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International audience; ObjectiveDespite efficiency and safety evidence, ambulatory endovascular revascularisation for lower extremity arterial disease (LEAD) accounted for only 5% of interventions in France in 2016. Such a low rate suggests temporal and geographical space disparities. The aim of this study was to describe the space–time development of ambulatory endovascular revascularisation for LEAD in France and to investigate the contributions of healthcare services and population characteristics as potential determinants.MethodsA retrospective study of discharge data from French hospitals that performed endovascular procedures for LEAD between 2015 and 2019 was conducted. Space–time analyses with Moran's Index, zero inflated Poisson regression, and clustering approaches were applied. Spatial clusters were compared on the basis of healthcare services and population characteristics (including poverty and single man household as proxies of social isolation).ResultsBetween 2015 and 2019, the number of ambulatory interventions tripled (1 104 vs.3 130). Of the 86 French departments, the proportion with >5% of ambulatory interventions increased from 10.7% to 28.7% over the study period. In 2019, ambulatory activity in French departments ranged from 0% to 39%. This change was accompanied by a northwest to northeast spatial trend. The clusters of 27 departments with substantial ambulatory activity differed from the others notably by the mortality rate of lower limb arterial thromboembolic diseases in males (OR 3.15, 95% CI 1.2–8.1), the proportion of single man households of age ≥75 (OR 0.37, 95% CI 0.2–0.8), and the poverty rate of people aged 50–59 years (OR 0.69, 95% CI 0.5–0.9).ConclusionsThe development of ambulatory interventions for LEAD in France is encouraging but heterogeneous. Some determinants of this evolution are clearly population based, with a positive impact of needs to take care of the burden of LEAD but negative effects of social isolation and poverty. Research should be conducted to overcome some patient constraints such as isolation.

This study aims to describe the socio-demographic profile of so-called “key workers” during the first lockdown in France and to assess their potential occupational exposure to SARS-CoV-2 under routine, pre-pandemic working conditions. We used the French list of essential jobs that was issued during the first lockdown to identify three subgroups of key workers (hospital healthcare, non-hospital healthcare, non-healthcare). Based on the population-based “Conditions de travail-2019” survey, we described the socio-demographic composition of key workers and their potential work-related exposures (to “infectious agents,” “face-to-face contact with the public,” and “working with colleagues”) using modified Poisson regression. In general, women, clerical and manual workers, workers on temporary contracts, those with lower education and income, and non-European immigrants were more likely to be key workers, who accounted for 22% of the active population. Non-healthcare essential workers (57%) were the most socially disadvantaged, while non-hospital healthcare workers (19%) were polarized at both extremes of the social scale; hospital healthcare workers (24%) were intermediate. Compared to non-key workers, all subgroups had greater exposure to infectious agents and more physical contact with the public. This study provides evidence of accumulated disadvantages among key workers concerning their social background, geographical origin, and potential SARS-CoV-2 exposure.