Feasibility of a morbidity study in the Lacq industrial area (Pyrénées-Atlantiques)

For the past sixty years, the industrial complex in Lacq (Pyrénées-Atlantiques) has been home to numerous chemical and petrochemical operations. In response to a request in October 2015 from the Ministry of Health regarding the need for epidemiological surveillance and an assessment of the site’s health impact on nearby residents, Santé publique France launched several studies, including an exploratory morbidity study presented in this report. The objective of this study is to assess the feasibility of a morbidity study among the resident populations in the Lacq industrial basin and, in particular, to identify the conditions of interest and the data sources necessary for their study. The conditions of interest to be included in the morbidity study were identified following the completion of: - a literature review of morbidity-mortality studies of chemical, petrochemical, or mixed industrial sites; - a toxicological analysis of the 9 substances of interest identified during a prior quantitative health risk assessment of the area. The selection of conditions was prioritized following a qualitative study among local stakeholders and a study measuring local healthcare professionals’ perception of excess risk for the various conditions. For each condition of interest selected, the available indicators were identified, along with their spatial and temporal distribution and their limitations (reliability, required statistical power). Of the 62 articles reviewed, 42 highlighted significant associations between the conditions and exposure to industrial emissions of the same type as those in the Lacq industrial basin, and 8 out of 9 substances were found to have adverse health effects. Among these, 2 are classified as known carcinogens. Acute and chronic respiratory diseases in adults and children, including asthma, can be studied using the national health data system (hospitalizations, drug reimbursements), as well as certain cardiovascular diseases and treated diabetes. Perinatal morbidity can be studied provided there are sufficient data. Due to the current lack of specific data, certain digestive or nervous system disorders cannot be studied. Based on the results of the feasibility study, a detailed protocol for studying morbidity in the area will be developed in consultation with a committee of experts. It will describe the analytical strategy for each of the selected conditions. Future analyses will enable the exploration of a health signal in this area across a wide range of morbidities. In the absence of a registry, these analyses will more generally help assess the utility of medical-administrative databases for studying health impacts in investigations of contaminated sites and soils. In addition to the analysis of healthcare utilization, a self-reported health survey will be conducted to characterize the perceived health of the population residing in the Lacq basin.

Author(s): Castor C, Coquet S, Chatignoux É, Roudier C

Publishing year: 2021

Pages: 74 p.

Collection: Studies and Surveys

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