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BackgroundAt a regional or continental scale, the characterization of environmental health inequalities (EHI) expresses the idea that populations are not equal in the face of pollution. It implies the analysis in order to identifying and managing areas at risk of overexposure where increasing risk to human health is suspected. The development of methods is a prerequisite for the implementation of public health actions aimed at the protection of populations.MethodsThis paper presents the methodological framework developed by INERIS (French national institute for industrial environment and risks) to identify a common framework for conceptualizing and operationalizing environmental exposures as an important step towards articulating a science of EHI. We develop an integrated exposure assessment approach capable to integrate the multiplicity of exposure pathways from various sources, through a series of models up to the internal exposure.ResultsMeasured data from environmental networks reflecting the actual contamination of the environment are reused to characterize the population's exposure. Sophisticated methods of spatial analysis are applied to include additional information and take benefit from spatial and inter-variable correlation to improve data representativeness and characterize associated uncertainty. Integrated approaches bring together all information necessary for assessing the source-to-human-dose continuum using Geographic Information System, multimedia exposure and toxicokinetic model. ConclusionThis framework could be used for many purposes, such as mapping EHI, identifying vulnerable populations and determinants of exposure to manage and plan remedial actions and assessing spatial relationships between health and environmental to identify factors that influence the variability of disease patterns.

Background: This study aims to describe and test a tiered approach for assessing compliance to Environmental Quality standards (EQSs) for priority substances in biota in line with the European Water Framework Directive. This approach is based on caged gammarids and trophic magnification factors (TMFs) at the first tier, with fish analysed at the second tier at sites exceeding the EQS. A dataset was implemented by monitoring perfluorooctane (PFOS) in caged gammarids exposed at 15 sites in French rivers, and in fish muscle and rest-of- body from the same sites. Isotopic ratios (δ13C and δ15N) were also measured in gammarids and fish. Two scenarios were developed to compare measured PFOS concentrations in fish against predicted concentrations based on measures in caged gammarids and TMFs. Scenario (1) compared measured PFOS concentrations in fish fillets with predicted PFOS concentrations based on measured concentrations in caged gammarids and δ15N. Scenario (2) tested whether or not EQS exceedance was correctly predicted based on measured concentrations in caged gammarids and trophic levels (TLs) from wild fish and gammarid populations.Results: δ13C and δ15N variations showed that caged gammarids used local food resources during exposure in the field. PFOS concentrations in gammarids were fairly variable through time at each site. In fish, concentrations ranged from non-quantifiable to 250 ng g− 1 (wet weight). After adjustment to the TL at which the EQS is set, 12 sites were above the EQS for PFOS. In scenario (1), predicted concentrations were almost correct at 7 sites out of 15. Most incorrect predictions were overestimations that were slightly improved by applying a lower TMF. In scenario (2) we tested several variants for parameters involved in the predictions. The most efficient combination yielded two wrong predictions out of 15. This result was obtained with a higher TMF value, mean concentrations in gammarids from several field exposures, and a TL for gammarids at the median of the distribution in French rivers.Conclusion: The proposed tiered approach was thus efficient. However, the number of sites was relatively limited, and the dataset was biased towards EQS exceedance. The tiered approach warrants further validation.