Santé publique France, the ARS, and the DREAL presented the environmental investigations that will begin in July. Santé publique France provided details on the epidemiological investigation, including the content of the questionnaire that will soon be sent to families.

Environmental investigations will begin this summer

The environmental assessments are intended to quickly “clear up doubts” regarding certain environmental exposures (identifying any instances where regulatory standards or guideline values are exceeded) and to implement protective measures if necessary. They will focus on the primary living environments of children with cancer.

Specifications have been developed by the ARS, Santé publique France, the DREAL, and the Ademe to enable the launch of calls for bids to conduct environmental monitoring at the various sites (Notre-Dame de Lourdes School in Ste Pazanne and a nearby industrial site). The measurements will cover water, indoor air (including radon) and outdoor air, soil, and electromagnetic fields1. These specifications were presented to stakeholders during a working meeting on June 13.

Sampling at the Notre-Dame de Lourdes School in Ste Pazanne will begin as soon as the school vacation starts, so that the first results will be available by the start of the school year in September. Measurements will also be taken inside the school cafeteria building. Special attention is being paid to this school due to its proximity to the former industrial site and the fact that several children with cancer attend this school.

Sampling near the homes built on the former industrial site (a wood treatment company) will begin in September. Some of the results will be available in November.

Regarding investigations at the children’s homes, preliminary visits to the residences will be conducted by the ARS with the aim of carrying out measurements starting in September.

Epidemiological investigation: Initial results expected by the end of August

The epidemiological study conducted by Santé publique France aims to identify a possible local source of exposure that would be common to all reported cases of childhood cancer. It draws on the agency’s full range of professional expertise.

The defined scope of the study includes pediatric cancers of all types diagnosed between 2015 and 2019. According to data validated by the Loire-Atlantique and Vendée tumor registry and the national pediatric cancer registry, this scope includes 14 children with cancer, 3 of whom have since died. These data are provisional and will be consolidated in August. The geographic area remains unchanged. It covers 7 municipalities: Sainte-Pazanne, Port-Saint-Père, Saint-Mars-de-Coutais, Machecoul-Saint-Même, Villeneuve-en-Retz, St-Hilaire-de-Chaléons, and the municipality of Rouans, which is near Sainte-Pazanne.

The questionnaire for families was developed based on a review of the scientific literature. It was shared during a discussion meeting with several members of the collective, who contributed to the content, the wording of certain questions, and the proposed response options. This questionnaire will enable the collection of information regarding:

• the child: details related to the diagnosis, the condition, and its management; family and personal medical history; information regarding primary and secondary residences and vacation destinations; childcare arrangements and schooling; leisure activities; dietary habits…

• the mother before, during pregnancy, and while breastfeeding (if applicable), as well as the father: personal medical history, environmental factors, medical factors, lifestyle habits…

It will be mailed to families in advance of the in-person appointments scheduled for July, so they can familiarize themselves with it. An initial analysis of the results is planned for late August. This will help establish/inform the specifications for the second round of sample collection, which will take place at families’ homes.