Suchergebnisse

ContexteL'humanité fait face à des bouleversements environnementaux sans précédent au cours de son histoire, et dont elle est majoritairement responsable : changement climatique, destruction de la nature, artificialisation des sols, pollution des milieux…. Ces bouleversements se répercutent déjà sur la santé, y compris en remettant en cause les acquis sanitaires des dernières décennies. Dans le cas du changement climatique, malgré une bonne vision des évolutions auxquelles il va falloir s'adapter d'ici 2040, les implications pour la santé demeurent peu prises en compte. De fait, peu de travaux épidémiologiques se sont confrontés à la question de l'adaptation au changement climatique. Comment mobiliser la santé publique afin de réduire les impacts déjà prévisibles du changement climatique? Comment mobiliser les sciences, et notamment l'épidémiologie, pour apporter des connaissances utiles, alors qu'étant donné la non-stationnarité du climat et les évolutions rapides des différents facteurs de risques, l'analyse du passé permet de moins en moins de prédire l'avenir ? Comment mesurer et promouvoir les co-bénéfices sanitaires possibles des politiques d'adaptation et d'atténuation ? Ces questions sont au cœur de mes travaux et de mon cheminement scientifique. Principaux résultatsDans une logique classique d'adaptation, l'épidémiologie et la santé publique doivent intervenir sur quatre grandes étapes : 1) la caractérisation de la vulnérabilité actuelle au climat, 2) la caractérisation de la vulnérabilité future, 3) le choix et la mise en place d'une politique d'adaptation 4) l'évaluation.Les travaux présentés ici illustrent cette démarche appliquée à la température et à la pollution de l'air. Ils mobilisent des outils variés de l'épidémiologie ; les études multicentriques en séries temporelles, les évaluations quantitatives des impacts sanitaires, le couplage avec des modèles climatiques, la surveillance syndromique, ou encore le développement de systèmes d'alerte. Ils ouvrent également vers l'identification de ...

ContexteL'humanité fait face à des bouleversements environnementaux sans précédent au cours de son histoire, et dont elle est majoritairement responsable : changement climatique, destruction de la nature, artificialisation des sols, pollution des milieux…. Ces bouleversements se répercutent déjà sur la santé, y compris en remettant en cause les acquis sanitaires des dernières décennies. Dans le cas du changement climatique, malgré une bonne vision des évolutions auxquelles il va falloir s'adapter d'ici 2040, les implications pour la santé demeurent peu prises en compte. De fait, peu de travaux épidémiologiques se sont confrontés à la question de l'adaptation au changement climatique. Comment mobiliser la santé publique afin de réduire les impacts déjà prévisibles du changement climatique? Comment mobiliser les sciences, et notamment l'épidémiologie, pour apporter des connaissances utiles, alors qu'étant donné la non-stationnarité du climat et les évolutions rapides des différents facteurs de risques, l'analyse du passé permet de moins en moins de prédire l'avenir ? Comment mesurer et promouvoir les co-bénéfices sanitaires possibles des politiques d'adaptation et d'atténuation ? Ces questions sont au cœur de mes travaux et de mon cheminement scientifique. Principaux résultatsDans une logique classique d'adaptation, l'épidémiologie et la santé publique doivent intervenir sur quatre grandes étapes : 1) la caractérisation de la vulnérabilité actuelle au climat, 2) la caractérisation de la vulnérabilité future, 3) le choix et la mise en place d'une politique d'adaptation 4) l'évaluation.Les travaux présentés ici illustrent cette démarche appliquée à la température et à la pollution de l'air. Ils mobilisent des outils variés de l'épidémiologie ; les études multicentriques en séries temporelles, les évaluations quantitatives des impacts sanitaires, le couplage avec des modèles climatiques, la surveillance syndromique, ou encore le développement de systèmes d'alerte. Ils ouvrent également vers l'identification de ...

This article proposes a methodological discussion based on an economic evaluation of the mortality impacts of chronic exposure to fine particulate matter in mainland France. It starts from the health impact assessment carried out by Santé publique France in 2016 for 5 scenarios of decrease in concentrations using two methods to measure mortality (number of premature deaths prevented, and total number of life years gained). After a justification of the monetary values used - €3 million for the value for a prevented fatality and €80,000 for the value of a life year gained - we apply them to the health data and obtain results comparable to contemporary studies. In particular, in a scenario without anthropogenic pollution, the 2016 EQIS estimates that 48,283 premature deaths could be prevented, corresponding to an economic assessment of €144.85 billion. We then address methods and practices: the sources of divergence with the previous French study conducted in 1998-99, the choice of monetary values and the conditions for using these results in public decision-making. Finally, we provide an additional argument on the need to reduce people's exposure to ambient air pollution in France. ; Cet article propose une discussion méthodologique à partir d'une évaluation économique des impacts sur la mortalité de l'exposition chronique aux particules fines en France continentale. Il prend comme point de départ l'évaluation quantitative d'impact sanitaire (EQIS), réalisée par Santé publique France en 2016, de 5 scénarios de réduction des concentrations par deux méthodes de mesure de la mortalité (nombre de décès prématurés évités et nombre total d'années de vie gagnées). Après une justification des valeurs monétaires utilisées – 3 millions € pour la valeur d'évitement d'un décès et 80 000 € pour celle d'une année de vie gagnée – nous les appliquons aux données sanitaires, et obtenons des résultats comparables aux études contemporaines. En particulier, dans un scénario sans pollution anthropique, l'EQIS de 2016 estime à 48 283 les décès prématurés évités, que nous évaluons à 144,85 milliards €2008. Nous questionnons ensuite les méthodes et pratiques : les sources de divergence avec la précédente étude française menée en 1998-99, le choix des valeurs monétaires et les conditions d'utilisation de ces résultats dans la décision publique. Au final, nous apportons un argument supplémentaire sur la nécessité de réduire l'exposition des populations à la pollution de l'air ambiant en France.

This article proposes a methodological discussion based on an economic evaluation of the mortality impacts of chronic exposure to fine particulate matter in mainland France. It starts from the health impact assessment carried out by Santé publique France in 2016 for 5 scenarios of decrease in concentrations using two methods to measure mortality (number of premature deaths prevented, and total number of life years gained). After a justification of the monetary values used - €3 million for the value for a prevented fatality and €80,000 for the value of a life year gained - we apply them to the health data and obtain results comparable to contemporary studies. In particular, in a scenario without anthropogenic pollution, the 2016 EQIS estimates that 48,283 premature deaths could be prevented, corresponding to an economic assessment of €144.85 billion. We then address methods and practices: the sources of divergence with the previous French study conducted in 1998-99, the choice of monetary values and the conditions for using these results in public decision-making. Finally, we provide an additional argument on the need to reduce people's exposure to ambient air pollution in France. ; Cet article propose une discussion méthodologique à partir d'une évaluation économique des impacts sur la mortalité de l'exposition chronique aux particules fines en France continentale. Il prend comme point de départ l'évaluation quantitative d'impact sanitaire (EQIS), réalisée par Santé publique France en 2016, de 5 scénarios de réduction des concentrations par deux méthodes de mesure de la mortalité (nombre de décès prématurés évités et nombre total d'années de vie gagnées). Après une justification des valeurs monétaires utilisées – 3 millions € pour la valeur d'évitement d'un décès et 80 000 € pour celle d'une année de vie gagnée – nous les appliquons aux données sanitaires, et obtenons des résultats comparables aux études contemporaines. En particulier, dans un scénario sans pollution anthropique, l'EQIS de 2016 estime à 48 283 ...

International audience ; Background: Ozone and PM2.5 are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. Method: We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM2.5 under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Results: Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM2.5 changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.

International audience ; Background: Ozone and PM2.5 are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. Method: We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM2.5 under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Results: Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM2.5 changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.

International audience ; Background: Ozone and PM2.5 are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. Method: We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM2.5 under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Results: Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM2.5 changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.

International audience ; Background: Ozone and PM2.5 are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. Method: We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM2.5 under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Results: Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM2.5 changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.

International audience ; Background: Ozone and PM2.5 are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. Method: We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM2.5 under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Results: Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM2.5 changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.

International audience ; Background: Ozone and PM2.5 are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. Method: We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM2.5 under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Results: Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM2.5 changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.

International audience ; Background: Ozone and PM2.5 are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. Method: We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM2.5 under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Results: Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM2.5 changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.

International audience Background: Ozone and PM2.5 are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. Method: We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM2.5 under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Results: Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM2.5 changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.

International audience ; Background: Ozone and PM2.5 are current risk factors for premature death all over the globe. In coming decades, substantial improvements in public health may be achieved by reducing air pollution. To better understand the potential of emissions policies, studies are needed that assess possible future health impacts under alternative assumptions about future emissions and climate across multiple spatial scales. Method: We used consistent climate-air-quality-health modeling framework across three geographical scales (World, Europe and Ile-de-France) to assess future (2030-2050) health impacts of ozone and PM2.5 under two emissions scenarios (Current Legislation Emissions, CLE, and Maximum Feasible Reductions, MFR). Results: Consistently across the scales, we found more reductions in deaths under MFR scenario compared to CLE. 1.5 [95% CI: 0.4, 2.4] million CV deaths could be delayed each year in 2030 compared to 2010 under MFR scenario, 84% of which would occur in Asia, especially in China. In Europe, the benefits under MFR scenario (219000 CV deaths) are noticeably larger than those under CLE (109000 CV deaths). In Ile-de-France, under MFR more than 2830 annual CV deaths associated with PM2.5 changes could be delayed in 2050 compared to 2010. In Paris, ozone-related respiratory mortality should increase under both scenarios.

BACKGROUND: Evidence on the short-term effects of fine and coarse particles on morbidity in Europe is scarce and inconsistent. OBJECTIVES: We aimed to estimate the association between daily concentrations of fine and coarse particles with hospitalizations for cardiovascular and respiratory conditions in eight Southern European cities, within the MED-PARTICLES project. METHODS: City-specific Poisson models were fitted to estimate associations of daily concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), ≤ 10 μm (PM10), and their difference (PM2.5-10) with daily counts of emergency hospitalizations for cardiovascular and respiratory diseases. We derived pooled estimates from random-effects meta-analysis and evaluated the robustness of results to co-pollutant exposure adjustment and model specification. Pooled concentration-response curves were estimated using a meta-smoothing approach. RESULTS: We found significant associations between all PM fractions and cardiovascular admissions. Increases of 10 μg/m3 in PM2.5, 6.3 μg/m3 in PM2.5-10, and 14.4 μg/m3 in PM10 (lag 0-1 days) were associated with increases in cardiovascular admissions of 0.51% (95% CI: 0.12, 0.90%), 0.46% (95% CI: 0.10, 0.82%), and 0.53% (95% CI: 0.06, 1.00%), respectively. Stronger associations were estimated for respiratory hospitalizations, ranging from 1.15% (95% CI: 0.21, 2.11%) for PM10 to 1.36% (95% CI: 0.23, 2.49) for PM2.5 (lag 0-5 days). CONCLUSIONS: PM2.5 and PM2.5-10 were positively associated with cardiovascular and respiratory admissions in eight Mediterranean cities. Information on the short-term effects of different PM fractions on morbidity in Southern Europe will be useful to inform European policies on air quality standards. ; This research was supported by the European Union under the grant agreement LIFE+ ENV/IT/327. ; Sí

There is conflicting evidence on the influence of weather on COVID-19 transmission. Our aim is to estimate weather-dependent signatures in the early phase of the pandemic, while controlling for socio-economic factors and non-pharmaceutical interventions. We identify a modest non-linear association between mean temperature and the effective reproduction number (Re) in 409 cities in 26 countries, with a decrease of 0.087 (95% CI: 0.025; 0.148) for a 10 °C increase. Early interventions have a greater effect on Re with a decrease of 0.285 (95% CI 0.223; 0.347) for a 5th - 95th percentile increase in the government response index. The variation in the effective reproduction number explained by government interventions is 6 times greater than for mean temperature. We find little evidence of meteorological conditions having influenced the early stages of local epidemics and conclude that population behaviour and government interventions are more important drivers of transmission. ; This work was generated using Copernicus Climate Change Service (C3S) and Copernicus Atmosphere Monitoring Service (CAMS) information [2020]. The authors would like to thank the European Centre for Medium-Range Weather Forecasts (ECMWF) that implements the C3S and CAMS on behalf of the European Union. D.R. was supported by a postdoctoral research fellowship of the Xunta de Galicia (Spain). A.G. was funded by the Medical Research Council-UK (Grant ID: MR/R013349/1), the Natural Environment Research Council UK (Grant ID: NE/R009384/1) and the European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655). R.L. was supported by a Royal Society Dorothy Hodgkin Fellowship. S.A. and S.M. were funded by the Wellcome Trust (grant 210758/Z/18/Z210758/Z/18/Z). The following funding sources are acknowledged as providing funding for the MCC Collaborative Research Network authors: J.K. and A.U. were supported by the Czech Science Foundation, project 18-22125S. S.T. was supported by the Shanghai Municipal Science and Technology Commission (Grant 18411951600). N.S. is supported by the NIEHS-funded HERCULES Center (P30ES019776). H.K. was supported by the National Research Foundation of Korea (BK21 Center for Integrative Response to Health Disasters, Graduate School of Public Health, Seoul National University). A.S., F.D.R. and S.R. were funded by the European Union's Horizon 2020 Project Exhaustion (Grant ID: 820655). Each member of the CMMID COVID-19 Working Group contributed to processing, cleaning and interpretation of data, interpreted findings, contributed to the manuscript and approved the work for publication. The following funding sources are acknowledged as providing funding for the CMMID COVID-19 working group authors. This research was partly funded by the Bill & Melinda Gates Foundation (INV-001754: M.Q; INV-003174: K.P., M.J., Y.L., J.L.; NTD Modelling Consortium OPP1184344: C.A.B.P., G.M.; OPP1180644: S.R.P.; OPP1183986: E.S.N.). BMGF (OPP1157270: K.E.A.). DFID/Wellcome Trust (Epidemic Preparedness Coronavirus research programme 221303/Z/20/Z: C.A.B.P.). EDCTP2 (RIA2020EF-2983-CSIGN: H.P.G.). ERC Starting Grant (#757699: M.Q.). This project has received funding from the European Union's Horizon 2020 research and innovation programme—project EpiPose (101003688: K.P., M.J., P.K., R.C.B., W.J.E., Y.L.). This research was partly funded by the Global Challenges Research Fund (GCRF) project 'RECAP' managed through RCUK and ESRC (ES/P010873/1: A.G., C.I.J., T.J.). HDR UK (MR/S003975/1: R.M.E.). MRC (MR/N013638/1: N.R.W.; MR/V027956/1: W.W.). Nakajima Foundation (A.E.). This research was partly funded by the National Institute for Health Research (NIHR) using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK Department of Health and Social Care (16/136/46: B.J.Q.; 16/137/109: B.J.Q., F.Y.S., M.J., Y.L.; Health Protection Research Unit for Immunisation NIHR200929: N.G.D.; Health Protection Research Unit for Modelling Methodology HPRU-2012-10096: T.J.; NIHR200908: R.M.E.; NIHR200929: F.G.S., M.J.; PR-OD-1017-20002: A.R., W.J.E.). Royal Society (Dorothy Hodgkin Fellowship: R.L.; RP\EA\180004: P.K.). UK DHSC/UK Aid/NIHR (PR-OD-1017-20001: H.P.G.). UK MRC (MC_PC_19065—Covid 19: Understanding the dynamics and drivers of the COVID-19 epidemic using real-time outbreak analytics: A.G., N.G.D., R.M.E., S.C., T.J., W.J.E., Y.L.; MR/P014658/1: G.M.K.). Authors of this research receive funding from the UK Public Health Rapid Support Team funded by the United Kingdom Department of Health and Social Care (T.J.). Wellcome Trust (206250/Z/17/Z: A.J.K., T.W.R.; 206471/Z/17/Z: O.B.; 208812/Z/17/Z: S.C.; 210758/Z/18/Z: J.D.M., J.H., N.I.B.; UNS110424: F.K.). No funding (A.M.F., A.S., C.J.V.-A., D.C.T., J.W., K.E.A., Y.-W.D.C.). LSHTM, DHSC/UKRI COVID-19 Rapid Response Initiative (MR/V028456/1: Y.L.). Innovation Fund of the Joint Federal Committee (01VSF18015: F.K.). Foreign, Commonwealth and Development Office/Wellcome Trust (221303/Z/20/Z: M.K.). ; Peer reviewed