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12th ICBEN Congress on Noise as a Public Health Problem, ZURICH, SUISSE, 18-/06/2017 - 22/06/2017; Objectives: Exposure to aircraft noise has been shown to have adverse effects on health and particularly on sleep. This study aimed to investigate the relationship between aircraft noise exposure and subjective sleep quality in the population living near airports in France. Methods: Sleep interview was made through a questionnaire administered to 1,244 residents of three major French airports: Paris-CDG, Lyon-Saint-Exupéry and Toulouse-Blagnac. For each participant, aircraft noise exposure was estimated at home using noise maps. Logisticregression models were used with adjustment for potential confounders. Results: Aircraft noise exposure was associated with the risk of being a short sleeper (sleep duration £ 6h), and with the feeling of tiredness while awakening in the morning. An increase of 10 dBA in aircraft noise level at night was respectively associated with an OR of 1.66 (95% CI: 1.16 to 2.35) and an OR of 1.24 (95% CI: 1.00 to 1.63). Conclusion: These findings contribute to the overall evidence suggesting that aircraft noise exposure at nighttime may decrease subjective quality of sleep.

Background: Noise in the vicinity of airports is a crucial public health issue. Exposure to aircraft noise has been shown to have adverse effects on health and particularly on sleep. Many studies support the hypothesis that noise at night can affect subjective sleep quality. Fewer studies, however, have performed objective measurements of sleep. Objectives: The aim of the present study was to investigate the relationship between aircraft noise exposure and objective parameters assessed by actigraphy of sleep quality in the population living near two French airports. Methods: This study includes 112 participants living in the vicinity of Paris-Charles de Gaulle and Toulouse-Blagnac airports. Wrist actigraphy measurements were performed during eight nights to evaluate objective parameters of sleep quality such as sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TB) and sleep efficiency (SE). Acoustic measurements were made simultaneously both inside the participants' bedrooms and outside (at the exterior frontage) in order to estimate aircraft noise levels. Energy indicators related to the sound energetic average for a given period of time, as well as indicators related to noise events (such as the number of events that exceed a given threshold for example) were estimated. Logistic and linear regression models were used, taking into account potential confounders: age; gender; marital status; education; and body mass index (BMI). Results: Energy indicators, and more particularly indicators related to noise events, were significantly associated with objective parameters of sleep quality. Increased levels of aircraft noise and increased numbers of aircraft noise events increased the time required for sleep onset (SOL) and the total wake time after sleep onset (WASO), and decreased sleep efficiency (SE). An association was also observed between aircraft noise exposure and an increase in total sleep time (TST) and time in bed (TB). Conclusion: The findings of the present study contribute to the overall evidence suggesting that nocturnal aircraft noise exposure may decrease objective quality of sleep. Aircraft noise exposure affects objective parameters of sleep quality, not only in terms of noise levels but also in terms of number of events. Mechanisms for adapting to sleep deprivation could be observed.

Background: Exposure to aircraft noise has been shown to have adverse effects on health, particularly on sleep. Exposure to nighttime aircraft noise clearly affects sleep architecture, as well as subjective sleep quality. Objectives: This study aimed to investigate the relationship between aircraft noise exposure and subjective sleep quality in the population living near airports in France. Methods: A total of 1,244 individuals older than 18 and living near three French airports (Paris-Charles de Gaulle, Lyon-Saint-Exupery and Toulouse-Blagnac) were randomly selected to participate in the study. Information on sleep as well as health, socioeconomic and lifestyle factors was collected by means of a face-to-face questionnaire performed at their place of residence by an interviewer. For each participant, aircraft noise exposure was estimated at home using noise maps. Logistic regression models were used with adjustment for potential confounders. Results: Aircraft noise exposure was significantly associated with a short total sleep time (TST) (£ 6 h) and with the feeling of tiredness while awakening in the morning. An increase of 10 dB(A) in aircraft noise level at night was associated with an OR of 1.63 (95%CI: 1.15-2.32) for a short TST and an OR of 1.23 (95%CI: 1.00-1.54) for the feeling of tiredness while awakening in the morning. Conclusions: These findings contribute to the overall evidence suggesting that aircraft noise exposure at nighttime may decrease the subjective amount and quality of sleep.

Background Saliva cortisol is a possible marker of noise-induced stress and could then mediate the relation observed between exposure to aircraft or road traffic noise and cardiovascular diseases. However, the association between transportation noise and cortisol levels is still unclear. The objective of the study was to investigate the variability of saliva cortisol concentration as an indicator of disturbed hypothalamus-pituitary-adrenal (HPA) axis regulation in relation to long-term aircraft noise exposure. Methods Saliva samples were taken when awakening and before going to bed for 1244 participants older than 18 years of age. Information about health, socioeconomic and lifestyle factors was also collected by means of a face-to-face questionnaire performed at home by an interviewer. Aircraft noise exposure was assessed for each participant’s home address using noise maps. Linear regression models were used to evaluate the effects of aircraft noise exposure on the morning and evening cortisol levels and on the daily variation of cortisol per hour. Results This study suggests a modification of the cortisol circadian rhythm in relation to aircraft noise exposure. This exposure was associated with a smaller variation of cortisol levels over the day, with unchanged morning cortisol levels, but higher cortisol levels in the evening. Conclusions These findings provide some support for a psychological stress induced by aircraft noise exposure, resulting in HPA dysregulation and a flattened cortisol rhythm, thus contributing to cardiovascular diseases.

Atelier technique sur les cohortes environnementales, BIVIERS, FRANCE, 05-/11/2019 - 05/11/2019; L'objectif de DEBATS est de mieux connaître et de mieux quantifier les effets du bruit des avions sur la santé des populations riveraines des aéroports français. Il s'agit d'adopter une approche globale en caractérisant les relations entre l'exposition au bruit des avions et les états de santé des riverains d'aéroport à la fois sur le plan physique et mental mais aussi en termes de gêne ressentie. En 2013, 1 244 riverains des aéroports de Paris-Charles de Gaulle, Toulouse-Blagnac et Lyon-Saint-Exupéry ont répondu à un questionnaire administré par un enquêteur à leur domicile concernant leur état de santé (perturbations du sommeil, pathologies cardiovasculaires, troubles anxio-dépressifs et gêne ressentie due au bruit des avions). L'enquêteur a également mesuré la pression artérielle et la fréquence cardiaque des participants et leur a demandé de prélever un échantillon de leur salive pour déterminer la concentration de cortisol salivaire (marqueur des états de stress). Ces participants ont été réinterrogés en 2015 et en 2017. Un sous-échantillon de 100 riverains a participé à une deuxième étude plus spécifique sur le sommeil avec des mesures acoustiques.

Réunion AdP, PARIS, FRANCE, 01-/07/2019 - 01/07/2019; Présentation de la méthodologie adoptée dans DEBATS et des premiers résultats au Groupe Aéroports de Paris

Contexte : Le cortisol, reflet de l'activité de l'axe hypothalamo-pituito-surrénalien (HPS), est un marqueur possible du stress induit par l'exposition au bruit des transports et pourrait se positionner comme un facteur intermédiaire dans la relation entre cette exposition et la survenue de pathologies cardiovasculaires. Cependant, les effets de l'exposition au bruit des transports sur la sécrétion de cortisol sont encore largement discutés. Objectif : L'objectif de l'étude est de rechercher l'existence d'une association entre l'exposition au bruit des avions et la variation journalière du cortisol salivaire. Méthodes : En 2013, 954 participants âgés de 18 ans et plus ont prélevé deux échantillons de leur salive, un au lever et un au coucher. Des informations relatives à leur état de santé, leur statut socioéconomique et leurs habitudes de vie ont été collectées grâce à un questionnaire administré en face-à-face par un enquêteur à leur domicile. L'exposition moyenne au bruit des avions au domicile des participants a été estimée à partir de cartes de bruit. Des modèles de régression log-linéaire ont été ajustés afin d'évaluer l'effet de cette exposition sur la variation horaire journalière des niveaux de cortisol salivaire. Résultats : L'exposition au bruit des avions serait associée à une diminution statistiquement significative de la variation horaire du cortisol salivaire au cours de la journée, avec des niveaux de cortisol inchangés au lever, mais plus élevés au coucher. Cette exposition engendrerait ainsi une modification du cycle physiologique de la sécrétion du cortisol. Conclusion: Ces résultats soutiennent l'hypothèse selon laquelle l'exposition au bruit des avions serait génératrice d'un stress psychologique induisant une perturbation du fonctionnement endocrinien et du cycle circadien du cortisol. Cette relation pourrait contribuer à favoriser l'émergence de pathologies cardiovasculaires.

Background: Many studies have demonstrated adverse effects of exposure to aircraft noise on health. Possible biological pathways for these effects include hormonal disturbances. Few studies deal with aircraft noise effects on saliva cortisol in adults, and results are inconsistent. Objective: We aimed to assess the effects of aircraft noise exposure on saliva cortisol levels and its variation in people living near airports. Methods: This study focused on the 1300 residents included in the HYENA and DEBATS cross-sectional studies, with complete information on cortisol sampling. All the participants followed a similar procedure aiming to collect both a morning and an evening saliva cortisol samples. Socioeconomic and lifestyle information were obtained during a face-to-face interview. Outdoor aircraft noise exposure was estimated for each participant's home address. Associations between aircraft noise exposure and cortisol outcomes were investigated a priori for male and female separately, using linear regression models adjusted for relevant confounders. Different approaches were used to characterize cortisol levels, such as morning and evening cortisol concentrations and the absolute and relative variations between morning and evening levels. Results: Statistically significant increases of evening cortisol levels were shown in women with a 10-dB(A) increase in aircraft noise exposure in terms of LAeq, 16h (exp(?) = 1.08; CI95% = 1.00-1.16), Lden (exp(?) = 1.09; CI95% = 1.01-1.18), Lnight (exp(?) = 1.11; CI95% = 1.02-1.20). A statistically significant association was also found in women between a 10-dB(A) increase in terms of Lnight and the absolute variation per hour (exp(?) = 0.90; CI95% = 0.80-1.00). Statistically significant decreases in relative variation per hour were also evidenced in women, with stronger effects with the Lnight (exp(?) = 0.89; CI95% = 0.83-0.96) than with other noise indicators. The morning cortisol levels were unchanged whatever noise exposure indicator considered. There was no statistically significant association between aircraft noise exposure and cortisol outcomes in men. Conclusions: The results of the present study show statistically significant associations between aircraft noise exposure and evening cortisol levels and related flattening in the (absolute and relative) variations per hour in women. Further biological research is needed to deepen knowledge of the pathway between noise exposure and disturbed hormonal regulation, and specially the difference in effects between genders.

59th ERSA, LYON, FRANCE, 27-/08/2019 - 30/08/2019; Introduction : HYENA (HYpertension and Exposure to Noise near Airports), a well-known study on the health effects of aircraft noise, involved 4,861 participants from six European countries (except France). DEBATS (Discussion on the health effects of aircraft noise), a study with a similar protocol, included 1,244 participants from France. Saliva samples were obtained for 439 and 954 participants in HYENA and DEBATS respectively, to determine cortisol concentration as a possible marker of noise-induced stress. Associations were found between aircraft noise and cortisol levels in each study separately, but they were not consistent between the two studies. The objective of the present study was to combine datasets to improve statistical power. Methods : We investigated the associations between aircraft noise levels and, the log-cortisol levels in the morning and in the evening, and the log-relative variation per hour, adjusted for relevant confounders. Results : We found evidence in women for an increase in the log-evening cortisol level ?=0.09 (95%CI 0.01;0.17), and for flattening of the log-relative variation per hour ?=-0.09 (95%CI -0.16;-0.02), with a LDEN 10-dB(A) increase, but no significant effects in men. Conclusions : These findings provide some support for psychological stress induced by aircraft noise exposure, resulting in disruption of hormonal rhythms.

47th International Congress and Exposition on Noise Control Engineering (inter-noise 2018) , CHICAGO, ETATS-UNIS, 26-/08/2018 - 29/08/2018; Aircraft noise has been shown to have adverse effects on health and particularly on sleep. The aim of the study was to investigate the association between aircraft noise exposure and objective sleep quality in the population living near airports in France. Methods: Actimetric measurements were performed during eight nights to evaluate sleep quality of 112 participants in terms of total sleep time, sleep onset latency, wake time and sleep efficiency. Simultaneously, acoustic measurements were performed inside and outside (at the façade) the participants' bedroom in order to estimate integrated indicators as well as the number of noise events. Logistic regression models were used with adjustment for potential confounders. Results: Integrated indicators as well as the number of noise events were significantly associated with objective sleep quality: increased levels or numbers of aircraft noise events increased time to fall asleep and total wake time, but decreased sleep efficiency. Unexpectedly, they also increased total sleep time, and time in bed, and delayed get up time. These latter results can be interpreted as an adaptation mechanism to sleep deprivation. Conclusion: Noise event indicators have been shown to be more often associated with sleep disturbances than integrated indicators.

Background: The effects of aircraft noise on psychological ill-health have not been largely investigated and remain to be discussed. No study has been performed in France on the health effects of aircraft noise. Objectives: The present study aimed to investigate the relationship between aircraft noise in dB and in terms of annoyance and psychological ill-health in populations living near airports in France. Methods: A total of 1244 individuals older than 18 and living near three French airports (Paris&ndash, Charles de Gaulle, Lyon&ndash, Saint-Exup&eacute, ry and Toulouse&ndash, Blagnac) were randomly selected to participate in the study. Information about their personal medical history and socioeconomic and lifestyle factors was collected by means of a face-to-face questionnaire performed at their place of residence by an interviewer. Psychological ill-health was evaluated with the 12-item version of the General Heath Questionnaire (GHQ-12). For each participant, outdoor aircraft noise exposure in dB was estimated by linking their home address to noise maps. Objective noise exposure in dB was considered to be the primary exposure of interest. Four noise indicators referring to three different periods of the day were derived and used for the statistical analyses: Lden, LAeq,24hr, LAeq,6hr&ndash, 22hr, and Lnight. Noise annoyance and noise sensitivity were the secondary risk factors of interest. Logistic regression models were used with adjustment for potential confounders. Results: The participation rate in the study was 30%. Approximately 22% of the participants were considered to have psychological ill-health according to the GHQ-12. No direct association was found between exposure to aircraft noise in dB and psychological ill-health. However, annoyance due to aircraft noise and noise sensitivity were both significantly associated with psychological ill-health. Moreover, a gradient was evidenced between annoyance and psychological ill-health, with increasing ORs from 1.79 (95% CI 1.06&ndash, 3.03) for people who were not all annoyed to 4.00 (95% CI 1.67&ndash, 9.55) for extremely annoyed people.Conclusions: These findings confirm the results of previous studies, suggesting there is no direct association between aircraft noise exposure in dB and psychological ill-health, but there is a significant relationship between noise sensitivity or annoyance due to aircraft noise and psychological ill-health. This supports the hypothesis that psychological aspects, such as noise annoyance and noise sensitivity, play important roles in the association between environmental noise and adverse effects on health. However, further studies are necessary in order to better understand the links between these variables.

EUROEPI 2018, European Congress of Epidemiology , Lyon, FRANCE, 04-/07/2018 - 06/07/2018; Background: Noise in the areas near airports is considered as a public health issue. Exposure to aircraft noise has been shown to have adverse effects on health and particularly on sleep. Sleep disturbances are the most investigated health effects related to environmental noise. Many studies support that noise at night can affect subjective and objective sleep quality. If habituation to noise can be observed for subjective sleep quality, no habituation has been shown with objective sleep quality. However, few studies have evaluated the effects of aircraft noise on sleep quality with objective measurements at home. No such studies have been performed around French airports. Objectives: The aim of the present study was to investigate the association between aircraft noise exposure and objective sleep quality in the population living near airports in France. Methods: Our study includes 112 people living around Paris-CDG and Toulouse-Blagnac airports. Actimetric measurements were performed during eight nights to objectively evaluate the sleep quality of the participants in terms of sleep onset latency, wake time, total sleep time and sleep efficiency. Simultaneously, acoustic measurements were performed inside and outside (at the bedroom façade) the participants' bedroom in order to identify aircraft noise and to evaluate the impact of this noise in the participants' bedroom. Thus, integrated (that is related to energetic average for a given period of time) as well as noise event indicators (that is the number of events that exceed a given threshold) were estimated. Logistic regression models taking into account measurements repetition were used with adjustment for potential confounders: age, gender, marital status, education and body mass index (BMI). Results and discussion: Integrated indicators as well as noise event indicators were significantly associated with objective sleep quality. Increased levels of aircraft noise or increased numbers of aircraft noise events increased time to fall asleep, total wake time and decreased sleep efficiency. Unexpectedly, they also increased total sleep time, time in bed and delayed get up time. This latter result can be interpreted as an adaptation mechanism to sleep deprivation. If deterioration of the sleep quality has been observed with an increase in time to fall asleep and in total wake time, a process of recovery and sleep maintenance has been shown with an increase in total sleep time. Noise event indicators seemed to be more often associated with sleep disturbances than integrated indicators. Increased numbers of noise events during the sleep period have been found to degrade objective sleep quality. Conclusion: The present study is the first one to investigate the effects of aircraft noise exposure around French airports on sleep quality evaluated with objective measurements. The findings contribute to the overall evidence suggesting that aircraft noise exposure at nighttime may decrease objective quality of sleep. Aircraft noise exposure affects objective sleep quality whatever the type of noise indicator. In front of this nuisance, adaptation mechanisms to sleep deprivation could be observed.

EUROEPI 2018, European Congress of Epidemiology , Lyon, FRANCE, 04-/07/2018 - 06/07/2018; Background : Many studies have evidenced adverse effects of exposure to aircraft noise on health, such as annoyance, sleep disturbance, cardiovascular diseases or altered cognitive performance. Mental health has been less investigated. In France, about 18% of the population suffer from mental disorders. The effects of noise annoyance on psychological distress have rarely been evaluated, and no study exists in France. We investigated associations between annoyance due to aircraft noise and psychological distress for people living near airports in France. Methods : The DEBATS longitudinal study included 1,244 residents around three French airports: Paris-Charles-de-Gaulle, Toulouse-Blagnac, and Lyon-Saint-Exupéry. Information about psychological distress was assessed by a face-to-face questionnaire, including a single question about the feeling of depression, and the 12-version of the General Health Questionnaire (GHQ-12). Annoyance due to aircraft noise was assessed with the following question 'Thinking about the last 12 months, when you are at home, how much does aircraft noise annoy you?' The five-point verbal scale proposed by the International Commission on the Biological Effects of Noise was used: extremely, very, moderately, slightly or not at all. Associations with psychological distress were investigated using logistic regressions including relevant confounders such as gender, age, country of birth, occupational activity, marital status, alcohol consumption, smoking, sleep duration, number of stressful life events, education, income, and antidepressant use. Results : About 13% of the participants reported depression and 22% were considered to have psychological distress according to the GHQ-12. Significant associations were found between annoyance due to aircraft noise and the feeling of depression, and between annoyance due to aircraft noise and psychological distress evaluated with the GHQ-12. The Odds Ratio (OR) for the feeling of depression ranged from 0.89 (95% CI 0.50-1.59) to 2.61 (95% CI 1.09-6.23). The OR for the GHQ-12 ranged from 1.49 (95% CI 0.94-2.39) to 3.64 (95% CI 1.70-7.78). For the both outcomes, OR reached the maximum estimate for people reporting to be extremely annoyed compared to those who are not at all annoyed. Discussion : The present study found significant associations between annoyance due to aircraft noise and psychological distress assessed both with a single question about the feeling of depression and with the GHQ-12, with gradual ORs according to the different categories of noise annoyance. This result is in line with the findings of a cross-sectional study performed in Minneapolis. However the direction of the association can be questioned. Extremely annoyed people might be more at risk to have psychological disorders, and it is also possible that people with psychological disorders might be more at risk to be annoyed.

18th International Conference Road Safety on Five Continents (RS5C 2018), JEJU, COREE, REPUBLIQUE DE, 16-/05/2018 - 18/05/2018; The expected total cost of accidents for France amounted between 37.5 and 50 billion Euros in 2014. It would represent between 1.5 % and 2 % of the Gross Domestic Product (GDP). At the European level, the total costs of crashes vary between 0.4% and 4.1% of the GDP and the total costs related to serious injuries vary between 0.04% of the GDP for Ireland and 2.7% for Poland, according figures advanced by a recent European research project (Safetycube). For France, the total costs of serious injury crashes/serious injuries is estimated at 10.5 billion Euros in 2014 and the total costs of slight injury crashes/slight injuries is estimated at 0,7 billion Euros. However,, the monetary values used for valuing the different types of injury are estimated by applying a simple percentage of the Statistical Value Of Life (VOSL) (3 billion Euros per fatality, 2010 value), aligned with the HEATCO or CEMT recommendations. Consequently, in France, there is no real and accurate knowledge of the amount of costs for the different components of the total costs of road injuries and there is a relative uncertainty concerning the assessment of that cost. However, that figure is quite crucial, because it could help the public decision maker in deciding to implement or not some road safety countermeasures, but also in establishing some hierarchies among the efficient road safety measures. That contribution proposes first a state of the art related to the estimation of the cost of the road injuries for the French case, the different components, and the potential sources of information and methods of estimation and second few methodological propositions in order to better identify the costs of injuries. It would sum-up the crucial information dealing with the cost of injuries, and especially the personal damage. In some way, it will propose for the first time in France a survey and a critical analysis of the most recent information available on that question. It would provide additional information collected from on-going projects.

Objective: better knowledge of the cost of road morbidity. Interests: Assessment of the impact of road accidents on society / Prioritizing investments in road safety, Objectif : meilleure connaissance du coût de la morbidité routière intérêts : Appréciation de l'impact des accidents de route sur la société / Priorisation des investissements en sécurité routière

Conseil national du bruit 2018, PARIS, FRANCE, 11-/06/2018 - 11/06/2018; Présentation des premiers résultats de la phase d'inclusion de DEBATS au Conseil National du Bruit

Objective - In 2009, a meta-analysis reported an increased risk of hypertension (HTA) related to long-term aircraft noise exposure. One of the objectives of the Debats (Discussion sur les effets du bruit des aéronefs touchant la santé) study was to assess the prevalence of HTA and to investigate the relationship between aircraft noise exposure and the risk of HTA among people living near airports in France. Methods - Blood pressure was measured for 1,244 participants living near three French airports: Paris-Charlesde-Gaulle, Lyon-Saint-Exupéry, and Toulouse-Blagnac. Information about major risk factors for HTA was collected by means of a face-to-face questionnaire or by means of objective measures performed by an interviewer. Aircraft noise exposure was estimated for each participant's home address using noise maps produced by the airports. The major risk factors for HTA were included in logistic regression models as confounding factors. Results - The prevalence of HTA was significantly higher in men (37.0%) than in women (30.5%). A significant relationship was evidenced between the risk of HTA and aircraft noise exposure at night for men, not for women. A 10 dB(A) increase in Lnight was associated with an ORa of 1.34 (95%CI: [1.00-1.97]) for men, and of 0.90 [0.66-1.22] for women. Conclusion - These ndings contribute to the overall evidence suggesting that aircraft noise exposure may increase the risk of HTA in men.; Objectif - En 2009, une méta-analyse a mis en évidence une augmentation du risque d'hypertension artérielle (HTA) avec l'exposition au bruit des avions. Un des objectifs de l'étude Debats (Discussion sur les effets du bruit des aéronefs touchant la santé), réalisée en 2013, était de décrire la prévalence de l'HTA et de rechercher l'existence d'une association entre l'exposition au bruit des avions et le risque d'HTA chez les riverains des aéroports en France. Méthodes - La pression artérielle a été mesurée chez 1 244 riverains des aéroports de Paris-Charles-de-Gaulle, Lyon-Saint-Exupéry et Toulouse-Blagnac. Des informations relatives aux facteurs de risque potentiels d'HTA ont été recueillies, soit via un questionnaire administré en face-à-face par un enquêteur, soit grâce à des mesures objectives réalisées par cet enquêteur. L'exposition au bruit des avions au domicile des participants a été estimée à partir de cartes de bruit produites par les aéroports. Les facteurs de risque potentiels de l'HTA ont été inclus dans des modèles de régression logistique comme facteurs de confusion. Résultats - La prévalence de l'HTA est significativement plus élevée chez les hommes (37,0%) que chez les femmes (30,5%). Une augmentation significative du risque d'HTA est observée chez les hommes (ORa=1,34, IC95%: [1,00-1,97]), mais pas chez les femmes (ORa=0,90 [0,66-1,22]) pour une augmentation de 10 dB(A) de l'exposition au bruit des avions pendant la nuit. Conclusion - Ces résultats confirment ceux de la plupart des études antérieures, qui suggèrent que l'exposition au bruit des avions pendant la nuit augmenterait le risque d'HTA chez les hommes.

Estimation of the risk of being responsible for a fatal crash when driving while impaired by drugs (alcohol, cannabis, amphetamines, cocaine, opiates), Estimation du risque d'être responsable d'un accident mortel en conduisant sous l'emprise de drogues (alcool, cannabis, amphétamines, cocaïne, opiacés)

Objectives The largest study until now around 6 major European airports, the HYENA (HYpertension and Exposure to Noise near Airports) study, reported an excess risk of hypertension related to long-term aircraft noise exposure. The DEBATS (Discussion on the health effects of aircraft noise) study investigated the relationship between this exposure and the risk of hypertension in men and in women near French airports. Methods Blood pressure of 1244 participants older than 18 years of age was measured. Information about health, socioeconomic and lifestyle factors was collected by means of a face-to-face questionnaire performed at home by an interviewer. Aircraft noise exposure was assessed for each participant9s home address using noise maps. They were calculated with the Integrated Noise Model with a 1 dB(A)-resolution. The major potential confounders being risk factors for hypertension were included in the logistic regression models: age, occupational activity, body mass index, physical activity and alcohol consumption. Results After adjustment for the main potential confounders, an exposure–response relationship was evidenced between the risk of hypertension and aircraft noise exposure at night for men only. A 10-dB(A) increase in L night was associated with an OR of 1.34 (95% CI 1.00 to 1.97). Conclusions These findings contribute to the overall evidence suggesting that aircraft noise exposure at night-time may increase the risk of hypertension in men. Hypertension is a well-known and established risk factor for cardiovascular disease. The association reported in the present study between aircraft noise and hypertension implies that aircraft noise might be a risk factor also for cardiovascular disease.

12th ICBEN Congress on Noise as a Public Health Problem, ZURICH, SUISSE, 18-/06/2017 - 22/06/2017; The impact of exposure to aircraft noise on health is of growing concern because of a steady rise in flights. While many studies address the annoyance associated with aircraft noise, very few studies consider the health status perceived by the population itself. We investigated associations between aircraft noise exposure and perceived health for people living near airports in France. The DEBATS longitudinal study included 1,244 residents around three French airports: Paris-Charles-de-Gaulle, Toulouse-Blagnac, and Lyon-Saint-Exupéry. Information about perceived health was assessed by a face-to-face questionnaire. Aircraft noise exposure was evaluated for each participant's home address. Associations with perceived health were investigated using logistic regressions including relevant confounders.No association was found between aircraft noise exposure and perceived health. After stratification on gender, significant associations were observed for men: OR=1.55 (95%CI=1.02-2.35) per 10-dB(A) Lnight-increase. The associations observed in this study could be due to residual confounding or to declaration bias which cannot be excluded. Further studies are necessary in order to better understand these associations.

Background Noise in the vicinity of airports is a public health problem. Many laboratory studies have shown that heart rate is altered during sleep after exposure to road or railway noise. Fewer studies have looked at the effects of exposure to aircraft noise on heart rate during sleep in populations living near airports. Objective The aim of this study was to investigate the relationship between the sound pressure level (SPL) of aircraft noise and heart rate during sleep in populations living near airports in France. Methods In total, 92 people living near the Paris-Charles de Gaulle and Toulouse-Blagnac airports participated in this study. Heart rate was recorded every 15 s during one night, using an Actiheart monitor, with simultaneous measurements of SPL of aircraft noise inside the participants&rsquo, bedrooms. Energy and event-related indicators were then estimated. Mixed linear regression models were applied, taking into account potential confounding factors, to investigate the relationship between energy indicators and heart rate during sleep measured every 15 s. Event-related analyses were also carried out in order to study the effects of an acoustic event associated with aircraft noise on heart rate during sleep. Results The more the SPL from all sources (LAeq,15s) and the SPL exceeded for 90% of the measurement period (LA90,15s) increased, the more heart rate also increased. No significant associations were observed between the maximum 1-s equivalent SPL associated with aircraft overflight (LAmax,1s) and differences between the heart rate recorded during or 15 or 30 s after an aircraft noise event and that recorded before the event. On the other hand, a positive and significant association was found between LAmax,1s and the heart rate amplitude calculated during an aircraft noise event. Results were unchanged when analyses were limited to participants who had lived more than five years in their present dwelling. Conclusion Our study shows that exposure to the maximum SPL linked to aircraft overflight affect the heart rate during sleep of residents near airports. However, further studies on a larger number of participants over several nights are needed to confirm these results.

ADELF, Congrès de l'Association des Epidémiologistes de Langue Française, Rennes, FRANCE, 07-/09/2016 - 09/09/2016; INTRODUCTION - Une précédente recherche, HYENA (Hypertension et exposition au bruit à proximité des aéroports) a mis en évidence un excès de risque d'hypertension lié à l'exposition au bruit des avions à proximité de six aéroports européens. OBJECTIF - L'objectif de notre étude est de rechercher l'existence d'une association entre cette exposition et le risque d'hypertension chez des riverains des aéroports français. MÉTHODES - 1 244 riverains des aéroports de Paris-Charles de Gaulle, Toulouse-Blagnac et Lyon-Saint-Exupéry ont répondu à un questionnaire, administré par un enquêteur à leur domicile, décrivant leurs éventuels troubles de santé supposés en lien avec le bruit (perturbations du sommeil, pathologies cardiovasculaires, troubles anxio-dépressifs et gêne due au bruit des avions). L'enquêteur a également mesuré la pression artérielle systolique (PAS) et diastolique (PAD) des participants. Ceux-ci ont été classés comme hypertendus si leur PAS dépassait 140 mm de mercure ou leur PAD 90 mm (valeurs limites définies par l'Organisation Mondiale de la Santé) ou s'ils déclaraient avoir eu un diagnostic d'hypertension par un médecin et prendre un traitement antihypertenseur. L'exposition au bruit des avions au domicile des participants a été estimée à partir des cartes de bruit produites par les aéroports. Les facteurs de risque connus de l'hypertension ont été inclus dans les modèles de régression logistique comme facteurs de confusion. RÉSULTATS - Une association positive significative a été obserÎe pour une augmentation de l'exposition au bruit des avions pendant la nuit de 10 dBA chez les hommes (ORadj = 1,34, IC à 95% = 1,00-1,97), mais pas chez les femmes (ORadj = 0,90, IC à 95% = 0,66-1,22). DISCUSSION - Les résultats de la présente étude confirment ceux de la plupart des études antérieures qui suggèrent que l'exposition au bruit des avions pendant la nuit augmenterait le risque d'hypertension chez les hommes.

VIIème Congrès international d'Epidémiologie ADELF-EPITER, Epidémiologie et Santé Publique, RENNES, FRANCE, 07-/09/2016 - 09/09/2016; INTRODUCTION - Le cortisol est un marqueur possible du stress induit par l'exposition au bruit. Il pourrait être un facteur intermédiaire dans la relation entre l'exposition au bruit des transports et la survenue de pathologies cardiovasculaires. Cependant, les études sur le sujet sont peu nombreuses. OBJECTIF - L'objectif de notre étude est de rechercher l'existence d'une association entre la concentration de cortisol salivaire et l'exposition au bruit des avions chez des riverains des aéroports français. MÉTHODES - 1244 riverains des aéroports de Paris-Charles de Gaulle, Toulouse-Blagnac et Lyon-Saint-Exupéry ont répondu à un questionnaire décrivant leurs éventuels troubles de santé supposés en lien avec le bruit (perturbations du sommeil, pathologies cardiovasculaires, troubles anxio-dépressifs et gêne due au bruit des avions). Ils ont également préleÎ un échantillon de leur salive au lever et au coucher (la sécrétion physiologique de cortisol étant maximale entre 6h et 8h du matin, diminuant ensuite pour être presque nulle vers minuit). La concentration en cortisol de ces prélèvements a été déterminée par technique immunoenzymatique. L'exposition au bruit des avions au domicile des participants a été estimée à partir des cartes de bruit produites par les aéroports. Des modèles de régressions linéaires ont été ajustés sur le logarithme de la variation horaire du cortisol avec prise en compte de facteurs de confusion potentiels. RÉSULTATS - Une baisse significative de la variation horaire du cortisol a été obserÎe lorsque l'exposition au bruit des avions augmente de 10 dBA (0,90, IC95%=0,74-1,00). DISCUSSION - La présente étude suggère une variation nycthémérale du taux de cortisol moins prononcée chez les individus les plus exposés au bruit des avions. Ceux-ci réguleraient donc moins bien leur sécrétion de cortisol, signature d'un stress généré par leur exposition au bruit des avions. Ces résultats restent cependant à être confirmés par des études de plus grande ampleur.

TAP 2016, 21st International Transport and Air Pollution Conference, LYON, FRANCE, 24-/05/2016 - 26/05/2016; The health impact of living in the vicinity of an airport has been of growing concern. The reduction of aircraft noise nuisance has been considered to be the main issue for a long time but in recent years, the question of air pollution around airports has been raised. Air pollution has been found to be associated with cardiovascular disease (Brook et al (2010)). As several studies have shown an association between aircraft noise exposure and hypertension (Babisch and van Kamp (2009)) or mortality from cardiovascular disease (Huss et al (2010), Hansell et al (2013)), concerns for disentangling the effects of air pollution and of noise on cardiovascular outcomes have increased. We performed an ecological study addressing the issue of an association between exposure to aircraft noise and mortality for cardiovascular disease, coronary heart disease, myocardial infarction and stroke. A secondary aim was to examine if this association was modified when air pollution was taken into account. The study was based on 161 communes (the smallest administrative unit in France) close to three major French airports: Paris-Charles de Gaulle, Lyon Saint-Exupéry and Toulouse-Blagnac. The mortality data were provided by the French Center on Medical Causes of Death. Based on noise maps produced by the French Civil Aviation Authority with the 'Integrated Noise Model', a population-weighted average exposure to aircraft noise was computed at the commune level. The average air pollution exposure for both NO2 and PM10 indicators was estimated with dispersion modelling by Airparif institute for the Paris area, and by Air Rhône-Alpes institute for the Lyon area (data for the Toulouse area were missing). The average concentration in NO2 was estimated to 22.3 mg/m3, the average concentration in PM10 to 23.9 mg/m3 and the average exposure to aircraft noise to 49.6 dBA, as shown in Table 1. NO2 and PM10 concentrations were positively correlated. NO2 concentrations were moderately correlated to aircraft noise levels while PM10 concentrations were not. Regardless of aircraft noise, neither NO2 nor PM10 concentrations were significantly associated with mortality. However, positive associations were observed between exposure to aircraft noise and mortality for all causes of interest except stroke. These associations were not attenuated when air pollution was taken into account. The present study seems to confirm the findings of recent studies suggesting that air pollution does not appear to be a confounding factor in the relationship between aircraft noise and mortality from cardiovascular disease, coronary heart disease and myocardial infarction. However, the potential for ecological bias and the possibility that this association could be due to unmeasured factors cannot be excluded. Further individual studies are necessary in order to better understand this association. This work was supported by funds from the French Ministry of Health, the French Ministry of Environment, and the French Civil Aviation Authority.

Rapport annuel d'activité du Registre du Rhône

INTRODUCTION – L’exposition au bruit des avions pourrait avoir des conséquences importantes pour la santé. Toutefois, celles-ci sont actuellement insuffisamment évaluées, tout du moins en France. La DGS en collaboration avec l’Acnusa a donc sollicité l’Ifsttar pour mettre en place un programme de recherche épidémiologique appelé DEBATS. OBJECTIF – L’objectif est de mieux connaître et d’évaluer les effets du bruit des avions sur la santé des riverains d’aéroports. MÉTHODES – Menée auprès de riverains de trois aéroports français (Paris-Charles de Gaulle, Lyon-Saint Exupéry et Toulouse-Blagnac), DEBATS comprend : Une étude écologique consistant à mettre en relation des indicateurs de santé agrégés à l’échelle de la commune (consommations de soins prescrits et remboursés par l’assurance maladie, vente de médicaments par les pharmacies hors remboursements, mortalité toutes causes et pour certaines causes spécifiques) avec le niveau moyen pondéré d’exposition au bruit des avions des communes concernées. Une étude longitudinale incluant 1 244 sujets. La gêne et l’état de santé sont évalués par questionnaire (perturbations du sommeil, troubles cardiaques ischémiques, hypertension, troubles anxio-dépressifs), et par la mesure de variables physiopathologiques (tension artérielle, fréquence cardiaque, et cortisol salivaire). Une étude complémentaire portant sur un sous-échantillon d’une centaine de sujets et dont l’objectif est de caractériser de manière détaillée et spécifique les effets aigus du bruit des avions sur la qualité du sommeil tout en affinant la mesure de l’exposition au bruit.

Introduction : En France, peu d’études se sont intéressés aux effets du bruit des avions sur la santé, et en particulier sur la mortalité. L’objectif de l’étude écologique du programme de recherche DEBATS (Discussion sur les Effets du Bruit des Aéronefs Touchant la Santé) est d’étudier l’association entre le niveau d’exposition au bruit des avions et le risque de mortalité par maladies de l’appareil circulatoire. Méthodes : La zone d’étude comprend 161 communes riveraines de trois aéroports français : Paris-Charles-de-Gaulle, Toulouse-Blagnac et Lyon-Saint-Exupéry. L’exposition moyenne au bruit des avions de chaque commune a été estimée à partir des cartes de bruit produites par les aéroports. Les données de mortalité par maladies de l’appareil circulatoire (CIM-10 : I00-I99) proviennent du CépiDc de l’Inserm pour la période 2007-2010. Afin d’estimer le risque de mortalité par niveau d’exposition au bruit, un modèle de Poisson à effets aléatoires ajusté sur l’âge moyen de la population, le pourcentage de femmes, le niveau socio-économique, le niveau de pollution, la densité de population et la zone géographique de la commune a été utilisé. Résultats : La mortalité par maladies de l’appareil circulatoire augmente significativement avec le niveau d’exposition au bruit : RR = 1,23 pour une augmentation de 10 dB(A), IC95% = (1,10 – 1,38) ; RR (>=60 dB(A) vs

ICAP 2014, 28TH International congress of applied psychology, PARIS, FRANCE, 08-/07/2014 - 13/07/2014; Background/Objectives: Independence for older people is linked to driving, this being their main mode of travel. Even in normal aging, sensory, functional, and cognitive deficits appear, and are more severe in brain pathology leading to dementia. These may profoundly affect driving, which is a complex task involving all of these functions. Many studies show that older drivers modify their driving habits (reduced distance, avoiding certain driving situations ...). When this regulation process occurs in later life, gender differences have been reported. Women regulate their driving more than men and do so earlier. Gender differences in image and roles could lead women to loss mobility prematurely and lead men to make insufficient driving regulation. The purpose of the study was to investigate driving regulation with a focus on gender, cognitive deficits and Central Nervous System pathologies. Design: Longitudinal Study over six years. Setting: the Three-City Cohort of Bordeaux, a longitudinal study of 2104 people aged 65 years and above. Participants: 523 drivers, 273 men and 250 women. Measurements: Our range of measurements included socio-demographic characteristics, driving habits, health variables, cognitive evaluation and dementia diagnosis. Results: Fifty seven percent of the population aged 76 years on average restricted their driving over six years. In gender specific models, pre-dementia, Parkinson's disease, advanced age and high initial mobility by car were common factors of restriction in both genders. But other restriction factors were gender specific. In men, prevalent dementia, depressive symptomatology and a decline in at least one Instrumental Activities in Daily Living were specific factors. The only cognitive factor was low performance in the Benton Visual Retention Test. Specific restriction factors in women were low income and fear of falling. Slow Trail Making Test A execution time or a severe decline in Mini Mental Status Examination performance were the cognitive factors specifically associated with female restriction. Conclusion: The results could allow advising certain persons to make changes in driving behavior, in order to conciliate mobility and security in older drivers.

While many surveys carried out both in France and abroad address aircraft noise annoyance or report adverse effects on sleep quality, much fewer consider at the same time the physiological effects of this noise exposure. The largest study to date, the HYENA study, has evidenced an association between aircraft noise exposure and hypertension. DEBATS is a research program (2011-2018) aiming to characterize the relations between aircraft noise exposure and the health status of the French population living in the vicinity of airports.

VIème Congrès International d'Epidémiologie - ADELF -EPITER, NICE, FRANCE, 10-/09/2014 - 12/09/2014; INTRODUCTION - Le cortisol salivaire est un marqueur possible du stress induit par l'exposition au bruit. Il pourrait se positionner comme un facteur intermédiaire dans la relation entre l'exposition au bruit des transports et la survenue de pathologies cardiovasculaires. Cependant, cette association n'est toujours pas claire. OBJECTIF - L'objectif de notre étude est de rechercher l'existence d'une association entre la concentration de cortisol salivaire et l'exposition au bruit des avions chez les riverains des aéroports français. MÉTHODES - Une étude pilote du programme de recherche DEBATS (Discussion sur les Effets du Bruit des Aéronefs Touchant la Santé) a été réalisée en 2011 afin de tester le protocole auprès d'une centaine de riverains de l'aéroport de Paris-Charles de Gaulle. Des instructions étaient données aux participants afin qu'ils prélèvent un échantillon de leur salive trente minutes après leur lever afin d'en déterminer la concentration en cortisol. Cette dernière atteint en effet un maximum trente minutes après le lever. L'exposition au bruit des avions au domicile des participants a été estimée à partir des cartes de bruit produites par les aéroports. RÉSULTATS - Une élévation de la concentration de cortisol salivaire a été obserÎe chez les participants exposés à des niveaux de bruit d'avions supérieurs à 55 dB(A) en termes de Lden comparativement à ceux exposés à des niveaux inférieurs à 50 dB(A). DISCUSSION - Les résultats de cette étude pilote suggèrent que l'exposition au bruit des avions augmenterait la concentration de cortisol salivaire au lever. Mais ils doivent être confirmés sur un plus grand nombre de sujets.

Objective.To compare health status, effect on family, occupational consequences, and quality of life (QOL) 1 year after an accident between patients with whiplash versus other mild injuries, and to explore the relationship between initial injury (whiplash vs other) and QOL.Methods.This was a prospective cohort study. The study used data from the ESPARR cohort (a representative cohort of road accident victims) and included 173 individuals with “pure” whiplash and 207 with other mild injuries. QOL at 1-year followup was assessed on the World Health Organization Quality of Life questionnaire. Correlations between explanatory variables and QOL were explored by Poisson regression to provide adjusted relative risks, with ANOVA for the various QOL scores explored.Results.One year post-accident, more patients who had whiplash than other casualties complained of nonrecovery of health status (56% vs 43%) and of the occupational effect of pain (31% vs 23%). QOL and posttraumatic stress disorder (PTSD) were similar in the 2 groups. Impaired QOL did not correlate with whiplash when models were adjusted on sociodemographic variables and history of psychological distress. Whatever the initial lesion, PTSD was a determining factor for poorer QOL.Conclusion.Sociodemographic factors, preaccident psychological history prior to the accident, and PTSD were the main factors influencing QOL, rather than whether the injury was whiplash. PTSD may also be related to pain.

In Côte d'Ivoire alcohol and drugs consumption in the general population is a serious issue. However, their role in Road Traffic Accidents (RTAs) has never been investigated. Our study aimed to estimate the prevalence of alcohol-impaired road users at the time of the RTA and report psychoactive drug use, in various categories of casualties, and in various circumstances of the crash. We conducted a cross-sectional study including 893 casualties involved in fatal or non-fatal RTAs and admitted at the Emergency Room or the Forensic Institute from March to September 2012. Blood alcohol dosage (BAC) and urine drug screening were carried out, and results were linked with hospital and police crash report data. The mean BAC in positive cases indicated heavy drinking before the crash: drivers (1.9 g/L), pedestrians (2.1 g/L), passengers (1.5 g/L). The prevalence of alcohol-impairment was significantly higher in drivers (41%) and riders (27%) compared to pedestrians (17%) and passengers (13%). Over 75% of casualties that tested positive for alcohol had a BAC largely above the legal limit. Psychoactive drug use was twice more prevalent in alcohol-impaired drivers than in sober drivers (20% vs 10%). Binge drinking is an emerging issue in African countries, which should be taken into account in the management or prevention of road traffic injuries.

Depuis 1995, fonctionne dans le département du Rhône, le Registre des victimes d’accidents de la circulation routière. Seul outil épidémiologique fiable, il représente un atout pour la France, à l’heure où l’Europe souhaite engager chaque pays dans la détermination du nombre de blessés graves basée sur un indicateur de réelle gravité lésionnelle. Afin d’améliorer les estimations nationales effectuées à partir de ce registre départemental, une extension géographique s’imposait. Par ailleurs, le dispositif constitué pour le recueil des accidents de la route pouvait aisément être étendu au recueil des autres types d’accidents : les accidents de la vie courante et les accidents du travail. C’est ainsi qu’en janvier 2013, est né le recueil de l’Observatoire Rhône-Alpes du traumatisme dont l’un des objectifs est la surveillance sanitaire systématique et continue de l’ensemble des victimes d’accidents sur une zone géographique délimitée : le département de l’Ain. Encadrés par le réseau des services d’urgences de la vallée du Rhône, des enquêteurs postés dans les services d’urgence des hôpitaux de l’Ain recueillent, auprès des victimes, des caractéristiques générales, celles de leur accident ainsi qu’un bilan précis de leurs lésions et de leur parcours hospitalier. Les victimes sont suivies jusqu’à leur retour à domicile ou leur décès. A termes, les informations seront saisies au moyen d’une application développée sur tablettes tactiles. L’Observatoire Rhône-Alpes du traumatisme permettra de répondre à des objectifs de recherche (définition de groupes à risque, base de sondage pour d’autres études) et à des objectifs de santé publique (surveillance, définition d’enjeux, évaluation de mesures). Ainsi, près de 60 000 cas sont attendus chaque année : environ 8 000 victimes d’accidents de la route dans le Rhône, et dans l’Ain : 42 000 victimes d’accidents de la vie courante, 7 000 d’accidents du travail et 2 000 d’accidents de la route.

La conduite automobile est une activité complexe qui requiert, en plus des capacités sensorielles et fonctionnelles de l’appareil locomoteur, des capacités cognitives qui peuvent diminuer avec l’âge. En France où il n’existe pas de procédure spécifique de suivi des conducteurs âgés, les médecins ont une obligation de conseil en matière de contre-indications médicales à la conduite. Or ils ne disposent pas d‘outils cognitifs validés leur permettant d’apprécier les répercussions éventuelles des troubles cognitifs sur l’aptitude à la conduite automobile. L’étude MG-CogCAPA (ANR PREDIT) a pour but d’étudier la faisabilité par les médecins et l’acceptation par les conducteurs âgés d’un protocole permettant de détecter des déficits cognitifs pouvant perturber la conduite automobile, et d’étudier l’évolution de leur mobilité en fonction de leur niveau cognitif. Méthode : 92 médecins généralistes tirés au sort sur des listes professionnelles ont accepté de participer à l’étude. Ils ont inclus 541 conducteurs âgés de 70 ans ou plus. Ils ont proposé à leurs patients un questionnaire de mobilité routière, deux tests cognitifs, le TMT A et B et le test des Codes de Wechsler, l’échelle des 4-IADL et le test de Up and Go. Résultats : les outils cognitifs proposés ont été jugés satisfaisants quant à leur faisabilité et leur utilité clinique. Une bonne validité de la passation des tests cognitifs a été observée et 70% des médecins se sont déclarés prêts à utiliser ce protocole dans leur pratique courante. Les performances cognitives ont été mises en relation avec le ressenti des personnes sur leurs propres performances d’une part, et avec l’évolution de leur mobilité d’autre part. Conclusion : L’étude montre la faisabilité par les médecins et l’acceptation par les patients âgés d’un tel protocole. Elle permet également de mieux comprendre les interactions entre déficits cognitifs, ressenti des déficits et adaptation des habitudes de conduite.

DEBATS is an on-going research program (2011-2018) involving adult residents around three French airports: Paris-Charles de Gaulle, Toulouse-Blagnac, and Lyon Saint-Exupéry. It aims to characterize the relations between aircraft noise exposure and health status of the French population living in the vicinity of airports, both physically and mentally but also in terms of annoyance. In particular, it includes a longitudinal field study whose objective is to follow-up approximately 1,200 of the above-mentioned airports residents during four years. At inclusion and two and four years later, annoyance and health status (in terms of sleep disturbances, cardiovascular diseases and anxiety and depressive disorders) are assessed by a questionnaire asked by an interviewer at the place of residence of participants. Physiological variables like blood-pressure, heart rate or salivary cortisol are also considered within the frame of this study. A pilot study was performed in 2011 in order to test and validate the protocol on 100 residents around Paris-Charles de Gaulle airport. The results of this pilot study will be presented and discussed. They will concern self-reported doctor-diagnosed hypertension and cardiovascular diseases, and measured blood-pressure, heart rate and salivary cortisol.

Background. Previous case-control studies on bicycle helmet efficacy are mostly Anglo-Saxon, and based on data from the early 1990’s when hard-shell helmets were common. Methods. In France, the Rhône county (1.6 million inhabitants) is covered by a road trauma registry that includes ED visits, inpatients and fatalities. Over the 1998-2008 period, 13,797 cyclist casualties were identified (outpatients, inpatients and deceased). The injuries sustained were coded using the Abbreviated Injury Scale (AIS) for injuries to the head (AIS1+ and AIS3+), face (AIS 1+) or neck (AIS1+). The study uses a case-control design where the control group includes cyclists injured below the neck, i.e. not injured in the region associated with the helmet. We adjusted for age, gender and crash severity. Results. The adjusted odds ratios of helmeted vs. unhelmeted cyclists are: for AIS1+ head injuries 0.69, 95% CI=[0.59-0.81], i.e. reduction of risk by 31%; for AIS3+ head injuries, 0.30, 95% CI=[0.16-0.50] i.e. reduction of risk by 70%; for AIS1+ facial injuries, 0.72, 95% CI=[ 0.62-0.83], i.e. reduction of risk by 28%; and for AIS1+ neck injuries, 1.18, 95% CI=[0.94-1.47], non significant. Conclusion. This study confirms the protective effect for head and facial injuries, even though soft-shell helmets have now become more common. The reduction of risk is greater for serious head injuries. The study is inconclusive about the risk of neck injuries.

RIVM Workshop NATO Airbase, UTRECHT, PAYS-BAS, 10-/10/2013 - 11/10/2013; A national survey carried out in 2005 shows that 6.6% of the French population are annoyed by aircraft noise. DEBATS aims to characterize the relations between aircraft noise exposure and health status of residents around airports. It is an on-going epidemiological research program including: An ecological study based on drug prescriptions, and on nonprescription drug sales, A longitudinal field study consisting in following-up approximately 1,200 of the Paris-Charles de Gaulle, Toulouse-Blagnac, and Lyon Saint-Exupéry airports residents during four years. Annoyance and health status are assessed by questionnaires. Physiological variables like blood-pressure or salivary cortisol are also considered within the frame of this study. A complementary study aiming to characterize specifically acute effects of aircraft noise on sleep quality using precise noise exposure measurements. Sleep quality of a sub-sample of 100 individuals will be evaluated using a wrist actimeter. Simultaneously, a sonometer located in their bedroom will record their noise exposure. A second sonometer set up outside (at the bedroom façade) will allow us to identify the aircraft noises and to investigate a link with sleep quality.

47th International Congress and Exposition on Noise Control Engineering (inter-noise 2018), CHICAGO, ETATS-UNIS, 26-/08/2018 - 29/08/2018; Background : The effects of annoyance due to aircraft noise on psychological distress have not been largely investigated, and remain discussed. The present study aimed to investigate the association between aircraft noise annoyance and psychological distress among people living near French airports.Methods : The DEBATS study included 1,244 residents around three major French airports. Information about psychological distress was provided by a face-to-face questionnaire including the 12-version of the General Health Questionnaire (GHQ-12). Annoyance due to aircraft noise was assessed through the verbal 5-point ICBEN scale. The association with psychological distress was investigated using logistic regressions. Results : About 22% of the participants were considered to have psychological distress according to the GHQ-12. A significant association was found between aircraft noise annoyance and psychological distress. The ORs ranged from 1.49 (95%CI=0.94-2.39) to 3.64 (95%CI=1.70-7.78), with gradual ORs across the different categories of annoyance. Conclusions : This study found a significant association between aircraft noise annoyance and psychological distress confirming the findings found in the literature. However the direction of the association can be questioned: annoyed people might be more prone to have psychological distress, but it is also possible that people with psychological distress might be more prone to be annoyed.

Safety CaUsation, Benefits and Efficiency (SafetyCube) is a European Commission supported Horizon 2020 project with the objective of developing an innovative road safety Decision Support System (DSS). The DSS will enable policy-makers and stakeholders to select and implement the most appropriate strategies, measures, and cost-effective approaches to reduce casualties of all road user types and all severities. This document is the first deliverable (4.1) of work package 4 which is dedicated to identifying and assessing human related risk factors and corresponding countermeasures as well as their effect on road safety. The focus of deliverable 4.1 is on identification and assessment of risk factors and describes the corresponding operational procedure and corresponding outcomes. The following steps have been carried out: Identification of human related risk factors - creation of a taxonomy, Consultation of relevant stakeholders and policy papers for identification of topic with high, priority ('hot topics'), Systematic literature search and selection of relevant studies on identified risk factors, Coding of studies, Analysis of risk factors on basis of coded studies, Synopses of risk factors, including accident scenarios, The core output of this task are synopses of risk factors which will be available through the DSS. Within the synopses, each risk factor was analysed systematically on basis of scientific studies and is, further assigned to one of four levels of risk (marked with a colour code). Essential information of the more than 180 included studies were coded and will also be available in the database of the DSS. Furthermore, the synopses contain theoretical background on the risk factor and are prepared in different sections with different levels of detail for an academic as well as a non-academic audience. These sections are readable independently.It is important to note that the relationship between road safety and road user related risk factors is a difficult task. For some risk factors the available studies focused more on conditions of the behaviour (in which situations the behaviour is shown or which groups are more likely to show this behaviour) rather than the risk factor itself. Therefore, it cannot be concluded that those risk factors that have not often been studied or have to rely more indirect and arguably weaker methodologies, e.g. self-reports , do not increase the chance of a crash occurring.The following analysed risk factors were assessed as 'risky', 'probably risky' or 'unclear'. No risk factors were identified as 'probably not risky'.