This monitoring effort builds on the work already carried out by the Normandy Occupational Health Alert Group and will make it possible, in the medium and long term, to identify whether specific health issues arise in this population. Details are available on the Santé publique France website.

Monitoring and describing the health status of workers exposed to the fire or its consequences

On the first day of the fire, the Normandy Regional Unit of Santé publique France organized an epidemiological surveillance of short-term effects, which continued for one month. For certain workers exposed to pollution emitted by the fire, medical monitoring was thus established by occupational health services and the medical team of the departmental fire and rescue service (SDIS) – 76. This monitoring covered workers present at their workplaces near the fire or under the smoke plume, as well as companies and firefighters who responded to the burning sites. This short-term surveillance showed that certain workers, particularly those on-site but also those under the smoke plume, were exposed to pollution emitted by the fire. The symptoms observed and reported by occupational physicians were primarily irritative in nature, similar to those described in the general population and typically observed following exposure to fire smoke.

The component of the “Post-Fire Health 76 ” initiative concerning worker health draws on the multidisciplinary expertise of the Normandy Occupational Health Alert Group (GAST), which proposed the implementation of an epidemiological follow-up for all workers exposed to the fire or its aftermath, present at the sites and in the municipalities exposed to the smoke plume.

A new phase in the epidemiological response regarding workers

The monitoring program currently implemented by Santé publique France aims to track and describe the health status of workers exposed to the fire or its aftermath using data from the National Health Data System (SNDS). It allows for comparison with that of reference workers, thereby identifying potential increases in the occurrence of health events.

The study area is similar to that of the general population study “Une étude à l’écoute de votre santé” and includes 119 municipalities in Seine-Maritime. The health indicators measured generally concern healthcare utilization and hospitalizations, and initially focus on cardiovascular diseases, mental health, and chronic respiratory diseases. This monitoring may be supplemented in the long term by other health indicators. Three categories of workers are included in the monitoring:

• workers who responded at the fire site;

• employees of businesses located near the fire and in the path of the smoke plume;

• employees of companies located across all 119 municipalities.

The indicators describing the health status of these workers, defined as exposed, will be compared to those of a reference group (not exposed to the fire but similar in terms of age, gender, and occupation).

Initial analyses of health status are expected to be shared and reported one year after receipt of the health data. In the longer term, a 5-year follow-up after the fire will be conducted.

The results will inform public decision-making regarding the implementation of medical care and prevention measures for the affected populations. These results will also help adapt the management of other industrial accidents.

They will be published in the form of institutional reports accessible to the general public on the agency’s website. Additionally, the results will be presented to local stakeholders.

A comprehensive framework for assessing the health status of all exposed individuals

“Santé Post Incendie 76” comprises a series of epidemiological studies to assess the health impact of this industrial accident on workers and the general population. Among the general population, in addition to short-term monitoring during the first month, the Agency conducted in 2020 “A Study Listening to Your Health,” which focused on health, information, and awareness of recommendations, as well as quality of life among people living in the study area potentially exposed to the fire.

A complementary component of this study aimed to assess the impact of the fire on the mental health of the exposed population (post-traumatic stress disorder, generalized anxiety, and depression).

The SPI76 program also includes the monitoring, over several years, of health indicators for the general population, such as the incidence of respiratory and cardiovascular diseases, mental health indicators, certain cancers, and pregnancy outcomes. This epidemiological surveillance covers the 350,000 residents of the 119 municipalities in the study area and is conducted using data available in the SNDS.