The “Santé Post Incendie 76” initiative comprises four studies and examines a range of health effects. The main findings, published today, highlight that short-term effects—primarily of an irritant and psychological nature—were observed among local residents and workers following the fire. A negative impact on psychological health is indeed observed, even one year after the event, among people present in the exposed area. Santé publique France proposes to implement, over several years, epidemiological surveillance of the health of the local population and potentially exposed workers, via the National Health Data System. Furthermore, based on an analysis of available environmental data, conducting a biomonitoring survey would not provide additional information to the proposed epidemiological surveillance or to the exposure reduction management measures implemented following the fire.

An initial study analyzing the population’s perception of the fire and its impact on their health

Launched after the accident, the survey titled “A Study Listening to Your Health” describes the exposures and symptoms perceived by the population during the fire, as well as their use of healthcare services, behaviors, and attitudes. This questionnaire-based study complements the information from the immediate post-accident monitoring conducted using data on emergency care utilization during the month following the accident. The second objective is to study the impact of the event on the population’s perceived health one year after the fire. The study was co-developed with representatives of civil society and elected officials from Seine-Maritime, as part of a participatory process conducted over a period of one and a half years. It was conducted among a representative sample of residents from 122 municipalities in Seine-Maritime affected by the accident: 3,764 adults and 1,029 children, as well as 1,015 adults and 208 children from a control area located in Le Havre and its surroundings, based on an INSEE database.

The initial results show that:

• More than 90% of the population surveyed reported having experienced at least one instance of exposure to this industrial accident (noise, flames, plumes of black smoke, odors, soot deposits, etc.).

• 86% of the population detected odors, a perception that often lasted a long time and was experienced as bothersome or very bothersome.

• 60% of residents in the exposed area, both adults and children, reported at least one symptom or health issue they attributed to the fire. These were primarily psychological symptoms (stress, anxiety, distress, panic), otolaryngological (tingling in the nostrils or throat, nasal discharge and congestion), general (headache, malaise, fatigue), ocular (watery eyes, conjunctival redness), respiratory (cough, shortness of breath, and, more rarely, asthma attacks), and sleep disturbances.

The perception of the nuisances caused by the fire had a negative effect on the perceived health of those exposed, as measured one year after the event. This deterioration is primarily due to an impact on psychological health, and this finding is consistent with the epidemiological literature on similar accidental events. It is more pronounced among individuals who experienced multiple nuisances and accidental pollution and among those who perceived the odors emitted during and after the fire for an extended period. The complementary component of the study focused on mental health, whose analyses will be available in the first quarter of 2022, will allow for a precise assessment of the accident’s impact on anxiety, depression, and post-traumatic stress.

Proposal to monitor the accident’s impact on the health of exposed workers

Santé publique France has also focused on the health of workers (employees at the two affected industrial sites, professionals who responded to the accident, and employees of other companies who were exposed to the hazards generated by the fire). The Normandy Region Occupational Health Alert Group (GAST) was tasked with assessing the need for—and, if appropriate, proposing—a strategy to monitor workers exposed to emissions from the fire and its long-term health consequences, in addition to the monitoring already conducted by occupational health services to date.

The main findings show that:

• some workers, particularly those on-site but also some workers present under the smoke plume, were exposed to pollution emitted by the fire;

• the short-term symptoms observed and reported by occupational physicians were primarily irritative in nature, similar to those described in the general population and typically observed in the context of exposure to fire smoke.

In light of these findings, Gast Normandie proposes that fire exposure conditions be recorded in occupational health medical records and that epidemiological surveillance be conducted by integrating it into the surveillance system established for the general population using the National Health Data System (SNDS).

Is a biomonitoring study appropriate?

Santé publique France has assessed the feasibility of conducting a biomonitoring study in the general population to characterize exposures resulting from emissions from the fire using biological samples.

By measuring the presence of chemicals in the body, such a study would aim to propose measures to reduce exposure to the emitted substances, complementing those implemented in the aftermath of the fire.

The additional analysis of environmental data conducted by Santé publique France aligns with the conclusions of the various stakeholders and operators involved. Based on current knowledge, there is no evidence to suggest that contamination resulting from the fire is distinguishable from historical industrial pollution. There is therefore no objective evidence to suggest that nearby residents were overexposed to the identified substances. In this context, conducting a biomonitoring study would not provide additional information beyond the enhanced epidemiological surveillance carried out through the SNDS and the measures implemented following the fire to reduce public exposure.