Suchergebnisse

International audience ; There is growing evidence of the interrelationships between ecosystems and public health. This creates opportunities for the development of cross-sectoral policies and interventions that provide dual benefits to public health and to the natural environment. These benefits are increasingly articulated in strategy documents at national and regional level, yet implementation of integrative policies on the ground remains limited and fragmented. Here, we use a workshop approach to identify some features of this evidence-implementation gap based on policy and practice within a number of western European countries. The driving forces behind some recent moves towards more integrative policy development and implementation show important differences between countries, reflecting the non-linear and complex nature of the policy-making process. We use these case studies to illustrate some of the key barriers to greater inte-grative policy development identified in the policy analysis literature. Specific barriers we identify include: institutional barriers; differing time perspectives in public health and ecosystem management; contrasting historical development of public health and natural environment disciplinary policy agendas; an incomplete evidence base relating investment in the natural environment to benefits for public health; a lack of appropriate outcome measures including benefit-cost trade-offs; and finally a lack of integra-tive policy frameworks across the health and natural environment sectors. We also identify opportunities for greater policy integration and examples of good practice from different countries. However, we note there is no single mechanism that will deliver integrative policy for healthier people and ecosystems in all countries and situations. National governments, national public agencies, local governments, research institutions, and professional bodies all share a responsibility to identify and seize opportunities for influencing policy change, whether incremental or ...

International audience ; There is growing evidence of the interrelationships between ecosystems and public health. This creates opportunities for the development of cross-sectoral policies and interventions that provide dual benefits to public health and to the natural environment. These benefits are increasingly articulated in strategy documents at national and regional level, yet implementation of integrative policies on the ground remains limited and fragmented. Here, we use a workshop approach to identify some features of this evidence-implementation gap based on policy and practice within a number of western European countries. The driving forces behind some recent moves towards more integrative policy development and implementation show important differences between countries, reflecting the non-linear and complex nature of the policy-making process. We use these case studies to illustrate some of the key barriers to greater inte-grative policy development identified in the policy analysis literature. Specific barriers we identify include: institutional barriers; differing time perspectives in public health and ecosystem management; contrasting historical development of public health and natural environment disciplinary policy agendas; an incomplete evidence base relating investment in the natural environment to benefits for public health; a lack of appropriate outcome measures including benefit-cost trade-offs; and finally a lack of integra-tive policy frameworks across the health and natural environment sectors. We also identify opportunities for greater policy integration and examples of good practice from different countries. However, we note there is no single mechanism that will deliver integrative policy for healthier people and ecosystems in all countries and situations. National governments, national public agencies, local governments, research institutions, and professional bodies all share a responsibility to identify and seize opportunities for influencing policy change, whether incremental or ...

International audience ; There is growing evidence of the interrelationships between ecosystems and public health. This creates opportunities for the development of cross-sectoral policies and interventions that provide dual benefits to public health and to the natural environment. These benefits are increasingly articulated in strategy documents at national and regional level, yet implementation of integrative policies on the ground remains limited and fragmented. Here, we use a workshop approach to identify some features of this evidence-implementation gap based on policy and practice within a number of western European countries. The driving forces behind some recent moves towards more integrative policy development and implementation show important differences between countries, reflecting the non-linear and complex nature of the policy-making process. We use these case studies to illustrate some of the key barriers to greater inte-grative policy development identified in the policy analysis literature. Specific barriers we identify include: institutional barriers; differing time perspectives in public health and ecosystem management; contrasting historical development of public health and natural environment disciplinary policy agendas; an incomplete evidence base relating investment in the natural environment to benefits for public health; a lack of appropriate outcome measures including benefit-cost trade-offs; and finally a lack of integra-tive policy frameworks across the health and natural environment sectors. We also identify opportunities for greater policy integration and examples of good practice from different countries. However, we note there is no single mechanism that will deliver integrative policy for healthier people and ecosystems in all countries and situations. National governments, national public agencies, local governments, research institutions, and professional bodies all share a responsibility to identify and seize opportunities for influencing policy change, whether incremental or ...

International audience ; Background: Vector-borne diseases (VBDs) continue to represent a global threat, with "old" diseases like malaria, and "emergent" or "re-emergent" ones like Zika, because of an increase in international trade, demographic growth, and rapid urbanization. In this era of globalization, surveillance is a key element in controlling VBDs in urban settings, but surveillance alone cannot solve the problem. A review of experiences is of interest to examine other solution elements. The objectives were to assess the different means of VBD surveillance in urban environments, to evaluate their potential for supporting public health actions, and to describe the tools used for public health actions, the constraints they face, and the research and health action gaps to be filled. Main body: For this scoping review we searched peer-reviewed articles and grey literature published between 2000 and 2016. Various tools were used for data coding and extraction. A quality assessment was done for each study reviewed, and descriptive characteristics and data on implementation process and transferability were analyzed in all studies. After screening 414 full-text articles, we retained a total of 79 articles for review. The main targets of the articles were arboviral diseases (65.8%) and malaria (16.5%). The positive aspects of many studies fit within the framework of integrated vector management. Public awareness is considered a key to successful vector control programs. Advocacy and legislation can reinforce both empowerment and capacity building. These can be achieved by collaboration within the health sector and with other sectors. Research is needed to develop well designed studies and new tools for surveillance and control.

International audience ; Background: Vector-borne diseases (VBDs) continue to represent a global threat, with "old" diseases like malaria, and "emergent" or "re-emergent" ones like Zika, because of an increase in international trade, demographic growth, and rapid urbanization. In this era of globalization, surveillance is a key element in controlling VBDs in urban settings, but surveillance alone cannot solve the problem. A review of experiences is of interest to examine other solution elements. The objectives were to assess the different means of VBD surveillance in urban environments, to evaluate their potential for supporting public health actions, and to describe the tools used for public health actions, the constraints they face, and the research and health action gaps to be filled. Main body: For this scoping review we searched peer-reviewed articles and grey literature published between 2000 and 2016. Various tools were used for data coding and extraction. A quality assessment was done for each study reviewed, and descriptive characteristics and data on implementation process and transferability were analyzed in all studies. After screening 414 full-text articles, we retained a total of 79 articles for review. The main targets of the articles were arboviral diseases (65.8%) and malaria (16.5%). The positive aspects of many studies fit within the framework of integrated vector management. Public awareness is considered a key to successful vector control programs. Advocacy and legislation can reinforce both empowerment and capacity building. These can be achieved by collaboration within the health sector and with other sectors. Research is needed to develop well designed studies and new tools for surveillance and control.

International audience ; Background: Vector-borne diseases (VBDs) continue to represent a global threat, with "old" diseases like malaria, and "emergent" or "re-emergent" ones like Zika, because of an increase in international trade, demographic growth, and rapid urbanization. In this era of globalization, surveillance is a key element in controlling VBDs in urban settings, but surveillance alone cannot solve the problem. A review of experiences is of interest to examine other solution elements. The objectives were to assess the different means of VBD surveillance in urban environments, to evaluate their potential for supporting public health actions, and to describe the tools used for public health actions, the constraints they face, and the research and health action gaps to be filled. Main body: For this scoping review we searched peer-reviewed articles and grey literature published between 2000 and 2016. Various tools were used for data coding and extraction. A quality assessment was done for each study reviewed, and descriptive characteristics and data on implementation process and transferability were analyzed in all studies. After screening 414 full-text articles, we retained a total of 79 articles for review. The main targets of the articles were arboviral diseases (65.8%) and malaria (16.5%). The positive aspects of many studies fit within the framework of integrated vector management. Public awareness is considered a key to successful vector control programs. Advocacy and legislation can reinforce both empowerment and capacity building. These can be achieved by collaboration within the health sector and with other sectors. Research is needed to develop well designed studies and new tools for surveillance and control.

International audience ; The study explores spatial data processing methods and the associated impact on the characterization and quantification of a combined health risk indicator at a regional scale with fine resolution. To illustrate the methodology of combining multiple publicly available data sources, we present a case study of the Lorraine region (France), where regional stakeholders were involved in the global procedures for data collection and data processing. Different indicators are developed by combining technical approaches for assessing and characterizing human health exposure to chemical substances (in soil, air and water) and noise risk factors. The results allow identification of pollutant sources, determinants of exposure, and potential hotspot areas. A test of the model's assumptions to changes in sub-indicator spatial distribution showed the impact of data transformation on identifying more impacted areas. Cumulative risk assessment enable the combination of quantitative and qualitative evaluation of health risks by including stakeholders in the decision process, helping to define a subjective conceptual analysis framework or assumptions when uncertainties or knowledge gaps exist. ; Le Plan national santé environnement (PNSE) vise à prendre en compte, de façon pérenne, la santé environnementale dans les politiques publiques. Ainsi, les actions des PNSE sont développées selon deux axes structurants : • réduire les expositions responsables de pathologies à fort impact sur la santé ; • réduire les inégalités environnementales.

International audience ; The study explores spatial data processing methods and the associated impact on the characterization and quantification of a combined health risk indicator at a regional scale with fine resolution. To illustrate the methodology of combining multiple publicly available data sources, we present a case study of the Lorraine region (France), where regional stakeholders were involved in the global procedures for data collection and data processing. Different indicators are developed by combining technical approaches for assessing and characterizing human health exposure to chemical substances (in soil, air and water) and noise risk factors. The results allow identification of pollutant sources, determinants of exposure, and potential hotspot areas. A test of the model's assumptions to changes in sub-indicator spatial distribution showed the impact of data transformation on identifying more impacted areas. Cumulative risk assessment enable the combination of quantitative and qualitative evaluation of health risks by including stakeholders in the decision process, helping to define a subjective conceptual analysis framework or assumptions when uncertainties or knowledge gaps exist. ; Le Plan national santé environnement (PNSE) vise à prendre en compte, de façon pérenne, la santé environnementale dans les politiques publiques. Ainsi, les actions des PNSE sont développées selon deux axes structurants : • réduire les expositions responsables de pathologies à fort impact sur la santé ; • réduire les inégalités environnementales.

International audience ; The study explores spatial data processing methods and the associated impact on the characterization and quantification of a combined health risk indicator at a regional scale with fine resolution. To illustrate the methodology of combining multiple publicly available data sources, we present a case study of the Lorraine region (France), where regional stakeholders were involved in the global procedures for data collection and data processing. Different indicators are developed by combining technical approaches for assessing and characterizing human health exposure to chemical substances (in soil, air and water) and noise risk factors. The results allow identification of pollutant sources, determinants of exposure, and potential hotspot areas. A test of the model's assumptions to changes in sub-indicator spatial distribution showed the impact of data transformation on identifying more impacted areas. Cumulative risk assessment enable the combination of quantitative and qualitative evaluation of health risks by including stakeholders in the decision process, helping to define a subjective conceptual analysis framework or assumptions when uncertainties or knowledge gaps exist. ; Le Plan national santé environnement (PNSE) vise à prendre en compte, de façon pérenne, la santé environnementale dans les politiques publiques. Ainsi, les actions des PNSE sont développées selon deux axes structurants : • réduire les expositions responsables de pathologies à fort impact sur la santé ; • réduire les inégalités environnementales.

Analyzing the relationship between environment and health has become a major preoccupation for public health in France as evidenced by the national action plans for health and environment. The aim of the study is to develop a spatial stochastic multimedia exposure model for detecting vulnerable populations and analyzing exposure determinants at a fine resolution and regional scale. A multimedia exposure model was developed by INERIS to assess the transfer of substances from the environment to human. The RESPIR project adds a spatial dimension by linking a GIS (Geographic Information System) to the model. Tools are developed using modeling, spatial analysis and geostatistic methods to build interesting variables on a 1 km2 regular grid. As application, INERIS performed a risk assessment of exposure to metals (cadmium, lead and nickel). The modeling was performed on a region of France (Nord-Pas-de-Calais). The considered exposure pathways include inhalation and ingestion. The two largest risk values correspond to an ancient industrial site (Metaleurop) and to the Lille city agglomeration. In these areas, cadmium, vegetation ingestion and soil contamination are the principal determinants of the computed risk. ; Le constat des inégalités environnementales et la reprise de la thématique dans les politiques publiques (axe prioritaire du second Plan national santé environnement) nécessitent la construction d'outils de diagnostic pour orienter les mesures de gestion permettant de contrôler ou de réduire les expositions en vue de garantir un niveau de « dégradation » et de risque non préoccupant. L'objectif de cette étude est de construire, dans un système d'information géographique (SIG), des bases de données environnementales spatialisées par milieu au niveau régional. Ces bases de données sont utilisées pour estimer l'exposition des populations à différents polluants. L'étude vise à identifier des zones de surexposition potentielle des populations aux polluants chimiques et leurs déterminants (types de polluant, voies ...

Analyzing the relationship between environment and health has become a major preoccupation for public health in France as evidenced by the national action plans for health and environment. The aim of the study is to develop a spatial stochastic multimedia exposure model for detecting vulnerable populations and analyzing exposure determinants at a fine resolution and regional scale. A multimedia exposure model was developed by INERIS to assess the transfer of substances from the environment to human. The RESPIR project adds a spatial dimension by linking a GIS (Geographic Information System) to the model. Tools are developed using modeling, spatial analysis and geostatistic methods to build interesting variables on a 1 km2 regular grid. As application, INERIS performed a risk assessment of exposure to metals (cadmium, lead and nickel). The modeling was performed on a region of France (Nord-Pas-de-Calais). The considered exposure pathways include inhalation and ingestion. The two largest risk values correspond to an ancient industrial site (Metaleurop) and to the Lille city agglomeration. In these areas, cadmium, vegetation ingestion and soil contamination are the principal determinants of the computed risk. ; Le constat des inégalités environnementales et la reprise de la thématique dans les politiques publiques (axe prioritaire du second Plan national santé environnement) nécessitent la construction d'outils de diagnostic pour orienter les mesures de gestion permettant de contrôler ou de réduire les expositions en vue de garantir un niveau de « dégradation » et de risque non préoccupant. L'objectif de cette étude est de construire, dans un système d'information géographique (SIG), des bases de données environnementales spatialisées par milieu au niveau régional. Ces bases de données sont utilisées pour estimer l'exposition des populations à différents polluants. L'étude vise à identifier des zones de surexposition potentielle des populations aux polluants chimiques et leurs déterminants (types de polluant, voies d'exposition, classes de population à risque) par l'analyse des variations de l'indicateur environnemental. Un modèle multimédia d'exposition est utilisé pour le calcul des doses d'exposition de populations cibles liées à l'ingestion de produits d'alimentation, d'eau de consommation, et à l'inhalation de contaminants atmosphériques. Utilisant les équations de transfert et l'architecture du modèle développé par l'INERIS (Modul'ERS), la composante spatiale a été apportée à l'outil de calcul par son couplage avec un SIG. Pour cette étude, le modèle évalue la dose journalière d'exposition pour des mailles de 1 km2 sur l'ensemble de la région Nord - Pas-de-Calais.

La prévention est aujourd'hui au coeur des politiques publiques du vieillissement. Cet article propose d'analyser l'acceptabilité d'ateliers de prévention mis en place à l'Île de la Réunion. L'objectif est de comprendre comment les personnes âgées se positionnent face à ces ateliers, face aux messages de prévention qu'ils véhiculent et comment elles les intègrent dans leurs pratiques de tous les jours. Ces résultats permettent de discuter de la temporalité, des échelles d'intervention et des leviers d'action pour la prévention du vieillissement.

La prévention est aujourd'hui au coeur des politiques publiques du vieillissement. Cet article propose d'analyser l'acceptabilité d'ateliers de prévention mis en place à l'Île de la Réunion. L'objectif est de comprendre comment les personnes âgées se positionnent face à ces ateliers, face aux messages de prévention qu'ils véhiculent et comment elles les intègrent dans leurs pratiques de tous les jours. Ces résultats permettent de discuter de la temporalité, des échelles d'intervention et des leviers d'action pour la prévention du vieillissement.

Identifying and ranking substances of concern is a complex task: the notion of substance of concern has a different meaning depending on regulations, public policies, existing ranking exercises or individual opinions. The choice of priority substances is generally supported by orders of substances constructed on an expert opinion. The process suggests providing, in addition, orders of substances elaborated on the basis of views identified among other people involved in the decision process: groups of decision makers, stakeholders, people from civil society, etc. This process advises using participatory multi-criteria methods. These methods give structure to the participatory approach, they make explicit the underlying logic of each generated order and they can be adapted to the available data. The process can adapt to any type of context and ranking objective. An application conducted in 2012, to support the choice of the priority substances of the future French Environmental Health National Action Plan (PNSE3), illustrate the process. ; Une des priorités du deuxième Plan National Santé-Environnement (PNSE2) est de définir une méthode d'identification et de hiérarchisation des substances toxiques les plus préoccupantes. La notion même de substance préoccupante revêt un sens différent selon les réglementations, les politiques publiques, les exercices de hiérarchisation existants ou les opinions individuelles. Différents critères peuvent être mis en avant, par exemple : le danger, le caractère Persistant Bioaccumulable et Toxique (PBT), la protection de populations sensibles et le risque individuel inacceptable. En termes d'actions publiques, le choix de substances prioritaires s'appuie généralement sur des ordres de substances construits sur la base d'un avis d'experts. Le processus décrit ici propose de fournir, en complément, des ordres de substances basés sur des points de vue identifiés parmi d'autres acteurs de la décision : groupe de décideurs, représentants d'intérêts divers, personnes issues de la ...

Identifying and ranking substances of concern is a complex task: the notion of substance of concern has a different meaning depending on regulations, public policies, existing ranking exercises or individual opinions. The choice of priority substances is generally supported by orders of substances constructed on an expert opinion. The process suggests providing, in addition, orders of substances elaborated on the basis of views identified among other people involved in the decision process: groups of decision makers, stakeholders, people from civil society, etc. This process advises using participatory multi-criteria methods. These methods give structure to the participatory approach, they make explicit the underlying logic of each generated order and they can be adapted to the available data. The process can adapt to any type of context and ranking objective. An application conducted in 2012, to support the choice of the priority substances of the future French Environmental Health National Action Plan (PNSE3), illustrate the process. ; Une des priorités du deuxième Plan National Santé-Environnement (PNSE2) est de définir une méthode d'identification et de hiérarchisation des substances toxiques les plus préoccupantes. La notion même de substance préoccupante revêt un sens différent selon les réglementations, les politiques publiques, les exercices de hiérarchisation existants ou les opinions individuelles. Différents critères peuvent être mis en avant, par exemple : le danger, le caractère Persistant Bioaccumulable et Toxique (PBT), la protection de populations sensibles et le risque individuel inacceptable. En termes d'actions publiques, le choix de substances prioritaires s'appuie généralement sur des ordres de substances construits sur la base d'un avis d'experts. Le processus décrit ici propose de fournir, en complément, des ordres de substances basés sur des points de vue identifiés parmi d'autres acteurs de la décision : groupe de décideurs, représentants d'intérêts divers, personnes issues de la société, etc.