Data
The first health alerts related to industrial soil contamination occurred in the early 1980s. These included Love Canal and Woburn in the United States, Montchanin in France, and, more recently, lead-contaminated sites and the Franklin Roosevelt School in Vincennes. Despite a significant number of contaminated sites, epidemiological studies have often yielded limited results, primarily due to two major challenges:
the difficulty in estimating population exposure to pollutants in contaminated soil
and the small size of the affected populations when considering the sites individually.
Significant health concerns therefore remain. To overcome this difficulty in measuring exposure, the research has primarily relied on modeling the transfer of pollutants from soil to other environments, and then to populations, using rather conservative exposure scenarios.
Studies conducted on contaminated soils have revealed discrepancies between what soil concentrations of these metals suggest, the resulting predictions of exposure levels, and measurements using biomarkers. This is particularly the case for chromium, arsenic, lead, and polycyclic aromatic hydrocarbons (PAHs).
Today, none of the available methods provides a universal answer. Depending on the compounds involved and the situation being studied, the most appropriate method must be selected.
Increasingly, the public is requesting biological measurements because they want a real measure of their exposure. They feel that this type of measurement provides a reliable and definitive answer regarding the health consequences of the pollution to which they are exposed. While it is true that these studies quantify the dose absorbed by the body, they often fail to identify the contribution of exposure pathways and sources, or the impact on health.
Furthermore, biomarkers useful in the context of exposure to soil pollutants exist only for a very limited number of pollutants, and reference values for the general population have been established in France only for certain pollutants. However, while they help answer the question of the reality of population exposure, they should not be viewed as a systematic intervention method in the health management of contaminated sites and soils.
On the subject of contaminated soils and the psychosocial dimension that the management of these situations may entail, Santé publique France has drafted a note aimed at communicating its position on the subject and presenting a synthesis of the available knowledge. This note is intended for:
The sponsors and institutional partners of Santé publique France
Stakeholders (residents near contaminated sites, healthcare professionals, associations, elected officials) who are confronted with a contaminated soil situation.
SEE ALSO
Contaminated Soil and Health at the Local Level: A Situation Analysis Incorporating the Psychosocial Dimension
Key local studies on contaminated soils by Santé Publique France:
Background
The Gard municipalities of Saint-Sébastien-d’Aigrefeuille (Carnoulès site) and Saint-Félix-de-Pallières, Thoiras, and Tornac (Croix de Pallières site) were home to significant metal ore mining and processing activities until the last century.
In response to inquiries from the Languedoc-Roussillon Regional Health Agency (ARS) regarding health risks to nearby residents, Santé publique France recommended in late 2013 that lead exposure levels be measured among potentially exposed populations.
Among the 23% of affected residents who participated in the study, the results primarily show:
That nearly a quarter of the study participants (22%) had arsenic exposure levels exceeding the reference value established for the general population, and 12% had cadmium exposure levels exceeding the reference value established for the general population. However,
While three cases of blood lead levels at or above the warning threshold (25 micrograms per liter) were observed in children, the results show no significant difference from the general population regarding lead, and no cases of lead poisoning were detected.
Most of the concentrations measured in participants’ soils were similar to those typically found in naturally metal-rich soils; however, some gardens had very high concentrations (22,000 mg/kg for lead, 950 mg/kg for arsenic, 47.5 mg/kg for cadmium).
The study identifies exposure patterns specific to the area. Body burden levels increase with length of residence and consumption of certain foods produced in the area (eggs, rabbits, poultry, game, and mushrooms). The higher the concentrations in garden soils, the higher the participants’ body burden levels. Consumption of water from individual wells, boreholes, or springs also appears to increase exposure levels. Exposure levels are lower when homes are mopped more frequently. Finally, young children, who often put their hands or objects in their mouths, exhibit higher exposure levels.
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The community gardens on the outskirts of Fort d’Aubervilliers show moderate soil contamination with trace metals. The source of this contamination is likely linked to past activities within the Fort and on the plots, as well as to vehicle emissions. Some vegetables show metal contamination (particularly lead, cadmium, and copper). This situation raised questions about the compatibility of this contamination with the vegetable gardens, which appeared to be intensively cultivated in these plots.
In agreement with the ARS and the subprefecture, Santé publique France Ile-de-France Champagne Ardenne therefore launched a dietary survey to identify the affected families with a view to providing specific support through the ARS. This study also provided an opportunity to gather information on adults’ self-consumption of produce and the factors promoting this behavior, as well as to describe the benefits provided by the gardens, in order to shed light on the risk-benefit analysis.
The dietary survey was conducted among 60 gardeners and showed that:
For gardeners’ children, the results are reassuring but of limited scope due to the low participation rate.
For adults, the high level of self-consumption during the peak harvest season (86% on average) as well as in winter thanks to stockpiles was confirmed, with percentages similar to those observed in rural areas.
High self-consumption (80% or more) is significantly linked to the number of species grown, the time spent in the garden during winter, and the age of the vegetable gardens.
Gardens play an important role in the well-being of their occupants, notably by significantly strengthening social bonds.
Therefore, based on the available evidence, Santé publique France IdF CA recommended maintaining the vegetable gardens at Fort d’Aubervilliers, with sensible and responsible use of these gardens, as well as maintaining vigilance regarding children.
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Background
Environmental studies, which led to the discovery of naturally occurring arsenic in the soils of the Moselle and Madon basin (54), were conducted around the SAM steel mill as part of systematic studies carried out around facilities classified for environmental protection by the Regional Directorate for Industry, Research, and the Environment. These studies showed that the arsenic concentrations corresponded to the natural geochemical background, which is characterized by high levels of naturally occurring arsenic, unrelated to the steel mill’s operations.
Objectives
In this context, following a referral from the prefecture in 2004 relayed by the Directorate General for Health, Santé publique France launched a biological exposure study in 2006 of the resident population of the Moselle and Madon basin in order to:
Determine urinary arsenic levels in the population residing in the Moselle and Madon basin
Identify the factors explaining the measured urinary arsenic levels.
Biological testing for markers of arsenic exposure was conducted among volunteers (n=351).
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Background
The municipality of Saint-Laurent-le-Minier in the Gard department (30) has been the site of significant mining activity since ancient times. This activity ceased in 1995. In March 2004, during a project to create a campground in Saint-Laurent-le-Minier, soil studies commissioned by the private owner revealed heavy metal contamination at the site. Following this, the mayor of the municipality initiated a risk assessment, and the prefect requested additional analyses to evaluate the potential level of contamination in food products.
The available data revealed:
Significant soil contamination with inorganic elements such as arsenic, antimony, cadmium, and lead at certain points where investigations were conducted
Suspicions of toxic products and substances buried beneath the “Hameau de la Papeterie” (a local area)
Contamination of the food chain. Concentrations of lead and cadmium up to ten times the standard limit were found in certain vegetables grown locally. Analyses of a private water source also revealed slight water contamination. However, water from the public water system is safe to drink
Varied levels of contamination across the area. Thus, some farms were found to be safe, while others were not.
Health measures to reduce public exposure were implemented by the municipality, following recommendations from the Interregional Epidemiology Unit and after a public meeting held in Saint-Laurent-le-Minier on February 10, 2005. In May 2005, a voluntary screening campaign for lead poisoning was conducted among children, young people under 18, and pregnant women residing in the municipality.
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Background
Significant contamination with lead, cadmium, and arsenic is present in Viviez (Aveyron), due to 150 years of industrial activity. This contamination affects the topsoil of private gardens, waterways, and locally grown fruits and vegetables. In 2006, at the request of the Aveyron Departmental Directorate of Health and Social Affairs (DDASS) and the Midi-Pyrénées Regional Directorate of Health and Social Affairs, a public health initiative was carried out by the Midi-Pyrénées Interregional Epidemiology Unit (Cire) Midi-Pyrénées to assess the consequences of this pollution on residents’ health, identify individuals requiring medical care, better understand residents’ environmental exposure, and thereby guide recommendations.
Objectives
The first stage of the initiative, akin to a health risk assessment, consisted of identifying the hazards (health effects) associated with these pollutants, determining pollution levels through a series of environmental measurements in the municipality (soil, water), and estimating the risks of these hazards occurring in the population of Viviez. At the same time, a search for potential health indicators (excessive incidence of diseases, mortality) related to the identified hazards was conducted among local healthcare professionals and available information sources.
The results of this first step were consistent in indicating that the health impact of this environmental contamination on the population was likely, though it was not possible to specify its magnitude or its link to the current environment in Viviez. An assessment was therefore conducted in 2008, including:
Screening for lead poisoning among children under 7 years of age and pregnant women in Viviez, and measurement of cadmium levels in the blood of all residents, followed by screening for kidney damage if levels exceeded 1 µg/g of creatinine, in order to identify individuals requiring medical care
A study of cadmium and arsenic exposure to assess whether residents of Viviez were more exposed than those in a non-exposed area, to identify factors related to exposure, and to inform public health recommendations.
Results
Screening for lead poisoning did not identify any cases, but participation was low.
However, 136 adults (23%) had cadmium levels in their urine exceeding the health threshold of 1 µg/g of creatinine. Among these individuals, 19 cases of kidney disease were identified. Compared to the unexposed area, adults in Viviez who were not occupationally exposed had higher cadmium levels in their urine and, to a lesser extent, higher arsenic levels. Analysis of environmental factors influencing cadmium accumulation suggested exposure through ingestion of local products and dust from contaminated soil.
Environmental exposure to arsenic in Viviez did not pose a health concern. However, exposure to cadmium led to an increased risk of kidney damage. Measures were proposed to eliminate or reduce exposures and limit health consequences.
Santé publique France released the final results of this assessment on September 8, 2011, in Viviez.
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Background
At the intersection of the municipalities of Mortagne-du-Nord, Château-l’Abbaye, and Thun-Saint-Amand, in the Nord department, a zinc smelter and a sulfuric acid plant operated for over 60 years, along with a lead smelter that operated for 6 years. Although the last of these plants has been closed since 1968, heavy metal contamination of the soil and sediments is still present today on the site of the former plants and in the surrounding area. The high concentrations of lead, zinc, and cadmium at the site have raised the question of whether studies should be conducted to assess the population’s exposure to these various elements.
Objective
The objective was to issue an opinion on the relevance of screening for childhood lead poisoning and measuring cadmium exposure in the population. For lead, in response to the initial inquiry from the Ministry of the Environment, the objective was therefore focused on screening children who might be overexposed.
Results
For cadmium, the estimated exposure for an affected individual is a maximum of 33.4 µg/day. This remains well below the toxicological reference value of 60 µg/day. Exposure is therefore acceptable. Measuring cadmium exposure in the population is not relevant.
For children living in the central contamination zone, the distribution of blood lead levels indicates that levels exceeding 100 µg/L are possible. The probability of exceeding 100 µg/L ranges from 0.8% to 6.3%, depending on the presumed bioavailability of lead. This probability is likely still overestimated. Overall, it does not appear appropriate to organize systematic screening for blood lead levels, as its effectiveness would be very limited.
The presence of older housing and post-industrial exposure justifies informing and raising awareness among general practitioners and pediatricians in the area about these specific risk factors for lead poisoning, so that they can assess, for each child aged 0 to 6 and for pregnant women in their patient population, the appropriateness of prescribing individual screening. This recommendation aligns with the "Practical Guide to Lead Poisoning in Children and Pregnant Women," which advises screening for risk factors during medical visits.
The public must also be informed of the potential risk of lead poisoning for children and pregnant women. In particular, they should be informed of the risk of significant contamination in gardens, as has been demonstrated in certain cases.
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Background
The southern coastline of Marseille was the site of significant industrial activity during the 19th century, which resulted in soil and marine pollution. On July 15, 2004, the prefect of the Provence-Alpes-Côte d’Azur region requested that the French Institute for Public Health Surveillance (InVS) conduct a health risk assessment. This study was entrusted to the Southern Interregional Epidemiology Unit.
Objective
The objective of this public health study was to provide the necessary decision-making information, from a health perspective, for the environmental and health management of the population.
A health risk assessment was conducted using existing data for the two pollutants found in the highest quantities in the environment and whose health impacts are well documented in the literature: lead and arsenic. Exposure of the population at the most frequented sites in the polluted area (residential areas and beaches) and the consumption of mussels and sea urchins harvested from this coastal area were studied.
Results
The main findings of the assessment indicate that young children living at the Escalette site or visiting Saména Beach face a health risk, primarily due to the ingestion of contaminated soil or sand. Health risks also apply to the consumption by adults or children of contaminated sea urchins and mussels caught locally.
These results led the InVS to propose public health measures aimed at providing medical care for the population and reducing their exposure:
Implementation of screening for childhood lead poisoning, at a minimum in the Escalette area (lead-related risk), and provision of information to the local medical community
Remediation of polluted sites, prioritizing those inhabited or frequented by the public
Closure of Saména Beach if it could not be decontaminated before the summer of 2005
A ban on fishing for and consuming sea urchins, as mussel fishing is already prohibited in this coastal area.
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Background
In 2002, analyses conducted on the plot of land intended to house a new school in Pavillons-sous-Bois revealed soil contamination, particularly with trace metals. The adjacent plots were home to a school complex serving 245 students and a housing complex with communal lawns housing 215 residents (half of whom were children).
In 2003, further investigations confirmed the presence of contaminated fill throughout the "La Poudrette" neighborhood and surface soil contamination with lead, arsenic, and cadmium. By spring 2004, the situation was as follows:
widespread soil contamination throughout the neighborhood, the unknown origin of which made it impossible to identify an operator as a point of contact;
uses involving a vulnerable population: a preschool and elementary school, and a settled Romani community that frequently uses the communal lawns;
an initial assessment of “unacceptable” health risks, raising concerns and high expectations among administrators.
Health Care for the Population
In close coordination with the Prefect of Seine-Saint-Denis, immediate protective measures were taken as early as September 2003 by the city of Pavillons-sous-Bois and the public housing authority. Barriers were erected to prevent access to green spaces within the school and residential areas. The mayor of Pavillons-sous-Bois issued municipal ordinances prohibiting access to these areas, as well as the consumption of produce from the school’s and the public housing authority’s vegetable gardens.
At the same time, in June 2004, a blood lead level screening campaign was proposed for children living on the site or attending the school complex. Its organization, led by the Departmental Directorate of Health and Social Affairs (DDASS), will be coordinated with the affected population. Of the 204 children screened, none had blood lead levels exceeding 100 µg/L.
Health Investigations
To better understand the factors contributing to lead exposure, a questionnaire-based study supplemented the findings from the blood lead level tests. This study of exposure factors revealed a correlation between spending time on outdoor lawns and blood lead levels, while school attendance did not influence blood lead levels.
In early 2005, a study on exposure to other trace elements found in the soil—arsenic and cadmium—was offered to individuals living or working in the area. Participation was low, and the results were not subjected to statistical analysis.
Conclusion
The historical study linked this pollution to the operation of a former household waste landfill and suggested that neutral soil was brought in under the school at the time of its construction. The updated risk levels, incorporating all detected substances and exposure pathways, were slightly higher than the acceptable threshold value for residents of the housing project.
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In relation to
Lead poisoning in children
thematic dossier
Lead poisoning in children refers to lead poisoning in children under the age of 18. It can have serious, irreversible consequences, particularly on cognitive and psychomotor development.
thematic dossier
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L’exposition à des substances chimiques présentes dans l’environnement ou en milieu de travail peut avoir des conséquences néfastes sur la santé. Santé publique France met en œuvre des dispositifs...
