On September 26, 2019, an industrial fire broke out in the warehouses of Lubrizol and NL Logistique, located in the Rouen port area, potentially exposing the public to various health risks (exposure to smoke, fallout, odors, and stress).

Santé publique France was commissioned by the Directorate General for Health to assess the impact on the physical and mental health of individuals who may have been exposed to one or more of these health risks. The description and analysis of their perceptions of the event, their exposures, and the symptoms they experienced, along with the measurement and monitoring of indicators of the population’s health status, should enable public authorities to implement public health measures if necessary and to better adapt the management of future industrial accidents.

In this context, a series of epidemiological studies has been launched to assess the health impact of the fire: the “Post-Fire Health-76” initiative. This initiative includes epidemiological surveillance of the population residing in the exposed area using data from the National Health Data System (SNDS).

Objectives

• To describe and track changes over time in the frequency of health events within the area exposed to the industrial fire;

• Compare it to that of unexposed areas and to the period before the fire to identify any difference in frequency.

This monitoring will inform public decision-making regarding the implementation of measures to care for affected populations and prevent future industrial accidents.

Study Population

The study includes individuals residing in the study area, namely:

• an area exposed to the fire or its consequences, comprising 119 municipalities in Seine-Maritime, divided into subzones defined in the health survey according to exposure types (odor, smoke, soot, etc.);

• two unexposed areas used as references, located around the cities of Le Havre and Caen.

Study Protocol

Study periods

The study period covers a three-year reference period prior to the fire and a post-fire period of varying duration depending on the health indicator, ranging from one month (cardiovascular diseases) to several years (for cancers).

Methodology

The study is based on an analysis of healthcare reimbursement data from the National Health Data System (SNDS). The occurrence of numerous health events related to cardiovascular, respiratory, mental health, or perinatal issues is tracked through these data. These health events will be identified using health indicators such as healthcare utilization, hospitalization, and prescription of medications.

Health events were selected based on:

• a review of the literature,

• the results of the self-reported health survey,

• the pollutants emitted,

• and local expectations.

The incidence rates of these health events per unit of time (per week, month, or year) during the post-fire period are calculated and compared to those observed during the reference period and in unexposed areas. This allows for the consideration of incidence rates already observed prior to the fire and temporal trends observed in areas that were not exposed to the fire. The analyses are conducted across the entire exposed area and the four sub-areas based on population counts.

When and how will the results be available?

Results have been published and reported to stakeholders by category of health outcomes (cardiovascular health, respiratory health, mental health, etc.) since 2023, according to the follow-up timeframe (short-, medium-, and long-term) defined in the protocol. For indicators monitored over several years, reports will be issued at regular intervals.

All results will be available on the Santé publique France website and may also be featured in scientific articles.

Data Privacy and Security

The SNDS data used is pseudonymized¹. Santé publique France processes this data within a specific section of the CNAM’s SNDS portal. Only aggregated, non-identifying data is extracted from the portal.

Committee Structure and Funding

The study relies on an independent thematic advisory committee titled: “Assessment of the Impact of the Lubrizol and NL Logistique Fires on Public Health,” established to support Santé publique France within the framework of SPI 76. It is composed of individuals from outside Santé publique France who are qualified in the fields of toxicology, cardiovascular and respiratory health, and medical administration. Its role is to assist with scientific decisions, the interpretation of results, and the formulation of public health proposals and actions arising from the research conducted.

This monitoring is funded through Santé publique France’s own resources.