This document, prepared by Santé publique France, serves as a guideline to assist healthcare professionals—and more specifically epidemiologists and risk assessors—in their efforts to anticipate and manage the health impacts associated with exceptional environmental events (industrial accidents, floods, storms, forest fires, earthquakes, heat waves, droughts, etc.). Through a methodical approach, it offers a structured analysis of public health issues, making it possible to precisely identify the priority health conditions to monitor from the onset of a crisis, whether they are caused directly by the event itself or indirectly through its consequences (property damage, management measures, etc.). Drawing on up-to-date bibliographic data (as of the first quarter of 2026) and the agency’s accumulated field experience, this framework provides a robust basis for defining relevant epidemiological indicators and deploying appropriate surveillance tools, such as syndromic surveillance tools (e.g., SurSaUD® dashboards).Beyond its immediate utility for Santé publique France teams and their local partners (emergency services, SOS Médecins, SAMU, etc.), this document also aims to raise awareness and coordinate all stakeholders involved in crisis management (healthcare, emergency response, security). Its objectives include establishing epidemiological surveillance that is consistent with actions taken on the ground—such as monitoring the impacts of management measures implemented (evacuations, water shutoffs, etc.), to track diseases based on exposure types and intensities, and to adapt healthcare provision to anticipated diseases.In short, the work undertaken on this framework lays the groundwork for a proactive approach to health risk management, combining scientific rigor, practical experience, and inter-institutional cooperation. It thus represents a significant step forward in preparing for and responding to the challenges posed by exceptional environmental situations, while remaining open to evolving knowledge and practices.