Following the floods of 1996, a biomonitoring study was conducted in October 1997 on a sample of 681 individuals randomly selected from 24 municipalities (20 exposed, 4 unexposed). The study aimed to estimate exposure among the resident population to the main pollutants identified in the Salsigne region (arsenic, cyanides, cadmium, lead).
Inorganic arsenic and its metabolites, cadmium, lead, and thiocyanates were measured in urine or hair. The results showed that residents of the Salsigne region had a slight overexposure to arsenic (reference value used: 15 µg/g of creatinine), and identified the factors contributing to this exposure, which led to the health recommendations implemented in the area: avoid consuming garden produce, using water from private wells, drinking locally produced wine, and hand-to-mouth activity in children.

Learn more:

• Survey on population exposure to industrial pollutants. Salsigne region (Aude).

A study of cancer mortality was conducted in 1998, supplemented in 2001, and updated in 2007 by comparing the exposed area with a control area in the Aude department that had similar characteristics, as well as with France as a whole. The study was based on cancer mortality data obtained from Inserm and covered all cancers and various tumor sites of interest. Its objective was to estimate the chronic impact of past exposures.
Results for the 1968–1994 period showed an excess risk of cancer (all types of cancer) and respiratory cancers in the exposed area, as well as an excess of digestive cancers among women. Additional studies published in 2005 covering the same period showed that the observed excesses in cancer could not be explained exclusively by occupational exposures. The 2007 update, covering the period 1995–2003, no longer showed an excess risk, except for pharyngeal cancers in the exposed area. Nevertheless, the results should be interpreted with caution due to the small sample sizes, which weaken the reliability of the conclusions in relation to reality. The statistical power—which expresses the probability of detecting a difference when one actually exists—is in this case well below the value usually considered acceptable (an 80% chance or higher).

Learn more:

• Assessment of the health consequences of industrial pollution in the Salsigne region (Aude). Cancer mortality survey: update 1968–2003.

• Cancer mortality during the 1968–1994 period in a mining area in France. Available in the Inserm open archives.

In 2014, the Occitanie Regional Health Agency consulted Santé publique France regarding the relevance and advisability of updating the health studies that had already been conducted. Santé publique France proposed focusing efforts on risk reduction measures combined with environmental monitoring and improving communication with the public regarding the risk and measures to reduce it.
Following this response, the ARS asked the ORS-CREAI to assess compliance with the health recommendations disseminated in the valley.

Learn more: Study on awareness and adherence to health recommendations among the population of the Orbiel Valley. Summary report. November 2015.

Following the 2018 floods in the Orbiel Valley, health concerns resurfaced among the population, prompting the Occitanie Regional Health Agency (ARS) to consult Santé publique France on the advisability of conducting further health studies. A “public health” approach was proposed to give the public an opportunity to voice their concerns, questions, and expectations. To this end, Santé publique France is launching the PRiOR study: practices and perceptions of risks among residents living along the Orbiel Valley, in partnership with scientists from the University of Toulouse-Jean Jaurès (UT2J) and the CNRS.

Learn more: Response to the requests from the Occitanie Regional Health Agency (ARS) regarding the Orbiel Valley following the October 2018 floods: note outlining proposals for management assistance. 2019, 16p.

A stakeholder health committee, comprising elected officials and community representatives, was established in 2020 by Santé publique France to address proposals put forward by Santé publique France (local context studies, health studies, and public health recommendations). The Health Committee was formed following a call for volunteers issued within the framework of the Site Monitoring Committee (SMC) to ensure that each subcommittee of the SMC was represented. It was chaired by Dr. Pascale Fabbro-Peray, a public health physician at the Nîmes University Hospital (Department of Biostatistics, Clinical Epidemiology, Public Health Innovation and Technology, University of Montpellier).

The committee prioritized cancers as the pathology of interest. In the absence of cancer incidence data at the municipal level (morbidity), it was decided to conduct a cancer mortality study. Following suggestions from external reviewers, other conditions linked to metal exposure were added to this mortality study: circulatory system diseases and neurodegenerative diseases such as Parkinson’s.

The summary of meeting minutes is made public. The committee was dissolved following the completion of the health studies in the valley in December 2024.

Following a referral from the Occitanie Regional Health Agency (ARS), Santé publique France proposed consulting with stakeholders in the valley to assess the need for a new health study. The decision was made to conduct a study on mortality from cancer, circulatory system diseases, and Parkinson’s disease.

The objectives of the study were:

• to describe the mortality observed among the population residing in the municipalities of the Orbiel Valley and potentially exposed to mining pollution;

• to assess whether this observed mortality differed from that of a population not exposed to mining pollution.

The results show no observable difference in mortality rates for the diseases studied between the exposed and unexposed areas. It should be noted, however, that the absence of statistically significant excess mortality does not mean that pollution management measures around former mining sites are unnecessary. Environmental data are essential for characterizing environmental pollution and must continue to guide management measures aimed at protecting public health.

• Learn more about:

  • The results of the mortality study in the municipalities of the Orbiel Valley for the period 2004–2017

  • The study protocol implemented

  • Results of a new mortality survey among residents of the Orbiel Valley (Occitanie) between 2004 and 2017. Summary

Between 2021 and 2023, Santé publique France, in partnership with scientists from the University of Toulouse-Jean Jaurès (UT2J) and the CNRS, conducted the PRIOR study: Practices and Perceptions of Risks among Residents Living Along the Orbiel Valley.

Conducted among approximately 600 adults, the study aimed to gather information on the risk practices and perceptions of residents of the Orbiel Valley by examining how they experience pollution in the area and perceive the associated risks (health, environmental, socio-economic, etc.). Understanding residents’ lived experiences has thus made it possible to propose actions tailored to their concerns.

• Learn more about the PRIOR study and its results

The Santé publique France Regional Unit in Occitanie consulted the Santé publique France Expert Committee on Health, Environment, and Work on July 6, 2023, to formulate recommendations based on the history of the situation in the Orbiel Valley, available knowledge, and the findings of recent studies.

• Opinion of Santé publique France regarding the studies conducted in the Orbiel Valley, following the opinion of the Health, Environment, and Work Expert Committee