3 air biomonitoring parameters: trace elements loads in lichens, lichenic biodiversity and dust deposition on poplar leaves), socioeconomic deprivation score and susceptible population score. Each score can be considered as a dimension of health vulnerability. CIS analysis and maps highlighted the unequal spatial distribution of EJ. After the multi-criteria hierarchization of spatial units, the influence of each dimension was characterized in each neighborhood with radar charts. The study was carried out in two living areas in the north of France: a costal industrial zone, the Dunkerque Urban Community and a densely populated area located at the crossroads of Europe, the European Lille Metropolis. Three neighborhoods of the highest vulnerability level were identified in each area. We highlighted a same level of vulnerability can be related to different profiles of determinants. This multidimensional approach was able to discriminate neighborhoods with a gradient level of vulnerability in each area, despite different environmental, demographic and economic contexts. This cross-use constitutes a preliminary validation in order to assess the replicability of the methodology. This step showed that this approach could be replicated in countries or regions which would have different characteristics: it is both specific to a given context and well suited for different contexts. We demonstrated that environmental biomonitoring is a smart approach to fill the lack of available data on multiple air pollution at the local scale. The tool developed is specific to the territory and transposable and communicant, which facilitate adoption by a variety of community agency and other regulatory stakeholders, and prioritization of public health actions. [ABSTRACT FROM AUTHOR]

Abstract Introduction A growing body of evidence suggests that long-term exposure to air pollutants like nitrogen oxides (NO x) and particulate matter (PM) is associated with the prevalence and incidence of type 2 diabetes mellitus. Serum glucose and glycosylated hemoglobin (HbA1c) levels are biomarkers of glucose homeostasis. Data on the association between glucose homeostasis biomarkers and air pollution are scarce. HbA1c and fasting blood glucose (FBG) concentrations have been linked to PM and NO 2 exposure in Taiwan, where mean pollution levels are 3 to 7 times higher than the guideline maximum annual mean values of 40 μg/m3 (for NO 2) and 20 μg/m3 (for PM10) set by the World Health Organization (WHO). However, this association is not consistently reported at lower levels of pollution. The objective of the present study was to investigate the relationships between long-term exposure to air pollution at the place of residence, diabetes biomarkers, and prevalent diabetes in two cities with relatively low level of pollution. Methods Data were recorded for 2895 adults (aged 40 to 65) having participated in the 2011–2013 ELISABET cross-sectional survey of the Lille and Dunkirk urban areas in northern France. Using multiple logistic and generalized linear regression models, we analyzed the associations between individual exposure to pollution on one hand and HbA1c, FBG and prevalent diabetes mellitus (DM) on the other. An atmospheric dispersion modelling system was used to assess annual exposure at the place of residence to coarse particulate matter (PM10), NO 2 , and sulfur dioxide (SO 2). Results The median pollutant levels were 21.96 μg/m3 for NO 2 , 26.75 μg/m3 for PM10, and 3.07 μg/m3 for SO 2. A 2 μg/m3 increment in PM10 was associated with an HbA1c increment [95% confidence interval] of 0.044% [0.021; 0.067]. This association was still statistically significant after adjustment for the neighborhood's characteristics. A 5 μg/m3 increment in NO 2 was associated with an HbA1c increment of 0.031% [0.010; 0.053]. Associations between DM or FBG and air pollution did not achieve statistical significance. Conclusion Our study of a middle-aged, urban population evidenced an association between elevated HbA1c levels and long-term exposure to PM10 and NO 2 pollution levels that were relatively low but close to the WHO's guideline maximum values. Highlights • There is debate as to whether air pollution is a risk factor for diabetes mellitus. • Few studies have focused on diabetes biomarkers. • Annual exposure to PM10 and NO 2 at the place of residence was associated with HbA1c. • Associations were observed for relatively low levels of exposure. • Effect sizes were consistent with those observed in areas with more contrasting pollutant levels. [ABSTRACT FROM AUTHOR]

Environmental inequalities are based on the proximity of socio-economically disadvantaged populations to sources of environmental and public health risks, and have recently been extended to environmental contamination. We evaluated such inequalities using a novel approach, at the scale of neighbourhoods in the industrial area of Dunkerque, France, by associating an index of social disadvantage with environmental biomonitoring measurements. A Localised Disadvantage Index (LDI), which characterises the socio-economic status of populations at a neighbourhood level, was developed using an eco-sociological approach. The burdens of 18 trace elements (TE) were recently determined using samples of epiphytic lichens, collected within the study zone. A mean value of TE burden was modelled for each neighbourhood and an integrated index (Mean Impregnation Ratio, MIR) was generated to assess the level of multi-metallic contamination. LDI mapping reveals socio-economic disparities. The neighbourhoods situated near to factories are the most disadvantaged. Environmental maps reveal high contaminations in the vicinity of the industrial zones. The LDI is significantly correlated with the MIR, and with 16 of 18 TE. Significant differences in the level of contamination are observed between high- and low-deprived neighbourhoods. Our results uncover the presence of environmental inequalities. The most disadvantaged populations live in a strongly contaminated environment. We have pioneered the use of biomonitoring data and an integrated index of contamination for the prospection of environmental inequalities. [ABSTRACT FROM AUTHOR]

• Composite indices contain many variables and selection methods for specific needs. • The absence of a common framework leads to strong subjectivity. • It is possible to harmonize dimension characterization practices. • A framework is provided for selection of relevant variables for composite indices. • An increase in methodological transparency will improve interterritorial comparison. The wide range of factors involved in environmental health and the complexity of interactions between all environmental determinants require the validation of multidimensional approaches. While the development of composite indices is receiving growing attention by scientists and public authorities, the concept continues to lack transposability and robustness partly due to varying conceptualizations and/or methodologies. This review aims to promote harmonizing practices governing the first step of development of composite index, namely identification and characterization of the dimensions and variables that are included in environmental health indices. A review of available literature (more than 1500 studies) was conducted to identify the composite indices developed to assess territorial determinants from an environmental health perspective. This process made it possible to identify 23 spatialized composite indices and to assess a total of 329 variables. This diversity highlights that the absence of a common framework can lead to a strong subjectivity and limit comparisons between different environmental health indices. The specificity and the availability of certain variables would limit the transposability of indices. In light of current knowledge, this review proposes a consolidated methodological framework based on a categorization of variables into dimensions and sub-dimensions related to heath, environment, social, economics, services and policy. To characterize the sub-dimensions, several variables are possible and can be chosen according to the availability and/or accessibility of the data. The adaptation of a composite index to a specific territory or to a specific issue would then be effective through the included variables. This also aims to be transposable to any spatial unit (country, region, census tract). This work is a first step towards a proposal of guidelines designed to provide a consensual framework that could facilitate the exploitation of environmental health indices. This transparency could also increase the understanding and adoption of these tools by public authorities and general public. [ABSTRACT FROM AUTHOR]